Open Collections

BC Sessional Papers

[Annual Report of the Ministry of Health for the year 1980] British Columbia. Legislative Assembly [1983]

Item Metadata

Download

Media
bcsessional-1.0368888.pdf
Metadata
JSON: bcsessional-1.0368888.json
JSON-LD: bcsessional-1.0368888-ld.json
RDF/XML (Pretty): bcsessional-1.0368888-rdf.xml
RDF/JSON: bcsessional-1.0368888-rdf.json
Turtle: bcsessional-1.0368888-turtle.txt
N-Triples: bcsessional-1.0368888-rdf-ntriples.txt
Original Record: bcsessional-1.0368888-source.json
Full Text
bcsessional-1.0368888-fulltext.txt
Citation
bcsessional-1.0368888.ris

Full Text

 JAMES A. NIELSEN. Minister
To Che Honourable Henry P.  Bell-Irving,  D.S.O., O.B.E.,  E.D.,
Lieutenant-Governor of the Province of British Columbia.
MAY IT PLEASE YOUR HONOUR:
The undersigned respectfully submits the Annual Report of
the Ministry of Health  for  the year  1980.
JAMES A.   NIELSEN
Minister of Health
Office of the Minister of Health
Victoria,   B.C.,   May   1,   1981.
  MINISTRY OF HEALTH, VICTORIA, B.C., HAY 1, 1981
The Honourable James A.  Nielsen,
Minister of Health, Victoria,  B.C.
SIR:       I have the honour  to submit  the Annual  Report of the
Ministry of Health for  1980.
PETER BA20WSKI
Deputy Minister of Health
PETER BAZOWSKI,
Deputy Minister
  TABLE OF CONTENTS
MINISTRY OP HEALTH-ORGANIZATION LIST  1
MINISTRY OP HEALTH ORGANIZATION CHART  g
DEMOGRAPHIC FEATURES... •*■•„. 7
THE YEAR IN REVIEW.....  g
SUPPORT SERVICES.  n
Legal Services • •  12
Management Services ..,  13
Personnel Services  14
Financial Services.  L5
Central Shared Services , 15
Community Care Facilities Licensing Board  18
Tables	
—Adult Care Facilities. ..... 18
—Child Care Facilities....    19
COMMUNITY HEALTH PROGRAMS  20
Community Health Program Highlights.....  20
Community Health Programs Organization Chart  21
Building Projects  22
Specialized Community Health Programs*.  23
Speech Therapy Program .ft.  27
Division of Tuberculosis Control Highlights........  29
Division of Tuberculosis Control  30
Division of Venereal Disease Control ■•■•  31
Community Vocational Rehabilitation Services  33
Division of Dental Health Services  37
Public Health Nursing.....***.  40
Public Health Inspection Services........  43
Communicable Disease Control  44
Laboratory Services  44
Bacteriology Service  45
Mycology  48
Paras itology   49
Tropical & Parasitic Disease Reference Service  SO
Virology Service »^-. * 51
Pearson Hospital ■■•>  54
Acknowledgements • * ■	
Tables——" '
—Reported Communicable Diseases, B.C., 1976-1980..	
—Reported Infectious Syphilis and Gonorrhoea, B.C  58
—Selected Activities of Provincial Health
Inspectors*	
  Caseload for Community Vocational Rehabilitation
Services, January 1 to December 31, 1980  60
 Tests Performed by Division of Laboratories in
1979 and 1980  61
 New Active Cases of Tuberculosis.  63
 Contacts to Pulmonary Active Tuberculosis
Source Cases, 1980  63
CARE SERVICES  64
Home Care/Long Term Care Program.  64
Highlights  64
Statistical Data  69
Home Care Program ,  70
Community Physiotherapy Program  72
Special Care Services  74
Tables	
 Home Care/Long Term Care  75
 Long Term Care Program  76
 Number  of Long Term Care Clients ,  77
 1980-81 Budget,  Long Term Care Program..  78
 Clients by Age Group  79
 Construction & Development,  Intermediate
Care Facilities  80
Charts	
 Percentage Distribution by Age Groups of
Patients Admitted to the Home Care Program  81
 Percentage Distribution by Age Group and Category
of Patients Admitted to the Home Care Program  82
 Percentage Distribution and Number of Home
Care Patients by Major Diagnostic Groups
in Descending Order  83
MENTAL HEALTH SERVICES  84
Mental Health Services Highlights  84
Community Services •  85
Services for the Acute Mentally 111 Adult  89
Services for Families and Children  90
Adjustment Reactions and Prevention Services  94
Riverview Hospital  95
Greater Vancouver Mental Health Services(G.V.M.H.S.)  96
Burnaby Mental Health Services  96
British Columbia Youth Development Centre,
"The Maples", Burnaby  99
Psychological Education Clinic  101
Consultative Services  102
Statistics  105
Tables	
 Patient Movement Data, Mental Health Facilities  106
 Patient Movement Trends, Mental Health Facilities  108
 HOSPITAL PROGRAMS.
110
Hospital Programs Organization Chart  HI
Hospital Programs Highlight*..	
Administrative Services Division.  iig
Hospital Finance Division  120
Hospital Consultation & Inspection Division......  124
Hospital Planning & Construction Division  ]?6
Projects Completed in 1980  128
Proiects Under Construction At Year-End  130
Project at Tendering Stages at Year End  132
Projects in Advsnced Stages of Planning..  133
Additional Projects Approved & in Various
Stages of Planning  133
Locations of hospital construction projects by regional
hospital district  135
Locations of Acute Care Hospitals in B.C  137
Locations of Extended Cere Hospitals in B.C  139
Medical Consults tion Division  141
Research Division ...•*_•*«••  142
Approved Hospitals  144
Tables—
—Patients Separated and Proportion Covered by
Hospital Programs.  148
—Total Patient-days & Proportion Covered by Hospital
Programs, B.C. Public General Hospitals Only  149
-—Patients Separated, Total Patient-days Average
Length of Stay According to Type & Location of
Hospital for Hospital Programs Patients Only  150
-—Summary of the Number of Hospital Programs
In-patients & Out-patients, 1975-1980/81  151
-—Summary of Hospital Programs Out-patient Treatments
by Category, 1975-1980/81  151
 Patients Separated, Total Days' Stay, & Average
Length of Stay •  152
—Percentage Distribution of Pstients Separated and
Patient-days for Hospital Patients Only  152
Charts—
-—Percentage Distribution of Days of Care by Major
Diagnostic Groups, Hospital Programs, 1979/80  154
 Percentage Age Distribution of Male & Female
Hospital Cases & Days of Care  155
 Percentage Distribution of Hospital Cases by
Type of Clinical Service - - - ■  156
 Percentage Distribution of Hospital Days by Type
of Clinical Service  157
 Average Length of Stay of Cases in Hospitals in
British Columbia, by Major Diagnostic Groups in
Descending Order, 1979/80  158
  MINISTRY OF HEALTH
THE HONOURABLE K. RAPE MAIR, MINISTER OF HEALTH1
THE HONOURABLE J. NIELSEN, MINISTER OF HEALTH'
C. KEY, DEPUTY MINISTER
SUPPORT SERVICES
J. BAINBRIDGE
Assistant Deputy Minister
R. A. MUNRO W. F. LOCKER
Senior Director (Comptroller)      Director of Personnel
Financial Services
J. H. DOUGHTY
J. P. B. LANGRAN Director of Administration
Director,
Management Services W. 0. BOOTH
Executive Director,
Supply and Services
COMMUNITY HEALTH SERVICES
G. H. BONHAM
Senior Assistant Deputy Minister
PREVENTIVE SERVICES
H. M. RICHARDS
Assistant Deputy Minister
A. R. ROSS
Senior Director, Preventive Clinical Services
L. M. CRANE A. GRAY
Director, Division of Public      Director, Division of Dental
Health Nursing Health Services
A. A. LARSEN 3 F. M. M. WHITE *
Director, Director,
Division of Epidemiology Division of Epidemiology
D. ZINK A. HINDLEY
Director, Division of Speech      Director, Division of Public
and Hearing Health Inspection
1   ReslEned January. 1981. 2 Appointed January, 1981.
3 Retired January. 1980. 4  Appointed April, 1980.
 VANCOUVER BUREAU
J. H. SMITH
Assistant Deputy Minister
W. A. BLACK
Director, Division of
Laboratories
J. MALLOW a
Director, Community
Voc a t iona1 Rehab iIi t a tio
Services
W. BOYD b
Director, Community Vocational
Rehabilitation Services
E. A. ALLEN
Director,
Tuberculosis Control
H. K. KENNEDY
Director, Division of Venereal
Disease Control
W. E. GUEHO
Executive Director,
Pearson Hospital
DIRECT CARE COMMUNITY SERVICES
I. KELLY
Assistant Deputy Minister
HOME CARE/LONG TERM CARE
P. SCOTT
Director
L. AUSTMAN*
Regional Manager
Home Care/Long Term Care
P. KERR
Regional Manager
Home Care/Long Term Care
M. A. RHODES L. DAVIS
Manager Manager,
Administrative and Licensing       Finance
M. HALL
Manager
Information Sys terns
D. OUSTON
Home Care Consultant
5  Resinned November. 1980.
7 Appointed April, 1980.
9 Appointed December, 1980
6 Appointed August, 1980.
8 Appointed March, 1980.
 MENTAL  HEALTH PROGRAMS
J.   E.   GRAY ,0
Director
J.   B.   FARRY
Regional Program Director
E. LUKE
Consultant in Psychiatry
R.   S.  MCINNES
Regional  Program Director
D.   FERNANDEZ11
Planning &  Research Officer
A. G. DEVRIES
Consultant in Psychology
SPECIAL CARE SERVICES
B. C. GEE '
Director
M. BEECHING
Grants Coordinator
W. NORTON
Planning and Evaluation
PROFESSIONAL AND INSTITUTIONAL SERVICES
R. H. MCDERMIT
Senior Assistant Deputy Minister
HOSPITAL PROGRAMS
J. GLENWRIGHT13
Assistant Deputy Minister
D.S. THOMSON14
Assistant Deputy Minister
P. BREEL ia
Senior Director
R. COODACRE
Director of Research
J. D. HERBERT
Director of Administrative
Services
H. R. MCGANN
Director, Hospital Consultation
and Inspection
G. F. FISHER
Director, Construction and
Planning Division
C. F. BALLAM
Senior Medical Consultant
Medical Consultation
A. C. LAUGHARNE
Director
Finance
10 Appointed February. 1980.        11   Resigned April, 1980.
12   Appointed February. 1980. 13   Retired January. 31. 1980.
1-  Appointed May 26.1980. 15  Resigned August 31. 1980.
"    3    "
 MEDICAL SERVICES COMMISSION
D. H. WEIR 16
Chairman
D. M. BOLTON17
Chairman
R. B. H. RALFS A. W. BROWN
Director, Salaried & Sessional     Director
Programs Plan Operations
R. MCMANAMAN
Director,
Financial Services
N. FINLAYSON
Senior Medical Consultant
EMERGENCY HEALTH SERVICES COMMISSION
D. H. WEIR
Chairman
P. BREEL18
Chairman & Executive Director
P. RANSFORD
Senior Medical Consultant
HEALTH PROMOTION AND INFORMATION
M. CHAZOTTES
Executive Director
J. MATTERS
Chief, Information Services
P. WOLCZUK
Director, Nutrition
& Health Education
L. D. KORNDER E. WOODWORTH
Director, Occupational Health      Librarian
16 Retired February, 1980. 17 Appointed June, 1980.
18 Appointed September, 1980,
	
 PLANNING AND DEVELOPMENT SERVICES
C. BUCKLEY
Execut ive Direc tor
P. PALLAN
Director, Planning & Policy
Analysis
S. BLAND
Consultant in Geriatrics
J. TALBOT
Director, Program Development
W. DIETIKER
Director, Management
Information Services
W. BURROWES
Director,
Vital Statistics
COMMISSIONS ETC.
H. F. HOSKIN I9
Chairman, Alcohol & Drug
Commission of
British Columbia
C. H. BONHAM
Chairman, Alcohol & Drug
Commission of
British Columbia
J. BAINBRIDGE
Chairman, Provincial Adult
Care Facilities Licensing
Board
J. DUFFY
Executive Director
Forensic Psychiatric
Services Commission
M. DAHL"
Chairman, Provincial Child Care
Facilities Licensing Board
F. J. BLATHERWICK
Chairman, Provincial Child
Care Facilities Board
19  Resigned May. 1980. 20  Appointed May. 1980.
21  Resigned December, 1980. 22 Appointed December. 19
- 5 -
 MINISTRY OF HEALTH
MINISTER
OF
HEALTH
MINISTER'S
OFFICE
DEPUTY
MINISTER
DEPUTY
MINISTER'S
OFFICE
CHAIRMAN
FORENSIC
CHAIRMAN
PSYCHIATRIC
ALCOHOL
SERVICES
& DRUG
COMMISSION
COMMISSION
EXECUTIVE
EXECUTIVE
DIRECTOR
DIRECTOR
PLANNING
PROMOTION &
INFORMATION
DEVELOPMENT
SENIOF
ADM
SENIOF
. ADM
1
ADM
PROFESSIONAL
COMMUNITY
HEALTH
INSTITUTIONAL
SERVICES
SERV
CES
CHAIR
MAN
AD
M
AD
M
MEDICAL
CARE
PREVENTIVE
VANCOUVER
SERVICES
SERVICES
SERVICES
BUREAU
EMERG
ENCY
HEALTH
SERVICES
September, 1979
-  6 -
 DEMOGRAPHIC FEATURES
The population in the province ia 1980 was estimated at
2,640,000 at the mid-year. This is a 2.8 per cent increase
over the 1979 figure of 2,567,000 and represents the highest
rate of growth recorded in recent years.
While the number of births which occurred during the year
was slightly higher than for 1979, because of the population
increase the ra te was somewhat lower, being 14.8 per I 000
population compared to 15.0 in 1979. II legitimate births
continued at a high level and represented 15.5 per cent of all
births,  about  the same as   in 1979.
Marriages registered for the year were higher in number
in 1980 than the previous year and the rate was also higher,
8.5 per  1,000 population compared  to 8.3  in  1979.
Deaths in 1980 were about the same in number as in 1979
and the rate per 1,000 population was down to 7.3 from the
previous year's   figure of 7.5.     The 1980  figure is a record  low.
Among the individual cause of death groups, heart disease
continued to rank as the leading cause, although the death rate
per 100,000 population declined to 233 from the rate of 241
recorded in the previous year. In contrast, cancer mortality,
the second leading cause, continued to register an increase and
the rate was up to 174 per 100,000 population in 1980, compared
to 171 in 1979. Little change was recorded in mortality from
cerebrovascular lesions of the central nervous system
("strokes"), the third leading cause. The death rate in 1980
was  73.1,   slightly  less   than 73.5   for   1979.
Accidental deaths were again at the somewhat lower level
of recent years in 1980; there were 60.2 deaths per 100,000
compared to 65.3 in 1979. Rates in the early 1970' s were much
higher, and a figure of 83.3 was recorded in 1974. Motor
vehicle accident deaths increased as a proportion of all
accidental deaths, representing 47 per cent in 1980 compared to
44 per cent in 1979. Falls accounted for the same proportion
of accidental deaths in both 1979 and 1980, namely, 19 per
cent. Drownings made up 9 per cent of accidental deaths in
1980, and 7 per cent last year, while poisonings accounted for
6  per cent,  a decline  from the   1979   figure of 8  per cent.
Suicides increased slightly in 1980 to 17 per 100,000
population,  compared  to  16  in  1979.
The infant mortality rate was substantially the same in
1980 as  in  1979,   11.4 per  1,000   live births.
 THE YEAR IN REVIEW
Announcement of a major dental program to benefit one
million British Columbians was the highlight of 1980, a year
which saw health service costs continue to mount substantially,
with the Ministry's budget consuming 30 per cent of total
Provinc ial  spending.
The Ministry's range of services broadened significantly
with the introduction of the Dental Care Plan of B.C. on
January 1, 1981, as announced in July last year. Unique in
Canada, the plan covers basic dental services and dentures for
low-income earners, all senior citizens and all children 14 and
under. It will help to protect people without private dental
insurance from the high costs associated with basic dental
care, and will give complete access to a full range of
preventive sevices.
The pressures of rising costs were felt throughout the
year. On July 1, the Ministry introduced increases in direct
charges for several health services to bring them into line
with general cost-of-living trends, and announced a policy of
indexing these charges to reflect future changes in the
economy. The increases applied only to treatment and
residential programs; preventive and basic home support
services were not affected.
For Medical Services Plan premiums and daily hospital
charges, the increases were the first since 1976. Premiums
rose approximately 15 per cent, and the daily charge for acute
in-patient hospital care was raised to $5.50 from $4. Daily
charges were also increased for day care surgery and long term
and extended care,   and ambulance charges were raised.
As part of the revision of direct charges, the Ministry
abolished the $l-a-day charge for day clinical services at
hospitals  and  for extended care  for children under  19.
To reduce the burden of higher medicare premium costs on
low-income earners, the premium assistance program was
broadened to include roughly 550,000 persons, effective July 1,
1981.
The hospital insurance and medicare plans, dating back to
1949 and 1968 respectively, continued to enhance their
benefits. Hospital insurance coverage was extended to include
day care surgery and emergency treatment provided to British
Columbians while in other provinces. Medicare benefits were
boosted by 25 per cent for senior citizens receiving
chiropractic and physiotherapy services.
 IT
Hospital operating expenditures remain a major obstacle
to  containing  the  upward  spiral  of  health  care  costs
especially since some 80 per cent of this spending comprises
staff wages and benefits.
A settlement between the Health Labour Relations
Association and the bargaining agents for registered nurses,
amounting to some 49 per cent over 27 months, was reached last
year. While the Ministry is not a party to negotiations
between hospitals and their employees, it is ultimately
responsible for providing the funds to meet the negotiated
labour contracts. The nurses' settlement had an immediate
impact on the 1980/81 budgets already set for hospitals, and
substantial special warrants were required to make up the
shortfall. Grants to hospitals from the Ministry now exceed
one billion dollars, making the achievement of greater
operating efficiencies more essential than ever.
The Ministry continues to emphasize day care and home
care as alternatives to in-patient care that are both better
for the patient and less costly to the taxpayer. For example,
more than 92,000 surgical procedures were provided on a day
care basis last year, compared with 13,450 in 1968, the year
such surgery began in B.C. hospitals as an insured benefit.
One consequence is a declining need for acute care
hospital beds in proportion to the population. In 1966, there
were 5.62 beds per 1,000 population in B.C. This had dropped
to 5.01 by 1976, and it is estimated that only 4.25 beds will
be needed by 1986.
Nevertheless, there remains a need to replace out-dated
hospital facilities, and 1980 saw the continuation of an
ambitious program of hospital construction and renovation that
began in 1976, and will extend to 1986. Last year, 13 major
projects were completed. At year—end six major projects were
under way, at an estimated total cost of $246 million, and 22
smaller projects were in progress.
The Long Terra Care Program's third year of operation was
marked by a partial amalgamation of Long Term Care and Home
Care into a single program under one director. The program
re-emphazised its policy of serving clients in their homes
where possible, with admission to an institutional facility
considered as a back-up to in-home services. More than 24,700
clients are receiving care at home, compared with nearly 16,000
in facilities.
 Preventive services were strengthened in 1980, through
both program expansion and renewal of facilities. Speech and
hear ing c1inics were added in Nanaimo and Nor th De11a, wi th
each expected to serve more than 1,000 new clients a year* New
community health centres were opened in Prince George, Nanaimo,
Terrace, Vernon and Parksville, each housing local services in
one building, other centres are being built in North Delta,
Cranbrook and Gibsons*
A major s tep was taken to improve the tr aining o f
ambulance crews by merging the training facilities of the
Emergency Health Services Commission with those of the B.C.
Justice Institute, which trains firefighters, police, and court
and corrections personnel. The new Emergency Health Services
Academy, situated at Jericho Beach in Vancouver, will enhance
the training that has given B.C.'s emergency health attendants
an international reputation for excellence.
During, 1980, the commission doubled the strength of its
infant transport team, which transfers critically ill infants
from all over the province to the neo-natal intensive care unit
of Vancouver General Hospital.
The Alcohol and Drug Commission underwent significant
changes in its structure and terms of reference late in the
year. The newly appointed commission will operate independently from its previous day-to-day operations and programs,
which will be administered directly by the Ministry, with
considerable use of funded agencies to provide treatment
services. This separation will free the commission from any
vested interest in existing programs, allowing it to provide
the government with independent advice on broad program and
policy issues.
Concrete steps were taken to improve care for disturbed
adolescents. Construction of a 26-bed facility with
out-patient services is under way at the B.C. Youth Development
Centre in Burnaby, with completion scheduled for late 1981. In
the meanwhile, arrangements were made to provide 10 places for
disturbed teenagers at the Malahat Educational Community, near
Victoria.
An innovative approach to the care of terminally ill
patients was introduced to British Columbia in 1980. Pilot
hospital programs in Vancouver and Victoria were started to
help dying persons cope with their situation, and assist their
families, and professionals and lay workers involved with their
care. The programs are sponsored by the Ministry, with
services provided by a hospital in each city, the local
community health department, and homemaker and volunteer
agencies.
 Another pilot program with Ministry sponsorship was aimed
st relieving nursing shortages by offering refresher courses
for nurses who have not practised for some time. Bssed on the
successful results at Royal Jubilee Hospital in Victoria, the
program will receive Ministry fund ing in any area of the
province where the need exists.
One of the most newsworthy events of 1980 was the attempt
by amputee Terry Fox to run from coast to coast to raise money
for cancer research. In December, the Ministry announced that
$75,000 had been allocated to the planning of the Terry Fox
Cancer Research Laboratory in Vancouver, to be financed through
a $1 million grant from the Province* The laboratory will
initially house a team of four researchers and their support
staff in 9,000 square feet at the B.C. Cancer Research Centre,
and it is hoped that eventually the staff can be increased to
30.
The Ministry made a contribution toward the future
direction of Canada's health care delivery system in its briefs
to the federal Health Services Review conducted by Special
Commissioner Honourable Emmett Hall. In his address to the
commission, the Minister of Health outlined the accomplishments
of the Ministry under the more flexible block funding
arrangement that superseded federal cost sharing grants in
1977, and urged that the new system be continued. The Minister
also presented British Columbia's contention that the federal
government should relinquish responsibility for providing
health care services to registered native Indians living on
reserves.
The submissions to the review provided an opportunity for
the Ministry to express its vision of the future of health
services. British Columbia has been a leader in the
development of many forms of service delivery, and the Ministry
of Health looks forward to continuing its leadership
responsibilities to meet  the challenges of the  1980s.
Chapin Key, M.D.
Deputy Minister of Health.
 SUPPORT SERVICES
The primary role of Support Services is to provide
managerial support to members of the Ministry who are
responsible  for  the delivery of services  to  the public.
Support Services includes financial services, personnel
services, central shared services, management services and
legal  services.
In addition, Support Services provides background
material and papers at the direction of the Deputy in matters
of current concern, such as the Ministry's position on
intergovernmental relations as they affect health care.
Support Services is also responsible for co-ordinating the
Ministry's relations with the B.C. Buildings Corporation, B.C.
Systems Corporation, Government Employee Relations Bureau, and
Treasury Board.
1980 was the second year in which Support Servies has
been responsible for managerial support, and there was
significant development of this area of the Ministry. Support
Services are committed to the provision of effective services,
to enable the Deputy Minister and Service Managers of the
Ministry to concentrate on the provision of efficient and
effective health services  to the public.
Legal  Services
The Health Legal Unit acts as the focal point between the
Ministry of Attorney-General and the Ministry of Health. The
members of the unit provide the whole range of legal services
to the Ministry of Health and to its several Commissions. The
duties of the Unit reflect the entire practice of law, namely:
provision of advice to the executive of the Ministry of Health;
development of legal opinions and memoranda; preparation of
agreements between the Crown and other groups; development of
policy and proposed legislation and regulations, and initiation
of legal  actions  on behalf of the Crown.
Since the Ministry of Health possesses one of the largest
aggregations of personnel within the Government, it is intended
that the Health Legal Unit will grow to fulfill the needs of
the Ministry.
 Management Services
During  the  year  the  division  had  the  following
responsibilities:
MANAGEMENT ENGINEERING SERVICES
These services were provided to the senior management of
Community Health Services, Professional and Institutions!
Services, and Support Services. The consultants and analysts
were involved in studies, and in the provision of consultative
services concerned with the better utilization of the
Ministry's resources. Included were projects such ss the
development of staffing methodologies for hospitals, the
establishment of a records management system for the Ministry,
and the study of clerical work in field clinics. Improvements
were made to supply and photocopier operstions, as a result of
studies of these areas.
BUILDING OCCUPANCY RELATED MATTERS
This involved the co-ordination of the Ministry's
accommodation needs, and the representation of these needs to
the B.C. Buildings Corporation, providing assistance with the
resolution of problem areas, and liaison with the Corporation,
on si I matters affecting space occupied by the Ministry. A
five-year projection of the Ministry space needs was prepared.
OPERATION  SUPPORT SERVICES
This included the management of those services which were
involved in the support of the Ministry's headquarters
operations, such as printing and photocopying, wsrehous ing,
security, and space planning. During the year the renovation
program for the Ministry's headquarters accommodation in
Victoria was completed, and a Records Management Unit was
established st the Support  Services Centre.
13
 Personnel Services
A personnel officer to lead the Ministry's staff training
and development activities joined the staff during the year.
The new program became effective very quickly through the
arranging of professional upgrading for management staff. An
expert in the management field was engaged to lead a pilot
group through a number of discussions of major topics.
The busy field of recruitment and selection required
additional attention from personnel, when a government hiring
freeze was declared in the latter part of the year. All
staffing action required a prepared defence and submission to
Treasury Board, and this situation continued through much of
the reorganizational phase of the Ministry staffing.
A new provincial dental program was developed with heavy
personnel input in staffing, and in leading the negotiations
for a fee structure with the B.C. College of Dental Surgeons.
Two groups — Dental Technicians and Dental Mechanics — were
added to those already in regular fee bargaining.
Agreements with the various para-professional health care
associations were renegotiated during the year, and in all
cases reasonable fee structures were developed for billings
under the provincial medical plan. Relations with all of these
associations were kept at the highest level and good
information exchanges developed as part of the negotiating
process.
Bargaining with the government professsional employees
opened during the year, and representing the Ministry in these
sessions added to the labour relations tasks, which included
all grievance investigations.
The three—phased program for student hiring - summer
students, Quebec exchange . students, and university co-op
student program — continued to be administered by Personnel
Services, as was the growing and important rehabilitation field.
Input into the Personnel Policy Advisory Committee of
G.E.R.B. was maintained through the Director, who served as
Chairman of the multi-ministry group during the latter part of
1980.
The generalist officers assigned to serve mental health
and community health centres continued the program of field
trips as time allowed, with the dual benefit of upgrading
knowledge of the field operations while allowing person to
person input from Health Centre staffs.
14
	
 Full personnel capability was extended to central shared
services through the placement of a new personnel officer in
Essondale. The planned transfer of the Hospital Programs
personnel function of the Headquarters' organization was
finalized, allowing the complete services of the personnel
organization to support the Hospital group-
Executive appraisals, merit pay, and executive benefit
plan details, were administered and co-ordinated during the
third and fourth quarters of the year. Continuous attention to
organizations, establishments, and classifications was given,
with great emphasis on the latter, as responsibility moved from
central agencies to the Ministries.
There were 23 personnel officers in the Ministry
(including commission, government hospitals, etc.) serving
almost 7,000 staff members throughout the Province*
Financ i a 1  Services
The program environment and the organizational structure
which the financial service division was originally set up to
support, changed considerably over  the year.
The Ministry of .the Provincial Secretary and Government
Services established its own Comptroller's Office in mid-1979,
with the resulting loss of a number of finance personnel and
related functions formerly administered by this Ministry for
other government services. Furthermore, as a result of
re-organization, the structure of the Ministry of Health
underwent a period of consolidation, and it became apparent
there was a need for improved Ministry-wide co-ordination of
the financial function to make the optimum use of the funds
available.
Finally, the traditional incremental approach to
budgeting and the allocation of government resources would soon
be replaced by a zero-base budgeting review procedure.
As an end result of these changes, the role of the
division was undergoing a considerable change in emphasis at
the year end focusing on an increased need to assist in
planning,  budgeting,   financial control and program analysis.
Accordingly, the division was re-structured to respond to
pressures for a more flexible and responsive organization. The
division was  segregated  into two main functional areas:
• Ministry  Financial   Operations  -  responsible   for   payroll,
accounts  payable and receivables.
- 15
 • Budget,   financial  analysis  and  planning  -  responsible   for
co-ordination of        budgets, financial analysis,
re-allocation     of    resources,     expenditure    control,     and
financial  information systems.
The Ministry of Health is responsible for the management
of a variety of complex and related health care programs. To
facilitate the effective management of the Ministry resources
at all levels there was a need to improve the quality of
financial information, and to develop and implement a
comprehensive, integrated financial information system. At the
same time, while the Office of the Comptroller-General
continued its work upgrading the central accounting system of
the government, ministries were encouraged to take initiatives
on  their own to improve  internal  financial management reporting.
Accordingly, the Ministry of Health decided to undertake
a consultant study aimed at a comprehensive identification of
the Ministry's  financial information requirements.
The study reviewed the Ministry's existing financial
systems and defined the current information requirements. The
results of the study will serve as a basis for the planning of
the Ministry's financial systems development projects over the
short and immediate term. It was expected that the development
of the new financial system over the next 15 months would be a
large undertaking, requiring a high degree of resource
commitment   from the Ministry.
Central  Shared Services
This division provides a Ministry logistical support
program which, in addition to materials management, includes
transportation, mechanical services, specialty equipment repair
and manufacture,   and audio visual  services.
The materials management division experienced an
exceptional 61 per cent volume increase in medical supplies,
and a 30 per cent growth in pharmacy and surgical issues.
These growth rates indicated the acceptability of the program
and the benefits of the user committee structure now in effect
in each supply and service division. Persons throughout the
province suffering from hemophilia, Crohn's Disease, and kidney
failure continued to receive personalized support from the
staff in this section. Much credit was due the staff who have,
through better work methods and personal effort, been able to
absorb added work loads and new programs without establishment
increases.
 IT
During the year the Victoria Regional Linen Services
experienced production di fficulties, due to staff shortages and
plant renovations. The renovations and new equipment will
per m i t an e x t ens ion o f services to the Oak Bay Manor and
several other smaller clients*
The mechanical superintendent's office was transferred
from Victoris to the Mainland to permit consolidated and
improved services. Improvements made to the physical
fscilities at Coquitlam will allow an expansion of mechanical
repair services*
A catalogue of available industrial services, prepared in
1980, created an awareness of this resource centre end resulted
in increased volume. The shoe repair section was closed to
allow better utilization of staff and faciiities. The audio
visual divison, located in the Blanshard Building, Victoria,
was amalgamated with the audio visual department of the
industrial division at Essondale on the Mainland.
Much needed administrative support was provided by Mr.
Tom Cox, who joined our administrative staff in June, and Mrs.
C. Watts, Personnel Officer, who commenced in November.
17
 Community Care Facilities Licensing Board
THE PROVINCIAL ADULT CARE FACILITIES LICENSING BOARD
The planning and development of new licensed facilities
under the Long Term Care Program showed a steady growth in
1980. The volume of work for field staff to meet the statutory
requirements of licensing'constantly increased.
A number of licensed care facilities changed hands and
some ceased operation abruptly, affecting the care of the
residents and placing a strain on services to provide alternate
accommodation.
During the year the Adult Care Regulations, 1977, were
revised. Amendments to areas of building design, staffing,
care and activity requirements were incorporated. Two new
sections were added, requiring financial and statistical
reporting and notice of change of operation of facilities.
TABLE I - ADULT CARE FACILITIES
ISSUED
SURRENDERED
Interim Permits
Interim Permits
Licenses
and Licenses
Net Total ■
Adults
Adults
Adults
Adul
Year
Facility
in Care
Facility
in Care
Facility
in Care
Facility
inj
1975 ...
59
1,792
453
14,534
130
1,928
382
14,3'
1976 ...
53
1,291
449
15,085
78
1,281
424
15,0'
1977 ...
51
1,734
465
15,008
30
511
486
16,2
1978 ...
58
1,805
481
15,407
—
	
539
17,2
1979 ...
65
1,892
531
15,933
47
995
549
16,8
1980 ...
60
1,735
565
16,839
27
359
625
19,1'
 THE PROVINCIAL CHILD CARE FACILITIES LICENSING BOARD
The Chi Id Care facilities continued to expand st a rapid
rate with frequent openings, closings and change of operator.
The Board reviewed 675 licensed applications, interim permits
and amendments in 1980 compared with 347 in 1979.
In 1980 the Board became more involved in the issuing of
certificates registering people to work in Child Care
facilities* An ongoing problem feeing the Board is the
reluctance of neighbours to accept s Child Care facility in
their area even when all licensing requirements are met.
The Board continued to review the Child Care Regulations
snd  related  policies  with  the  assistance  of the  Board
representatives  from  the  Ministries  of  Human Resources,
Education and Health.
CHILD CARE FACILITIES
ISSUED
SURRENDERED
Interim Permits
Interim Permits
Licenses
and Licenses
Met Total
Children
Children
Children
Children
Facility
in Care
Faci lity
in Care
Facility
in Care
Facility
in Care
155
2,229
909
16,786
267
4,130
797
14,885
192
2,694
929
16,869
308
4,034
813
15,529
235
3,063
1,005
17,866
75
900
1,165
20,029
291
3,675
1,028
18,370
30
364
1,289
22,045
300
3,633
1,228
19,187
177
2,065
1,351
20,755
334
3,372
1,417
21,355
177
1,587
1,751
24,667
- 19
 COMMUNITY HEALTH PROGRAMS
Community Health Programs Highlights
During 1980 there was a decline in measles incidence, but
an increase in reports of whooping cough.
The incidence of tuberculosis continued to decline, but
there were important variations in the characteristics,
such as age, sex, and race, of the more seriously
affected population groups. Some three-quarters of
active cases were being treated on an ambulatory basis.
New cases of gonorrhea detected continued to increase,
and demand for information on sexually transmitted
diseases (S.T.D.) was heavy.
Approximately 94 percent of the province's population in
provincial health districts had access to an audiology
clinic.
Increased demand necessitated a 34 percent increase in
the parent education classes presented by the public
health nurses.
"Outreach" projects established in several Health
Districts appeared to be achieving positive results for
the "at risk" expectant mothers, who were provided
concentrated service by nursing and nutrition staff.
A randomly selected sample of 10,000 school children
throughout the province was examined orally, and the
survey is expected to provide extremely useful data on
the dental health of children in the province.
Work performed by the Division of Laboratories continued
to increase, and there was a dramatic rise in
examinations for intestinal parasites in 1980.
 m'ffl
ii is si s* fil:-
:| 3. i. Is sllii
3   e   * I;     »|
i"    |    |   »
1
1
1
.
•
5
1
_
8
if
1
i
_.
•3
■
|
£
o
O
' -
1 •
-.1
hi i
,
1 =
= s
£?
z ?
|z
O
1.
ll
SI
*
Ii    -
I'd,
< o
L
c   _
lei
Is 1°
am  JI
 Building Projects
The following health centre building projects were completed
and the premises occupied during 1980, thereby consolidating
all local community health services into one building.
1. Prince George - A new 38,000 square foot
complex.
2. Nanaimo - A 35,000 square foot complex.
3. Terrace - A 32,000 square foot complex shared
with the Ministry of Human Resources.
4. Vernon - A 32,000 square foot complex.
5. Parksville - A 5,000 square foot building
shared with Human Resources.
Projects under construction at the year end included:
1. Cranbrook - A new 28,000 square foot complex, to be
shared with the Ministry of Human Resources.
2. North Delta - A new 18,000 square foot complex, to be
shared with the Ministry of Human Resources.
3. Gibsons - A new municipally-owned complex to be
leased.
Feasibility studies that are ongoing and approved by Treasury
Board included:
1. Nelson - A new centre to replace the present, obsolete
one.
2. Surrey - An addition to be built to the present
building.
3. Kelowna - Architect assigned and schematic drawings
were being prepared.
4. Chilliwack - Architect assigned and schematic
drawings were being prepared at the year end.
 Specialised Community Health Programs
VANCOUVER BUREAU
The Vancouver Bureau includes a variety of services
locsted in Vancouver which are grouped together for
administrative purposes. The major services included are
tuberculosis and venereal disease control; provincial
laboratories; vocational rehabilitation; kidney dialysis
services and the Pearson Hospital. Several of these services
e.g. laboratory and the control services, act as support or
operation centres for the total provincial program. The
Assistant Deputy Minister in charge of the Bureau represents
the Ministry of Health on a variety of committees, and per forms
special functions as required.
MEDICAL SUPPLY SERVICE
The headquarters of this service is locsted at 1159 West
Broadway in Vancouver* The warehouse is at Riverview Hospital
in Essondsle, and Pharmacy Services are located at 828 West
10th Avenue, Vancouver.
The largest function of the service is to provide support
for patients wishing to carry out kidney dialysis at home* The
first method of home dialysis, hemo or blood dialysis, is the
more complex method end the number of patients at home on this
procedure decreased from 53 to 48 during the year. Peritoneal
dialysis wss csrried out by various methods, but st present the
method called "Continuous Ambulatory Peritoneal Dialysis"
(C.A.P.D.) is the most popular method* A sterile technique
method which was introduced by Dr. Oreopoulos in Ontario, and
the Beta Cap method pioneered by Vancouver General Hospital are
being used. The number of patients on peritoneal dialysis
increased from 71 to 128.
This service employs two technicians, and contracts with
an equipment manufacturer to provide some of the service and
with technicians from hospital renal units to assist with local
services.
To ensure that home patients carry out safe procedures
and do not encounter insurmountable social problems, it is
necessary for a nurse to visit the home on a regular basis. In
addition to employing nurses to visit patients at home, a
contract arrangement has been made with the hospital renal
- 23
 units to provide this service from Trail, Victoria, Kamloops
and New Westminster*
Dietary supplements were provided to patients with renal
disease in order to delay the requirement for dialysis, to
assist children with growth, and to provide weight gain in
debilitated patients. These supplements are high calorie but
are low in protein, sodium and potassium*
1980 was the third year in which the Kidney Foundation
supported a summer camp. This was a national project and the
Kidney Foundation collected the funds and bought the supplies
from this Division.
There were 15 kidney transplants during the year. This
Division arranged transportation when necessary to carry this
out. A co-ordinator for this program has been employed to
ensure that it could function throughout the province. She
also participated in a public relations program in order to
encourage the donation of kidneys and other organs.
The Willow Dialysis Unit located at 1159 West Broadway,
Vancouver, had an average of 15 patients dialysing themselves
with minimal assistance. Nurse assistants were employed to
support one patient each, in up to 10 locations around the
province. Hospital Programs is cooperating with the Kidney
Dialysis Service by providing space for some patients who were
unable to dialyse in their own homes and lived too far away to
commute to one of the six renal units.
There were 50 patients who were deficient in Factor 8
(Classical Hemophilia), eight patients deficient in Factor 9
(Christmas disease), and one patient deficient in Factor 7, all
of whom provided their own treatment at home. The Medical
Supply Service provided the intravenous materials, and the
Canadian Red Cross Society provided the plasma products
required. A grant was provided to the B.C. Hemophilia Society
so that it could employ a part-time nurse co-ordinator,
physiotherapist, and social worker for the Hemophilia
Assessment Clinic. A physician volunteered his service to
operate this program.
Some patients with a severely diseased bowel were unable
to absorb food. It was necessary to feed these patients by the
intravenous route, called Total Parenteral Nutrition. Six
patients were trained to carry out this procedure and feed
themselves at home.  This Division supplied their requirements.
- 24
 HEARING CONSERVATION PROGRAM
The Division of Speech end Hear ing delivers a
comprehensive, cost-efficient Community hear ing conservation
program across the Province providing complete hearing
services, including diagnostic testing and hearing aid
fittings, to an age-group ranging from new-borns to 100-plus
years* These 19 clinics continued to develop their services
during the year on a phased development basis. In addition,
the Division was, through contractual agreement, providing
these services to two independent boards of health*
The success of these programs is based on the high level
of local community and medical input achieved through the use
of medical advisory committees in each hearing clinic
locality. In addition, programs are closely co-ordinated with
other community fecilities and services such as hospitals,
school boards, other public health personnel and local offices
of other provincial ministries*
The prevention of hearing loss and its secondary effects,
and provision for the earliest possible detection of
unavoidable hearing loss, are the primary objectives of the
hearing    program.      Efforts    towards    these    aims    are    provided
through
1. the High Risk Hearing Register for identifying hearing
impairment in newborns;
2. the pre-school  and school hearing screening program;
3. the Industrial Hearing Conservation Program for
Government workers exposed  to high noise levels;
4. environmenta1 noise control  and analysis;
5. British Columbia Hearing Aid Program.
Children and adults who are evaluated at the Ministry
audiology clinics and who are at risk for secondary language
and communication disorders are eligible for the following
services:
1. Hear ing aid evaluation, selection and fitting: If
indicated, the individual may purchase a high quality
durable hearing aid, scientifically selected to
provide maximum hearing enhancement. Other integral
services provided are comprehensive repair services,
battery service, earmold services and individual case
follow-up and counselling service.
- 25 -
 2. Selection of classroom amplification systems: Upon
request, a detailed analysis of individual school
auditory training needs will be provided. A
cost-benefit analysis is provided to the school
district.
3. Development of auditory potential: Training to help
the individual maximize the use of the level of
hearing either with or without the use of artificial
amplification.
4. Speech Reading: Training the hearing impaired
individual to make the best use of other senses of
communication.
In a co-operative program with the Ministry of Education,
the Division is providing specialized auditory training
equipment to hearing impaired students throughout the Province.
As well as working closely with the Ministry of
Education, the Ministry of Health also works with other
agencies such as the Ministry of Human Resources, the
Department of Veterans' Affairs and Health and Welfare Canada
to provide all services to individuals covered by these
agenc ies.
VISION SERVICES
In 1980 the orthoptist visited 10 health district main
offices and 32 branch offices. During these visits she carried
out vision screening, in conjunction with the public health
nurses in the district. She also attended meetings with
doctors, optometrists and public health nurses, which included
slide showings and demonstrations of various testing procedures.
The vision services learning module was again updated and
distributed to all health district offices in the province, so
that all health district staff has access to up-to-date
information.
From June to September, a follow-up study of vision
referrals from Kindergarten to Grade 3 students during the
1979/80 school year was carried out in three separate
districts. The statistics derived from the study provided a
valuable evaluation of the vision services program, and it is
hoped to repeat this type of study each year in a different
area and with various age groups.
In the area of public education and awareness, two
posters and several pamphlets were prepared for distribution.
One pamphlet, Refractive Errors, covers the common eye problems
 with very simple explanations, in order to give the public a
better understanding of their eyes*
The  vision  services  display,  prepared  last  year
travelled extensively throughout the province during 1980, and
was set up in schools, community centres, shopping malIs,
health district offices, and at meetings of the Canadian
Ophthaimological Society, end so on.
Speech Therapy Program
The Speech Pathology program provides speech and language
assessment, therapeutic and preventive services, to all age
groups residing outside of Vancouver and the Capital Regional
Distr ict * These services are provided from local Health
District Speech and Hearing Clinics, and through school board
programs. Continued services were given to school populations
during the year, resulting from a co-operative agreement
previously reached with the Ministry of Education, Science and
Technology. The Program for Communication Disorders was
delivered, on a contract for service agreement, to nine school
districts within seven local health regions. School districts
not participating in the pr ogr am continued to apply for
services.
All program services were provided to communicatively
handicapped populations, within a framework of standardized
guidelines. These policies resulted in increased effectiveness
and consistency of client services throughout the province.
Twenty four speech pa thology positions were available to
provide services to local health districts, and 15 speech
pathlogists delivered speech and language services through the
school program.
On the average, clients were referred for speech and
language services at a rate of 300 clients per month. Of the
individuals receiving assessments, 70 percent were recommended
for treatment programs. Each month, an average of 820
communicatively handicapped individuals received at least
weekly treatment from the Division of Speech and Hearing. Nine
percent of all treatment cases were dismissed each mon th.
Seventy percent of staff time was devoted to direct client
treatment, and 41,000 individual therapy sessions were
conducted during the year. This was a significant increase in
direct remediation of communication disorders.
Local staff were utilizing advanced techniques and
procedures in a variety of program areas, which improved the
- 27 -
 quality and effectiveness of service to speech and language
handicapped individuals. Sixty percent of these severely
handicapped clients were reported to have achieved their
therapy goals upon dismissal.
28
 Division   of  Tuberculosis  Control   Highlights
Lower incidence of active tuberculosis (2S.7 per 100,000
population  in 1972;   15.0 in  1979)
Continuing high rates among selected population groups in
the province, i.e. males 55 years and over, the
unemployed male and persons not born in Canada.
Fewer admissions to hospital, and s greater use of
ambulatory  antimicrobial  therapy.
Close supervision of 'At Risk' cases, especially contacts
of active cases.
- 29
 Division of Tuberculosis Contro1
The Division of Tuberculosis Control is charged with the
responsibility of correlating and directing all phases of
tuberculosis prevention and treatment in British Columbia, In
maintaining this responsibility, the Division recognizes the
assistance given by private physicians, Community Health, the
Division of Laboratories, and other health agencies in the
province, including the valuable co-operation with the Director
and staff of the Medical Services, Pacific Region, who are
responsible for the health services of Native Indians. It
would be remiss if recognition was not given to the many
volunteers who render invaluable support and to the B.C. Lung
Association, whose assistance in the form of grants for special
projects relating to respiratory diseases is acknowledged.
Although the overall incidence of new active tuberculosis
continued to decline, there were important differences within
the population when such variables as age, sex, race, country
of origin, residence and duration of residence in British
Columbia are considered. The highest rates of new active
disease in relation to age and sex continued to be found in
males 55 years and older, and among women 35 - 44 years of
age. Males listed as unemployed and living in Vancouver City
continued to pose a problem from the viewpoint of case finding,
treatment, and control. However, it is now possible to
identify these high risk persons in the population, and to
concentrate the efforts of control towards the isolation and
treatment of the infected individuals. The effect of this has
been an increase in the population of ambulatory treated active
cases of approximately 76 per cent. Very close supervision is
maintained by the Division of contacts of new source cases of
tuberculosis, and selected high-risk persons. Many in these
two groups are placed on a programme of chemoprophylaxis. At
the end of the year, 328 contacts wi th a pos i t ive tub er cul in
were taking this form of therapy.
Recently, 3401 contacts were identified and examined by
the physicians of the Division; 48 new active cases of T.B.
were diagnosed from this group. Recent statistics suggest that
close supervision and medical treatment have been effective in
controlling reactivations. Some years ago it was estimated
that approximately 1 per cent of persons with inactive
tuberculosis who previously had active disease reactivated. In
1979, only 58 persons, or about 2 per/1000 inactive cases
reverted to active status.
Geographically, the largest number of new cases continues
to come from Metropolitan Vancouver, although the highest rates
30
 of new  active  tuberculosis  occur   in  the central,   north  central
and mainland coast areas of the province.
Division of Venereal Disease Control
INTRODUCTION
The new approach to the control of sexually transmitted
infections initisted in 1977 was continued in 1980. It
entailed introducing a new term (sexually transmissible
disease, or STD) to better convey the fact that there are many
more diseases at issue than just gonorrhea and syphilis* Other
diseases which are now considered problematic include
non-gonococcal urethritis (NGU), candidiasis, herpes simplex
virus, trichomoniasis, chlamydia        and        two        parasitic
infeetations,   pubic  lice and scabies.
PUBLIC AWARENESS
The pub1ic awareness campaign that had been developing
since late 1977, and which reached a zenith in 1979, was
substantially reduced in 1980. One brief campaign was carried
out in the late suramer/early fall, . in five major centers
outside of Vancouver.
Clinic attendance, particularly at the main Clinic in
Vancouver, did not drop over the previous year, despite the
absence of advertising. There was, furthermore, a noticeable
increase in the number of new cases of gonorrhea being
detected,  especially among male  patients.
Information demand continued to be heavy, with
approximately 50,000 pamphlets on STD being distributed during
the year, and some 50,000 new calls to the STD Information
Line. Since its inception in Se p temb er of 1977, the STD
Information Line has received a  total of over 200,000 calls.
VANCOUVER CLINIC
Due to increased patient load, an additional male nurse
was hired in 1980, bringing the staff complement dur ing regular
clinic hours to one physician, four male nurses, and two female
nurses.  An examination of the feasibility of introducing an
 appointment system for the Clinic, in contrast to the "drop-in"
basis on which it had operated, was also undertaken, with the
anticipation that appointments would be initiated early in
1981. This again, became necessary due to the large numbers of
people seeking examination and treatment at the Clinic.
To further facilitate handling of the patient load, a
preliminary draft for developing a computerized record system
shared by the Divisions of V.D. Control, T.B. Control and
Laboratories, was prepared by the B.C. Systems Corporation.
Computerization of V.D.Control records will permit separation
of the Control center from the Clinic, allowing more space for
the Clinic. It will also allow for longer retention of patient
records and more information inputs for research purposes,
especially with respect to recording the incidence of STD's
such as NGU, herpes, vaginitis and cervicitis.
HEALTH EDUCATION
A summer project saw the development of several new
pamphlets on individual STD's. In addition, a wholly new
Physician's Manual on the Diagnosis and Management of STD's was
prepared and distributed, and a paralled manual for use by
community health nurses was printed.
During the year the grant obtained from the Federal
Division of Family Planning was transferred from the education
consultant position in the Division of V.D. Control, to the
health educator working with the Planned Parenthood Association
of B.C. Future program developments in the area of STD,
contraception, and adolescent sexuality, were being planned at
the year end.
COMMUNITY HEALTH NURSES
The Division of Venereal Disease Control continued to
provide nursing time and clinics throughout the province, to
ensure that local needs were met with respect to screening,
diagnosis and treatment of STD. Full or part-time nurses were
provided in Victoria, New Westminster, Kamloops, Dawson Creek,
Prince George, Prince Rupert, Quesnel, Williams Lake, Vernon,
Kelowna and Pentic ton. The responsibilities of these nurses
include liaising with private physicians involved with STD
patients, and providing them with services for interviewing,
contact tracing, and the diagnosis and treatment of named
contacts.  The center of the V.D. Control Program, located in
32
JJ
 Vancouver, provided the same services to physicians in Greater
Vancouver, and offered telephone consulting services to
physicians  throughout the province*
PHYSICIAN AWARENESS
Physicians   ore   still reluctant    to   report    the    positive
cases    of    STD    which    they treat*      Without    such    reporting,
attempts   to notify  infected partners   (who  may be   asymptomatic)
are severely constrained.
The Vancouver Clinic physician continued his involvement
in promotional and educational seminars with the UBC Faculty of
Medicine, and local medical associations. On-going dialogue
was maintained with the British Columbia Medical Association.
By the year end, these approaches in themselves had not had a
noticeable impact*
During the year an arrangement was made whereby patients
attending clinics at peak periods are referred to physicians in
their community who ere prepsred to accept new patients and
diagnose and treat STD's. It was also hoped that the new
Physician's Manual would serve as an incentive to increase
physician co-operation with  the Control Program of the Division*
CHLAMYDIA AND NON-GONOCOCCAL URETHRITIS
The Division of Venereal Disease Control continued
research into the etiological role of chlamydia in
non-gonococcal urethritis* This project is co-sponsored by the
U.B.C. Faculty of Medicine and the Division of Venereal Disease
Control.
Community Vocational  Rehabilitation Services
This Division is the provincial authority responsible for
the administration of the federal Vocational Rehabilitation of
Disabled Persons Act. Under this Act, the Ministry of Health
has an agreement with Health and Welfare Canada which enables
the Province to recover fifty percent of all costs incurred for
designated vocational rehabilitation programs.
The purpose of the Vocational Rehabilitation of Disabled
Persons Act is to provide assistance for the development,
within    the    province,     of    a    comprehensive     and    co-ordinated
33 -
 program    of    vocational    rehabilitation    services     for    disabled
persons.
SOURCES  OF REFERRALS
The   Division   accepts   referrals    from   community   agencies,
physicians,   parents and self-referrals.
The    Division    carries    out    its    responsibilities    in    two
complementary streams:
1) Individualized Rehabilitation Process - this process is
designed to assist persons disabled as a result of
accident, disease or congenital defect, to obtain the
services they require to become capable of obtaining a
substantially gainful occupation. These occupations
include employment in the competitive labour market, the
practice of a profession, self-employment, homemaking,
farm work (where payment is in kind rather than in cash),
sheltered employment, home industries or other homebound
work of a remunerative nature. In carrying out this
process, Community Vocational Rehabilitation Services
functions as a 'focal point* and as a 'broker' on behalf
of the individual, assisting him to identify his needs
and to utilize all existing assessment, treatment,
training and job placement resources in an organized and
co-ordinated manner, providing continuity and follow-up
throughout with a view to the individual attaining
maximum social and economic functioning in his
community. The success of the process is directly
related to the involvement and participation of all
relevant community resources. Accordingly, Community
Vocational Rehab il itation Services works through a nucaber
of local rehabilitation committees, which include
representatives from government and non-government
agencies.
2) Resource Development — it is apparent that in carrying
out this individualized process, Community Vocational
Rehabilitation Services identifies many unmet needs.
Following identification, Community Vocational
Rehabilitation Services, in conjunction with relevant
government and non-government agencies, associations,
etc., tries to develop new programs and facilitate
funding.
- 3*
 REGIONAL ACTIVITIES
Examples of some of the activities pertaining to resource
development thst took plsce in 1980 include:
• the Rehabilitation Consultant in the Terrace region was
directly involved in the establishment of an Advisory
Committee on the Educational Needs of Disabled Persons,
in the Northwest Community College region. In sddition,
he participated in the development of a dynamic work
incentive program.
e in the Kootenays, the Rehabilitation Consultant was an
active participant in the development of improved and
increased services for mentally retarded persons*
• in the Upper Vancouver Island region, the Rehabilitation
Consultant was involved in the establishment of a special
workshop located at Courtenay, to serve young adults
classified as "slow learners" with accompanying physicsl
or emotional disability. The objective of this workshop
is to assist these young people to successfully bridge
the gap between school and the labour market*
e in the Upper Fraser Valley region, Community Vocational
Rehabilitation Services was instrumental in developing
the Winslow Works Cafeteria Program, at Douglas College
In Port Coquitlam. This program provides work adjustment
and skill training for a number of mentally retarded
adults, in preparation for the competitive labour market.
REGIONAL OFFICES
The Division operates through a network of regional
offices located in Nanaimo, Victoria, Terrace, Prince George,
Vernon, Port Coquitlam, Surrey, Cranbrook and Vancouver, which
covers greater Vancouver. The Central Office is located in
Vancouver•
EXAMPLES OF CLIENTS SERVED
A   25-year-old   man,    severely   disabled   by the   congenital
absence   of   both    legs   and    left    arm,    was in   receipt   of
public    assistance.      Following   extensive assessment,    he
was   provided with  an electric   wheelchair, a   short   period
- 35
 of training on-the-job, and specialized computer word
processing equipment, adapted to his employment needs.
The end result is full-time employment at a local radio
station as a copywriter. His long term objective is to
be a broadcaster.
For an investment of approximately $7,000, this man has
become a member of the work force.
A 35-year-old woman, disabled by a spinal injury, and was
confined to a wheelchair. Prior to her accident, she was
trained as a computer operator and, subsequently, offered
employment in that field. However, transportation
presented a major barrier. On her own, she purchased a
van and requested assistance with the cost of hand
controls and a hydraulic lift. These items were provided
and her economic independence is assured. In addition,
she is the sole support of her dependent child.
GENERAL DEVELOPMENTS
Recent technological advances placed a number of new
pieces of special equipment on the market, including visual
teks, opticons, etc. This new equipment made it possible for
many severely disabled persons to benefit from vocational
training and to enter competitive employment. A few disabled
persons were provided with this type of assistance, and a
marked increase in demand was anticipated.
During 1980 Community Vocational Rehabilitation Services
was actively involved in planning for the International Year of
Disabled Persons. The Director of the Division is a member of
a provincial Inter-Ministry Committee, and the B. C. Government
representative on the Canadian Organizing Committee.
During the year, Community Vocational Rehabilitation
Services continued to provide funds in the form of salary
subsidies, to a number of designated voluntary agencies engaged
in special vocational rehabilitation services.
Community Vocational Rehabilitation Services would like
to gratefully acknowledge the continued and valued co-operation
of the Provincial Ministries of Education, Human Resources,
Labour; the Federal Department of National Health and Welfare
and the Canada Employment and Immigration Commission; and the
many voluntary agencies throughout the Province.
- 36 -
 Division of Dental Health Services
The Division of Dental Health Services continued to
expand its services throughout the Province, end for the first
time was able to extend service to the Pesce River end Skeena
Health Districts.
The field staff was comprised of 6 dental officers, 19
dental hygienists and 26 dental assistants. One dental officer
returned from public health training to assume his role in the
Northern Region of the province*
THREE YEAR OLD BIRTHDAY CARD PROGRAM
The Three Year Old Birthday card program operated in 49
school districts. Through this program, approximately 12,000
three year old children received a free examination and
parental counselling by the family dentist. A provineisl
participation rate of almost 70Z of eligible children was
achieved, with some regions achieving almost 90%.
DENTAL EXTERN PROGRAM
Two years ago 13 dental externa formed the largest dental
extern service in the program's history* At the same time, the
dentist/population ratio improved, and more dentists are moving
into rural locations, improving accessibility to resident
dental service* In 1980, seven dental externa were appointed;
two of them to the semi-permanent dental facility in Prince
Rupert. These dentists visited 20 separate communities,
provided routine dental care, and rendered treatment to 6,075
citizens. The new Dodge Maxivans, which carry packaged
equipment to augment the mobile dental units, functioned well*
SCHOOL DENTAL HEALTH PROGRAM
Provincial dental hygienists and dental assistants
provided oral hygiene instruction, education, prevention and
motivation, to almost 90,000 elementary school children, an
increase of about 3,000 from 1979. Of this total, 66,000 used
the self-applied fluoride paste and rinse, on a twice yearly
basis. In      addition,       73,139      children      received      dental
inspections,   an   increase   of  almost   18,000   from   last   year.     Of
37 -
 these, 23,840 children were referred for dental decay, and
growth and development problems. Parents voluntarily carried
out many of these referrals, and a further 13,143 were
followed up at home by the health district dental staff. Over
12,000 children were also referred to their parents as having
poor  oral hygiene.
From inspection data collected over the years, a dental
health profile of children became discernible. Many school
districts showed that 90% of the children have dental disease
under control, and regularly visit the family dentist. Records
indicated a steady improvement in dental health in many areas,
and a great reduction in loss of teeth in children. Continued
improvement depends upon the close co-operation developed
between the dental profession, teachers and parents, with the
health district dental staff, and the quality of the program
delivered to the public, especially the inclusion of an
effective follow-up system that is essential to secure
treatment for children who need it.
LONG TERM CARE
Dental care of the physically and mentally handicapped,
and the long term care/extended care patients, particularly
those institutionalized or otherwise not able to visit the
dentist, was becoming an increasing concern. Approximately 600
such persons (long term care residents, and homemakers'
clients) were surveyed during  the year for dental needs.
METRO  HEALTH UNITS
Autonomous dental services exist in the metropolitan
health units sUch*: as Victoria, Vancouver, Burnaby., West
Vancouver, North Shore and Richmond. Some health units operate
dental treatment centres for certain age groups. Others
operate educational and motivational programs that include
thousands of children, in addition to those serviced by the
provincial health districts.
PROVINCIAL CHILDREN'S DENTAL HEALTH SURVEY
From March to June of the 1980, over 10,000 children
randomly selected from schools around the province were part of
an   on-going   dental   health   survey.     Dentists   from  provincial   and
J
 metropolitan staffs travelled extensively to examine these
students. The 1980 survey will be the most complete dentsl
survey of children ever carried out in B.C., end will rank the
Province in the forefront of dental epidemiology*
UNIVERSITY OF BRITISH COLUMBIA
The  Minis try  provided  fund
support
j.ui_ ii.ii.3_i-/ pj_wvj.u_.vi iuuu« _u suppur. a aencai
department for the extended/acute care units of the University
Hospital. In addition, a dentist was appointed to augment this
service in a hospital residency program. This hospital
department will serve as a special resource to the community,
as well as a provincial referral centre*
SCHOOL HEALTH SERVICES
The comprehensive school program was augmented by the
Teacher Information Kits, and teacher workshops* Classroom
teachers were provided with specially designed kits complete
with lesson plans, dental supplies, follow—up and reference
material, and audio visual aids. The aim of these kits is to
have teachers reinforce the dental program, and provide dental
input into the areas and the classrooms not receiving the
program.
OTHER ACTIVITIES
In-service training programs that provided positive
learning experiences for staff; the development of various
pre-school programs that focus on early detection of dental
diseases; and the development of a perinatal tape/slide series,
were a few of the activities that took place over the year* A
successful fluoridation referendum occurred in Campbell River;
unfortunately this did not occur in Kimberiey. Special
consultative/teaching services were provided to Medical
Services staff, Department of National Health and Welfare, and
to the Dental Therapist staff in Fort Smith,
39 "
 Public Health Nurs
During 1980 the volume of preventive nursing services
increased due to:
• The growth (approximately 50,000) in the general
population.
• The focus on the benefits of good perinatal health, which
resulted in an increase in the number of parents
attending classes.
• The work involved in inspection and licensing of an
additional 62 community care facilities with an increased
capacity of 515 beds for children and adults.
• The interest in, and requests for, additional preventive
health services by the general public.
Public health nurses attempted to cope with the increased
demands and needs for services, while maintaining effective
programs already well established and accepted. Effective
management of staff time in the delivery of public health
programs was essential, and a study was commenced to identify
specific tasks by program areas, and to measure related units
of performance time. When completed in 1981, this time study
will not only identify procedures and practices which may be
improved, but will also provide base material by which program
objectives and outcomes can be reviewed for cost effectiveness.
PERINATAL PROGRAM
The services provided to expectant parents, and to the
family after the baby's birth, continued to expand. A 34 per
cent increase in the number of parent education classes
offered, was needed, in order to accommodate the number of
parents enrolling for service. Many voluntary nurses, working
closely with experienced public health nursing staff, made it
possible to cope with the additional class sessions required.
Statistical data for the period January to August 1980
showed that public health nurses had contact with over 90 per
cent of all parents of new infants within 28 days following
birth. A similarly high percentage of new infants were brought
to Child Health Clinics for health counselling, supervision,
and for primary immunization against diptheria, whooping cough
and tetanus.
Special "Outreach" projects in the Cariboo Health
District at Williams Lake, and in the Upper Island District in
 the Comox Valley and Campbell River areas, were still in
progress. These projects were funded by the International Year
of the Child and the Family Fund. A preliminary report of the
results achieved by the nursing and nutrition staff( working
with expectant mothers considered to be "at risk", showed that
an improvement in the birth weights of the babies was achieved
by the provision of concentrated .services to meet specific
needs. It also indicated that the professional services were
well received by these "at risk" mothers, many of them
teenagers or non-English speaking  immigrants*
A new exercise manual entitled Perinatal Fitness was in
the final stage of production and will be available in early
1981* It will be an adjunct to the 1979 publication, Baby's
Best Chance, to be used with it during prenatal class
instruction to encourage healthy lifestyle for the whole
family, and special prenatal exercises as preparation for
labour and childbirth* Perinatal Fitness will be available
free of cherge to expectant parents  in British Columbia.
PRESCHOOL PROGRAM
Preventive health services for preschoolers were provided
et Child Health Conferences; in assessment clinics where
vision, hearing, speech, dental health, safety and overall
growth and development were the aims of screening and health
education; in day care centres and nursery schools, and in the
family homes.
Provincial statistics indicated that upon completing
Grade I 85 per cent of the children were up to date for
diphtheria, pertussis, tetanus and polio immunizations; and 79
per cent were protected against measles. Although specific
statistics were not available for children aged two or three
years of age, there was an indication that the immunization
status of these younger preschoolers was inadequate, and Health
Districts are working to promote the completion of basic
immunizations by the time the children reach two years of age.
During the first eight months of 1980, public health nurses
completed a total of 58,887 immunization series for
preschoolers of which: 11,937 were for diphtheria, pertussis,
and tetanus; 12,456 for polio; 13,364 for measles; 13,530 for
rubella,   and 7,600  for  mumps.
Public health nurses continued their active participation
in parenting groups, believing that all parents should have
access      to     the     necessary      information,      encouragement,      and
M   -
 support, which other parents and professionals can offer to
enhance productive parenting practices.
As in the perinatal program, pub 1ic health nurses made
home visits to, or on behalf of, thousands of preschoolers to
help parents in the identification of preschool health
problems, and to work with them in obtaining the necessary
treatment, support and resources. They also made many visits
to community care facilities for children, to ensure that
licensing standards were being met, and to work with the staff
in providing a healthful environment.
In contacts with preschoolers and their families, as well
as with day or family care workers, public health nurses
emphasized their commitment to a healthy lifestyle; and
demonstrated their belief that the concept of fitness, good
nutrition and health must begin with children from one to five,
if the best results throughout life are to be achieved.
SCHOOL HEALTH PROGRAM
The public health nurse contributed to the School Health
Program through the following areas of activity:
• Co-ordination of the school health services provided by
the local health district.
• Communicable Disease Control, including immunization and
necessary epidemiological investigation and surveillance.
• Early identification of health problems and planning with
parents for appropriate care.
• Nursing support to students with acute, or chronic
health, or family problems, in order that they might
achieve and function at their optimum levels.
• In co-operation with parents, school and other health
personnel, the development and implementation of
effective health education projects appropriate to the
particular school and community.
During the year a review of the nursing time required to
effectively carry out the above activities was undertaken.
Further studies were being conducted to verify or correct these
estimated time requirements, and to identify essential nursing
activities not previously included.
With the increased number of handicapped children
attending regular schools, and the increasing number of
personal and family problems identified among the secondary
school population, new methods of assuring appropriate follow-
up of these students were being explored.
42
 The public health nurse's involvement in health education
in elementary and secondary schools showed that, in addition to
individual student and parent health counselling, nurses ware
heavily involved with group classes in discussing a wide
variety of health related topics* Health personnel believe
thst opportunities to influence student attitudes and behavior
regarding healthy lifestyles, and individual responsibility for
personal health, can be encouraged by comprehensive education
programs in schools. Public health staff were working closely
with school personnel to develop such programs, which will
encourage students to participste in health promotion
activities, and to use the resources of the health care system
sppropriately and effectively*
COMMUNITY CARE FACILITIES
As the number of facilities and capacity continued to
grow, the publie health nurse's work gr ew pro por t i on ately. In
addition to the functions and procedures involved in licensing
facilities for adults and children, the nurse was involved in
investigations related to complaints, inquiries from families
and operators, and in the development of new accommodations*
She worked in close co-operation with the public health
inspector, medical health officer, staff of the Ministry of
Human Resources, as well as many others, to ensure that
adequate care and accommodation was being provided. This
required on-going surveillance and work with staff and
operators, to promote adequate programs within each facility*
In addition, inspection of camps and mental health boarding
homes was also included in the activities involved in this time
consuming but challenging program.
Public Health Inspection Services
Public Health Inspection Services contribute to the
Preventive Program by carrying out a series of specific
environmental health programs.
Table III indicates the trends of Public Health
Inspection Services over a period of five years. The
statistics in this table do not include activities of the
municipally-employed public health inspectors in the cities of
Vancouver and New Westminster, the districts of Burnaby and
Richmond,  and the North Shore Health District.
 By the year end it was possible to make a comparison of
present activities with those one decade ago. This showed a
five-fold increase in food control work; the quadrupling of
activities on private sewage disposal; a fifty percent increase
in public water supply monitoring, and an increase in community
care facilities control by a factor of fifteen.
The increase in food control was consistent with the
trend in utilization of dining facilities. Private sewage
disposal activity was greatly influenced by development on
properties considered boderline for this purpose.
Communicable Disease Control
The incidence of communicable disease remained stable
during 1980. Vaccination coverage by Grade I, for the province
as a whole, was estimated at between 80 and 85 percent. A
major decline in measles incidence was observed, reflecting the
underlying cyclic pattern in this disease. By contrast, a
greater than two-fold increase in pertussis (Whooping Cough)
was reported, and lower levels of incidence can be achieved
through increasing vaccination coverage. In order to assist in
further promoting immunization, a steering committee for this
purpose was developed. In addition, a detailed review of all
immunization procedures and communicable disease regulations
was initiated.
Laboratory Services
The British Columbia Provincial Health Laboratories, with
the main laboratory in Vancouver and branches in Nelson and
Victoria, perform routine, referral and consultative services,
for investigation, diagnosis, treatment and control of
communicable disease, and for amelioration of environmental
problems. These services include advice and laboratory tests
for diseases caused by bacteria, fungi, parasites, viruses and
other communicable agents, related immunology and serology, and
environmental microbiology. Tests are available to registered
physicians, hospitals, and health-related agencies at all
levels of government; specimens are shipped by courier from all
parts of the province.-
Between 1979 and 1980 the work load of the Division of
Laboratories increased by 3.5 per cent. In Table V the numbers
of tests performed at the Main Laboratory and at the Branch
Laboratories in Nelson and Victoria during 1980 are compared
- 44
 with the corresponding figures for 1979. Slight increases in
work performed occurred in several laboratory sections but
examinations for intestinal parasites increased dramatically
  42 per cent.
Bacteriology Service
CORYNEBACTERIUM DIPHTHERIAE
The        number        of        patients from        whom        toxigenic
Corynebacterium diphtheriae was isolated decreased from 61 in
1979, to 30 in 1980, The number of patients from whom
non-toxigenic  C.  diphtheriae was   isolated  in 1980  totalled  120.
BORDETELLA PERTUSSIS
The  number  of patients   from whom Bordetella  pertussis  was
isolated increased  from 20  in  1979,   to 96  in  1980.
HAEMOPHILUS   INFLUENZAE AND H.   PARAINFLUENZAE
Haemophilus isolates increased from 77 in 1979, to 81 in
1980. Most organisms were isolated from genital sources and
the eye. Other sources included nose and throat, ear,
cerebrospinal  fluid and blood.
NEISSERIA GONORRHOEAE
In 1980, 5,139 cultures yielded N. gonorrhoeae, 9 per
cent more than in 1979. The number of genital smears showing
gonococci microscopically increased from 4,700 in 1979, to
4,992 in 1980. Bacteriological confirmation of gonococcal
infection represents  only about 50 per  cent of reported cases.
NEISSERIA MENINGITIDIS
The number of first isolates of N. meningitidis was 416
in 1979, and 329 in 1980. Of the 329 cultures, 261 were
recovered   from   nose   and   throat   specimens,    and   68    from   other
A5
 sources such as blood, cerebrospinal fluid and genito-urinary
tract. The serogroups of 156 isolates were A (8), B (39), C
(10),   D   (I),   X  (10),   Y  (8),   Z   (22),   29c   (22),   and  W135  (36).
OPPORTUNISTIC PATHOGENS
Opportunistic infections are often caused by
micro-organisms, formerly considered non-pathogenic. Such
infections are common in immuno-suppressed patients. In 1979,
2,700 opportunistic pathogens were identified, but only 2,500
were recovered in 1980, a decrease of more than 7.4 per cent.
The three .most often recovered were Acinetobacter
calcbaceticus,  Acinetobacter   lwoffi and Escherichia coli.
ANAEROBIC BACTERIA
Of 232 anaerobic strains identified, the three most
common were Bacteroides fragilis, Clostridium perfringens ■ and
Peptostreptococcus  anaerobius.
ENTERIC BACTERIA
The number of specimens submitted for culture for
Salmonella, Shigella and enteropathogenic Escherichia coli
(EEC) increased by 9 per cent. First isolations from 1,456
persons included Salmonella (880), Shigella (260), and EEC
(316). One hundred and forty-six (146) Campylobacter jejuni
coli were isolated from 13,247 specimens. The common human
Salmonella types were Salmonella typhimurium and S. typhimurium
var. copenhagan (333), S. saint paul (124), S. heidelberg (50),
S. infantis (46), S. blockley (37), S. haardt (33), ||
schwarzengrund (29), S. hadar (26), S. typhi (23), S. agona
(16), S. newport (15), S. enteritidis (14). Types isolated for
the first time in British Columbia were S. archeveleta, S.
dub 1 in, S, grumpensis, S. miami, S. minnesota, S. saarbrucken,
S. waycross; for the first time in Canada were S. manila.
Twenty-three (23) cases of typhoid fever were confirmed
bacteriologically. Salmonellae      were      identified       from      148
non-human sources; animals such as bovines, dogs, felines,
hogs, horses, mink and moose; birds such as chickens, pigeons
and turkeys; reptiles such as chameleon, iguana, knightanole,
snake and tegu lizard; food and fertilizer such as shrimp and
fish meal; and enviornmental swabs. Of 34 types identified,
most common were S. typhimurium (36), S. infantis (22), S.
saint  paul   (18)   and   S.   blockley   (12).
46
 The 260 Shigella strains included Sh. sonnei (171), Sh.
flexneri (81), Sh. boydii (6) and Sh. dysenteriae (2). The
most common enteropathogenic E. coli were 018:K77 (56), 02:K56
(38), 026:K60 (37), 011l:K58 (26), 0126:K71 (22), 055:K59 (15)
and  0125:K70   (8).
FOOD POISONING
During the investigation of 249 incidents of suspected
food poisoning in 1980 (compared with 218 in 1979) 478
specimens were cultured. Food poisoning organisms were
isolated in 33 incidents - Staphylococcus aureus (9), Bacillus
cereus (7), Salmonella (7), (S. typhimurium (3) , S. hadar, S.
-schwarzengrund, S. montevideo and S. blockley); Clostridium
perfringens (4), double contamination of Staphylococcus aureus
and Bacillus cereus (3), enterococci (2) and one double
contamination of Staphylococcus aureus and Clostridium
perfringens.
The Food Poisoning Section reported 167 incidents of
food-borne disease in 1976. Health Protection Branch, Ottawa,
collected and collated such information from all parts of
Canada and published "Food-borne and Water-borne Disease in
Canada - Annual Summary  1976" in  1980.
MYCOBACTERIUM TUBERCULOSIS
The number of specimens cultured for Mycobacterium
tuberculosis and other mycobacteria increased 7.8 per cent
from 29,660 in 1979, to 31,988 in 1980. The number of
microscopic examinations increased from 27,465 in 1979, to
29,430 in 1980. The number of other mycobacterial isolates
investigated rose 33.6 per cent from 292 in 1979, to 390 in
1980. Drug susceptibility tests increased 17.4 per cent from
964 in 1979,   to  1132  in  1980.
BACTERIAL SEROLOGY
Serological Tests   for   the Diagnosis  and Control of Syphilis
Screening tests for syphilis increased by about 8 per
cent from 180,000 in 1979 to 195,000 in 1980. The Confirmatory
Microhaemagglutination-Treponema pallidum (MHA-TP) test
increased by  3   per   cent   from  7,200   in   1979,   to   7,400   in   1980,
-  47  -
 and    the    Fluorescent    Treponemal    Antibody-Absorption    (FTA-ABS)
test  remained   the  same,   7,200  in   1979  and   1980.
During   1980   exudates   from   357   patients   were examined  by
darkfield       microscopy       and       by       the       Direct Fluorescent
Antibody-Treponema  pallidum  (DFA-TP)   technique.     In 31 patients
(9  per cent)   the examinations were reactive.
Other  Serological Procedures
Serological tests for the diagnosis and control of
febrile illnesses decreased by 3 per cent from 11,500 in 1979
to  11,100  in 1980.
534 sera sent to reference laboratories for titration of
bacterial antibodies yielded 85 reactive specimens which
included: Yersinia (41), Bordetella pertussis (29), Legionella
pneumoph ilia (9), Neisseria gonorrhoea (4), Pseudomonas
pseudomallei  (2).
Mycology
The number of specimens examined for fungi increased by
4.55 per cent from 4,068 in 1979, to 4,253 in 1980. Fungi
identified were:
DERMATOPHYTES
Trichophyton rubrum (241), Ma1as sezia fur fur (101),
Trichophyton mentagrophytes (78), Microsporum canis (64),
Epidermophyton floccosum (26), Trichophyton verrucosum (10),
Trichophyton tonsurans ^(8), Scopulariopsis brevicaulis (6),
Trichomycosis axi»lfl.aris (4), Cladosporium werrie'ck^ii- j(1) , C.
minutissimum  (Erythrasma)   (1).
SYSTEMIC AND  SUBCUTANEOUS  FUNGI OR DEEP MYCOSES-
Candida   alb icans    (339)
fumigatus     (20),
(10),   Aspergillus
asteroides    (2),    Coccidioides
Sporqtrichura spp.(1).
Candida spp. (320), Aspergillus
Aspergillus spp. (11), Torulopsis glabrata
niger   (8),   Geotrichum  candidum   (3),   Nocardia
immitis    (1),    Nocardia
co,
48
 FUNGAL SEROLOGY
Fungus antibodies were demonstrated in 29 of 343 serum
specimens r submitted to reference laboratories: Histoplasma
(25), Blastomyces (2), Coccidioides (2).
Parasitology
The number of specimens examined for parasites increased
from 34,455 in 1979, to 49,583 in 1980, or 43.9 per cent. The
additional 15,128 specimens included 9,000 from South East Asia
refugees.
The protozoan parasites identified from faeces, asperates
and urine specimens were: Giardia lamblia (2,369), Entamoeba
coli (2,304), Endolimax nana (2,112), En tamoeba h ar tmanni
(910), Entamoeba histolytica (446), lodamoeba butschlii (216),
Cysts of Entamoeba spp. (not further identified) (95),
Chilomastix mesnili(71), damaged cysts (32), Enteromonas
h-mTirris   (1).
The number of helminthic eggs identified from faeces and
urine were: Trichuris trichiura (2,758), Ascaris lumbricoides
(2,235), Hookworm (1,441), Clonorchis sinensis (785),
Hymenolepis nana (142), Enterobius vermicularis (118),
Trichostrongylus spp.(108), Schistosoma japonicum (18),
Diphyllobothrium latum (17), Schistosoma mansoni (15),
Fasciola/Fasciolopis spp.(14), Taenia spp. (13), Schistosoma
haematobium (11), Echistoma spp. (7), Strongyloides stercoral is
(3), Heterophyes heterophyes (2), Dicrocoelium spp. (1),
unidentified eggs (13). Helminth larvae identified were:
Resembling Strongyloides stercoralis (249), Hookworm (127),
damaged (unidentifiable) (42). Worms or worm segments
identified were: Ascaris lumbricoides (37), Diphyllobothrium
latum (4), Taenia saginata (2), Enterobius vermicular is (1).
Insect parasites identified or referred for identification
were: Ticks - Dermacentor andersoni (1), Ixodes pacificus (3),
Nits (2), Lice - Phthirus pubis (1), Pediculus humanus (I) Mite
- Western  fowl mite  (1)   Bedbug  (1).
BLOOD AND TISSUE  PARASITES,,
The number of specimens submitted for examination for
parasites of blood or tissue was 600 compared to 438 in 1979,
an  increase of 37 per cent.
49 -
 Of the 600 specimens, 597 were blood films for malaria;
211 for diagnosis of the disease and 386 for confirmation. The
malarial species identified were: Plasodium vivax (444),
Plasmodium falciparum (4), unidentified or too few for
speciation (8).
SEROLOGY OF PARASITES
Antibodies to parasitic helminths and protozoans were
demonstrated in 27 of 270 serum specimens sent to reference
laboratories. Helminthic parasites - Toxocara spp. (9),
Trichinella (8) , Ascaris) ( 1) , Echinococcus (1), Filaria ( 1)
Paragonimius (1) Taenia (1); Protozoan Parasites - Amoebae (5).
The Indirect Haemagglutination (IHA) and Indirect
Flourescent Antibody (IFA) tests for Toxoplasmosis decreased by
10 per cent from 1,060 in 1979 to 954 in 1980.
Tropical and Parasitic Diseases Reference Service
The Tropical and Parasitic Diseases Reference Service
provides advice on preparation for travel to the tropics, and
on the diagnosis and treatment of tropical and parasitic
diseases acquired by travellers returned from the tropics, and
immigrants to Canada.
During 1980 the Tropical Disease and Travel Clinic was
opened, operating on a once weekly basis. This Clinic will
greatly enhance the Tropical and Parasitic Disease Reference
Service, and the Exotic Drug Depot, which have operated in the
Provincial Laboratories since 1972.
During the year, exotic drugs not available commercially
in Canada were supplied for the treatment of 19 patients with
parasitic diseases, such as amoebiasis, filariasis, malaria and
schistosomiasis.
ENVIRONMENTAL MICROBIOLOGY OF WATER
The number of water samples examined by the Coliform Test
decreased from 40,120 in 1979, to 39,713 in 1980. The decrease
was partly due to interruptions in postal service, causing a 16
per cent increase in the number of unsatisfactory samples
received at the Laboratory (not tested, too long in transit).
- 50 -
 Three thousand, two hundred and thirty four (3,234) samples
labelled drinking water were also examined by the completed
coli form test, an increase of 7 per cent from the previous
year. More importantly, there was an increase of 166 per cent
in the number of 5/5 confirmed test results for drinking water
samples, from 499 in 1979, to 1,327 in 1980. The faecal
coli form test was done on 9,090 samples, a decrease of 12 per
cent from the previous year. It is also of interest to note
that in 1980, 451 samples of drinking water, positive at the
presumptive test stage, were tested for the presence of faecal
coliforms. This test is done on request, in cases where faecal
contamination of a water supply is suspected. The number of
bathing beach samples submitted and examined by the faecal
coliform test was 2,665. The standard plate count was done on
3,582 samples,  an  increase of 2  per cent  from 3,509  in  1979.
Virology Service
A diagnostic and consultative service in medical virology
is provided for physicians in British Columbia, through the
Provincial Laboratories. During 1980 over 850 viral and other
agents were identified as causes of human disease. Included
were adenovirus (29) cytomegaloviruses (17) enteroviruses (80)
herpes simplex virus (494) influenza A and B (67) measles (14)
mumps (8) mycoplasma pneumoniae (33) parainfluenza virus (1)
psittacosis (2) lymphogranuloma venereum (1) respiratory
syncytial virus (2) rotavirus and other viruses of
gastroenteritis (48) rubella (44) varicella-zoster (10)
Legionnaires'   disease  (I).
The epidemics of measles and rubella experienced during
1979 had waned by  the new year.
INTRAUTERINE VIRAL   INFECTIONS
A number of common viruses, such as cytomegalovirus,
enteroviruses, herpes simplex virus and rubella virus can
infect the developing fetus if the mother contracts the disease
during pregnancy. The results may be abortions, stillbirth or
live born infants with congenital anomalies.
While the number of babies born with congenital anomalies
due to rubella virus are rarely seen now, due to the rubella
vaccine, cytomegalovirus was isolated from 17 patients, the
majority   of   which   were   newborn   infants,    many   with   anomalies.
 Herpes simplex virus  infection was  also responsible  for  a
number of infant deaths.
POLIO, COXSACKIE AND ECHOVIRUSES
Although no illness due to wild poliovirus was identified
during the year, a number of strains of polio vaccine virus
were isolated from patients. Several coxsackie and echo
viruses were prevalent in the community, coxsackie A9 and echo
9 predominating. Illness associated with these viral
infections varied from peculiar rashes to meningitis,
encephalitis, myocarditis, pericarditis, and acute
gastroenteritis.
The influenza epidemic in British Columbia during 1980
was almost entirely due to influenza type B. (Influenza
B/Singapore/222/79).
HERPES GENITALIS ("LOVE BUG")
Herpes_ simplex virus was isolated 'from 494 patients
during 1980. The vast majority of these infections were
genital in nature, again underlining the increasing importance
of herpesvirus infections acquired by sexual contact.
On at least two occasions herpes simplex virus was
isolated from brain tissue acquired at brain biopsy, in
patients suffering from encephalitis.
RESPIRATORY INFECTIONS
The organism most commonly associated with acute
respiratory disease, i.e. pneumonia, during the past year was
mycoplasma pneumoniae. However, two cases of psittacosis and
one of Legionnaires' disease were diagnosed.
 TOXOPLASMOSIS
Although the organism responsible for this disease is not
a virus, it can cause serious anomalies in the developing fetus
if the mother acquires the infection during her pregancy. At
least two toxoplasmosis babies were diagnosed during 1980, each
with severe developmental anomalies.
The Virology Service now offers a number of tests for
detection of patients suffering from hepatitis type A and B
infections. This service will assist physicians who do not
have access to these tests from other sources, and will operate
as  a reference service  for  the province.
STAFF APPOINTMENTS
Three senior scientists and a new administrative officer
were appointed to the staff of the Division of Laboratories in
1980. Ms K. Bernsohn, Ms L. Cunningham, Dr. P. McMyne and Dr.
E. Proctor will assist in reorganizing and up-dating the
laboratories.
In March Dr. Peter Gill, Director of the Bureau of
Microbiology, Laboratory Centre for Disease Control
Directorate, of the Department of National Health and Welfare,
Ottawa, visited  the British Columbia Provincial Laboratories.
On Augus t 29. 1980, Dr. Alan Woodruff, Director of the
London School of Hygiene and Tropical Medicine, London,
England, visited the British Columbia Provincial Laboratories
and delivered a  lecture on "Imported Tropical Diseases."
ACKNOWLEDGEMENTS
The services, biological reagents, expertise and advice
provided by reference laboratories in Canada and elsewhere are
gratefully acknowledged.     These reference  laboratories   include:
53
 Laboratory  centre   for  Disease  Control   (Ottawa)   and   its
reference  laboratories:
• Internal
Bureau of Microbiology
National Enteric Reference Centre
National Reference Centre for Hepatitis
National Influenza Reference Centre
National Reference Centre for Neisseria
National Reference Centre for Tuberculosis
National Reference Service for Staphylococcal
Phage Typing
National Reference Service for Streptococci
Bureau of Medical Biochemistry
National Centre for Hemoglobin Standards
• External
National Reference Centre for Arbovirus
University of Toronto
National Reference Centre for Parasitology
McGill University
National Reference Service for Treponema-Pallidum
Immobilization Test
Ontario Ministry of Health
National Reference Service for Yersinia
Ontario Ministry of Health
National Reference Centre for Leptospira
Toronto Western Hospital
National Reference Service for Diphtheria
University of Alberta
Other Canadian Laboratories
Ontario Agricultural College,
University of Guelph
Environment Canada,
Vancouver, B.C.
City Analyst,
Vancouver, B.C.
University of British Columbia,
Vancouver, B.C.
Foreign Laboratories
Centre for Disease Control,
Atlanta, GA.
National Jewish Hospital,
Denver, CO.
Royal Infirmary,
Edinburgh, Scotland.
 Pearson Hospital
Pearson Hospital, located in South Vancouver, provides
several unique programs for both the local community and the
citizens of the province as a whole. Programs include
in-hospital and out-patient services for persons suffering from
severe respiratory disabilities mainly from poliomyletis or
spinal cord injury; an enriched extended care program for
severely physically disabled young adults and younger
middle-aged persons; an in-hospital program for treatment of
tuberculosis patients and a theraupeutic out-patient program
for persons eligible for either intermediate or extended care,
but not yet hospitalized.
During 1980, negotiations continued with Hosptial
Programs, the Vancouver Bureau and the Vancouver General
Hospital to re-open the Willow Chest Centre in-patient unit for
treatment of the tuberculosis patients presently at Pearson
Hospital. It was anticipated that the move would take place
early  in  1981.
Pearson Hospital continued to work closely with G.F.
Strong Rehabilitation Centre in planning longer term care and
maintenance therapy for younger physically disabled people who
no  longer required intensive  therapy at  that unit.
The number of respiratory dependent, high lesion
quadraplegics transferring from the Spinal Cord Unit at
Shaughnessy Hospital was less than anticipated, but even these
strained the available space in the polio-respiratory program
at Pearson Hospital to its limit. It was expected that this
program would be able to cope with the number of admissions
currently anticipated, provided some space reallocation could
be arranged.
The average age of patients in the hospital's extended
care program continued to drop from 49.8 in 1978 and 47.4 in
1979  to 46.8  in  1980.
Considerable progress was made during 1980 in proceeding
with long planned structural alterations and physical plant
up-dating. The centralized food service system got under way
with the commencement of construction of a new main kitchen.
The replacement of the old, inefficient, and labour intensive
power plant was all but completed, with the construction of a
much smaller packaged unit. Funds were approved for the long
overdue renovations of two extended care wards, and work was
expected to begin soon and be completed early in 1981, leaving
only two more wards requiring major renovations.
 On May 26th, 1980, Premier Bennett officially opened the
Stan Strong Pool for the Disabled at the hospital.  The Pool
was designed and constructed from the proceeds of a Lottery
Fund donation, and was furnished through a donation from the
Marpole Women's Auxiliary to Pearson Hospital.
The long-planned patient's hairdressing salon was
completed, providing shaving, haircutting, manicure and hair
styling services to the patients.  While the hospital prepared
the physical facility, the services are for the most part
funded by the Women's Auxiliary and are very much enjoyed by
the patients.
New and continued staff development programs, along with
improved communications within the Nursing Division, and the
continuing development of better team philosophies and
practices, considerably improved staff morale in all
departments, and in the Nursing department in particular.  The
attrition rate among registered nurses was a good indication of
this, as there were no vacancies during a year when many Lower
Mainland hospitals were closing beds because of a shortage of
registered nurses.
The Social Service department experienced a very active
year with Asian refugees, increased liaison with Human
Resources and Long Term Care staff as well as, for the first
time in many years, participation in the field instruction
program of the School of Social Work masters level program and
the University of British Columbia.  During September, the
Canadian Council of Hospital Accreditation conducted a survey
of the hospital.  The Council Program and Standards Committee
recommended full accreditation for a three year period, and
this was then awarded to Pearson Hospital by the Council.
The hospital has gradually obtained recognition from
other centres throughout the province of the special skills it
offers in the treatment of particularly difficult cases of
chronic neurological diseases.
 5
Ol
WM M
CO to
-.      ■». * 3   1  °> N   . <°   ,
(D
o
CO
at
CC
CO
o      --g   1 „«   1 g   1
1 d
rt
*~
a"   n
E 3
_!    u
i   en 5 r-       & o>
1   CM t- CO         Jg CM
1     1
CO *-
"    « " 8 ' 2 S ' ® '
1 o>
en
CO
1
CO
.    O)  ^   CM          »     .
o> r
OLD*-. ^CM^CO1^^
^
o
1  o d CM      ""j   '
1
;_. o   '      no^ooi^rxigo
o o
^f
o>
CM
o>
"""
E JS
CM
,   CO -. to       2   1
i  cm o1 in      5   1
1
in r-
i   s;g-g|s|»
T-    °°
CD
tn
I
(O
,_■ f- CO         <"> _
__
-*  IT
[-.eDT-r-CDr-CM^
q
CC
o
1   .- O CM         CO °
d   '
CO c
'      "-d^-dcoid**^   '
I d
CO
CO
ll
__ £
£ <3
2
I   in r- co        Sn
1  co*- in      g "
-     1
en £
■          -fl"*-c>*^C0tNOCMl
1 £
is
CO*
O
T-
|
-COCO CO        &9
"^ <c
CD CD CO     ,   — *"*. O ^ *-
gj
^>
CC
o
6  CM  d  CM          "I
1 c
CO <=
1      rid^^N^Ro
1 d
CO
r-
co
__  ffl
_j °
2 o"
—
"S^S    o i
1 I
CO  |
i     2*"-.? i £258*-
** *^ "^      ^ co *- to
1    Ol
CO
■^
CM
1
~
- in co      SB
g|
.       cotncM   . co v oj ^. r-
i "
CO
CC
o
1  CM d cd      J2 c
^ o   '      «-o<o'CMr~irgjo
1 o
o
m
en
_5    QJ
E 8
2 o"
|    gZg          CM  CO
'   lO t- CO         M
1   1
"e
1       5-R   1  Sgggrv
1   |
o
tn
CM*
Stj
8
o
o"g
o
o
«rt
LU
c
o
-Q
t
I!
- §
S  c
LO CC
§1
m
ca >
o
c
-c
1
o
__
{
. '
c
o
o
CL  C
■  1
■s
'J
<
E
<
c
—
i
c
c
1
J-
c
c
1
c
c
TJ
o
- o
LL
c
"O
o
o
LL
Q.
X
o   >=
Q.  £
" S
:
t
Q.
E
.£
c
rj.
1
i
~i
__
CC
c
_-
CO
8 -
a |
to 1—
lie
L
C
__
a
c
1-
57
 i II- REPORTED INFECTIOUS SYPHILIS AND GONORRHOEA
BRITISH COLUMBIA,
1946, 1951, 1956, 1961, 1966 and 1971 - 80
Year
Infectious Syphilis
Number    Rate^-
Gonorrhoea
Number    Rate*
1946	
834
36
11
64
71
73
98
101
146
174
106
70
121
125
140
83.0
3.1
0.8
3.9
3.8
3.4
4.4
4.4
6.1
7.2
4.3
2.8
4.8
4.9
5.4
4,618
3,336
3,425
3,670
5,415
7,116
7,921
8,955
9,284
9,793
9,728
9,800
9,004
9,961
10,010
460.4
1951	
286.4
1956	
244.9
1961	
225.3
1966	
1971	
1972	
353.4
1973	
388.9
1974	
390.8
1975	
402.5
1976	
394.4
1977	
393.0
1978	
355.9
1979	
368.1
19802	
383.5
1 Rate per 100,000 population.
2 Preliminary.
58
 TABLE  III   SELECTED ACTIVI1
IES  OF  PROVINCIAL  PUBLIC HEALTH  INSPECTORS
fype of Inspection or Activity
1976 ,
1977
1978
1979
1980(2)
Bpection -
Food  premises -
[    Eating  and drinking places
10,525
17,294
19,281
19,665
25,212
1    Food stores
2,366
4,594
4,878
5,013
5,810
1    Other
1,972
2,811
3,881
3,795
4,782
Factories
156
157
224
213
456
Industrial  camps
Community  care^-
348
345
497
388
221
2,464
3,294
4,337
4,670
5,998
Schools
587
1,058
1,237
770
1,431
1 Summer camps
312
318
487
338
321
["Housing
1,308
1,803
1,967
1,618
2,094
Mobile home  park
1,355
629
583
334
324
Campsites
1,138
1,273
1,350
1,423
1,633
Other housing
474
713
879
573
981
Hairdressing places
396
874
906
944
1,479
warms
309
364
346
389
449
Parks  and beaches
300
740
851
994
1,464
later and waste  investigation -
Swimming  pools
1   Inspection
2,126
3,585
4,137
4,077
4,938
1   Samples  (Pools & Beaches)
1,626
3,060
5,420
5,914
7,740
Hgurveys  (Sanitary & Other)
425
713
976
1,780
2,364
Waste Disposal
616
705
711
657
777
Public Water  Supplies
1   Inspection
1,861
2,876
3,633
3,609
4,998
Samples
7,790
11,524
14,367
14,200
18,464
Private  Water   Supplies
[    Inspection
3,221
4,094
4,427
4,221
5,891
■   Samples
3,273
4,414
4,317
4,527
6,033
Pollution and survey samples
512
1,782
1,864
1,318
1,330
Private   sewage  disposal
26,608
35,986
36,134
35,247
48,335
Municipal   outfalls   and   plants
320
262
323
247
315
Other sewage control
4,749
8,308
7,868
6,212
9,529
and Use Investigation -
Subdivisions
6,225
8,355
9,522
9,000
12,606
Site  inspections
13,749
13,589
14,964
14,636
19,820
uisance Investigation -
sewage
3,370
3,699
4,273
4,192
5,409
Garbage  and  refuse
1,373
2,168
2,595
2,261
3,071
Other  (pest,  etc.)
2,345
3,998
4,553
4,503
5,933
isease Investigation
609
1,056
1,530
1,393
2,214
iucational Activities
1,255
1,511
2,043
2,154
2,636
I apings
2,819
3,433
3,599
3,554
4,672
I JjE: Activities   of   the   Capital    Region
al   Distric
1   Community
Health   S<
rvices    Ins
pectors   are
included  for   1977  to  1980 only.
1*    Includes     boarding-homes,      youth
hostels,
day     care
centres,
hospitals
and     o ther
Winstitutions.
2.    Preliminary.
- 59 -
 TABLE IV- CASELOAD FOR COMMUNITY VOCATIONAL REHABILITATION SERVICES
January 1 to December 31, 1980
CASES CURRENTLY UNDER ASSESSMENT OR RECEIVING SERVICES, January 1, 1980
New cases referred to C.V.R.S. Committees in
Vancouver Metropolitan Region (7 Committees). .      226
New cases referred to C.V.R.S. Committees outside
Vancouver Metropolitan Region (41 Committees)       655
Cases re-opened (all regions)      217
Total new referrals considered for services, January 1, 1980
to December 31, 1980 (includes re-opened)  109]
Total cases provided with service in 1980  25^
ANALYSIS OF CLOSED CASES
January 1 to December 31, 1980
EMPLOYED:
Employment placement made:
Canada Employment & ImmigrationManpower         12
C.V.R.S  16
Self        146
Other         77
TOTAL  251
SERVICES COMPLETED:
Referred to Other Service  133
Competitive Employment not Feasible  75
Vocational Rehabilitation not Feasible   158
Increased Independence   23
Maintained Employment  25
Self Care  0
Sheltered Employment   4
Other  51
TOTAL  469
SERVICES NOT COMPLETED:
Declined Services  171
Unable to Locate Client  117
Left Province       35
Other       33
TOTAL  356
OTHER:
Consultation Only       21
Decreased        2
TOTAL  23
Total cases closed in 1980  1_3
Cases remaining in assessment or receiving services 	
GRAND TOTAL 	
- 60 -
 TABLE V -  TESTS  PERFORMED
BY  DIVISION OP  LABORATORIES   IN  1979  ar
d   1980
Main Laboratory,  Nelson Branch Laboratory and
Victoria B
ranch Laboratory
ITEM
1979
1980
Main
Nelson
Victoria
Main
Nelson
Victoria
lErERIOLOGY SERVICE
.teric  Section:
Imiltures - Salmonell/Shigella
17,654
179
6,546
17,478
86
5,399
- Enteropathogenic E.  coli
4,074
-
1,732
3,921
-
1,508
-  Sensitivity   tests
704
-
-
782
-
-
od Poisoning Section
422
-
-
478
-
-
scellaneous   Section:
IBultures - C.  diphtheriae
1,757
70
1,353
2,351
22
1,008
- Haemolytic  Staph/Strep
4,717
751
468
3,485
831
241
- Miscellaneous
43,772
719
43
52,043
1,021
89
- N.  gonorrhoeae
28,502
200
8,125
33,169
156
8,154
Smears  -  N.   gonorrhoeae
99,460
1,278
358
71,738
548
163
t Immunofluorescence  -  N.   gonorrhoeae
8,297
-
-
8,583
-
-
- other
2,892
-
-
3,658
-
-
Anaerobes
416
-
-
398
-
-
■ Eiimal Virulence
471
-
-
291
-
-
berculosis  Section:
Igultures  - M.   tuberculosis
29,660
-
2,452
31,988
-
2,376
pSmears  - M.   tuberculosis
27,560
-
2,279
29,430
-
2,160
Sensitivity   test
964
-
-
1,132
-
-
Atypical Mycobacteria
292
-
-
390
-
-
irasitology   Section:
iFaeces
34,455
-
4,881
49,583
-
5,878
1 Pinworm  swab s
1,129
33
-
1,163
37
-
Malaria blood   film
903
-
-
965
-
-
;ology   Section
4,068
-
-
4,253
-
-
Iter Microbiology  Section:
Presumptive/Confirmed  coliform test
40,120
3,680
6,655
39,713
2,888
6,960
Completed  coliform test
3,037
390
208
3,234
588
-
Faecal coliform test
10,377
-
59
9,090
-
-
■"aecal   streptococcal   test
-
-
-
-
-
-
Standard   plate  count
3,509
-
-
3,582
-
-
Htther  tests  (Algae,   Shellfish)
2
-
-
-
-
a
rology  Section:
Syphillis
U Screening
184,608
-
-
196,988
-
-
Confirmatory
14,803
-
-
18,379
-
-
IlisTo
7,381
_
796
7,110
-
497
3?ebrile Diseases
4,169
-
925
4,060
-
669
U toxoplasmosis
2,424
-
-
2,323
-
-
contin
ued
1
-  61   -
 TABLE  V -  TESTS  PERFORMED BY  DIVISION OF LABORATORIES  IN 1979  and  1980
Main Laboratory,  Nelson Branch Laboratory and Victoria Branch Laboratory
Continued
ITEM                                                            1979
1980
Main
Nelson
Victoris
Main
Nelson
Vicj
VIROLOGY  SERVICE
Virus  Isolation:
Tissue culture
7,027
-
-
9,840
-
Rubella
657
-
-
898
-
Embryonated   egg
663
-
-
135
-
Mouse
~
r
-
22
-
Serological  Identification:
Haemagglutination inhibition
Rubella
74,785
-
-
78,462
-
Other viruses
10,497
-
-
11,045
-
Reverse Protein Haemagglutination
601
-
-
-
-
Complement  fixation
21,693
-
-
22,337
-
Neutralization
5,973
-
-
6,815
-
I
Radioimmuneoassay   (Hapatitis)
-
-
-
3,356
-
Electron Microscopy
1,614
p
-
803
-
Fluorescent Microscopy
895
-
-
1,319
-
TOTALS
707,004
7,300
36,880
736,790
6,177
1 35'
COMBINED  TOTAL
751,184
778,069
62
 TABLE VI- NEW ACTIVE CASES OF TUBERCULOSIS
(Rates per 100,000 population)
Under 25
25-34
1	
i 35-44
|
44-54
55 and
over
Total
Males
1
6.7
13.8
I  21.2
29.2
41.0
18.4
Females
7.5
13.4
18.9
11.4
13.6
§B!.6;
Total
7.1
13.6
1  20.1
1
20.4
1 ~—
25.9
15.0
TABLE VII CONTACTS TO PULMONARY
SOURCE CASES, 1
ACTIVE TUBERCULOSIS
980
Close or Household
Non-Household
total
TOTAL CONTACTS
819
2,582
3,401
Ratio of Contacts
to Total Active
Cases (385)
2.1:1
6.7:1
8.8:1
Contact with
Positive tuberculin
280
717
997
Percent of Contacts
with Positive
Tuberculin
34.2%
27.7%
28.1%
NEW ACTIVE CASES
FOUND
24
24
48
Percent of New
Active Cases from
Contacts
2.9%
0.9%
1.4%
63
 CARE SERVICES
Home Care/Long Term Care Program
The Long Term Care Program was introduced on January 1,
1978 as an innovative and ambitious effort to produce a
universally available service to those persons who could no
longer function independently as a result of a health related
problem. The Program assumed responsibility for a wide range
of both community and residential programs and provides an
integrated service with strong emphasis on community-based
programs.
Since the introduction of the Program, public demand for
services has continued to increase and the Program has
experienced a substantial rate of growth. Combined with the
rapidly shifting age distribution of the population to include
a higher proportion of the elderly, the Home Care/Long Term
Care Program will undoubtedly continue to be in great demand.
Highlights
During the year the Long Term Care and Home Care Programs
were partially amalgamated into one single Program. The
new position of Director of the Home Care/Long Term Care
Program was established, and given responsibility for the
Long Term Care institutions (formerly Government Health
Institutions) of Valleyview, Skeenaview and Dellview, as
well as Community Physiotherapy Programs.
The consulting firm of Deloitte, Haskins and Sells was
commissioned to review the financial and operating
results of a sample of proprietary long term care
facilities. The review was initiated to determine the
adequacy of the per diem rates and the need for further
rate increases, as well as to make recommendations to
ensure an equitable rate setting structure* It was
anticipated that their recommendations of a revised rate
setting structure could be implemented by the beginning
of the new fiscal year.
The Minister announced the formation of the Long Term
Care Review Team, which examined the quality of care
being provided in Long Term Care institutions. This team
visited a number of facilities throughout the Province
and their report and recommendations were under staff
review at the year end.
64 -
I
 During the year, the client contribution charge of £>6.50
per day was increased to $8.50 per day. This was the
first increase in the per diem contribution since the
introduction of the program.
The consulting firms of Deloitte, Haskins and Sells, and
Western Health Care Associates, were commissioned to
perform an organizational and financial review of
homemaker agencies.
During the year, computerization of the extended care
waitlist management system was completed, and work on the
homemaker payments subsystem was initiated.
A project to develop specific standards of residential
care was initiated in order to implement a clearly
defined statement of quality of care.
ORGANIZATION
The nature of the Long Term Care Program has required the
establishment of a decentralized professional organization,
with the central office providing overall policy direction and
control. The program is divided into 17 provincial health
districts and five municipal districts. A Long Term Care
administrator is based in each of these 22 health districts and
is responsible, through the health district director, for the
implementation and development of the program in the community
served. This responsibility includes the identification of
service needs, the development of societies or volunteer groups
to initiate or expand resources, and the co-ordination of
services and resources available within the local community and
Health District.
The senior official responsible for the overall
development, implementation, and operation of the Home
Care/Long Term Care Program is the director, Home Care/Long
Term Care. The director reports to the Assistant Deputy
Minister, Care Services.
The Provincial Adult Care Facilities Board, established
under the Community Care Facilities Act, is the organizational
body responsible to the Minister of Health for the licensing
and inspection of community care facilities participating in
the Program, recommending approval of the construction of new
long term care f ac i 1 ities in the var ious coramuni t ies , and
liaison with other programs that may have desirable input to
the Long Term Care Program.
 SERVICES PROVIDED
Entry into the Long Term Care Program occurs following an
assessment performed by Long Term Care staff in the health
district office. This assessment determines eligibility,
assesses the nature and severity of the health problem, and
identifies the appropriate level and type of service.
The services available through the Home Care/Long Term
Care Program are as follows:
HOME SUPPORT SERVICES
Emphasis is placed on supporting the individual in their
own home as opposed to admission to a residential care
facility. Only when personal, family and community resources
have been exhausted, will the Long Term Care Program provide
assistance and then only at the minimum level necessary. The
objective of this policy is to encourage the - individual to
retain maximum independence and avoid institutionalization for
as long as possible.  Component home support services include:
• Homemaker Services. A homemaker assists the client in
performing household tasks of which he or she is no
longer capable, e.g. bathing, heavy cleaning, washing,
cooking, minor house repairs and maintenance. As of
November, 1980, there were 102 non-profit homemaker
agencies and 21 proprietary homemaker agencies providing
service to over 24,000 homemaker clients.
• Community Physiotherapy Services. Phys iotherapis ts
provide direct treatment, consultative and preventive
services to clients in their own homes, arrange provision
of required equipment to cope with physical disability
and train family members in assisting clients.
• Home Care. Home Care provides required professional
nursing services in the clients' own homes. These
services allow the client to remain in the home, rather
than being admitted to a residential facility or acute
care hospital.
• Adult Day Care. These centers provide a formal program
of social and health services for people who require
assistance and are a major component of a supportive
service plan which allows clients to remain at home.
There were 20 Adult Day Care Centers in operation as of
November, 1980, with an additional 13 centers planned for
the 1981-82 fiscal year.
66
 RESIDENTIAL CARE
Admission to a Long Term Care facility or institution is
considered a back-up service to home support services. If
maintenance in the community becomes impossible, the client is
admitted to one of the following types of Long Term Care
facilities or institutions:
• Community Care Facilities. These facilities, licensed
under the Community Care Facilities Act, are totally
funded by the Long Term Care Program and consist of both
private and non-profit operators. As of November, 1980,
there were 94 non-profit facilities and 291 private
facilities, providing care services to 15,972 clients.
These facilities accommodate a wide range of
dependencies, including residents who are very seriously
debilitated and require heavy nursing and medical care.
• Mental Health Boarding Homes. These homes are also
licensed under the Community Care Facilities Act but are
intended specifically for the client experiencing
psychiatric difficulties. In 1980 there were 220
proprietary mental health boarding homes receiving
funding through the Long Term Care Program.
• Licensed Private Hospitals. These facilities, licensed
under the Hospital Act, are privately operated hospitals
providing care primarily to severely debilitated
residents at the extended care level. There were 37
licensed private hospitals operating in November, 1980.
• Family Care Homes. These are unlicensed homes, providing
care to a maximum of two Long Term Care clients. The
emphasis is on creating a home-like supportive
environment, usually operated by a couple or family in
their own home.
• Assessment and Treatment Centers. In difficult cases
where multiple aetiology is present and formulation of an
appropriate care plan is difficult, the client may be
referred to an Assessment and Treatment Center. These
centers operate in public hospitals, provide short stay
(up to six weeks) intensive assessment services, and
diagnose multiple disorders. The goal of the center is
to rehabilitate the client to an optimum level of
functioning, and define a care plan which can then be
followed either in the community or other Long Term Care
setting. There were three such centers in operation in
the 1980 fiscal year, two in Vancouver, and one in
Victoria.
 Group Homes for Independent Living. The Program funds
the direct care component of these homes to provide
increased health and maximum independence of eligible
Long Term Care clients. Residents retain responsibility
for the normal activities of daily living but cooperative pooling of available care resources result in
the most appropriate provision of care. In 1980 17 group
homes were receiving funding and providing services to
both the physically and mentally handicapped.
Long Term Care Institutions. The Long Term Care Program
directly operates the institutions of Valleyview,
(Coquitlam); Dellview, (Vernon); and Skeenaview,
(Terrace). The latter two facilities will be closed over
the next two or three years. These institutions cater
primarily to the severely psychiatrically disturbed and
often aggressive resident, who frequently possesses
multiple dependencies.
 Statistical Data
The tables which follow present statistical data which
provides an overall view of the Home Care/Long Term Care
Program.
Tab le I - Indicates the size and complexity of the Home
Care/Long Term Care Program. In total, an estimated 44,152
clients received services at any one time.
Table II - Provides a historical review of the growth of the
Long Term Care Program over the last three years. Since the
introduction of the Program in 1978, the number of facility and
homemaker clients has increased by 122 per cent, while the
budgetary costs over the same period increased by 67 per cent.
(This does not include Home Care, Physiotherapy or Long Term
Care Institutions).
Table III - Indicates the growth in the number of facility and
homemaker clients, by level of care, over the periods November
1, 1979 to November 1, 1980.
Tab le IV - Compares the cost of administrating the Program
versus the actual payment for services in the 1980-81 fiscal
year. Administration costs include all objects of expenditure
(e.g. staff salaries, travel, office expenses, etc.) other than
direct payment for services to outside agencies.
Table V - Illustrates facility and homemaker clients by age
group.
Table VI - Shows the number of new intermediate care facilities
constructed since January, 1978, and in full operation, those
scheduled for opening in the 1980 fiscal year, and the number
of beds under construction or in the planning stage.
69
 Home Care  Program
The Home Care Program provides, or assists in
co-ordinating, the variety of professional and non-professional
services required to help patients remain in their own homes I
The patient's medical care continues to be directed by his or
her physician while on the Home Care Program.
ORGANIZATION
The Home Care Program is provided at the community or
local level, by the 17 provincial health districts and five
municipal  health  departments.
The Home Care Nurse is a Registered Nurse, working under
the administration of the local health district director or
health department, and is the major provider of care to
patients  on this  program.
• The   estimated   number   of   nursing   visits   made   during   the
1980   calendar   year   was   691,253,   or   an   average   of   57,604
visits   per  month.
The Home Care Program consists  of  two categories:
• The hospital replacement category is for patients who are
discharged early or as an alternative to admission to an acute
care hospital. This category has the potential for making
efficient use of hospital beds by enabling more patients to be
cared for in their homes. Patients admitted for hospital
replacement receive the necessary services, such as nursing,
physiotherapy, homemaker, meals on wheels, medication and
equipment. The services are co-ordinated and paid for by the
Home Care Program. Approximately 20 per cent of the population
of British Columbia do not have the hospital replacement
category available  to  them.
• The non-hospital replacement category is for patients who
do not need acute hospital care but require nursing and/or
other services in order to remain at home. This category is
available in most areas in the province and provides nursing
care and a limited amount of physiotherapy, at no charge to the
patient.
J
 The patient is responsible for payment of other services
such as homemakers, medication, or equipment that may be
required.
RELATIONSHIP OF  HOME  CARE  PROGRAM TO ACUTE  CARE  HOSPITALS
The following statistics were derived from the 1978-79
annual Home Care Program computer data:
• Of the 49,144 patients admitted to the Home Care Program,
16,908 or 34.4 per cent were in the hospital replacement
category: i.e., those patients would have remained in an
acute care hospital or been admitted to hospital if the
Home Care Program had not been available  to   them.
.c_%ftfl| 6.59 persons per 1,000 population (B.C. population
estimated at 2,566,900) were admitted to the hospital
replacement category.
• 16,908 patients replaced 202,020 acute care hospital
inpatient days, or 78.7 hospital patient days replaced
per   1,000  population  (B.C.   population).
• The 202,020 patient days replaced would have cost
hospital programs in 1980, using an average hospital per
diem rate of $175, a total of $35,353,500, whereas the
total Home  Care budget was   $11,127,000.
The Home Care staff continued to develop close liaison
with the acute care hospitals by making regular rounds on the
wards to discuss referrals, sharing in joint orientation,
inservice programs, and participating on' hospital medical and
nursing committees.
RELATIONSHIP   OF   THE    HOME    CARE   PROGRAM   TO   THE   LONG   TERM   CARE
PROGRAM
The Home Care Program provided professional nursing care
services to assist many clients who were on the Long Term Care
Program to remain in their own home.
• During 1980 an average of 4,644 Long Term Care clients
received home care nursing visits.
• The 4,644 patients received an average per month of
22,334 nursing visits, for an estimated total of 288,914
nursing visits  during   1980.
 •    Of the 49,144 patients on Home Care during 1978/79, 17.6%
(8,666) were also on the Long Term Care Program.
The availability of Home Care nursing services to Long
Term Care clients delayed, or eliminated, the need for
admission of many of these clients to Long Term Care facilities.
Community Physiotherapy Program
During 1980 the goal of the Community Physiotherapy
Program was the promotion and maintenance of the population of
a given area at the highest possible level of functioning,
through the provision of services directed towards treatment at
the primary care level, active participation in health
maintenance programs, and involvement in the preventive aspects
of health care.
Community Physiotherapy Programs, organized under the
present health district structure, have defined their own
central principles of action under the broad guidelines of the
provincial ^plan. These principles have required the community
physiotherapist to be a multi-faceted community health care
worker, Involved In administration, education, consultation,
research and clinical practice.
The scope of activities of the community physiotherapist
for the year was broad and diversified, and the demand for
physiotherapy services from the communities in general
continued to increase. During the year the Community
Physiotherapy Program continued to provide direct treatment,
consultative, and preventive services to patients, families,
physician, public health staff, hospitals, government
ministries, and the general public, through 12 health districts
representing 16 office locations. These services were provided
to the three major program areas, namely Home Care, Long Term
Care, and preventive programs.
The demand for community physiotherapy services by
physicians and the public generally continued to outpace the
available resources within the Program. In all health
districts in the province where community physiotherapists are
employed, services were utilized to their maximum.
During the year there were a total of approximately 2,276
new patients referred to the service, with an approximate total
of 17,439 individual visits, (an increase of 230 over 1979).
In addition to the treatment oriented visits, 10,530 (an
increase of 230 over 1979) separate services were provided
through the Preventive Program, including 376 Long Term Care
72
 program assessments, and 318 separate visits to schools in the
Province. An analys is of the 1980 caseload s tat is tics by age
shows  the following distribution:
under  1 year      -       1.93% 19 - 64 years       -      36.1%
2-5 years -      2.5% 64 and over -       53.64%
6-18 years      -      5.79%
In 1980 there was an increase of approximately 11% in the
services provided, which is a direct result of being better
able to offer services in the ^patient's home where medical
status, geographical location, transportation, and cost, make
home or  facility care more appropriate.
The establishment of new services, and the evaluation of
present services, will be the major focus for 1981 in Community
Physiotherapy Programs. All efforts will be made to make
Community Physiotherapy program services available in all
Health Districts, and to a degree which will satisfy the
demands  of the referring physicians  and the community.
-  73
 Special Care Services
This new Division was established in April and is
responsible for the provision of primary health care in rural
communities throughout the Province and administers the
Ministry's  community  grants   program.
The purpose of community grants is to provide, or
supplement through non-government agencies, preventive,
therapeutic, rehabilitative or promotional health activities,
consistent with Ministry priorities, objectives and funding
capabilities. During the year, funding was approved for a
variety of community-based agencies, providing a wide spectrum
of health services.
Agencies funded by the Ministry were requested to
complete an application form for each program requiring
financial support, and to set measurable objectives for the
programs. Based on a score of 0 - 10, each program was rated
on six categories — low cost alternative; record of
effectiveness; limited or short term; use of volunteers;
innovative/unique, and community support. The score in each
category was multiplied by a weighing factor, which reflected
the relative priority of each category within the Division's
terms of reference.
The   Division    is   moving towards    the    implementation   of   a
contract    system,    which   will allow    the    Ministry    to    negotiate
with   individual   agencies    for a   specific   health   service   on   an
annual basis.
RURAL  HEALTH
Special Care Services is responsible for the provision of
primary health care to rural and isolated communities in
British Columbia. The Division functions as a planning,
funding and coordinating body, in mobilizing those services
within the Ministry which can be utilized in providing services
to rural communities.
 TABLE I
HOME CARE/LONG TERM CARE
Type of
Number of
Number
Budget
Service
Service
Providers
of Active Clients
(November, 1980)
Estimates.
1980-81
WE
a) Homemaker
123
24,268
36,250,000
Kport
b) Community Physiotherapy
-
215
621 ,000
[RVICES
c) Home Care
-
2.6931
11,127,000
d) Adult Day Care
20
273
1,688,000
a) Community Care
4,22
Faci1i t ies
12,667
82,204,000
b) Private Hospitals
37
2,016
20,996,000
ESIDENTIAL
c) Mental Health Boarding
2292-
KRVICES
Homes
d) Assessment/Treatment
1,170
6,780,000
Centres
3
45
3,157,000
e) Group Homes
17
141
1,317,000
f) LTC institutions (Dell-
view, Val leyview,
Skeenaview.)
3
664
19,227,000
TOTAL
44,152
183,367,000
'• Average monthly caseload for Long-Te
rm Care clients receiving
Home Care.
2. This includes Family Care Homes of \
. or less clients.
-  75 -
 TABLE  II
LONG   TERM  CARE   PROGRAM
30,000
27,000
24,000
y*iHOME   SUPPORT
21,000
NUMBER
18,000
^^                                                     . *■" *
OF
/                      .ia                        S  fi ■ |
CLIENTS
15,000
12,000
/                 ™"             FACILITY  CARE
9,000
6,000
229
(E s t i maj
3,000
$   BUDGETS
Mil]ions
162
118
97
■
1978
1979                     1980                       1981
FISCAL    YEAR
- 76 -
M
 NUMBER
OF
CLIENTS
TABLE III
NUMBER OF LONG-TERM CARE CLIENTS
NOVEMBER 1979 - NOVEMBER I980
24,000
22,000
20,000
18,000 •
16,000
14,000
12,000
10,000 ■
8,000
6,000
4,000
2,000
FACILITY
CLIENTS
15,261
15,972
NOV./79
_l_
HOMEMAKER
CLIENTS
24,737
16,786
N0V./80
NOV./79
NOV./80
Facil
ties
Homema
ker
Wov./79
Nov./80
Nov./79
Nov./80
Personal Care
5,567
5,067
10,125
14,463
Intermediate Care 1
3,983
4,324
3,179
5,143
Intermediate Care 11
2,584
3,110
1,855
2,891
Intermediate Care 111
2,056
2,445
751
1,095
Extended Care
1.0731
1.0261
876
1,145
Total
15,261
15,972
16,786
24,7372
'Does not include extended care clients in public extended care units.
Subject to ]0%  over estimation.
77
 s
TABLE IV
-81 BUDGET
LONG TERM CARE PROGRAM
ADMINISTRATION (PROVINCIAL) 2.%\
ADMINISTRATION (MUNICIPAL)  2.]
SALARIES S ADMINISTRATION (PROVINCIAL)
SALARIES 6 ADMINISTRATION (MUNICIPAL)
PAYMENTS FOR SERVICES
4.407,Offll
4,564,OO0C
153,002,0^1
161,973,0^1
- 78
J
 TABLE V
CLIENTS BY AGE GROUP
October 31, 1980
3500 -
1 NUMBER OF 300°
3281
3065
1 LONG-TERM
CARE   2500 -
1 FAC 1 L 1TY
CUENTS  2000-
'285
2081
2124
1500 .
1000 .
382
750
948
n
Undei
65
65-69   70-74   75-79   80-84   84-89   90-9'
95+
5000 .
4805
4000 .
NUMBER OF 3°°° j
HOMEMAKER
3796
l
033
450!
166
730
1 CLIENTS  2000 -
1000 .
1283
341
1 1
Under
65
65-69   70-74   75-79   80-84   84-89   90-94
95 +
- 79 -
 TABLE VI
CONSTRUCTION AND DEVELOPMENT
INTERMEDIATE CARE FACILITIES
2,000 -
1,800 -
,898
1,600 -
NUMBER       1,400 -
OF
BEDS        '>20° "
1,247
1,000 -
800  -
827
600 -
400 -
200 -
Built         To Be       Under Construct
on/
Since         Opened        Planning Stag
1978         1980
2S
CONSTRUCTION AND DEVELOPMENT
INTERMEDIATE CARE FACILITIES
NUMBER OF     NUMBER
FACILITIES     OF BEDS
Built or Acquired Since January, 1978             16         1,247
Facilities Under Construction To Be
Opened 1980-81                             17           827
Facilities Under Construction or in
Planning Stages                              28          1,898
- 80 -
 Percentage Distribution by Age Groups
of Patients Admitted to the Home Care Program.
April 1, 1979 - March 31, 1980
 Percentage Distribution by Age Group and Cate
of Patients Admitted to the Home Care Program
April 1, 1979 - March 31, 1980
£2__y_
Percentage
Hospital
Replacement
Percentage
Non-Hospital
Replacement
Total
Percentage
00-01 years
01-19 years
20-44 years
45-60 years
61-74 years
75-84 years
35+ years
35%
82 -
 CHART III
Percentage Distribution and number of
Home Care Patients by Major Diagnostic
Groups in Descending Order.
April 1, 1979 - March 31, 1980
Diagnos is
No . of
Patients
Percentage of
Total Patients
C i rculatory
8, 239
16.80
Neoplasms
6, 150
12.50
Ace id ents
5,354
10. 90
Digestive
4, 984
10. 00
Symptoms-Undiagnosed
4 ,577
9. 30
Musculo-skeletal
3,216
6. 60
Endocrine
2 , 702
5. 50
Skin
2, 544
5. 20
Nervous System
2,464
5. 00
Genito-urinary
2 ,310
4 . 70
Childbirth
2 ,053
4.20
Resp i ratory
1,887
3 . 80
Blood Disorders
1,174
2.40
Mental Disorders
725
1. 50
Infective
418
.87
Congenital
242.
. 51
Perinatal
105
.22
TOTAL
49,144
100.00
- 83
 MENTAL HEALTH SERVICES
Mental Health Services Highlights
The Ministry of Health consolidated its services to the
chronically and acutely mentally ill through further
development of the four priority programs in Mental
Health Services. This development included the
refinement of services for care to the chronically
disabled, the acutely ill, children and their families,
and clients with adjustment problems.
The year also saw an increase in therapy and consultative
services by the staff of the Province's 30 mental health
centres, where clients were provided with nearly 11,000
therapy sessions per month, and agencies received
approximately 8,000 hours of consultation per month.
Sub-offices and travelling clinics delivered service to
clients in the outlying regions. The British Columbia
Youth Development Centre, the Burnaby Children's Team,
and Victoria's Integrated Services for Child and Family
Development continued to provide specialized services to
children and their families.
Inservice workshops, under the organization of the
Continuing Education Committee, increased to 150 over the
year, and the Annual Provincial Conference was held at
U.B.C. in June, with a wide participation by staff from
other agencies.
There was a slight increase in the admission rate to the
Greater Vancouver Mental Health Services with 1,653
clients being admitted, and the year-end caseload
increased minimally to 3,007 cases.
 Community Services
SERVICES FOR THE CHRONICALLY DISABLED MENTALLY ILL ADULT
In October 1979 new priorities for Mental Health Services
emphasized the chronically disabled mentally ill adult as a
first priority for services. Since that time services to this
group have been enhanced largely by shifting staff time from
other activities. The chronically disabled mentally ill tend
to be characterized by a diagnosis of schizophrenia, affective
psychosis or an organic brain syndrome. They usually had
multiple hospital admissions and often a gross deficiency in
the ability to care for self, or to engage in work either paid
or unpaid (for example, as a student or responsible for home
management). To manage these individuals out of hospital
requires psychiatric supervision, medication, and a variety of
psycho-social programs.
During the year a special focus in Mental Health Services
headquarters was developing for the promotion of services to
this group, and a Chronically Mentally 111 Adult Services
Advisory Committee was established, consisting of eight field
staff representing the disciplines of psychiatry, mental health
nursing, psychology, and psychiatric social work. The
committee began to define the target population and necessary
community services, and was developing means of surveying the
prevalance of these individuals and the availability of
community services.
MEDICATION
Community Services for the chronically disabled are not
new in B.C. One of the cornerstones, the pharmacy service, has
been in operation for many years. It was established
originally to make certain that former Riverview patients
released to the community would be able to continue on
necessary psychotropic medication. In the majority of Mental
Health Centres it is provided by a part-time pharmacist who
dispenses on site, and specializes in mental health drugs and
the centre caseload, providing a much needed drug compliance
and interaction monitoring. Many of the most disabled patients
are resistant to medication taking, so any service which helps
to overcome that resistance is a critical link in community
maintenance of these individuals.
In addition to the work of the pharmacist in drug
 compliance, this is also a major area of concern for other
Mental Health Centre staff, particularly nursing in the case
management of the chronically disabled. Increasingly,
schizophrenics are being maintained by an injectible form of
phenothiazine, with results lasting for a week or more, which
obviates many of the problems of daily oral drug taking
compliance. In most Mental Health Centres where there is a
mental health nurse on staff, injection clinics were
organized. These clinics usually were held in conjunction with
social activities, and provided a general time of social
support and patient assessment.
The overall drug program was monitored by a Pharmacy
Committee, setting policy and standards. It consisted of field
representatives of psychiatry, pharmacy, nursing, and
administration. There was no regular reporting on the pharmacy
program, but surveys indicated that the majority of recipients
of drugs were the chronically disabled mentally ill, and that
approximately 3,000 persons were serviced with some 60,000
prescriptions per year. The chronically disabled residing in
licensed community care facilities were provided medication
through the Pharmacare Community Facilities Program.
Another cornerstone of services for the chronically
disabled is the Mental Health "Boarding Home" Program which
provides case management, facility consultaton and activation,
for individuals residing in facilities licensed by the
Provincial Adult Care Facilities Licensing Board, unlicensed
two person family homes, and minimally supervised independent
living residences. In the Mental Health Centre areas a typical
team consisted of a boarding home social worker, an
occupational therapist or activity worker, and a case aide.
Additional clinical services were provided by other Mental
Health Centre staff including psychiatry, psychology,
psychiatric social work, and mental health nursing. In the
Mental Health Centre areas, the program carried a caseload of
approximately 2,400 in 1980. Of that number approximately 800
were mentally retarded, usually with some degree of behavioral
difficulty and serious health problems. Approximately 600
placements were made during 1980. The program was sustained by
a specifically dedicated staff of 40 professionals. The
Greater Vancouver Mental Health Service had approximately 700
mentally ill clients in living arrangements similar to those
discussed previously for the Mental Health Centre Program.
86
 On September 15th a new nine-bed resource for
psychiatrically disabled adults was opened in Duncan. It is
s ta ffed to provide a program of intens ive rehab ili tation. The
capacity of facility operators to give better service is
enhanced by a regular consultation and structured learning
s ituations. In Kelowna, for example, the occupational
therapist assisted workshops for the activity workers employed
by the boarding homes. These efforts, combined with
consultation, resulted in three of the homes providing more
in-depth therapeutic programs for their clients, using
behavioral management techniques, and behavioral contracting
and cooperative self-care management. Another pattern
represented by Langley were monthly in-service events,
representing mental health, boarding homes and long term care
staff. Topics included treatment of depression, death and
dying, difficulties of the aged, and specific treatment
models. Operators with perfect attendance received a
certification of acknowledgement. Mental Health Centres and
Community Teams were increasingly involved in providing some
type of mental health service to the elderly and their
families, when decisions about the requirements for sheltered
residential care were being considered. There were 17
psychiatric social workers assigned specifically to work with
the Long Term Care Program in this regard. Increasingly
services from other team members, particularly psychiatrists,
were being called upon for this group. Further, centres were
frequently asked to evaluate the competence of the elderly for
the public trustee, under the Patients Property Act.
Providing meaningful activity, whether paid or unpaid, is
a critical factor in the quality of life and maintaining the
chronically disabled person in the community. In this regard,
Community Mental Health Services provides a broad spectrum of
programs. The Greater Vancouver Mental Health Service has
activity staff for each of its teams. Their activities include
exercise, relaxation, swimming, hiking and bowling groups, for
clients of various ages and treatment requirements. Most areas
with the Mental Health Centre Boarding Home Program have an
activity coordinator, concerned with promoting activation
through community resources, and organizing activities
specifically for sheltered care residents on their caseload.
As part of its Adult Day Program, the Burnaby Mental
Health Centre offers a part-time re-educative and socially
rehabilitative program.  Included are structured courses on
communication, assertiveness training, cooking and nutrition,
87
 stress management, and creative job search. Several centres
have helped to organize and sustain community activity
programs, operating with minimal funding and volunteer help.
Typically, these provide lifeskills activities, recreational
crafts, socialization, and inter-personal relationship
activities, for some of the most severely chronic adult
population. , Examples include the Creative Centre in
Chilliwack, and the open door program in Duncan. Where a
community activity centre for the handicapped exists, most
centres are involved in consultation, joint planning and
coordination. The Saanich Centre, cooperatively with the
Victoria Centre, had a special self-development group, to
provide a service for those so disabled by their mental illness
that they were not able to attend any other day program.
During the year the Victoria Centre started a modest day
program with regular staff and students, with an emphasis on
socialization and communication skills.
During the summer, students provided to the centres were
often involved in enlarging the spectrum of activities
available to the chronically disabled. Many of the activity
programs were not simply diversional but offered training
components. Two programs specifically aimed at training were
developed by the Port Coquitlam Centre, one for woodworking,
and the other a cafeteria program.
Finding suitable work for the chronically disabled
continued to be a problem, but several steps were taken during
the year to increase opportunities. The Kamloops Centre
instituted a survey of business and industrial concerns, to
determine willingness to receive mentally handicapped persons
in jobs. A new work program of recycling waste paper was
developed in Mission. In Nanaimo, largely through Centre
efforts, a woodworking shop was set up for 15 persons. In
Trail, the Centre undertook a collaborative effort with the
major employer, to place a limited number of persons in
competitive employment.
SUPPORTIVE SERVICES
It was in the area of general supportive services that
centres were able to offer a variety of special programs.
Burnaby developed a special group for parents of schizophrenic
patients. Courtenay has a men's group for young
schizophrenics.  Several centres developed special homemaker
 services for the psychiatrically disabled! utilizing the
existing program. Examples included Kimberley, Golden and
Penticton. In Osoyoos, in a one person office, considerable
time was spent in meeting with families of the chronically
disabled to assist them in coping with the home living
situation. In Trail, a strong hospital and home visiting
program was achieved, through close working relationships with
the local Mental Health Association.
Most of the chronically disabled do not own cars or
drive. Consequently, the availability of public transportation
is a key element in their lifestyle. A research project was
established with the aid of summer students to investigate
general transportation to and from the health centre. Though
labelled a survey for seniors, the chronically disabled
mentally ill share the same problem, and will benefit from the
survey results.
Services for the Acute Mentally 111 Adult
Reports from Mental Health Centres emphasized the
importance of early intervention in acute illness to prevent
hospitalization wherever possible. Those centres which lacked
sufficient psychiatric sessional time found themselves at a
disadvantage, in that the lack of a bio-medical evaluation
hampered community management of the acutely 111 patient, and
therefore, otherwise avoidable admissions to in-patient
services occurred. This lack of psychiatric input was felt
most keenly by those centres which did not have a local
psychiatic unit.
The value of the availability of an acute psychiatric
in-patient unit was emphasized in reports from various
centres. During the year there was a concentration of effort
on improving communication and liaison with the local
psychiatric units, involving scheduled meetings between the
hospital and community staff. This resulted in the
facilitation of placement of patients in hospital where
appropriate, and in continuity of care.
Several centres es tablished a community psych iatr ic
service planning group, consisting of local hospital
administration, nursing and medical representation, and other
community agencies including volunteer groups. The focus of
the study was the quality and availability of resources to plan
and maintain comprehensive community based psychiatric
programs. Position papers were submitted by these planning
groups, indicating local needs.
 In many centres there was a focus on clarifying
procedures for emergency intervention for the acutely ill
patient, in particular, an attempt to co-ordinate rapid
assessment, evaluation, and treatment. The expediting of
hospitalization for the seriously disturbed patient required
planning, especially in the densely populated areas. The local
psychiatric units find co-operation with Riverview Hospital,
and other intensive care units, of great value for the more
unmanageable patients requiring short-term highly specialized
treatment.
The consensus of reports from the various mental health
centres was that of a multiaxial diagnos tic sys tem, which
emphasized psychosocial factors with the support of medical
knowledge, both within the community and hospital systems.
There was an emphasis on the philosophy of community oriented,
comprehensive, mental health services. The lack of supportive
out-patient services and supporting s taff was emphas ized in
several centres. Adequate support systems can prevent
hospitalization for certain patients who become acutely ill.
The role of the community mental health movement must be
actively promoted with support from the universities, Research
is needed to plan and carry out a broad based community program
of prevention, maintenance, and cure.
Services for Families and Children
Family and Children's Programs are the third priority of
the Ministry. The long term objective for this priority is to
develop a multi-agency community based service system for
children and families, in each Mental Health Centre area, with
clearly specified roles for Mental Health staff. The short
term objectives are:
To establish a twenty-six bed secure adolescent unit and
a day care unit at the Maples in Burnaby.
To ensure that other community agency staff are
co-participants in the case management of 90 percent of
child and family cases.
To establish at least one non-statutory family support
service in each Mental Health Service area.
To establish a short term crisis service for children and
adolescents in each Health District.
 To have a neuro-psychology assessment capacity in at
least ten Health Districts.
Although Family and Children's Programs are third in
priority, the demands for service are the greatest for these
types of problems in many, if not most, of the Mental Health
Centres. The most serious problems for which assistance from
the Mental Health Centre staff is requested include
developmental delay, speech problems, learning problems, sexual
abuse, child abuse, hyper-activity, the use of alcohol and
drugs, pregnant teenagers, single parents, separation and
divorce, and marital and family malfunctions.
Providing appropriate services to children and
adolescents takes special training. Unfortunately, childhood
problems do not magically disappear when a person reaches
adulthood. Minor problems which could have been handled
relatively easy at the time of occurrence, if let alone, are
likely to develop into major problems which are difficult to
deal with and may affect a child for many years or all its
life. The increase in the degree of seriousness of problems
which come to the attention of the various Mental Health
Centres in the past few years, attests to the fact that more
attention must be paid to prevention and early intervention
programs.
The current range of services focus primarily on such
services as Assessment and Differential Diagnosis, Individual
and Group Counselling, Individual and Family Treatment, Marital
Therapy, Case Management, the provision of Consultation
Services to other Community Resources, the Training of
Personnel dealing with these types of problems, including the
use of workshops and the media, such as newspapers and
television. Special services may include Court Appearances,
providing Screening Services for such problems as Development
Delay, Emotional Disabilities, Speech and Language etc., Crisis
Intervention, School Programs, including Learning Assistance
Programs, the provis ion of Parent Resource fac ilities,
Follow-up Services, Participation in Inter-Agency, and in
Co-ordinating Planning Groups.
In addition to the Services provided by the Mental Health
Centres, there are three specialized facilities which provide
services to families and children. These facilities are the
Psychological Education Clinic, and the Residential and Day
Care Centre, both located in the British Columbia Youth
Development Centre in Burnaby, and The Integrated Services for
Family and Children in Victoria.
- 91 -
 The Psychological Education Clinic is a provincial
resource for children and their families, and focuses primarily
on providing a therapeutic training program for children with
emotional and learning problems. The Clinic has a teaching and
treatment staff, who act as the change agents for both the
children and their families. They can accommodate at any one
time, forty children between the ages of six to thirteen. The
average length of stay for the types of problems seen in this
Clinic is slightly over one year. The Clinic also provides
services to parents, the family, and to the school system. In
addition, the Clinic provides specialized neuro-psychological
assessment services for a limited number of referrals, to
assist in differential diagnosis for both children and adults.
The Residential and Day Centre programs of the British
Columbia Youth Development Centre provide in patient and day
care treatment for psychological, social and learning problems
in adolescents. Services are stressed which focus on
inter-personal relationships, personal growth, life skills, and
the development of assuming responsibilities. The services
center on both the individual, the group and the family. This
Centre also has a school attached to the program, which is
attended by all the adolescents on a regular basis. A major
goal of the Centre is to equip adolescents with the skills
necessary to re-enter the regular school system, to1 attend
courses, or to achieve job placement. Centre programs are
designed to enhance a sense of accomplishment, self worth,
independence, and bring the adolescents into contact with the
community. In order to ensure high standards of clinical
practice, a formal training program for their child care
counsellors is also provided. In addition, the unit is used
for field placement training for students from the University
of Victoria, U.B.C. and Douglas College. In November, 1980, a
community based Transition Home for six adolescents was
opened. This will allow a more effective flow of the
residents, and help reduce the long admission waiting list.
The Integrated Services for Child and Family Development
Centre in Victoria provides services primarily to the Capital
Regional District. This area comprises about 70,000 children.
In addition, the staff provides some consultation, assessment,
and training services for the province as a whole. Besides
client service, the Centre is actively involved in community
development of coordinated services. Client services focus on
general and specialized assessment, including neuropsychological, psychoeducational, psychiatric etc., on family
therapy, counsel ling and consultation, on individual and group
therapy for both children and parents, and on consultation and
case management services to schools and other community
agencies and resources.  A changing pattern of referral sources
 has taken place over the past few years. Referrals from other
community resources decreased, while "walk-in" referrals
increased. Twice as many children between the ages of 6 to 12,
and 13 to 17, were referred to the Centre, as there were in
ages 0 to 5. Dur ing the year there was an increas ing
awareness, however, of the importance to provide service to the
pre-school aged child. Because of the changing parent
population it is important to insure that the community is kept
informed of the types of services available especially for this
age group. The demand for services from the Centre increased
considerably, and the waiting period for admission by the year
end was approximately four months. Special liaisons were set
up with the Saanich and Sooke School Districts, to promote the
coordination and effectiveness of educational and mental health
services offered to children in these school districts.
Discussions with the Victoria School Board were underway to
initiate a similar service in that School District. Services
include the identification of suspected mental health and
education disorders, supportive counselling to those children
with social and behavioural problems, family intervention and
consultation to school personnel, especially in relation to the
early recognition and management of mental health and
educational disorder.
The Greater Vancouver Mental Health Services, which is
funded by the Ministry of Health and administered by the
Metropolitan Board of Health of Greater Vancouver, is an
integral part of the Mental Health delivery system for
Vancouver and Richmond.
During 1980, this Service was responsible for the
operation of eight Community Care Teams providing treatment in
the community to a total caseload of approximately 6,000
seriously mentally ill patients, a significant number of whom
included families and children. Treatment services provided
for families and children included medications, individual and
family therapy, as well as life skill programs for dealing with
stresses within the family unit, at school, and in the
community. In addition, the Greater Vancouver Mental Health
Services also offers a specialized treatment program for
emotionally disturbed pre-school children and their families.
This program is called Blenheim House and was relocated during
the year in the Dunbar area, Vancouver. Besides direct therapy
of clients, Blenheim House staff offer treatment and
consultation services to those community agencies which also
are involved in the care of young children.
 Adjustment Reactions and Prevention Services
Although Mental Health Services' priorities were
redefined by the Ministry of Health to emphasize services to
the acute and chronic mentally ill during 1980, nevertheless,
the pressure to respond to personal and situational crisis
still constituted the major demand for mental health services
during the year. These pressures confirmed the appropriateness
of the Ministry's overall concern for the development of more
innovative programming in the areas of prevention, stress
management, and lifestyle enrichment.
As the result of the redefined priorities, resources for
the purposes of responding to personal, situational and family
crisis diminished. Particularly affected were rural areas,
where resource alternatives are not as readily obtainable. In
these instances it is often left to the family physician of the
hospital outpatient services to cope with heavy service demands.
However, it was still possible to maintain a modicum of
service in a number of Mental Health Centres. It is
interesting to note in retrospect that B.C.'s mental health
services have been able to develop many effective and
innovative program modules for intervention at this level. For
example, in the area of prevention, programs still being
provided include workshops with couples in distress; stress
management and assertiveness training groups; life skill and
communication effectiveness programs, and the recognition and
treatment of psychosomatic disorders.
In the area of crisis management and early intervention,
mental health services offered short term counselling to
individuals and families in distress. Consultation was
provided to other community resources, such as the school
system, law enforcement services and family court, especially
with regard to problem recognition and case management. In the
area of encouraging the development of, and working with, self
help and volunteer groups, mental health services were provided
to such groups as single parents, separated and divorced,
adolescents, parents in crises, and to various chapters of the
Canadian Mental Health Association and its associated projects
throughout the Province of British Columbia.
At the year end a consultant in Social Work was appointed
to this program area of prevention, and a Preventive Services
Committee comprising both field as well as headquarters
representatives was to be established.
 Riverview Hospital
At Riverview Hospital, the patient population, admission
rate, and general range of services remained relatively
constant over the year. Successful efforts were made to shorten
response times for admissions, especially in critical priority
areas such as patients from jails.
Throughout the year Riverview continued to make progess
in improving standards of patient care, as well as in
responding to community needs. This was reflected in the
hospital's primary goal of attaining accreditation. Much work
was done on the quality assurance aspects of care, the
development and refinement of Hospital Policy and Procedures
Manuals, the updating of disaster plans, and the preparation of
extensive accreditation awareness materials for staff education.
Other highlights of the year included the work of the
Utilization Committee, engaged in an ongoing study of patient
movement, length of stay, and bed utilization.
The restructuring of pharmacy services at Riverview
resulted in an increase in the practice of clinical pharmacy at
the hospital, and allowed for standardization of drug
distribution.
The Riverview Hospital Volunteer Assocation became a
legal entity during 1980, with formal ratification of the
Society's Constitution and Bylaws. The Social Learning Program
underwent extensive reorganization, including the revision and
clarification of administrative and reporting relationships;
the development of a staff training program; and the
distribution of standards, policies and procedures.
In addition, numerous administrative changes were
implemented at the hospital, including the relocation of the
Radiology and Rehabilitation Departments to more convenient
locations on campus; the utilization of a new thermal tray
system by the Dietetics Department; and a study involving a
proposed central commissary kitchen for the hospital.
In 1980 Riverview continued to strive for increased
community involvement in the planning and delivery of Mental
Health Services. To this end staff dietitians increased their
emphasis on diet consultations to include not only patients
receiving treatment at Riverview, but also the planning and
follow-up for patients discharged into the community.  Also,
95
 the Outreach Program continued to provide outreach
consultation, education and direction to psychiatric services
in the community. Finally, the hospital was active in resource
planning, through participation on many community-based
meetings with staff from other service agencies.
Greater Vancouver Mental Health Services (G.V.M.H.S.)
During 1980 the G.V.M.H.S. was funded by a Ministry of
Health grant and it continued to deliver a high calibre of
treatment to the acutely mentally ill. The treatment involved
a total rehabilitation program involving care of the patient's
biological, psycho-social and environmental needs.
The acutely mentally ill, or those suffering from
exacerbation of a chronic illness, may be admitted to the ten
bed short stay emergency residence 'Venture' when the necessity
for hospitalization is unwarranted or uncertain. The operation
of this service continued to require solid psychiatric
experience, sound judgement and knowledge of community
resources.
The G.V.M.H.S. was very actively involved in research in
1980.
Burnaby Mental Health Services
Burnaby Mental Health Services provides a regionalized,
decentralized,  integrated, and  comprehensive  program  of
psychiatric  services  for adults,  families,' and  children
resident in the community.
INPATIENT UNIT
The 25-bed acute psychiatric Inpatient Unit treated large
numbers of seriously disturbed patients, (usually with brief
hospitalization and without loss of ties with family, friends
and community. Although the unit is small, rapid intensive
treatment maintains high turn-over.
Assistance and co-operation is provided by Riverview
Hospital Intensive Care Unit, and Burnaby General and Vancouver
General Hospital Emergency Departments, for the occasional care
of dangerous, unmanageable patients.
96 -
 ADULT DAY PROGRAMS
Burnaby offered three distinct Adult Day Programs during
1980: an intensive 5-day per week milieu program designed to
produce major behavioural change; a part-time more gradual
re-educative and socially rehabilitative program; and a series
of structured courses including Communication, Assertiveness
Training, Cooking and Nutrition, Stress Management, and
Creative Job Search. The summer gardening group and Monday
evening social club continued to be popular additions to the
regular programs. Regular liaison meetings with the Outpatient
Teams, the Inpatient Unit, and the Burnaby Achievement Centre
continued to facilitate interactions with these programs.
A new project in 1980, entitled the "Happy Age Club", was
initiated by Day Program staff to provide community activities
and outings for a group of shut-in elderly patients resident In
a large senior citizens' complex. An imaginative program of
social activities, occupational therapy, life review therapy
and sharing sessions, recreational activities, and out-trips
was instrumental in increasing the level of activity and
preventing withdrawal of this group of the elderly, who were
seen to be at special risk for development of depressive
illnesses!
ADULT OUTPATIENT DEPARTMENT
The three geographic Adult Outpatient Teams continued to
consolidate their position in the community, treating the
acutely disturbed, as well as participating in the
rehabilitation of the chronically mentally ill. Specialized
group treatment programs for patient groups with special needs,
such as abusing spouses, parents of schizophrenic patients, and
widows, were continuing to be developed.
CONSULTATION PROGRAM
The psychiatric consultation program to Burnaby General
Hospital functioned at a high level with a regular consultant,
who continued to improve the quality and continuity of the
service, as well as the relationships with physicians and
nurses in Burnaby General Hospital and the community.
97
 CHILDREN'S OUTPATIENT SERVICES
The Children's Outpatient Department remained somewhat
overloaded during 1980, in spite of the development of
additional group programs for disturbed children. Consultation
work with Burnaby schools, and the Ministries of Human
Resources and the Attorney General, was continued. The popular
summer programs for preschoolers, latency children, and their
parents, were continued with the assistance of summer students.
BOARD ING ^-HOME PROGRAM
The Boarding Home Social Worker was extremely busy with
placements, especially from the Inpatient Unit. Attempts were
underway to foster the development of additional alternative
housing resources for the mentally ill, which were seriously
depleted by increased activity in the local real estate market.
LONG TERM CARE PROGRAM
The Long Term Care Social Worker, added last year,
developed a close liaison between the Outpatient Teams and the
Long Term Care Service; assisted in the assessment of many
patients with emotional problems referred for long—term care;
and embarked on an ambitious educational program for operators
of Long Term Care facilities.
CONSULTATION AND EDUCATION SERVICES
Burnaby Mental Health Services continued to consult with
community groups and organizations, including Burnaby physicians, Canadian Mental Health Association, Burnaby Health
Department, Long-Term Care Program, Burnaby General Hospital,
Burnaby Preschools, Dogwood Lodge, Burnaby Achievement Centre,
Parents in Crisis, etc. As well, many staff members served on
advisory boards for community organizations, a gratifying
recognition of the skills and service they provide the
community.
Burnaby continued to offer educational placements for
students in registered and psychiatric nursing, psychology,
social work, and occupational therapy.
—4
 Regular in-service training experiences offered during
the year included half-day workshops on the following topics:
The Elderly, Medication Review, Family Therapy, A Cognitive
Approach to Anger Management, and The Narcissistic
Personality. Most staff members attended the annual Mental
Health Programs Workshop held in June at U.B.C., which had as
its theme the care of the chronically mentally ill. A number
of staff also received educational time to attend individual
upgrading programs.
British Columbia Youth Development Centre, "The Maples", Burnaby
RESIDENTIAL AND DAY CENTRE PROGRAMS
The adolescent Residential and Day Centre Programs
provide a variety of services which include comprehensive
consultation, assessment, inpatient and day care treatment of
psychological, social, and learning problems in adolescents.
While in treatment, the adolescents interact in a milieu which
promotes interpersonal relationships, personal growth, life
skills, and responsibilities. Staff serve as healthy role
models by encouraging appropriate activities such as school,
athletics, recreation, and arts and crafts. Problem areas are
worked on in individual, group, and family therapy.
All adolescents in the program attend the school on a
regular basis. Most of the adolescents in care have
experienced difficulty in the regular school system because of
behavioural, emotional, or learning problems. The adolescents
are given a comprehensive educational assessment, and are then
placed in individual programs that allow them to progress at
their own rate. When indicated, some adolescents attend
classes in nearby community schools. A major goal.is to equip
adolescents with the skills necessary to re-enter the regular
school system, to attend courses, or to achieve job placement.
A variety of appropriate activities and programs are
provided for the adolescent in care. These programs are
designed to enhance a sense of accomplishment, self-worth, and
independence. A gymnasium, swimming pool, and arts and crafts
centre are located on the grounds. Regular activities in these
areas are provided for the adolescents by child care and
residential staff. Special individualized programs such as art
and dance therapy, drama, gymnastics, and swimming, are
designed to improve motor and expressive skills. Socialization
is an important goal  in the activities program.  Camping,
- 99 -
 skiing, movies, social events, and regular outings promote and
develop social skills by bringing the adolescents into contact
with the community.
The Residential and Day Centre Programs endeavour to
ensure high standards bf clinical practice by providing an
ongoing, in-service training program leading to a diploma in
child care. The planning and implementation of this program is
under the direction of a training coordinator, who works with
the unit psychiatrists, social workers, psychologists, and
child care counsellors, in developing a curriculum which
stresses an integrated approach to the treatment of
adolescents. The inservice training program aims at skill
development in the area of milieu, family, individual and group
therapy; interpersonal and group dynamics, assessment,
supervision, administration, and personality and growth
development. The Residential Unit is also affiliated with the
University of British Columbia and provides field training to
the students from the University of Victoria and Douglas
College. Field placement training is provided to psychiatric
residents, students in social work, child care counselling,
nursing, psychology, education and recreational therapy.
Private physicians, psychiatrist, school counsellors,
social workers, probation officers, and tho'se working in mental
health centres refer their clients to the Residential and Day
Centre Programs. Once received, the referrals are assigned to
an interdisciplinary team for assessment and diagnostic
recommendation. During the year, the Residential and Day
Centre Programs of the B.C. Youth Development Centre received
175 referrals. Throughout the year, all of the residential
beds and Day Centre places were filled. There was a continual
waiting list of between 30 to 40 adolescents. Approximately 30
percent of all admissions during the year came from outside the
Lower Mainland.
In November, 1980, a community based Transition Home for
six adolescents opened to service those adolescents who have
been in the residential cottages. This program provides more
effective patient flow, thereby making the residential cottages
more access ible to needy adolescents.
Construction was under way to expand the unit so as to
provide secure services for acute crisis intervention and
longer stay care, an outpatient department, expanded Day
Centre, and educational and recreational facilities.
 Psychological Education Clini
The Psychological Education Clinic is a provincial
resource for children and their families. The main thrust of
the Clinic is to operate a therapeutic school for children with
emotional and learning problems. There is a teaching and
treatment staff who act as the change agents for both the
children and their families.
The Maples school accommodates 40 children between the
ages of 6 to 13 years, with the average length of stay just
over one year. The major academic problem encountered is
concerned with reading. First, there is the child who is
unable to read even after the special services within the
school system have been exhausted. This requires using a
variety of specialized programs to meet the child's unique
problems. Next, is the child who lacks the motivation to
learn, even though thought to be capable. In both cases, an
emo t ional c omponent is pr esent and exis ts to a deb ili ta t ing
degree. Another category of child is the one with no learning
problem, but with emotional problems within the home and
school. A final group of children are those with an individual
psychopathology where no external cause is noted.
Treatment of these children involves working with their
learning disability, which takes considerable time as it
entails one-to-one therapeutic tutoring. This is necessary
because of the uniqueness of the child, which required the
program to be altered almost daily. Also these children
function best when they have immediate and accurate feedback of
their performance. The approach is a pragmatic behavioural
one, using task analysis, rewards, and helping the children
accept responsibility for their behaviour and that they possess
the ability to change. Social relationship experiences are
provided on an individual, group, and milieu basis• The
families are seen by psychologists who offer counselling in
child management techniques, family relationships, marital and
individual problems.
When treatment has been successfully terminated, it is
essential to follow a child, to ensure that the disturbance
does not occur again. Maintenance of improved behaviour has
always been a problem in treatment programs, and a liaison
worker was appointed to cope with this. Every child is
monitored during their re-entry into the school system, and
every family is continued in treatment until they can cope with
their own resources.
 There was a close liaison with residential treatment
units, and a service was provided for the children that are too
disturbed to be in the school system. There also appeared to
be a shift in the degree of pathology that the children
presented, and the referrals indicated that they were more
disturbed and the families harder to treat than a few years ago.
During the year specialized neuropsychological assessment
service was available to Mental Health Centres for a limited
number of referrals, to assist in differential diagnoses for
both children and adults.
Consultative Services
CONSULTANT IN PSYCHIATRIC EPIDEMIOLOGY
During the year organizational changes in the Mental
Health Services, placed emphasis on an integrated total care
system at the community level. The Consultant in Psychiatry
assisted with administrative decisions which affected the needs
for expansion and quality of patient care facilites.
The Consultant answered a number of enquiries directed to
the Ministry regarding patient treatment. These questions
either concerned individual patients or involved the discussion
of broader issues regarding certain types of treatment
modalities.
During the year other ministries were advised of trends
in mental health services, such as the expansion of
comprehensive community care and the need for more psychiatric
in-patient units in general hospitals.
A field research study on the aged was completed, and the
report was available from the library within the Ministry of
Health.  An abridged version was accepted for publication.
A community follow-up of patients discharged from
Riverview Hospital was undertaken during the summer. The
purpose was to evaluate the contact between discharged chronic
mental patients and community support services, and the
patient's psychosocial adjustment in the community.
Two other research proposals were submitted for funding
next year. Research for unambiguous evidence as to what
constitutes adequate care, including placement, treatment and
102 -
 their duration, remained an abiding overall aim of research in
psychiatry.
As a result of attendance at administrative and planning
meetings, including inter-ministerial meetings, various reports
and position paper were submitted following the evaluation and
discussion of issues.
As a member of the Clinical Records Committee, an
evaluation was done of a pilot project on Data Base Recording
at a mental health centre. The clinical staff using the system
reported favourably in their experience with a more
standardized system of record keeping, and offered further
suggestions for improvement in the system.
The Consultant attended the American Psychiatric
Association convention, and a two day seminar on a
comprehensive review of trends in psychiatry.
Educational workshops were given to several mental health
centres. The subjects dealt with the use of medications in
psychiatric illness, and mental health in the non-western world.
CONSULTANT IN PSYCHOLOGICAL SERVICES
The year saw a significant increase in requests for
Psychological Services in the various Mental Health catchment
areas. Fortunately, it was possible to effect some alleviation
of this through sessional services in a number of Centres,
contracted for specific purposes for a temporary period of time.
The increased demands for Psychological Services were
partly the result of changes in Mental Health Services
priorities. These changes were aimed at providing, in order of
priority, services to the chronically emotionally or
behaviourally disabled, to the acutely emotionally or
behaviourally disabled, to children and families, and to
persons with adjustment problems.
The provision of Psychological Services reflect the new
focus, especially in terms of requests for more differential
psychological assessment and diagnostic services; for more
specialized psychological treatment procedures of emotional
behavioural disabilities; as well as for consultation services
to both Mental Health staff, community agencies, and other
professional resources.
 The changes in Mental Health priority also saw greater
utilization of Psychological Services in planning, program
definition, and program analysis and evaluation. In addition,
there was a major involvement by psychologists in a variety of
training and continuing education programs.
In the area of accountability, Mental Health Services
followed the lead of the B.C. Psychological Association by
adopting the same standards for the provision of psychological
services as those set by the Association. The assistance of
the Association was also requested to provide guidelines to
enable the determination of which Mental Health facilities are
appropriate settings for Psychological Interns and Practicum
Experiences.
CONSULTANT IN SOCIAL WORK SERVICES
During 1980, the Consultant was engaged in a number of
functions involving the social work profession and its
relationship to the Mental Health System.
Recruitment of clinic social work personnel, assisting in
panelling, and adjudication on matters of a professional and
interprofessional nature, comprised a considerable portion of
the Consultant's time during the year. In addition, the
Consultant was involved in two ongoing professional committees
in the interest of Mental Health Services: the Series Review
Committee, and the Committee on Social Work Education. In
reference to the latter committee, a symposium was carried out
to assist the two professional schools, and the two
professional associations, to better understand the relevant
issues for social workers who function within health care
settings.
In addition to program responsibilities for the Okanagan
Thompson Region, the Consultant functions also as the director
of the Continuing Education Committee and in this capacity
coordinated a 1980 Provincial Mental Health Conference dealing
with the chronic mentally ill patient. It was a further
responsibility to develop the 1980/81 Electives Program in
continuing educational workshops for mental Health
professionals serving both urban and rural communities.
Approximately two hundred workshops will have occurred under
this program's auspices by the end of the 1980/81 academic year.
 Statistics
Throughout the year, the main duties of the statistician
revolved around the statistical systems in use at Mental Health
Services. Maintenance of the Management Information System is
a major facet of the statistician1s responsibilities, and in
September, the system was enlarged with the addition of Fort
Nelson as  a new sub-office.
Another change to the system involved the creation of a
more accurate inventory of the tape library. To accomplish
this, all Mental Health tapes were reviewed by the B.C. Systems
Corporation and were copied onto new "D" tapes, re-cataloged,
and assigned a new common  identification prefix.
During the year more progress was made on the
client-record microfilm project and on the care conversion
project, and because of the assiduous checking required, a
summer student and a temporary assistant were hired to assist
the  regular   staff.
The organization and the dissemination of statistical
data continued to occupy much of the statistician's time. A
considerable amount of time was spent bringing the Annual
Statistical Report up to date, and by the year end the 1978
Report was  completed and  the  1979 Report was nearing Completion.
Other activities of the statistician included
participation on the Joint Clinical Records Committee, and
liaison with Statistics Canada, the Division of Vital
Statistics,   and the B.C.   Systems Corporation.
-  105
 PATIENT MOVEMENT DATA FOR MENTAL HEALTH FACILITIES, 1980
MENTAL HEALTH
FACILITIES
P o
<i to
All Mental Health Facilities
Hospital Programs, Riverview
Geriatric Facilities
Valleyview
Dellview
Skeenaview
2
Mental Health Services
Total In-Patients
Burnaby
B.C.Y.D.C.
Total Out-Patients
All Mental Health Centres
Abbotsford
Burnaby Central
Burnaby Children's
Burnaby Day Program
Burnaby North
Burnaby South
Burns Lake - Vanderhoff
(Feb.79)3
Campbell River (Aug.79)
Chilliwack
Courtenay
Cranbrook _
Dawson Creek (July 79)
Duncan
Fernie-Sparwood (Apr.79)
Fort St. John
Grand Forks
Kamloops
Kelowna
Kitimat
Langley
Maple Ridge    «
Merritt (Apr.79)
Nanaimo
New Westminster
North Delta
13,003 12,671
1,293
179
91
76
12
398
325
73
972  285
178    1
91
75    1
12
9,858
38ft
320
68
11,133
9,283
339
216
99
115
155
161
53
16
132
173
216
191
209
77
255
92
488
363
119
165
187
47
267
73
276
36
10,296
1,296
244
124
84
36
392
323
69
9,322 755
520 723
90 1
51
32 1
7
17
4
7,167  7,123
348
280
68
8,364
6,567
336
129
40
93
108
77
3
117
184
59
8
177
68
76
65
111
755
85
151
99
256
71
72
202'
49
153|
73l
51
29:
13
31
31  13
31  12
1
106
continued
 TABLE I - PATIENT MOVEMENT DATA FOR MENTAL HEALTH FACILITIES,
conti nued
1980
ENTRIES
EXITS
1     MENTAL HEALTH
to
in
FACILITIES
2:
o
H
>
<
2: K
1=1 Id
o
z: c.
H Cfl
•Z. i-J
2: ^
in
_- u.
O IA
s
<  IT.
TOTAL
_■  £
H O
s 2:
TOTAL
r_>
en
1
E"
<*
hi q
b: a
:=] c;
o <2
r_ fc.
Q, H
Q
B
n. Eh
>--
3
Osoyoos   (Aug.79)
97
5
Penticton
336
497
Port Alberni
325
97
Port Coquitlam           -
Ijort Hardy (Mar.80)
307
192
120
4
Powell River
116
152
Prince George
93
96
Prince Rupert                            _
iQueen Charlottes,, (June 79)
Quesnel   (Mar.79)
115
108
35
24
44
49
Saanich
Salmon Arm (Mar.79)
244
184
136
47
Sechelt
Smithers  (May 79)
124
77
43
23
Squamish
90
68
Surrey
268
247
Terrace
156
100
Trail
248
135
Vernon
452
232
V.I.S.C.  .
559
508
Victoria
244
285
Whalley
237
67
Williams Lake
83
56
1 Community Care Teams
1,663
1,589
Blenheim House
45
56
Broadway Clinic
223
211
Kitsilano
187
157
Mt. Pleasant
199
220
(Richmond
148
113
Secure
68
40
South Vancouver
153
157
Strathcona
199
215
dest End
264
219
9est Side
177
201
C.Y.D.C.   (Out-Patient)
187
208
■ ■Table compiled from actual data through Sej
tember
1980 and projected for
the
IBremainder of the year.     NOTE:     For Centres
opened
in 1980,   table compiled on basis
of available data.
Sub-total does not include Community Care Teams.
Month sub-office commenced
reportir
>g-
107 -
 TABLE II - PATIENT MOVEMENT TRE
TOS FOR MENTAL
HEALTH FACILITIES, 1978
- 1980
Yearly Sum o
f Entries^-
Resident of
Caseload
MENTAL HEALTH FACILITIES
Oct. 1978
Oct. 1979
to
to
End of
End of
Sept. 1979
Sept. 1980
Sept. 1979
Sept. 1980
All Mental Health Facilities
10,902
12,831
17,139
19,523
Hospital Programs, Riverview
1,362
1,314
1,098
1,113  <
Geriatric Facilities
276
175
805
687
Valleyview
207
98
534
452
Dellview
48
65
153
139
Skeenaview
21
12
118
96 \
Mental Health Services2
7,448
9,634
12,280
14,712 i
Total In-Patients
738
394
55
52
Burnaby
377
326
23
17
B.C.Y.D.C.
62
68
32
35
Venture3
299
	
	
 1
Total Out-Patients
8,526
10,948
15,181
17,671
Mental Health Centres
6,545
9,062
12,126
14,573
Abbotsford
318
354
348
341
Burnaby - Central
160
220
289
366
Burnaby - Children's
60
94
129
176 I
Burnaby - Day Program
102
112
21
28 1
Burnaby - North
160
152
477
518
Burnaby - South
106
140
245
. 292
Burns Lake-Vanderhoof (Feb. 79)*
17
42
17
46
Campbell River (Aug. 79)*
10
14
10
22  .
Chilliwack
101
137
244
177 i
Courtenay
169
146
212
198
Cranbrook
105
187
114
235
Dawson Creek (July 79)*
132
211
132
335 \
Duncan
56
230
112
187
Fernie-Sparwood (Apr. 79)*
37
81
31
59 1
Fort Nelson (Sept. 80)*
	
6
	
6
Fort St. John
92
264
209
400
Grand Forks
71
97
33
87
Kamloops
307
445
785
1,117
Kelowna
339
341
705
438 "
Kitimat
44
125
112
161
Langley
199
165
446
409
Maple Ridge
124
169
467
531
Merritt (Apr. 79)*
2
37
2
39
Nanaimo
139
291
315
330
Nelson
305
358
325
460
New Westminster
82
98
308
329
North Delta (Aug. 79)*
41
281
41
259
Osoyoos (Aug. 79)
42
- 108 -
98
42
134 1
cont±nuod 1
 TABLE II - PATIENT MOVEMENT TRENDS FOR MENTAL HEALTH FACILITIES, 1978
- 1980
continued
Yearly Sum of Entries*
Resident of
Caseload
MTAL HEALTH FACILITIES
Oct. 1978
Oct. 1979
to
to
End of
End of
Sept. 1979
Sept. 1980
Sept. 1979
Sept. 1980
Penticton
353
350
782
721
■Port Alberni
109
331
242
457
■Port Coquitlam
264
334
407
461
| Port Hardy (Mar. 80)*
	
86
	
83
■ Powell River
134
127
200
177
Prince George
50
97
355
374
Prince Rupert
75
141
62
38
Queen Charlottes (June 79)*
7
38
6
25
Rjuesnel (Mar 79)*
57
44
56
47
Saanich
81
234
184
233
1 Salmon Arm (Mar 79)*
40
112
40
109
Sechelt
95
127
213
239
Smithers (May 79)*
26
58
25
66
Squamish
7
67
115
131
■Surrey
201
258
776
800
Terrace
63
148
98
161
■Trail
179
244
443
505
■Vernon
488
425
780
925
Victoria
212
223
415
394
V.I.S.C.
614
419
459
472
Whalley
85
208
210
344
Williams Lake
85
85
87
131
All Community Care Teams
1,816
1,708
2,956
3,011
Blenheim House
35
42
83
78
■ Broadway Clinic
250
240
660
686
Kitsilano
186
188
236
256
1 MHBH North Shore5
63
	
2
	
Mt. Pleasant
149
190
256
325
Richmond
195
161
287
306
■Secure
59
73
65
87
South Vancouver
173
147
253
247
Strathcona
237
211
331
317
Best End
239
269
295
357
Best Side
230
187
388
352
Ri.Y.D.C. (Out-patient)
165
178
99
87
1. For the residential facilities, this includes permanent transfers, admis
sions from
■ the community, returns from leaves and escapes.
2. Sub-total does not include Community Care Teams.
3. Venture stopped reporting as of July 1, 1979.
4. Month Sub-office commenced reporting.
5. Opened in September, 1978 and closed in September 1979.
- 109 -
 HOSPITAL PROGRAMS
Prior to the introduction of the British Columbia
Hospital Insurance Service on January 1, 1949, the Province had
been interested in developing a comprehensive program for many
years. In 1932 the findings of a Royal Commission had
recommended that a compulsory health insurance maternity plan
be considered and in 1936 a Health Insurance Act had been
placed on the statutes but never proclaimed. In 1937, British
Columbians voted in favour of health insurance in a referendum
held in conjunction wi th a Provincial general elec tion.
Finally, in 1948, the Hospital Insurance Act was passed,
establishing a Hospital Insurance Service which, when
implemented on January 1, 1949, provided coverage for acute
care in approved general hospitals.
The funding of the operating costs of the service
(Hospital Programs) was a 100 per cent responsibility of the
Province until 1958 when the Federal Government agreed to share
on a Canada-wide basis approximately 50 per cent of the
approved cost of certain hospital services. Subsequent to
March 31, 1977, Hospital Programs was brought under the
Federal-Provincial Fiscal Arrangements and Established Programs
Financing Act, 1977, when shared-cost arrangements under the
Hospital Insurance and Diagnostic Services Act were terminated.
In March 1975 the name of the service was changed to
Hospital Programs as part of a reorganization within the
Ministry of Health.
The following pages contain individual reports of the
divisions which comprise the administrative structure of
Hospital Programs, and brief reviews of pertinent legislation
and statistical data.
 P2
at i/i
os jog
rjggE.
sogg
fees y
H eg <JZco
»5Zoa
S^lrrrr-g
IESS-
_o Q
Q
Kfh£
"lJr/3
5z
qSzq
Oz
°4
>
OjHcO
05H
roH it;
a
<<
Crf CO
OZ
S9
o
z
<-S
og
Ir-
 Hospital Programs Highlights
In 1980, 13 major projects were completed, including
three new acute hospitals: the 240-bed Health Sciences
Centre Hospital on the campus of the University of
British Columbia; a new hospital at Bella Coola to
replace the old one originally built in 1930, and a new
acute facility for Delta. In addition, a new Diagnostic
and Treatment Centre was built in Fraser Lake, and a new
Regional Laundry to serve some Greater Vancouver
hospitals was opened on the Tilbury Industrial Site. A
further 176 extended care beds were brought into
operation at Burnaby General, Kelowna General, Priory
Hospital and Queen Alexandra Hospitals in Victoria.
These projects, plus a major services expansion at St.
Joseph's General Hospital, Comox, a new laboratory at
Penticton and renovations at Tahsis, were estimated to
cost just under $50 million dollars.
The Planning and Construction Division continued to
handle a heavy volume of work, during 1980. In addition
to the completed projects listed above, six multi-million
dollar projects were under way at the year end, estimated
to cost a total of over $246 million, in addition to 22
other smaller projects.
The gross expenditure approved for public, general,
rehabilitation and extended care hospitals for 1980/81
was $795 million.
More than $400,000 was made available through hospital
operating budgets to enable hospital employees to
participate in short-term educational training courses.
A physiotherapy consultant was hired to compile a
province wide perspective on the delivery of
physiotherapy services in B.C. hospitals.
New computerized tomography whole body scanners were
approved in principle for Children's/Shaughnessy/Grace
Hospitals (a shared unit) and for the new Victoria
General Hospital North.
Regulations under the Hospital Insurance Act were changed
to allow the Ministry to provide 100 per cent grants for
energy conservation projects carried out in the
province's hospitals.
 HOSPITAL INSURANCE ACT
The Hospital Programs branch of the Ministry of Health
operates under the authority of the provisions of the Hospital
Insurance Act, which also authorizes the establishment of the
Hospital Insurance Fund, from which grants are made to
hospitals toward operating expenses and capital costs. Grants
are also made to regional hospital districts. (See following
sections.)
• Generally speaking, every permanent resident who has made
his home in British Columbia during the statutory waiting
period is entitled to benefits under the Act.
• Operating grants to public general hospitals are based on
approved annual budgets; for accounting purposes, per
diem rates are used for medically necessary in-patient
care rendered to qualified British Columbia residents who
are suffering from an acute illness or injury, and those
who require active convalescent, rehabilitative and
extended hospital care. The payment made to a hospital
by Hospital Programs from the Hospital Insurance Fund
amounts to the per diem rate approved for that particular
hospital minus the co-insurance charge paid to the
hospital by the patient. The patient is responsible
(1979) for paying a daily co-insurance charge of $4 for
acute-care, $6.50 for extended-care, or $1 for
extended-care patients under 19 years of age. The
Provincial Government pays the co-insurance charges on
behalf of Provincial recipients of Income Assistance from
the Ministry of Human Resources.
• A wide range of in-patient and out-patient benefits is
provided under the Act.
• Qualified persons who are temporarily absent from British
Columbia are entitled to certain benefits during a period
which ends at midnight on the last day of the twelfth
month following the month of departure.
In addition to the payments toward operating costs, paid
to hospitals as described above, hospitals and regional
hospital districts receive grants of up to 60 per cent of
approved costs of construction or acquisition of hospital
facilities, one-third of the cost of minor movable
equipment, 75 per cent of the cost of major diagnostic
equipment, and 100 per cent of the cost of equipment
which results  in proven  savings  in operating costs.
 Also, the Province may provide additional financial
assistance in respect of the approved cost of equipment
for facilities which have been designated by the Minister
as Provincial referral centres. The grants are made on
the basis of 100 per cent of the initial or first
purchase and installation cost of equipment, and 75 per
cent of the replacements costs of existing equipment,
where the Minister classifies it as being of a type
required for operating a Provincial referral centre.
HOSPITAL ACT
One of the important functions of Hospital Programs is
the administration of the Hospital Act. The Assistant Deputy
Minister of Hospital Programs is also the Chief Inspector of
Hospitals for British Columbia under the Act.
The Hospital Act controls the organization and operation
of hospitals, which are classified as follows:
• Public hospital: Non-profit hospitals caring primarily
for acutely ill persons.
• Private hospital: This category includes small
hospitals, most of which are operated in remote areas by
industrial concerns primarily for their employees, and
licensed nursing-homes which are not under hospital
insurance coverage.
ffcgfc-ja Rehabilitation and extended-care hospitals: These
non-profit hospitals are primarily for the treatment of
persons who require long-term rehabilitative and extended
hospital care.
HOSPITAL DISTRICT ACT
The Hospital District Act provides a mechanism for
financing the capital cost of hospital buildings and
equipment. The Act provides for the division of the province
into large districts to enable regional planning, development,
and financing of hospital projects under a formula which
permits substantial financial assistance from the Provincial
Government.
Each regional hospital district is, subject to the
requirements of the Act, able to pass capital expense proposal
by-laws authorizing debentures to be issued covering the total
11*
 cost of one or more hospital projects. Once a capital expense
proposal by-law has been approved by the Lieutenant-Governor in
Council the district is able to proceed to arrange both
temporary financing and long-term financing on a favourable
basis. The long-term financing is provided by the Regional
Hospital Districts Financing Authority (see below), which
purchases debentures issued by the various districts as
required.
Each year the Provinc ial Government pays through Hospi tal
Programs from the Hospital Insurance Fund a portion of the
principal and interest payments required on the debentures
issued by the Regional Hospital Districts' Financing Authority
in accordance with section 22 of the Act. The balance of the
principal and interest requirements are raised by the district
through taxation.
Under the sharing arrangements the Province pays annually
to or on behalf of each district 60 per cent of the approved
net cost of amortizing the districts' borrowings for hospital
construction projects after deduction of any items which are
the districts' responsibility, such as provision of working
capital, funds for hospital operation, etc. If a 4-mill tax
levy by the district is inadequate to discharge its
responsibility in regard to annual charges on old debt for
hospital projects as well as the remaining 40 per cent of the
charges on new debt resulting from hospital projects, the
Province will provide 80 per cent of the funds required in
excess of the 4-mill  levy.
The affairs of each regional hospital district are
managed by a board comprised of the same representatives of the
municipalities and unorganized areas who form the board of the
regional district (incorporated under the Municipal Act) which
has  the same boundaries as   the regional hospital district.
The board of each regional hospital district is
responsible for co-ordinating and evaluating the requests for
funds from the hospitals within the district, and for adopting
borrowing by-laws subject to approvals and conditions required
under the Act, in respect to either single projects or an
over-all  program for hospital  projects  in the district.
The purposes of a regional hospital district, as
described in section 20 of the Act, are basically to acquire,
construct, enlarge, operate and maintain hospitals; to grant
aid for these purposes; and to act as an agent of the Province
in receiving and disbursing monies granted out of the Hospital
Insurance Fund. In order to exercise these powers that board
is   authorized,   with   the   approval   of   the   Minister,   to   raise   by
115
 taxation an amount not exceeding the greater of $200,000 or the
product of one-quarter of a mill on the assessed value of lands
and  improvements  within   the  district.
HOSPITAL DISTRICT FINANCING ACT
The Hospital District Financing Act es tab1ishes an
authority to assist in the financing of hospital projects,
medical and health facilities, community human resources and
health centres, and any other community, regional, or
provincial facilities for the social improvement, welfare and
benefits of the community or the general public good approved
by  the  Minister  of Health.
The financing authority purchases sinking fund debentures
issued by regional hospital districts to finance approved
hospital      construction      projects. The      financing      authority
obtains its money by marketing its own debentures. The raising
of funds by a Provincial Authority helps ensure a better market
and,   on average,  a  lower  interest rate.
HOSPITAL BUDGET  REVIEW  BOARD
The Hospital Budget Review Board, appointed by Order in
Council, is responsible for advising the Assistant Deputy
Minister in regard to hospitals' operating budgets and rates of
payments to hospitals for both in-patient and out-patient
benefits.
METHODS  OF PAYMENT TO  HOSPITALS
A system of firm budgets for hospitals, which, with
modifications, has been in use since January 1, 1951, provides
for a review of hospitals' estimates by the Board. Under the
firm-budget procedure, hospitals are required to operate within
the total of their approved budgets, with the exception of
fluctuation in days' treatment and other similar items. They
are further advised that deficits incurred through expenditures
in excess of the approved budget will not be met by the
Provincial Government. However, hospitals retain a portion of
surplus funds earned as a result of keeping expenditures within
the  total   amount  approved.
The value of variable supplies used in patient-care has
been established. It is generally recognized that the addition
of   a    few   more    patient-days    does    not    add    proportionately    to
-  116 -
 costs because certain overhead expenses (such as heating etc.)
are not affected. However, some additional supplies will be
consumed, and it is the cost of these variable supplies which
has been determined.
When the number of days' treatment provided by the
hospital differs from the estimated occupancy, the budgets are
increased or decreased by the number of days' difference
multiplied by the patient-day value of the variable supplies.
Individual studies and additional budget adjustments are made
in those instances where large fluctuations in occupancy
involve increases  or reduction  in stand-by cost.
Policies to be used in the allocation of the total funds
provided are approved by the Government. The Hospital Budget
Review Board reviews the detailed revenue and expendi ture
estimates forwarded by each hospital and applies the policies
in   establishing  approved  budgets.
About 96 per cent of all in-patient hospital accounts
incurred in British Columbia are the responsibility of Hospital
Programs. Cash advances to hospitals are made on a
semi-monthly basis, so that hospitals do not have to wait for
payment until patients' accounts are submitted and processed by
Hospital Programs. The co-insurance charges paid by patients
are deductible when calculating payments to hospitals from the
division.
Nonqualifying residents are charged the hospitals'
established per diem rate, which is all-inclusive; that is, the
daily rate covers the cost of all the regular hospital
services, such as X-ray, laboratory, operating-room, etc.,
provided to patients, in addition to bed, board, and nursing
care.
 Administrative Services Division
The division provides a variety of administrative
services to the other divisions of Hospital Programs, and to
outside agencies. These services include the following:
ADMINISTRATION
Personnel functions, including payroll, recruitment,
promotion and labour relations matters.
Requisitions and vouchers are reviewed for all divisions,
including travel expenses and requisitions for supplies and
equipment.
All incoming cheques are received and deposited.
Handling and distributing all hospital forms, and sorting and
distributing mail.
Co-ordinating the preparation of the annual estimates for
Hosital Programs.
Preparing and publishing the Hospital Programs Bulletin.
Preparing and distributing information pamphlets for
Hospital Programs.
LEGISLATION
The drafting of legislation, regulations, and Orders in
Council, related to the various statutes administered by
Hospital Programs. In performing these duties the division
works closely with the Ministry of the Attorney-General.
Statutes which relate to the Division's activities
include:
Hospital  Insurance Act;
Hospital Act;
Hospital District Act;
Hospital District Financing Act;
Practical  Nurses  Act.
 SOCIETIES
Hospital Societies — Providing assistance to hosital
societies  in connection  with  the  drafting  of  hospital
constitutions and  by-laws,  and  their  interpretation  and
application.
Reviewing hospital by-laws, or amendments to hospital
by-laws, prior to their submission for government approval as
required under the Hospital Act.
The processing, in collaboration with the Hospital
Consultation and Inspection Division, of transfers of private
hospital property, and transfers of shares in the capital stock
of private hospital corporations.
Co-ordinating the acquisition and disposal of hospital
sites and private hospitals.
In conjunction with the Land Title Office, maintaining
control over the property of hospitals and private hospitals,
to ensure that the property records are suitably endorsed, so
that land transfers may not be made until they are approved
under the Hospital Act.
Long Term Care Societies — The Administrative Services
Division is also responsible for reviewing society matters and
land transactions for long term care societies.
FEDERAL-PROVINCIAL HOSPITAL ARRANGEMENTS
The drafting and processing of the necessary amendments
to the Federal-Provincial Agreement and associated matters.
REGIONAL HOSPITAL ARRANGEMENTS
In conjunction with officials of other divisions, other
government ministries, and the various regional hospital
districts, the division assists in processing capital expense
proposals and in arranging for the necessary by-laws and Orders
in Council for temporary borrowings and related matters.
- 119 -
 ELIGIBILITY
Reviewing applications for benefits made by or on behalf
of persons admitted to hospitals.
Maintaining uniform standards of eligibility in all
hospitals and providing assistance to hospitals in training
admitting staff.
Handling applications to the Health Insurance Supplementary Fund.
THIRD-PARTY LIABILITY
This section is responsible for the review of all
hospitalization reports for patients admitted to hospitals with
accidental injuries. This also includes the processing and
verification of the reimbursement from public liability
companies, for hospital expenses paid on behalf of accident
victims. During the year ended March 31, 1980, a total of
$4,758,938.24 was recovered through this process.
Hospital Finance Division
The Hospital Finance Division is responsible for
assembling relevant information and preparing data, for the use
of the Hospital Budget Review Committee in its review of the
annual and pre-construction operating estimates of hospitals.
During this process, estimated revenues and expenditures are
examined in detail, and adjustments to estimated amounts are
recommended. The gross expenditure approved for public
general, rehabilitation, and extended-care hospitals for
1980/81 amounted to approximately $795 million.
The financing of new construction, additions and major
alterations and improvements, is also handled by the division.
Until 1980, all financing had been provided through the
processing of twenty year sinking fund debentures. With rising
interest rates, a short term of financing with chartered banks,
usually three to five years, was encouraged.
Debentures lodged as security with the British Columbia
Financing Authority tocalled $530 million as at December 31,
1980.
 The annual budgets of the Hospital Districts which
determine the mill rate levy for the year, are examined and
approved by this division. This levy provided funds for 45.7%
of the interest and sinking fund requirements for 1980. The
remaining 54.3% is paid by Provincial Government Grants, which
exceed $30 million.
Tne Finance Division is responsible for the approval of
equipment grants given to hospitals for purchases of approved
major moveable depreciable equipment. During the 1980/81
fiscal year, hospitals received grants in excess of $12,000,000
to assist them in the purchase of equipment which totalled
approximately $23,000,000; with the major purchases being in
the Radiology, Pathology, Nuclear Medicine, Ultrasound and
Biomedical fields.
During the year progress was made to revise and reduce
the volume of work involved, by the introduction of a policy
allowing hospitals to purchase items or equipment up to a unit
value of $750, with certain provisions entailed. A Hospital
Equipment Review Committee was created, and the recommendations
containing the new procedures and policies were forwarded to
the Senior Deputy Minister, who had initiated the Committee.
In order to ensure that plans for new hospitals or
hospital additions are prepared with economical and efficient
operation in mind, pre-construction operating estimates are
completed by hospitals at the final sketch-plan stage. It is
essential that the estimated operating costs of the new
hospital, or any new addition, compare favourably with other
hospitals actually in operation. Where the hospital's
pre-construction operating estimates do not indicate a
reasonable operating cost, it may be necessary for the hospital
board to revise its construction plans to ensure efficient and
economical operation. Once a satisfactory pre-construction
operating budget has been agreed upon by the hospital officials
and Hospital Programs, the hospital board is required to
provide written guarantees relative to the projected operating
cost. It is considered that this method of approaching the
operating picture for proposed hospital facilities ensures more
satisfactory planning, efficient use of hospital personnel, and
an economical operation.
As a means of assisting hosital staff to maintain and
develop health care skills, Hospital Programs provided more
than $440,000, included within hospital operating budgets
during the year, to enable hospital employees to attend or
participate in short-term educational training courses.
 The following is a summary of comparative expenditures of
Hospital Programs (including capital) for the Calendar years
1976-80 inclusive.
ADMINISTRATION & PAYMENTS TO HOSPITALS, 1976-80
1977
1978
1979
Administration
Grants to hospitals
Totals
$
3,556,066
483,107,890
486,663,956
3,619,325
536,939,951
540,559,276
4,253,000 4,640,000
606,186,'ClOO 707,398,000
610,439,000 712,038,000
5,060
365,48{l I
870,545
Another function of the division is the processing of
admission/separation records (accounts), which hospitals submit
for each patient, and approving for payment all acceptable
claims and coding for residential data, etc. Also included are
out-patient,  day care,   and out-of-Province accounts.
FINANCE  CLAIMS  SECTION
More than 2,200 patient accounts were processed each
working day during 1980, as well as more than 3,500 emergency
and minor  surgery accounts.
The staff of Admission Control reviews each Application
for Benefits under the Hospital Insurance Act. Patient
accounts are checked to ensure that proper signatures appear on
the forms and that sufficient information for ver i ficaton
purposes and related matters has been provided. During the
year approximately 4,800 claims had to be returned to the
hospitals because they were incomplete or unacceptable and more
than 2,300 letters were written regarding more involved
problems with specific claims.
The In-Patient Claims Section pre-audits the charges made
to Hospital Programs and ensures that all information shown on
each claim is complete, so that it can be coded for statistical
purposes, and charged to the correct agency, such as Hospital
Programs, Workers' Compensation, the Department of Veterans
Affairs, or other provinces and territories. This section
returned  more   than 3,000 claims   for clarification  of  inforation
 during the year and preliminary figures for 1980 show that more
than 450,000 accounts (excluding out-of-province) were
processed.
The day-care surgical services, day-care/night-care
psychiatric services, out-patient psychiatric services,
day-care diabetic services, and dietetic counselling accounts
again increased in volume during 1980 to more than 18,000 per
month. Payments for out-patient physiotherapy patients were
also provided and preliminary figures indicate that accounts
for more than 490,000 treatments were processed. During the
year more than 23,000 renal dialysis treatments were given for
out-patient treatments of chronic renal failure. The service
continued to provide a quarterly statistical run of day-care
surgical  services  for  the hospitals  of the Province.
The Out-of-Province Section processes all claims for
hospital accounts incurred by British Columbia residents in
hospitals outside the Province. This involves establishing
eligibility and the payment of the claims. During 1980
approximately 7,000 in-patient accounts, and more than 14,000
out-patient accounts, were processed for payment. On April I,
1980, day care and emergency and minor surgery out-patient
services performed elsewhere in Canada were added as a benefit
to B.C.  residents.
The Claims Distribution Centre receives, sorts and
distributes all the forms, correspondence and documentation for
the Hosital Claims Section; approximately 15,000 claims,
documents, etc. were handled daily in this section during the
year.
123
 Hospital Consultation and Inspection Division
This division provides consulting services to public and
private hospitals, and to other areas of the Ministry of
Health, in all aspects of hospital organization, operation and
management. It is also responsible for an inspectional program
to ensure that minimum standards of care, safety and licensure
are met.
The services of the division are provided by consultants
in hospital administration, biomedical engineering, dietetics,
clinical laboratory, laundry and housekeeping, nursing,
pharmacy, phys iotherapy, soc ial services and X-ray. During the
year the consultant in biomedical engineering accepted
employment with one of the province's larger hospitals, and the
division was without consulting services in this area for the
latter part of the year.
The ongoing work of consultation and inspection saw every
hospital in the, province visited at least once. A total of 360
visits were made to general and extended care hospitals, and
140 to private hospitals.
Division personnel continued to participate actively on
advisory and working group committees, at both the federal and
provincial levels.
A review of Hospital Programs hospital staffing policy
guidelines was started during the year, and an initial draft
proposal was near completion by the year end.
Consultation in hospital pharmacy matters commenced in
June following the appointment of a new consultant. Thirty-
three hospital reviews and on-site visits were accomplished,
along with special projects at Valleyview and Riverview
Hospitals, for Long Term Care and Mental Health Services. Work
was started on standards and guidelines. A task force on
pharmacy services to extended care patients was appointed.
In the area of biomedical engineering real progress was
achieved through the two-year Lower Fraser Valley project.
This project provided a complete biomedical program of combined
engineer and technician services to six hospitals. The review
and evaluation demonstrated clearly the need for, and value of,
the utilization of both engineers and technicians in the
programs. The Clinical Engineering Committee, established as a
standing committee of the Biomedical Engineering Advisory
Council in November of 1979, actively pursued its functions
relating  to  professional  standards,  clinical  engineering
124
 activity, staffing needs and criteria, regulations and other
appropriate procedural matters.
Nursing consultants of the division continued their
involvement in support of expanded perinatal care, quality
assurance programs and patient classification systems, in
hospitals throughout the province. Ministry financial
ass istance was provided to hospitals conducting graduate nurse
refresher courses, which allowed some alleviation of the
provincial nursing shortage.
The development of a quality assurance program for the
Department of Dietetics was commenced during the year, in
collaboration with the B.C. Dietetic Association. The planned
expansion of large hospital food service facilities prompted
increased research into new systems for food production and
service. The dietetic department methodology, distributed
throughout the province last year, received wide acceptance at
a meeting of provincial dietetic consultants.
A phys iotherapy consul tan t was added to the divis ion's
staff in August. The initial objective of this consultant is
to compile a total perspective on the delivery of physiotherapy
service in B.C. hospitals, including staffing, scope of service
and local conditions.
During 1980, the division's consultant in social work
assisted the B.C. Society of Hospital Social Work Directors in
initiating a monthly newsletter called INFORM. This newsletter
facilitates the dissemination of pertinent issues in the
practice of medical social work, and it was well received in
the field. Work still continued on the development of a
uniform reporting system for hospital social work services.
Revisions were planned for the quality assurance and
accountability paper, developed jointly by the consultant and
the society, and circulated to hospitals early in the year.
New CT. whole-body scanners were approved in principle
for New Children's Hospital, Vancouver; as a shared unit for
Children's/Shaughnessy/Grace Hospitals, and for the new
Victoria General Hospital North. Ultrasound services were
approved in many more locations, and were extended into
suitable hospitals with less than 100 beds, resulting in a
general expansion in the scope of service provided by this
technology. The concept of including all imaging modalities in
new and expanded radiology departments was continued. Greater
provision was also being given to the incorporation of dental
radiological facilities. In the field of radio-therapy, a new,
additional high-energy 20 meV treatment machine was approved
for  A.  Maxwell  Evans  Clinic,  Vancouver,  which  will  be
125
 functional in the new Radio-therapy Department in approximately
three years.
Hospital Planning and Construction Division
During 1980, the Planning and Construction Division
continued to work closely with hospital boards of management or
project building committees, and their consultants, as well as
regional hospital districts, to develop programs for new
facilities by, acquiring, adding to, or renovating existing
buildings, including minor building improvements. In advising
hospitals, the Division worked towards its objective of
providing a service to hospitals to facilitate the development
of optimum facilities in the most cost-effective way. This
became increasingly difficult as inflation continued to rise at
a very high level.
The first step for many of these programs is the
development of an overall master plan, based on that hospital's
role in relation to the provision of hospital services for that
area. In order that planning may progress in an orderly
manner, once approval-in-principle has been given by the
Minister of Health, the Division has established a number of
procedures, which recognize the importance of financial control
and ensure the regional hospital district's full involvement in
the development of the project. These procedures include
financing arrangements, and the assurance that the resulting
facility meets National Building Code requirements and can be
operated economically. During these planning stages,
assistance in reviewing the hospital's functional program and
design drawings is given by various professional groups
represented in the Hospital Consultation and Medical
Consultation Divisions, as well as such organizations as the
Laboratory Advisory Council, the Radiological Advisory Council,
and the Nuclear Medicine Advisory Council. When these
recommended procedures are followed it results in a smooth
progression of the project.
The Division is responsible for recommending Ministerial
approval of project financing through regional hospital
districts, and works with the Administrative Services Division
of Hospital Programs so that the capital expense proposal may
be finally approved by Order-in-Council. During the year, new
acute hospitals were opened on the campus of the University of
British Columbia, in Bella Coola and Delta, as well as a new
Diagnostic and Treatment Centre at Fraser Lake, and a new
regional laundry for the Greater Vancouver Regional Hospital
District.  Other hospitals completed renovation programs, some
 of which provided extended care beds.  For details, please see
further in this report.
During the year the Planning and Construction Division
maintained and fostered a close working relationship with
several professional agencies, including the Architectural
Institute of B.C., and the Consulting Engineers' Division of
the Association of Professional Engineers of B.C. Division
staff met monthly throughout the year with representatives of
these two professional associations, to discuss many items of
common concern on which mutual agreement had been reached. It
was felt these meetings greatly improved relations between the
members. At year-end discussions continued on a new
client/architect agreement, and a basic fee structure which
would be satisfactory to all groups. The Division also
maintained its good relationship with the B.C. Construction
Association and the industry, as well as various trade
organizations. Staff members participated regularly in the
semi-formal meetings of the Public Construction Council, and
together with members of the construction industry, resolved
problems, particularly in the tendering process. The
publication of the document "Guidelines for Quantity Surveying
Services, Tendering Procedures, Insurance and Bonds in Acute
and Extended Care Facilities", to which staff members
contributed, was of assistance in resolving some of these
problems.
Before the end of 1980, "Guidelines for Project Brief
Submissions and Facility Programming of Acute Care Facilities
in British Columbia" were issued, and work was nearly completed
on a revised design and program guideline for Extended Care
Units. Design guidelines for surgical suites, radiological,
laboratory and physiotherapy departments were also nearing
completion. Space programming methodologies for 16 departments
were developed, in consultation with the Federal Government and
other provinces, and a British Columbian edition will be
produced in 1981. The Registered Nurses' Association of
British Columbia, the Physiotherapy Association of British
Columbia, the British Columbia Health Association, and various
advisory groups assisted in the development of several of these
documents.
The Division's consultants (engineering) continued to
promote energy conservation. Due to a change in the Hospital
Insurance Act designed to reduce operating costs, it is
possible for Hospital Programs to provide 100% grants for
energy conservation projects, if the savings in the cost of
energy can be recouped within a period deemed reasonable by the
Minister of Health.
 Hospital Programs also produced a manual entitled
"Management of Energy in Health Care Facilities", which was
distributed to all hospitals, in conjunction with a series of
very successful two-day seminars held throughout the Province
for all hospital maintenance personnel. These workshops were
designed to outline the concepts contained in the manual, and
provide maintenance staff with a basis for developing their own
energy management programs. Following the workshops, the group
worked in conjunction with the B.C. Health Association in
preparing a basic tape-slide presentation to introduce the
techniques of energy management to administrators and hospital
board members.
Members of the Division continued to work with the
Canadian Standards Association in the production of standards
in health care technology. The Division also has
representation on the Standing Committee on Fire Safety in
Buildings, which is developing a draft of the 1985 issue of the
National Fire Code of Canada. A staff member also serves on
the Task Group dealing with health care facilities'
requirements, in connection with revisions to the National
Building Code.
The new Plumbing Code for British Columbia, mentioned
last year, was completed and the staff member on that committee
is also a member of the National Research Council's Standing
Committee on Plumbing Services, which is working on aligning
the Provincial Code with the plumbing portion of the National
Building Code, with emphasis on health and safety.
In May, hospitals were asked to change over to new
accounting forms so that the Division could start putting
current information on computer, as part of the Capital Budget
and Cash Flow Moni tor ing Sy s tem (C.B.C.F.M.). It was expec ted
this entire system would be operational by early 1981.
Projects Completed in 1980
Bella Coola General Hospital
On September 20, 1980, Dr. Chapin Key, Deputy Minister of
Health, opened a new hospital which replaced an existing
facility. The new hospital has a complement of 10 acute beds,
2 extended care beds, and 3 intermediate care beds.
Burnaby General Hospital
A project which made possible the temporary redesignation
of 72 acute beds for extended care use, was completed in April,
1980. The total number of extended care beds at the hospital
is 219.
I
 St. Joseph's General Hospital, Comox
A services expansion project was completed in June, 1980
and  included  emergency,   laboratory,  radiology,  central
sterilizing, and physiotherapy service.
Delta Centennial Hospital
A new 75-bed acute addition was opened by the Honourable
K. Rafe Mair, on September 5, 1980. The first patients were
admitted to the facility on September 30, 1980.
Fraser Lake Diagnostic & Treatment Centre
A new diagnostic and treatment centre with 2 overnight
stay beds was completed in March, 1980.
Boundary Hospital, Grand Forks
A project involving the expans ion of radiology,
laboratory, medical records and administration departments, was
completed in April, 1980.
Kelowna General Hospital
On May 24, 1980, the first patients were admitted to 50
additional extended care beds that had been left unfinished at
the completion of the Cottonwoods project in 1977.
Penticton Regional Hospital
A laboratory expansion project was completed in October,
1980.
Princeton General Hospital
An addition of 6 extended care beds was opened to
patients in January, 1980.
Richmond General Hospital Annex
The first patients were admitted to the renovated
facility on April 1, 1980. The project provided 20 extended
care beds and 16 psychiatric beds.
Tahsis Hospital
Alterations to provide administration, morgue and storage
facilities were completed in July, 1980.
Cancer Control Agency of British Columbia, Vancouver
Phase II, the parking structure, was completed in
September, 1980.
Tilbury Regional Laundry, Vancouver
A new regional laundry which will serve the needs of the
new  Children's  Hospital,  the  new  Grace Hospital,  and
Shaughnessy Hospital, was opened on August 15,  1980.  The
129
 laundry has   a  capacity  of   15  million  pounds   of   linen  per  year,
with room for expansion  to 20 million pounds.
University  of British Columbia Health  Sciences  Centre,   Vancouver
A     new     240      acute      bed     hospital,       including      teaching
facilities was opened by the Ministry of Health on May  16,   1980.
Priory  Hospital,   Victoria
An additional 40 extended care beds, made available by
renovations to the House of Peace, were opened to patients on
June 9,   1980.
Queen Alexandra Hospital, Victoria
The completion of a previously unfinished area in the
first week of June, 1980, provided accommodation for 14
additional   paediatric  extended  care  patients.
Projects   Under Construction at Year End
Matsqui-Sumas-Abbotsford  General Hospital
An   expansion   project,     including    an   additional    54   acute
beds,   and  enlargement  and  upgrading of services.
St.  Michael's Extended Care Hospital,   Burnaby
A  new  40-bed   extended   care   unit   is   being   constructed,    in
conjunction  with   a 40-bed   intermediate  care unit.
Campbell  River  and District  General Hospital
Completion   of   an   additional   15   beds   in   the   extended   care
unit.     Only  10  beds  will be opened   initially.
Chilliwack General Hospital
Fire   protection   upgrading   project.      Interim   improvements,
including   the  addition of   1  intensive  care/coronary  care  bed.
St.   Joseph's   Hospital,   Comox
Construction    of    a    new    75-bed    extended    care    unit    to
replace  the existing 45-bed unit.
Cranbrook and District   Hospital
Phase    I,    expansion    of    services    including    radiology   and
emergency  departments,   and  administration areas.
Enderby and District Memorial
Addition of a  12-bed extended care unit.
 Hudson's Hope
New Diagnostic & Treatment Centre.
Royal Inland Hospital, Kamloops
Stage II addition including a new tower for 90 acute care
beds, and service areas. Also operating suite renovations, and
expansion of outpatient waiting area.
Kelowna General Hospital
New emergency/outpatient department, and provision of
space for ambulatory care.
Langley Memorial Hospital
Additional 50 extended care beds and 25 in "shell".
Maple Ridge Hospital
A new addition of 32 acute beds plus construction of one
unfinished floor; new service areas including radiology,
laboratory, surgical suite, and central sterilizing facilities.
Nanaimo Regional Hospital
Electro-diagnostic laboratory.
Slocan Community Hospital, New Denver
Replacement of existing facility with a health care
centre, including 10 short-term and acute care beds.
Royal Columbian Hospital, New Westminster
Renovations to Sherbrooke Building (old Nurses'
Residence) to accommodate a 30-bed psychiatric unit.
Port Hardy Hospital
A new 23 acute bed hospital to replace existing
facility. Services being constructed to accommodate further
acute and extended care accommodation.
Prince George Regional Hospital
Stage III addition for expansion of services including
surgical, obstetrical and radiology suites, central sterilizing
and laundry. Stage IV expansion of emergency/medical day care,
laboratory, psychiatric inpatient and outpatient services.
Richmond General Hospital
Expansion of acute beds to 229, including 26 paediatric
and 30 obstetrical beds, plus one additional patient floor in
"shell".  Services are being constructed for 300 acute beds.
Lake General Hospital, Salmon Ar
Expansion of central supply and operating rooms.
 St.  Mary's Hospital,   Sechelt
A dietary upgrading project.
Children's  Hospital/Grace  Hospital,   Vancouver
New replacement hospitals on Shaughnessy site with 200
paediatric and 122 obstetrical beds, and some service areas to
be shared jointly by these two hospitals and Shaughnessy
Hospital. The new Children's Hospital will also replace the
existing Health Centre for Children at the Vancouver General
Hospital.
St.  Paul's Hospital, Vancouver
Phase I, replacement of 261 acute beds, and renovations
to  existing  structure   and   services.
Shaughnessy Hospital,  Vancouver
Development of shared services' facilities for
Children's/Grace/Shaughnessy Hospitals. Also the construction
of a 150-bed extended care unit for Veterans, and interim
improvements  and Building Code upgrading of existing structures.
Sunny Hill  Hospital   for  Children,   Vancouver
An expansion program, including the provision of 45
activation/rehabilitation beds, 30 extended care beds and 30
day care spaces. Also expansion of treatment and service
facilities.
Vancouver  General Hospital
A new emergency department and coronary care unit;
completion of emergency basement to house central sterilizing,
morgue, stores, housekeeping; general upgrading of Centennial
and Heather Pavilions to meet the requirements of the Building
Code.
Royal  Jubilee Hospital,   Victoria
Short-stay surgical program in three Phases. Phase II
includes  6   inpatient beds.
Victoria General  Hospital  North
New 496 acute bed facility to replace the present
Victoria General Hospital.
Project  at Tendering Stages  at Year End
Trillium Lodge,   Parksville
A  55-bed   extended   care   unit,   to  be  built   in   conjunction
with 50  intermediate and personal care beds.
132
 Projects   in Advanced  Stages of Planning
Dr. Helmcken Memorial Hospital,  Clearwater
Addition to, or renovation of, emergency, laboratory,
radiology and storage areas.
Overlander Hospital,  Kamloops
Addition of 50 extended care beds.
Kimberley and_ District Hospital
Expansion of emergency, physiotherapy, radiotherapy,
laboratory,   and  provision of space  for  in-service education.
Lions Gate,  North Vancouver
Renovations,   final  phase of services  expansion project.
Surrey Memorial Hospital
Addition of 72 acute beds in the "shelled"-in space of
the 5th floor plus minor improvements to services. Addition of
78 extended care beds. Renovations to the former King George
Private Hospital  for  75 extended care beds.
Vernon Jubilee Hospital
A new extended care unit containing 25 paediatric beds,
38 adult beds, 50 beds for patients with behavioural disorders
and  15 beds  in "shell" on Dellview site.
Lions Gate Hospital,  North Vancouver
Renovations,   final  phase of services expansion.
Additional Projects Approved and
In Various  Stages  of Planning
Additional and/or  Replacement Acute Beds
Alert Bay (10), Duncan (12 psychiatric), Kamloops, Royal
Inland (90 additional), Kelowna (45 rehabilitation), Langley
(40), Nanaimo (number undetermined), New Westminster, Royal
Columbian (340), Penticton (45), Squamish (21), Vancouver,
Cancer Control Agency of British Columbia (100), Port Moody
(200), Vancouver General (number undetermined), Vernon (73),
Victoria - Royal Jubilee  (redevelopment).
New Extended Care Facilities
Squamish (8),  Vancouver,   St.   Paul's   (50).
Additional  and/or Replacement Extended Care Beds
Abbotsford,     Matsqui-Sumas-Abbotsford     (50),     Abbotsford,
133
 Menno (50), Alert Bay (2), Creston (20), Grand Forks (20),
Kelowna (100), Maple Ridge (50), Mission (25), Penticton (87),
Saanichton (50), Salmon Arm (deferred), Summerland (35),
Vancouver - Lions Gate (125), Victoria - Aberdeen (150), White
Rock (150).
Expansion and/or Updating of Services
Abbotsford,  Campbell  River,  Grand  Forks,  Kamloops,
Kelowna, Langley, Nanaimo, Penticton, Summerland, Vancouver -
Cancer  Control  Agency  of  British  Columbia,  Port  Moody,
Shaughnessy,  Surrey,  Vancouver  General,  Vernon,  Victoria
Royal Jubilee, Victoria General (South), White Rock.
Diagnostic & Treatment Centres
Houston, Logan Lake.
134 -
 Locations of hospital construction projects
by regional hospital district as of December 31, 1980.
1.
Chilliwack
2.
Abbotsford
3.
Mission
4.
Lang ley
5.
White Rock
6.
Delta
7.
Surrey
8.
Richmond
9.
Richmond
10.
Vancouver
11.
Vancouver
12.
Vancouver
13.
New Westminster
14.
Burnaby
15.
Port Moody
16.
Maple Ridge
17.
North Vancouver
18.
Victoria
19.
Saanich Peninsula
20.
Victoria
21.
Duncan
22.
Nanaimo
23.
Parksville
24.
Sechelt
25.
Comox
26.
Comox
27.
Campbell River
28.
Squamish
29.
Tahsis
30.
Alert Bay
31.
Port Hardy
32.
Princeton
33.
Grand Forks
34.
Grand Forks
35.
Creston
36.
Cranbrook
37.
Kimberley
38.
New Denver
39.
Penticton
40.
Penticton
41.
Summer land
42.
Kelowna
43.
Vernon
44.
Arms trong
45.
Enderby
46.
Salmon Arm
47.
Kamloops
48.
Clearwater
49.
Bella Coola
50.
Prince George
51.
Houston
52.
Hudson Hope
53.
Fraser Lake
135
 136
 Locations of Acute
Care Host
itals in B.C.
1.
Chilliwack
47.
Penticton
2.
Abbotsford
48.
Summer land
3.
Mission
49.
Merritt
4.
Langley
50.
Lytton
5.
White Rock
51.
Kelowna
6.
Surrey
52.
New Denver
7.
Delta
53.
Kaslo
8.
New Westminster
54.
Invermere
9.
Burnaby
55.
Nakusp
10.
Richmond
56.
Vernon
11.
Maple Ridge
57.
Armstrong
12.
Vancouver
58.
Enderby
13.
North Vancouver
59.
Salmon Arm
14.
Saanich
60.
Kamloops
15.
Victoria
61.
Ashcroft
16.
Duncan
62.
Lillooet
17.
Ganges
63.
100 Mile House
18.
Chemainus
64.
Clearwater
19.
Ladysmith
65.
Revelstoke
20.
Nanaimo
66.
Golden
21.
Port Alberni
67.
Bella Coola
22.
Comox
68.
Bella Bella
23.
Campbell River
69.
Quesnel
24.
Powell River
70.
McBride
25.
Sechelt
71.
Prince George
26.
Squamish
72.
Vanderhoof
27.
Queen Charlotte City
73.
Burns Lake
28.
Tofino
74.
Kitimat
29.
Tahs is
75.
Prince Rupert
30.
Port Alice
76.
Terrace
31.
Port McNeil
77.
Smithers
32.
Alert Bay
78.
Fort St. James
33.
Port Hardy
79.
Mackenzie
34.
Hope
80.
Hazelton
35.
Princeton
81.
Stewart
36.
Oliver
82.
Che twynd
37.
Grand Forks
83.
Fort St. John
38.
Rossland
84.
Dawson Creek
39.
Trail
85.
Fort Nelson
40.
Creston
41.
42.
Cranbrook
Fernie
43.
Sparwood
44.
Kimberley
45.
Nelson
46.
Castlegar
137 -
  Locations of Extended Care Hospitals in B.C.
1.
Victoria                    48.  Golden
2.
Saanich                    49. Quesnel
3.
Duncan                     50. McBride
4.
Ganges                     51.  Bella Coola
5.
Ladysmith                   52.  Bella Bella
6.
Port Alberni                53.  Kitimat
7.
Comox                      54.  Prince Rupert
8.
Powell River                55.  Hazelton
9.
Nanaimo                    56.  Burns Lake
10.
Campbell River              57.  Smithers
11.
Sechelt                    58.  Prince George
12.
North Vancouver              59.  Dawson Creek
13.
Vancouver
14.
Richmond
15.
Burnaby
16.
New Westminster
17.
Delta
18.
White Rock
19.
Surrey
20.
Langley
21.
Maple Ridge
22.
Mission
23.
Abbotsford
24.
Chilliwack
25.
Alert Bay
26.
Princeton
27.
Oliver
28.
Grand Forks
29.
Rossland
30.
Trail
31.
Creston
32.
Fernie
33.
Cranbrook
34.
Kimb er ley
35.
Nelson
36.
Castlegar
37.
Penticton
38.
Kelowna
39.
Merritt
40.
Lytton
41.
Lillooet
42.
Ashcroft
43.
Kamloops
44.
Salmon Arm
45.
Vernon
46.
Nakusp
47.
Revelstoke
- 139 "
  Medical Consultation D
ivis ion
This division provides medical consultation within
Hospital Programs, to other Government ministries, to hospitals
at all levels of care, and to regional hospital districts.
Within Hospital Programs, in addition to medical consultation,
the division assists in planning and implementing new services
by having representatives in the Planning Group, on the
Equipment Committee, on the Functional Program Review Committee
and the Hospital Budget Review Committee (formerly known as
Rate Board). Development of standards of care; evaluating the
effectiveness of present programs, and estimating the probable
effectiveness of those proposed is a special interest of this
division.
The Medical Consultation Division is responsible for a
general auditing of the quality of medical care for hospitals.
This function is performed by on-site visits, and by a central
review of discharge diagnosis and related information,
prevalence statistics, lengths of stay, and patterns of care.
The staff includes a physiatrist, as well as occupational
therapists and physiotherapists, in order to provide similar
functions in the rehab ilitative field. Regular visits by the
Medical Records Librarian consultants assist hopitals in
maintaining a high standard of medical documentation. The
auditing process also involves assessment of eligibility for
acute care, and other types of care or insured benefit. During
1980, registered nurses within the division audited and
medically coded abut 514,000 admission/separation records and
day care surgical services records. The coded information is
used by the Research Division to produce both the regional and
hospital profiles needed for planning and auditing functions.
During the year the division continued to maintain
liaison with other health agencies, such as the College of
Physicians and Surgeons of British Columbia, the B.C. Medical
Assoc iation, the B.C. Health Association, and the Faculty o f
Medic ine at U.B.C. Unders tandably, in a Province wi th more
than 100 hospitals, problems relating to medical staff
activities occasionally occur. The Joint Hospitals Committee,
with representation from the B.C. Health Association, the
College of Physicians and Surgeons, the B.C. Medical
Association Hospitals Committee, and this division, made visits
to assist hositals in reviewing problem areas. Participation
on the Medical Advisory Committee of the B.C. Medical
Association, with advisory sub-committees to the Government on
many subjects, continued to be very worthwhile. A new
sub-committee to study allergy services in the province was
struck during 1980.
 The Medical Consultation Division has responsibility for
both the program and eligibility status of extended care
patients. Physiotherapy and occupational therapy consultants
continued to make regular visits to extended care units, to
carry out these functions and perform a consultative role.
The policy of short term admission of extended care
patients continued to be very useful, as more and more units
become active in supporting and encouraging relatives who wish
to take care of extended care patients in their own homes, but
who require an occasional holiday or other relief.
Research Division
The Research Division is responsible for assessing the
need for acute and extended care hospital beds and services,
and for the provision of a co-ordinated management information
service for Hospital Programs. Through the establishment and
management of a comprehensive data base, the Research Division
assists in meeting Hospital Programs' responsibilities for
program and facility planning, medical audit, and expenditure
control.
In order to determine the need for facilities, the
Division carries out studies both on an individual hospital and
a regional basis. These studies involve a comprehensive
analysis of hospitalization data, as well as economic and
demographic information.
The preparation of recommendations for additional
hospital capacity, in the face of an ever-increasing range of
benefits and services covered by Hospital Programs, requires
close liaison at the hospital, regional and provincial levels.
In spite of a greater emphasis being given to alternatives to
acute in-patient beds, the population growth of the Province
necessitates a continuing review of general hospital bed
requirements. Reports and proposals for revised hospital
capacity are reviewed by the Hospital Programs' Planning Group
and, if approved, are submitted to the Minis ter. Dur ing the
course of the year, a number of meetings were held with
representatives of regional hospital districts and hospitals,
to review their 1981 and 1986 acute care bed requirements.
The Division also compiles statistical data relating to
all hospitalization in the Province. The admission/separation
records submitted by hospitals for each patient form the basis
of this information. All diagnosis and operations are coded
according  to  the  Ninth  Revis ion  of  the  International
142 -
 Classification of Diseases, and the Canadian Classification of
Diagnostic, Therapeutic, and Surgical Procedures. Through this
classification system, the incidence of disease is analysed by
age, sex, and geographical location, as well as other variables.-
In connection with morb idity analys is, the Divis ion
publishes a number of annual reports. "Statistics of Hospital
Cases Discharged" includes the s tandard morb idity tables
consistent with other provinces, affording an opportunity to
make interprovincial comparisons of hospital data. "Statistics
of Hospitalized Accident Cases", also prepared annually,
provides a broad analytical coverage of hospitalized accident
cases by circumstance, type of accident, and nature of injury.
"Day Care Surgery in British Columbia Hospitals" is prepared by
the Division to show the potential and development of this type
of service. In addition to these reports, the Division
supplied data to many agencies, both inside and outside the
Government. The demand for hospital morbidity data continued
to grow and has become particularly useful in planning
specialized hospital services.
- 143
 Approved Hospitals
Hospitals as defined under the Hospital Insurance Act
designated by Order in Council 2044, 1977, published as B.C.
Reg. 233/77.
PUBLIC HOSPITALS (ACUTE CARE)
A. Maxwell Evans Clinic, Vancouver.
Armstrong & Spallumcheen Hospital, Armstrong.
Arrow Lakes Hospital, Nakusp.
Ashcroft and District General Hospital, Ashcroft.
Bella Coola General Hospital, Bella Coola.
Boundary Hospital, Grand Forks.
Bulkley Valley District Hospital, Smithers.
Burnaby General Hospital, Burnaby.
Burns Lake and District Hospital, Burns Lake.
Campbell River & District General Hospital, Campbell
River.
Cariboo Memorial Hospital, Williams Lake.
Castlegar and District Hospital, Castlegar.
Ghemainus General Hospital, Chemainus.
Chetwynd General Hospital, Chetwynd,
Children's Hospital, Vancouver.
Chilliwack General Hospital, Chilliwack.
Cowichan District Hospital, Duncan.
Cranbrook and District Hospital, Cranbrook.
Creston Valley Hospital, Creston.
Dawson Creek and District Hospital, Dawson Creek.
Dr. Helmcken Memorial Hospital, Clearwater.
Enderby and District Memorial Hospital, Enderby.
Fernie District Hospital, Fernie.
Fort Nelson General Hospital, Fort Nelson.
Fort St. John General Hospital, Fort St. John.
Fraser Canyon Hospital, Hope.
G. R. Baker Memorial Hospital, Quesnel.
Golden and District General Hospital, Golden.
Kelowna General Hospital, Kelowna.
Kimberley and District Hospital, Kimberley.
Kitimat General Hospital, Kitimat.
Kootenay Lake District Hospital, Nelson.
Lady Minto Gulf Islands Hospital, Ganges.
Ladysmith and District General Hospital, Ladysmith.
Langley Memorial Hospital, Langley.
Lillooet District Hospital, Lillooet.
Lions Gate Hospital, North Vancouver.
McBride and District Hospital, McBride.
Mackenzie and District Hospital, Mackenzie.
Maple Ridge Hospital, Maple Ridge.
Mater Misericordiae Hospital, The, Rossland.
 Matsqui-Sumas-Abbotsford General Hospital, Abbotsford.
Mills Memorial Hospital, Terrace.
Mission Memorial Hospital, Mission.
Mount Saint Joseph Hospital, Vancouver.
Nanaimo Regional General Hospital, Nanaimo.
Nicola Valley General Hospital, Merritt,
100 Mile District General Hospital, 100 Mile House.
Peace Arch District Hospital, White Rock.
Penticton Regional Hospital, Penticton.
Port Alice Hospital, Port Alice.
Port Hardy Hospital, Port Hardy.
Port McNeill and District Hospital, Port McNeill.
Powell River General Hospital, Powell River.
Prince George Regional Hospital, Prince George.
Prince Rupert Regional Hospital, Prince Rupert.
Princeton General Hospital, Princeton.
Queen Charlotte Islands General Hospital, Queen Charlotte
City.
Queen Victoria Hospital, Revelstoke.
Richmond General Hospital, Richmond.
Royal Columbian Hospital, New Westminster.
Royal Inland Hospital, Kamloops.
Royal Jubilee Hospital, Victoria.
R. W. Large Memorial Hospital, Waglisla.
St. Bartholomew's Hospital, Lytton.
St. George's Hospital, Alert Bay.
St. John Hospital, Vanderhoof.
St. Joseph's General Hospital, Comox.
Saint Mary's Hospital, New Westminster.
St. Mary's Hospital, Sechelt.
St. Paul's Hospital, Vancouver.
St. Vincent's Hospital, Vancouver.
Saanich Peninsula Hospital, Saanichton.
Salvation Army Grace Hospital, The, Vancouver.
Shaughnessy Hospital, Vancouver.
Shuswap Lake General Hospital, The, Salmon Arm.
Slocan Community Hospital, New Denver.
South Okanagan General Hospital, Oliver.
Sparwood General Hospital, Sparwood.
Squamish General Hospital, Squamish.
Stewart General Hospital, Stewart.
Stewart Lake Hospital, Fort St. James.
Summerland General Hospital, Summerland.
Surrey Memorial Hospital, Surrey.
Tahsis Hospital, Tahsis.
Tofino General Hospital, Tofino.
Trail Regional Hospital, Trail.
University Health Service Hospital, University of British
Columbia, Vancouver.
University of British Columbia Health Sciences Centre
Hospital, Vancouver.
145
—
 Vancouver General Hospital, Vancouver.
Vernon Jubilee Hospital, Vernon.
Victoria General Hospital, Victoria.
Victorian Hospital, Kaslo.
West Coast General Hospital, Port Alberni.
Windermere District Hospital, Invermere.
Wrinch Memorial Hospital, Hazelton.
REHABILITATION HOSPITALS
G. F. Strong Rehabilitation Centre, Vancouver.
The Gorge Road Hospital, Victoria.
Holy Family Hospital, Vancouver.
Pearson Hospital (Poliomyelitis Pavilion), Vancouver.
Queen Alexandra Hospital for Children, Victoria.
Sunny Hill Hospital for Children, Vancouver.
EXTENDED-CARE HOSPITALS
Delta Centennial Hospital, Delta.
Fellburn Hospital, Burnaby.
Juan de Fuca Hospitals, Victoria.
The Louis Brier Hospital, Vancouver.
Menno Hospital, Abbotsford.
Mount St. Francis Hospital, Nelson.
Mount Saint Joseph Hospital (top floor), Vancouver.
Mount St. Mary Hospital (excluding top floor), Victoria.
Overlander Extended Care Hospital, Kamloops.
Pearson Hospital (excluding facilities for tuberculosis
patients), Vancouver.
Pouce Coupe Community Hospital, Pouce Coupe
Queen's Park Hospital, New Westminster.
St. Vincent's Arbutus Hospital, Vancouver.
DIAGNOSTIC AND TREATMENT CENTRES
The Arthritis Centre of British Columbia, Vancouver.
Cumberland General Hospital,. Cumberland.
Elkford and District Diagnostic and Treatment Centre,
Elkford.
Fraser Lake Diagnostic and Treatment Centre, Fraser Lake.
Gold River Health Clinic, Gold River.
Houston Hospital, Houston.
Keremeos Diagnostic and Treatment Centre, Keremeos.
Ocean Falls General Hospital, Ocean Falls.
Pemberton and District Diagnostic and Treatment Centre,
Pemberton.
146
 OUTPOST HOSPITALS
Red Cross Outpost Nursing Station, Alexis Creek.
Red Cross Outpost Nursing Station, Atlin.
Red Cross Outpost Nursing Station, Bamfield.
Red Cross Outpost Nursing Station, Blue River.
Red Cross Outpost Nursing Station, Edgewood.
Red Cross Outpost Nursing Station, Kyuquot.
FEDERAL HOSPITALS
Canadian Forces Station Hospital Holberg, San Josef.
Canadian Forces Station Hospital Masset, Masset.
PRIVATE HOSPITALS
Cassiar Asbestos Corporation Private Hospital,  Cassiar.
Mica Creek Private Hospital,  Mica Creek.
HOSPITAL FACILITIES
Division of Laboratories, Community Health Programs,
Vancouver.
Provincial Drug and Poison Information Centre, Vancouver.
Tilbury Regional Hospital Laundry, Delta.
147
 Patients Separated and Proportion Covered by Hospital Programs, British Columbia Public General Hospitals*
Only (Excluding Federal, Private, Extended Care and Out-of-Province Hospitalization),   1975.1980/81
Total Hospitalized in
Covered by
Public Hospitals
Hospital Programs
Adults
Adults
and
New
and
New
Children
born
Total
Children
born
Total
Patients Separated—
1975
415,805
36,538
452,343
398,279
35,700
433,979
1976
408,278
36,117
444,395
390,641
35,292
425,933
1977
406,180
36,980
443,160
386,872
36,119
422,991
1978/79
408,606
37,938
446,544
389,922
37,293
427,215
1979/802
410,648
39,880
450,528
390,513
39,125
429,638
1980/813
410,224
42,036
452,260
390,533
41,279
431,812
Percentage of Total Patient!
Separated-
1975
-
-
-
95.8
97.7
95.9
1976
-
-
-
95.7
97.7
95.8
1977
-
-
-
95.2
97.7
95.4
1978/79
-
-
-
95.4
98.3
95.7
1979/802
-
-
-
95.1
98.1
95.4
1980/8l3
-
-
-
95.2
98.2
95.5
1 Includes rehabilitation and Long Term Care Statistics.
2 Amended as per final report received from hospitals.
3Estimated, based on hospital reports to September 30,1980.
- 148
 TABLE  II
Total Patient-days and Proportion Covered by Hospital Programs, British Columbia Public General Hospitals *
Only (Excluding Federal, Private, Extended Care and Out-of-Province Hospitalization^   1975.1980/81
Total Hospitalized
n
Covered by
Public Hospitals
Hosp
tal Programs
Adults
Adults
and
New-
and
New-
Children
bom
Total
Children
bom
Total
Patient Days—
1975
3,565,532
213,846
3,779,378
3,413,630
207,471
3,621,101
1976
3,488,179
207,316
3,695,495
3,343,172
201,111
3,544,283
1977
3,473,838
208,574
3,682,412
3,337,330
202,751
3,540,081
1978/79
3,565,659
208,969
3,744,659
3,428,709
203,299
3,632,008
1979/802
3,603,701
232,226
3,835,927
3,460,477
225,992
3,686,469
1980/813
3,433,580
231,352
3,664,932
3,299,670
225,800
3,525,470
Percentage of Total Pat
ent Days-
1975
—
—
—
95.7
97.0
95.8
1976
-
-
',-4r- '~
95.8
97.0
95.9
1977
-
-
* .-^r-'V*.-
96.1
97.2
96.1
1978/79
-
-
-
96.2
97.3
96.2
1979/802
-
-
-
96.0
97.3
96.1
1980/813
-
-
-
96.1
97.6
96.2
1 Includes rehabilitation and Long Term Care Statistics.
2 Amended as per final report received from hospitals.
3Estimated, based on hospital reports to September 30, 1980.
149
 8  I
H '43
sag
£■0
9-c
1"S
_ p.
s 8
I?
CO £
■§__
2_?
so vo vo Os c
)  CO  Os
)  00   Os
so O "si"   O   Cl  Cl
CN ij. « *0   f   O
Tj-m _. r-^ ^ c\ o
t-- O O On O  c-1
-   00   oo   00  C-   00
SO 00 00  —  ON SO
<"! ■*_ °s. °_ "X ""S.
Os Os 00 CO Oi On
"*_ n. m "* "* M
"3 "S 9   .
O    O (-.
o.t_! g -g.
Ills
S||.s
*T T) -5 °*
°   e   « *-
d <  £ r-
5 ■" ci
°« ^°„ S3 °l ^_ "1
\o o ^- r» co c-
O O Os On   Os   0\
st  st  M <"1   <*>   f>
g 00 CO
i r- oo os o
■ t— r- r- co
i On On. OS OS
ci os os r~- o ci
sn
00
>
o
e_
w q
00
t^
^f
■*
|
t-
■s
—<
,
x a
O
n
Tl
m
iy
c
£
7
■o
C a
00
o
U.
SO
■*
i^-
3
oo
00
00
oo
ou
oo
d
D.
c
o
o
c
o H
<rt so r- co on o
'. g r_j 3 tg r> oo
n> vo so r- co as o
-or- r- r- t- t-- oo
2 Os on on os. os on
il
150
 Summary of the Number of Hospital Programs In-Patients and Out-Patients,
1975-1980/81
Estimated Number
Total Adults
of Emergency
Children
Minor Surgery
Total
and Newborn
Day Care and
Receiving
In-Patients
Out-Patients
Benefits
1975
445,081
1,191,650
1,636,731
1976
440,099
1,228,723
1,668,822
1977
435,249
1,303,679
1,738,928
1978/79
438,392
1,464,799
1,903,191
1979/80i
441,526
1,678,768
2,120,294
1980/812
442,330
1,839,126
2,281,456
l Amended as per final report received from hospitals.
2Estimated, based on hospital reports to September 30, 1980.
Summary of Hospital Programs Out-Patient Treatments, by Category
1975 -1980/81
1975
1976
1977
1978/79
1979/80
1980/813
Psychiatry—
Out-Patient
17,915
22,352
23,974
26,222
24,481
27,378
Day Care
34,219
40,392
46,323
53,725
57,209
63,054
Minor and Emergency
571,055
542,223
575,000
645,634
814,317
945,716
Day Care Surgery
62,019
66,663
76,405
82,979
89,312
92,358
Diabetic Day Care
2,354
3,426
4,126
4,515
4,949
6,378
Physiotherapy
338,583
368,867
387,993
454,697
484,110
491,370
Dietetic Counselling
5,937
10,218
12,942
18,189
22,077
25,170
Renal Dialysis Day Care'
-
10,481
18,351
19,717
20,253
22,832
Other 2
159,568
164,101
158,565
159,121
162,060
164,870
TOTALS
1,191,650
1,228,723
1,303,679
1,464,799
1,678,768
1,839,126
1 Commenced June 1,1976.
2Other includes (a) Cancer Out-Patients and (b) Rehabilitation Day Care.
3 Estimated.
151
 Patients Separated Total Days' Stay and Average Length of Stay in British Columbia Public
Hospitals for Hospital Programs Patients Only Grouped According to Bed Capacity, 1980/811
(Excluding Extended Care Hospitals).
BED CAPACITY
Total
250 & Over
100 to 249
50 to 99
25 to 49
Under 25
Patients Separated—
Adults & Children
Newborn
390,533
41,279
204,683
19,862
101,019
9,736
46,747
8,233
27,951
2,532
10,133
916
Patient Days-
Adults & ChDdren
Newborn
3,299,670
225,800
1,982,704
119,464
789,137
50,178
313,561
41,326
160,712
10,878
53,556
3,954
Average Days' Stay-
Adults & Children
Newborn
8.45
S.47
9.69
6.01
7.81
5.15
6.71
5.02
5.75
4.30
5.29
4.32
-Estimated, based on hospital reports to September 30, 1980.
TABLE VII
Percentage Distribution of Patients Separated and Patient-Days for Hospital Programs Patients
Only, in British Columbia Public Hospitals, Grouped According to Bed Capacity, 1980/81   (Excluding
(Extended Care Hospitals):
BED CAPACITY
Total
250 & Over
100 to 249
50 to 99
25 to 49
Under 25
Per Cent
Per Cent
Per Cent
Per Cent
Per Cent
Per Cent
Patients Separated—
Adults & Children
100.0
52.41
25.87
11.97
7.16
2.59
Newborn
100.0
48.12
23.59
19.94
6.13
2.22
Patient Days-
Adults & Children
100.0
60.09
23.92
9.50
4.87
4.87
Newborn
100.0
52.91
22.22
18.30
'   4.82
1.75
1 Estimated, based on hospital reports to September 30, 1980.
152 -
.
 The statistical data shown in the following charts
prepared by the Research Division are derived from
admission/separation forms submitted to Hospital Programs.
Note that the figures given are for fiscal 1979/80.
Readers interested in the more detailed statistics of
hospitalization in British Columbia may wish to refer to
Statistics of Hospital Cases Discharged During 1979/80 and
Statistics of Hospitalized Accident Cases, 1979/80, available
from the Research Division.
153
 HOSPITAL PROGRAMS
Chart 1 — Percentage Distribution of Days of Care * by Major Diagnostic Groups,
Hospital Programs, 1979/80
Metabolic diseases
Mental disorders
•Including rehabilitative care.
15*1
Infective & parasitic diseases 1.4% I
Metabolic disorders
2.3%
FEM
ALES
Ill-defined conditions            2.0%
Other
3.0%
3.5%'
5.2%
6.6%
m
^v                   Infective & parasitic diseases 1.6%|
Nervous system
\\\r
s\              Skin                                      1.0%1
Respiratory system 1
./     -
Circulatory system              14.0™
Genito-urinary system
1          Deliveries                            13.6%
Bones
7.2%
\        m- ■
J          Accidents                           13.3%]
L             ^**
Digestive system
Neoplasms
 1 °*
p-
■ 8.3
■ 8.4
B 8.7
I  7.5
o
1
Os
M
|
p
SO
p
|
, so
1
p
^
so
°)\
OS O
sq
p
'so
I
i
Os
5
t|;
sq
I
1
Os
CO
as
os   -r   os
S.-S
a J
os
co
-*
5
sq
SO
*o
3
£
s
oo
t>
^
C;
oo
tn
__
p
sq
p
to
tJ;
so
sq
OS
SO
l<
SO
3
^
sq
c*
so
■■O
2
5
■*
Os
i
II
Is
_f Si1
c   £
&.s
a o
m
< I
—i os ■* a
co    r~   t--   so    so
155 -
 HOSPITAL PROGRAMS
Chart III—Percentage Distribution of Hospital Cases* by Type of Clinical Service,
Hospital Programs, 1979/8<t'*'<
Psychiatric
Rehabilitative Care     0.7%
Psychiatric
5.0%
Rehabilitative Care
0.7%
Paediatric Surgical
Paediatric Medical
4.3%         A.
5.6%      /
^—\* \ !
•	
\        Adult Surgical
40.0%
Maternity
* Including rehabilitative care.
156 -
I Adult Medical 24.9%
 HOSPITAL PROGRAMS
Chart TV—Percentage Distribution of Hospital Days * by Type of Clinical Service,
Hospital Programs, 1979/80
Paediatric Surgical    3.7 9
Rehabilitative Care     3.2%
Paediatric Medical    5.9
Psychiatric
Adult Surgical
Rehabilitative Care   3.9%
Paediatric Medical    3.1
Psychiatric 8.0
Maternity 12.1%
Adult Medical        32.2%
Paediatric Surgical      2.1
Adult Surgical 37.!
'Including rehabilitative care.
157
 HOSPITAL PROGRAMS
Chart V — Average Length of Stay of Cases* in Hospitals in British Columbia, by Major
Diagnostic Groups in Descending Order, 1979/80 (Excluding Newborns).
Mental disorders 13.8 1
Diseases of the circulatory system 13.1 1
Certain conditions originating in ,
the perinatal period
Complications of pregnancy,
childbirth, and the puerperium
Symptoms, signs and ill defined,
conditions
•Including rehabilitative care.
Endocrine, nutritional and
metabolic diseases
Neoplasms
11.9
Diseases of the musculoskeletal
10.6
system and connective tissue
Injury and poisoning
9.2
Diseases of the blood and
blood-forming organs
Diseases of the skin and
subcutaneous tissue
Congenital anomalies
8.6
PROVINCIAL AVERAGE
8.5
LENGTH OF STAY
Infective and parasitic diseases
83
Diseases of the nervous
system and sense organs
8.0
Diseases of the digestive system
7.8
Diseases of the genito-urinary
6.4
system
Diseases of the respiratory
6.2
system
4.5
Supplementary classification 4.4
158
 HEALTH PROMOTION AND INFORMATION
Introduction
As part of the Ministry of Health's growing commitment to
improving the health of residents of British Columbia, those
sections of the Ministry concerned with health education and
information and the general improvement of personal lifestyle
were brought together under the heading of Health Promotion
Programs early in 1979.
The constituent divisions and sections now operating
under this general title are:
Division of Nutrition and Division of Health Education
(operating under one director), Division of Occupational
Health, Information Services, Art Services, Photographic
Services, Special Events and Displays, the Ministry of Health
Library, and a government funded agency, Action B. C, which
operates under the Societies Act with its own board of
directors.
Health Promotion Programs also operates the Ministry of
Health's audiovisual services (including the audiovisual
library, which was transferred to Supply and Services on
November 1, 1980) and is responsible for the staffing and
operation of the centralized television production centre,
which is available to all government departments for videotaped
information and education programs. (Responsibility for the
television production centre was to be transferred April 1,
1981, to Government Information Programs under the Ministry of
Provincial Secretary and Government Services).
The Executive Director of Health Promotion and
Information, to whom the above operations report, is a member
of the Deputy Minister's advisory committee; the Executive
Group of the Ministry of Health; and the Community Health
management group, with a view to integrating health promotion
activities with all sections of the ministry.
159
 Information Services
Maintaining public awareness of the large social issues
confronted by the Ministry of Health was the responsibility of
information services staff. The public cannot be expected to
use the health system responsibly without greater general
awareness  of its  problems  and policies.
During the year, a large volume of printed materials were
developed or processed by information services. Included were
more than 180 press releases, which is a reflection of both the
scope and intensity of this Ministry's  activities.
The introduction of the Dental Care Plan, major hospital
improvements, and refinements to the Long Term Care Program,
all  required  special  publicity  and   promotion efforts.
Staff with public information skills also regularly
consulted health professionals, administrators and others on
how local involvement in the Ministry's services might be
heightened.
160 -
 Division of Nutrition and Health Education
HEALTH EDUCATION
The focus of Health Education for 1980 was to increase
contact with those not usually involved in health district
programs, in order to increase their participation. The health
topics of special interest were smoking, prenatal health,
school health, and weight reduction. Despite limited resources
progressive steps were made.
In order to become more aware of effective processes for
initiating and maintaining positive health practices in British
Columbia communities, inservice programs on health education
skills were made available. A workshop on the effect of
cultural norms on health related behaviours was conducted for
the health education staff. Workshops were also held on the
use of audio-visuals, program planning and evaluation, and
group instructional techniques.
Initiatives were made in the area of school health
education. A series of study prints and lesson plans for
elementary school teachers were developed. A discussion paper
on school health education was prepared, outlining the needs,
issues, and barriers to progress in developing health
education programs for children.
In the North Okanagan Health District a pilot study was
designed to stabilize the population of grade 8 non-smokers.
The research study, entitled Project Non-Smoker was based upon
a Stanford University design and adopted the use of peer
leaders from high school to deliver the intervention sessions.
The project used a psycho-social approach to the problem,
emphasizing the need for students to recognize pressures to
smoke, as well as ways in which they could refute the pressure
situation verbally. There were 1250 students involved in the
initial testing phase, which will be repeated at the end of the
1981 school year, to evaluate the program.
A new "Kick-It" smoking cessation group was initiated by
the health educator in the North Okanagan Health District, who
assisted in the training of volunteers to run the program.
Inservice training was organized for the staff of the health
district. In Vernon a seminar on "Effective Communication
Skills" and "A Positive Response to Stress" took place, in
addition to a workshop for the dental staff on "Creating New
Approaches to Teaching Grade Ones".
The Planning of a Health Education Telephone Access
161 -
 Service was completed in 1980, in the Vernon area. Consumers
will soon be able to phone a local number and receive a 4
minute talk on a variety of different health topics.
Local community television productions were undertaken
during the year. In Vernon a series entitled "Lifestyle
Education" was produced. This included half hour programs on
such topics as "Foods That Make You 111", "The Simplicity of
Staying Healthy", and the "Process of Making Lifestyle
Changes". In addition, an 8-part series on nutrition was
developed, to guide wary consumers through a variety of topics
from food additives to vegetarianism.
A number of school initiates were taken, and in Vernon
the educator worked with counsellors to establish new
approaches to preparing the educational readiness o£ students
to sex education topics. The renewed interest in sex education
prompted demands to assist in planning of this important
curriculum subject.
Summer students, under the guidance- of the education
consultant, produced some useful studies. In the North
Okanagan area one student surveyed and compiled an interesting
booklet of "Elderly Educators". Various organizations in the
community were sent a listing of these resource people, and
asked to stimulate the involvement of the elderly in their
subject area. A second s tudent compiled an analysis of
pre-school nutrition, creating a survey-based report useful in
assessing the nutrition education needs in this area.
During 1980, Health Education in the Selkirk Health
District undertook a variety of programs to encourage
utilization of preventive programs offered by the health
district, as well as developing self-learning tools on health
for isolated communities.
Starting in January and February a weight reduction
campaign called the "Flab Fite" was conducted throughout the
towns and villages within the Selkirk Health District and West
Kootenay Health District boundaries. With support from four
local radio stations (CKKC - Nelson, CJAT - Trail, CKGF - Grand
Forks and CKQR - Castlegar) a competition was held between
towns. Over 700 people registered and reported a loss of
near ly a ton of fat during the four weeks. A main educational
tool was the Fat Kat Fit Kit, which included lifestyle and
promotional materials to aid with home weight reduction.
During the spring, staff from both the Selkirk Health
District and West Kootenay Health District designed and
produced a Community Health Services Information Package, which
 clarified programs, roles, relationships and interactions of
health district services with other services in the community.
In May, a grant from the Federal Health Promotion
Directorate enabled a staff of three to investigate the home
birth phenomena in the Selkirk Health District. An important
relationship with the Kootenay Childbirth Counselling Centre
was established, which resulted in an interesting and
informative study. Perhaps the most important result was the
relationship developed by the two groups in information sharing
and analysis.
During the summer, staff at Selkirk Health District were
involved in the production of a preventive health newspaper,
called "Rural Route", which was distributed to all residents
living in posted rural routes within the area. Topics included
environmental health, nutrition, self care, and child care
segments, along with coupons for further materials and current
book reviews. Published tri—annually, "Rural Route" will also
recreate the Flab Fite in 1981 in more isolated areas, by
developing a mail order weight reduction campaign throughout
the District based on mail-in requests and mail-out kits. This
will aid in overcoming geographical and inclement weather
problems, encountered earlier in 1980.
Further to these activities, various inservice workshops
were presented to a cross section of area professionals. The
main focus was the development of program planning and
promotion aspects of rural community development.
Activities continued throughout the year to encourage
staff to utilize health education resources for programs.
Future plans include the development of a waste water/sewage
systems design course, developed in conjunction with the Public
Health Inspection Division, to educate homeowners, contractors,
real estate and land developers, to properly install adequate
disposal systems.
Health education services were made available to the
Northern Interior Health District in June of this year. These
services took the form of assisting all health unit programs to
improve the health education being carried out. In the
Northern Interior Health District a special emphasis was placed
on the evaluation of health education activities.
Prenatal classes provide an opportunity to influence the
smoking behavior of pregnant women. Pregnant women and their
partners attending prenatal classes were asked what they knew
about smoking and pregnancy, what they had done during their
 pregnancy, and what assistance should be offered to prenatal
classes for women who smoke. The information will be used in
1981 to develop educational strategies to reduce smoking among
pregnant women.
In conjunction with the home care staff, a campaign was
organized to promote the Early Maternity Discharge Programme.
Materials which emphasized the under-utilization of the
programme in Prince George were sent to local general
practitioners and their receptionists, hospital nursing staff,
and prenatal class teachers. Evaluation indicated this
campaign increased public contact with the health district
office concerning available home care services.
NUTRITION
In 1980, the Nutrition component of the Division of
Nutrition and Health Education continued with the refinement
and improvement of current programs. It also undertook to
assess or survey selected portions of the population, in order
to determine the direction that nutrition should take during
the 1980's. Pregnant women and infants continued to be the
major risk group receiving nutritional attention. Another
group showing a growing need on which to focus was the
school-age population, including the adults (parents and
teachers) who have direct contact with that group.
Activities directed toward the high risk maternal and
infant population included two outreach programs with major
nutrition components, which were planned in co-operation with
Public Health Nursing, located in Williams Lake and Courtenay.
Funded with International Year of the Child money, these two
programs established a referral network, nutritional
assessment, and nutrition education, to those high risk
portions of the population who do not routinely seek out
available prenatal health care. The major group contacted in
Williams Lake were East Indian women; those contacted in
Courtenay included teenagers, Native Indians and women with low
income. The results were impressive, with a significant
increase in birth weights over the normal average observed for
these risk groups. A final report on the project will be
available following the birth of the last baby, early in 1981.
Several surveys on infant feeding practices in British
Columbia Were conducted during the year. Selected communities
in the Boundary and Central Fraser Valley Health Districts were
surveyed during the summer, to obtain information on the
amounts and types of foods offered to infants, as well as the
164
 time of introduction of solid foods. When the results were
compared between mothers who attended regular prenatal classes
and those who had received no formal prenatal education, a
larger precentage of the prenatal class attendees fed their
infants in accordance with nutritionally sound infant feeding
practices. A comprehensive survey on the practices and
attitudes of parents on breast feeding was under way in the
North Okanagan Health District at the year end.
A member of the Division participated in the Nutrition
Committee of the British Columbia Medical Association to help
develop an Infant Nutrition Policy. This policy was accepted
at the British Columbia Medical Association Annual General
Meeting, and adopted by the Ministry of Health, in December,
1980.
The Division recognizes there is a growing need for
establishing a nutrition education component in the school
curricula. Many of the field nutrition personnel were active
in making overtures in this direction during the year. Several
activities included nutrition assessment surveys directed at
students' eating habits (Kamloops), breakfast-eating habits of
school children (Mission), and foods served in schools
(Cranbrook). A breakfast campaign was under way in selected
schools in North and South Okanagan, East Kootenay, and
Northern Interior Health Districts. The campaign is directed
towards elementary schools and focused on K-3 students and
teachers. Breakfast kits containing a teacher resource sheet,
posters, stickers, and a new publication on nutritious
breakfasts were provided to teachers in the selected schools.
The initial response was enthusias tic, and a comprehensive
evaluation of the project continued.
The Community Nutritionist in the East Kootenay Health
District presented a brief on nutrition education and school
foods to the Honorable Brian Smith, Minister of Education, at a
regional education meeting. Another nutritionist, from South
Okanagan, was working on a film promoting the use and sale of
nutritious foods in our schools. In addition to these
activities, there was a strong nutrition education component in
the draft of the School Health Education policy. As a result
of these and other similar activities, a growing number of
schools were adopting the "Guidelines for Accessory Foods
Served in Schools", prepared by the Division.
Additional nutrition support was provided for the Long
Term Care system in the province. New Adult Care Regulations
were adopted, which included considerable changes to the Food
and Nutrition section. These new regulations will assist
ministry staff to better ensure a high level of care for all
 Long Term Care residents. Field nutrition personnel working
primarily in the area of Long Term Care focussed on nutrition
workshops for facility operators, as well as continuing to do
annual assessments and consultations. The first workshop for
Meals-on-Wheels co-ordinators was organized by provincial
nutritionists located in the lower mainland, and was presented
in the fall. Nutrition was the main topic on the program,
which was well attended by co-ordinators from the surrounding
area.
During 1980, time was spent developing tools that would
result in a more effective use of nutritionists' time. The
major item is a computer program for nutrient analysis. Due to
the time and money required to perform even the most limited
nutrient analyses by hand, a computer program was developed and
added to the divisional resources. All nutrition staff
received initial training on the operation and use of the
program, which has many applications, including assessment of
one or more days' diets of high risk groups such as pregnant
women or school age children, or assessment of menus or recipes
used in care facilities. The program can provide very specific
information on diets of select groups, such as vegetarians or
infants, and it can provide assessments both on individuals or
on groups of individuals. At the year end, the major
limitation of full utilization of the program across the
province was the lack of computer terminals available to the
field nutrition staff.
The second annual food pricing survey, conducted in
November, will provide data useful in counselling low income
families and establishing monthly food cost guidelines for food
budgeting. The data on food costs for individuals of different
ages and sex, also has implications for facility operators when
establishing their food budgets.
Publications have long been used as tools to augment
nutritionists' time. Additional items developed and produced
by the division in 1980 include: all the items used in the
breakfast campaign; School Nutrition Calendar for 80-81; a
pamphlet on vegetarianism and pregnancy; an East Indian Food
Guide; the pamphlet, Food for the Trail; Nutrition Guidelines
for Refugee Sponsors; and Nutrition Reports: Volume I.
Another publication, the "B.C. Diet Manual", underwent a major
revision in 1980 and was published in a new format. This
manual has been adopted by all major hospitals in British
Columbia, and is to be used as the primary diet therapy
reference by Ministry staff.
 The "Senior Chef" program has^ a fifth series that will be
aired on commercial television beginning in January, 1981. To
augment the new series the cookbook was revised and extensive
guidelines were developed for use in group teaching
situations. The "Senior Chef" program has been aired across
Canada and in selected parts of the United States during recent
years, and is well accepted by the senior viewing audience.
The very successful Nutrition Aide project, begun in
1979, was continued into 1980. This federally funded program
provided training for the aides in a basic nutrition
information and educational methodology to non-professionals
during a one month session. The eleven aides were then placed
in various health district offices under the supervision of a
community nutritionist, and effectively augmented the nutrition
program. The termination of the project created a gap in the
nutrition program.
Publicity for the division was obtained through a number
of channels. 1980 saw the third provincially sponsored
Nutrition Week in March. Most of the activities carried out
during Nutrition Week were aimed at promoting good nutrition,
and making people aware of the services and materials available
through the Division. Nutrition Week will be going national
for the first time in 1981 and, because of experience and past
organizational success, B.C. is being called upon to provide
leadership at that time.
Nutrition promotion also took the form of a major display
outlining nutrition programs in B.C. which was exhibited at two
conferences in 1980. As a result, the division was recognized
at both a national and an international conference as a leader
in the area of promotion and education.
Future directions of the Nutrition component of the
division include continued work on the expansion of nutrition
education and services into the schools. The division staff
will also be actively involved in refining and expanding the
use of the nutrient analysis computer program. There is a need
to do a comprehensive nutrition survey of the population of
B.C., to establish the current nutrition status of select age
groups. This information is necessary for detetmination of
those people who are nutritionally at risk, and will enable
more effective program plans to be made for the future.
SPECIAL EVENTS AND DISPLAYS
1980 saw continued progress and expansion of the Displays
Sec t ion.  Major events included Career Days in Terrace and
- 167
I
 Courtenay, as well as Health Fairs in Victoria, Chilliwack and
Maple Ridge. Once again the Provincial Ambulance Service
presented major displays at Victorias' Jaycee's Fair, the
Pacific National Exhibition, the Abbotsford International Air
Show, and the British Columbia Summer Games in Kelowna.
Representatives of the Speech and Hearing Division
attended the Washington Speech and Hearing Conference held in
Spokane, Washington, and mounted an impressive display in the
education and institutional division.
The Public Health Nurses were represented at the Canadian
Public Health Association Convention in Ottawa, Ontario, and
presented a display on perinatal programs available in the
Province.
Representatives of the Division of Nutrition attended the
Canadian Dietetic Association Conference in London, Ontario,
and the Society of Nutrition Education Convention in Montreal,
Quebec. In co-operation with the nutritionists, a display was
developed for use at these conferences.
On going projects at the year end included providing
services for the opening ceremonies for health district offices
at Terrace, Prince George, Nanaimo, Vernon and Parksville. New
displays constructed during the year included Public Health
Nursing, Physiotherapy, Radiation Protection, Speech and
Hearing, Perinatal, Victoria Hospice, and six new Ambulance
displays which were distributed throughout the province.
During the summer months, Special Events and Displays
employed five summer students and transformed the old T.B.
Society X-ray tractor-trailer into a Mobile Display Unit. The
new year will see this travel throughout the province. Special
Events and Displays had 556 display days through the 1980 year,
a considerable increase over 1979.
On January 1, 1981, the offices of Special Events and
Displays will move to a new location in Victoria, in order to
provide additional services.
 Library Services
The library enjoyed a very active year,  aided by its
three summer students, and by an addition to its regular staff.
The project of converting the catalogue from the Dewey
-...-> ,.  i    ,_.,.,,-...  --iy» the Chilliwack and Nanaimo
health districts were brought  into  this system, with the
librarian acting as consultant.
The library published a serials holdings list of its 500
periodical titles and distributed copies to all Ministry of
Health offices.
Circulation and other figures include:
• Books ordered 750
• MEDLINE AND ORBIT
literature searches  .216
• Book and report circulation....2,278
• Photocopy service 1,512
• Inter library  loans 652
These figures indicate a very progressive use of
published  information by Ministry of Health staff.
-  169
 Division of Occupational Health
The Division of Occupational Health, through a broad
variety of programs and a multidisciplinary staff of
physicians, nurses, counsellors, radiation specialists and
supportive staff, has as its objective the encouragement of a
safe and healthy work environment, and the prevention of
occupational and non-occupational diseases and injuries. The
major goals of the Division are the placement of individual
employees in positions compatible with their total health, and
insuring that high quality treatment and rehabilitation are
obtained. Consultation services on occupational and
environmental problems are provided to both government and
non-government agencies. Offices are located in Vancouver,
Victoria and Kamloops. Major centres such as Prince George,
Vernon, Cranbrook, Nelson, Terrace and Nanaimo are visited on a
regular basis by physicians, nurses and counsellors.
In 1980 there were seven full-time and one half-time
Occupational Health Nurses on staff. Twelve thousand six
hundred (12,600) employees were seen. Pre-employment
screening, audio logy testing, immunizations, tuberculin
testing, and indiviudal counselling services were provided. In
addition, nursing staff were involved in group seminars for
employees as members of a multidisciplinary team of physicians
and Employee Development counsellors, covering topics such as
the function of occupational health services, the management of
stress, and the identification and management of the troubled
employee. On an on-going basis, classes were given on body
mechanics, cancer detection, non-smoking, cardiopulmonary
resuscitation, survival first aid, and preparation for
retirement. The nursing staff were in frequent contact with
supervisors and personnel officers, regarding the management of
employees in need of occupational health services, on a
pre-referral and follow-up basis, accounting for approximately
15,000 telephone calls during the year.
The Employee Development Service works very closely with
medical and nursing personnel to provide appropriate
counselling assistance for government employees and their
families affected by marital, family, parental, financial,
legal, stress, alcohol or drug problems. This assistance with
psycho-social problems as they affect the employee's job is a
totally confidential service. The staff of two provides
diagnostic counselling and referral to appropriate community
resources, for all employees and all ministries throughout the
province. During the year over 1,600 such interviews were
conducted, an increase o.f approximately 10 percent over 1979,
with a highly significant and gratifying increase in the number
of employees who referred themselves,  or a member of their
 family. An evaluation of the program carried out in the summer
indicated that at least 75% of all employees whose job
performance had been affected by their personal problems
returned to at least a satisfactory work performance, which is
both a social and financial benefit to the employer and the
employee.
The Employee Development Service provided supervisory and
shop s teward training seminars in the identification of
troubled employees, and their referral to the counsellors.
During the year over eight such seminars were presented, for a
total of 1,500 supervisors, personnel officers and shop
stewards throughout the province. Because stress management is
crucial in the prevention of most psycho-social problems, the
counsellors began a series of stress management seminars for
all government departments. The Director of the program was
invited by the Government Employee Relations Bureau, and the
B.C. Government Employee's Union, to act as a consultant in the
establishment of a greatly expanded and province-wide employee
assistance program. It is recognized that the troubled
employee is a major concern of both management and union, and
his proper management will benefit all concerned.
In 1980, opportunities in fitness and nutrition were
provided for employees in Victoria by the Employee Fitness
Program. Exercise and nutrition counselling were the core of
the program, with a variety of other services such as exercise
classes, fitness assessments, individual activity programs,
obesity reduction programs, educational workshops and
recreational events. There was a notable increase in those
attending the programs during the year.
The Division continued to develop a nurses resource kit,
which will provide fitness information to public health nurses
around the province. A fitness motivation project in the
summer of 1980, a follow-up to a similar program in 1979,
attempted to determine a change over the previous year. A
third project was the October FitFest 80, which resulted in
over 3,000 government employees in the Victoria area taking
part in physical activities of various forms, an increase of 5%
over 1979.
A nutrition profile was developed and sent to
approximately 2,900 employees in Victoria. The profile
increased awareness of nutrition, as 22% of those circulated
requested and received more nutritional information. The
Employee Fitness Program continued to reach more and more
employees, and there was an increas ing demand for similar
programs throughout the province.
The Ministry of Health, through its Radiation Protection
 Service, was a major participant in the Royal Commission of
Inquiry into Uranium Mining. Members of the Radiation
Protection Service were present at all the hearings and
participated fully in the discussions, and prepared four
briefs. Three technical briefs were presented to the Royal
Commission: a) Backgroud Radiation, b) The Ministry of Health's
Concerns for Worker and Public Health, and c) The Toxicity of
Uranium.
Natural radiation sources continued to interest the
general public and the Radiation Protection Service during the
year. A collection and monitoring program of water sampling
was carried out in cooperation with the Ministry of Energy,
Mines and Petroleum Resources, and a report was issued in April
1980. Investigations were also conducted into post-glacial
uranium deposits, and the uranium content of water in the
Okanagan Region. Uranium uptake studies were carried out with
the assistance of Simon Fraser University. The radioactivity
levels of road beds and home site material were measured and
studied, to safeguard the health and safety of workers and the
public at  large.
Safety surveys of the numerous X-ray units located
throughout the province continued to be a major responsibility
of the Radiation Protection Service, in order to ensure safety
of equipment operators and to keep radiation exposures to the
patient as low as is reasonably achievable. The introduction
of computerized tomographic units in B.C. hospitals created an
additional  demand.
The increased use of industrial and domestic microwave
ovens, radio-frequency equipment, video-display terminals and
lasers has aroused public curiosity regarding possible health
hazards and personal safety. This has put an additional burden
on the staff of the Service, and numerous radiation safety
slide presentations were given throughout the year to
interested  groups.
Activities   of  the Radiation Protection  Services   included:
1980       1979
Radiation  surveys   (X-ray,   radioisotopes
and microwaves)
Consultations   and visits
Talks  and   lectures
Radioisotope   leak   tests
Analyzed water samples
Air  samples
Planning for the establishment of a computerized health
information     system     continued      during      the     year.        When      in
1462
1419
1840
2132
60
55
510
379
400
419
40
75
 operation, this system will be an extremely important activity
of the Division of Occupational Health and will provide a much
needed epidemiologic capability. It will be possible to
provide up-to-date information on employee health and health
trends within each government department, and to evaluate
associations between employee classifications and adverse
health effects. At the end of 1980, in cooperation with the
Department of Highways, Transportation and Communications, and
the Division of Vital Statistics, the Division of Occupational
Health had completed plans for the study of motor-vehicle
mechanics who had been employed in the government service from
1960 to 1970. It is anticipated that the Division will become
more involved in this type of study.,in the future.
I
 Action B.C.
When Action B.C. was organized in 1973 it was given the
following aims  and objectives:   I
• to develop and foster public awareness of health in its
broadest  aspects,  both preventive and curative;
• to provide a vehicle for two-way communication between the
community  and  government   in relation   to health  matters;
• to provide a vehicle for inter-disciplinary communication
between disciplines concerned with  the aspects of health;
• to provide to communities and interested groups information
and resources  concerning health and related matters;
• to provide for such other charitable purposes as may, in the
discretion of the directors of the Society, appear to
contribute to the promotion, advancement, encouragement or
development of a high  level of  fitness   in British Columbia.
These goals have been adhered to closely, with pehaps only the
term "curative"  being  in question.
The original emphasis on phys ical activity has expanded over
the years to include nutrition, smoking cessation, tension awareness
and relaxation.
In 1980 the Health Promotion Program for business and industry
was  re fined  to  include  the  fo1lowing i terns:
Cardiovascular  test
Flexibility
Strength
Skinfold
Health Hazard Appraisal  (computer printout)
3-Day  Nutrition Analysis   (computer  printout)
These items have been conducted at the work site and, together
with the individual lifestyle counselling, take one-hour of the
employee's time. In all cases follow-up testing was recommended for
six months, one year after the first visit, with periodic workshops,
as requested, on back care, smoking cessation, aquatic exercises,
sporting activities, running/jogging, relaxation, and health and
fitness   for  retirement.
Using the three vans donated by Kiwanis, this program has been
taken throughout the province at the request of companies and
groups.      In   the   new   year   a   computer   printout   is   to   be   developed   to
- 174
 complement the tes ting and counselling. This will make use of
portable micro computers, which can be taken to the test-site and
provide  the  "ins tant  feedback"  important  in motivation.
The highlight to the program in 1980 for industry was the 2nd
Annual Action B.C. Corporate Cup, held in May at Swangard Stadium in
Burnaby. This event brought together 60 teams from local businesses
(900 participants), in the spirit of friendly competition, and was
videotaped by the Health Ministry Audio-Visual Production
Department. The showing of this tape has provided the incentive for
other cities and provinces throughout the country to hold similar
events of their own. Greater participation is expected at the 1981
Corporate Cup,   to be held in May.
The Health Promotion display, developed in co-operation with
the Ministry's Special Events and Displays department, toured the
province throughout the year, visiting malls, fitness festivals,
Community Days, Recreation Centres, and Conferences, etc. This
provided a cardiovascular test, a 1-day nutritional analysis or
lifestyle appraisal or stress assessment (the last three having
printouts on the micro-computer). To set up these displays,
co-operation from local Health Units, the Heart Foundation, service
clubs, recreation commissions and health professionals was required
to help with   the extra staffing needed  for  these  popular  events.
As in other years, the community program highlights were the
Sea Festival and the Pacific National Exhibition, both of which drew
huge crowds   to  the many  lifestyle  programs Action B.C.   offered.
Having a nutritionist on staff enhanced the quality of the
nutrition program, and improved liaison with nutritionists
throughout the province. The computerized nutrition analysis (1—7
days) underwent extensive revisions and 1981 will see the time of
day in which food is consumed playing a role in trying to tackle the
problems of no breakfasts and overeating at night. This program was
used increasingly by the public and schools in 1980 (approximately
10,000),   and Action  B.C.   continued   to   try  and  expand   its  utilization.
In   1980   two   leadership   training   programs   were   used   by   Action
• "Butt Out" for teenagers.
• "Target" for adults.
Also, a "Do-It-Yourself" booklet, originally written for the
Cassiar Asbestos Co. was reprinted by Action B.C. and widely
distributed throughout the province.
Tension Awareness and Relaxation Training workshops were of
growing importance in Action B.C.'s programming.
 The Ac t ion B.C. newsle t ter, "Optimum", provided a
communication link with the public, focussing on commentary and news
in the various health and fitness fields.
In all areas of Action B.C.'s involvement it was stressed that
the methods are neither diagnostic or clinical, but serve to
emphasize the awareness and motivation role, essential in guiding
the individual to a healthier lifestyle.
176
 PLANNING AND DEVELOPMENT
Planning and Development Services is responsible for
providing leadership and support in the following areas:
planning and policy analysis, program development, research and
evaluation, management information systems, consultation,
manpower planning and educational liaison. In addition, the
operation of the Vital Statistics Division is an integral part
of Planning and Development Services. A separate report on the
Vital Statistics Division's activities during the year follows.
The year 1980 could best be described as being
developmental in nature. The Planning and Policy Analysis
Division, with Paul PalIan as director, and the Program
Development Divis ion, with John Talbot as director, were
established. The position of Director of Research and
Evaluation was posted and should be filled in early 1981.
Considerable progress was made developing a consultation policy
for the Ministry, and determining the number and types of
consultants that will be located in Planning and Development.
The Management Information Systems unit was reorganized,
in order to give line management more direct control over the
regular operation of their EDP systems. Responsibility for the
planning, development and the integration of the information
systems was allocated to Planning and Development Services,
where the management information systems group was assigned
responsibility for developing a health planning and development
data base and computer based modelling.
Planning and Development Services directed, co-ordinated,
or was extensively involved in the following projects during
1980:
.^?S?3 Hospital Role Study - Phase I of this study was discussed
at regional B.C. Health Association meetings throughout
the province for comments, feedback and suggestions. All
comments had been received by August and the process of
revising Phase I was started.
"-■■.•'ts&T. Provincial Handicap Study - This inter-ministerial
(Health, Human Resources and Education) review of the
services to severely handicapped children and adolescents
was carried out and a report will be presented in
January, 1981.
•    Workshops  and educational  activities  -  Planning and
Development  Services organized and sponsored a major
177
 seminar on program evaluation for senior managers in the
Ministry of Health, in early spring.
In addition, workshops were presented throughout the year
on planning, objective-setting, program development,
budgeting, and related subjects.
• Objective setting - Planning and Development Services was
actively involved in other aspects related to objective
setting within the Ministry. This included providing
assistance to divisons in developing objectives, the
ranking and priorizing of objectives and in integrating
the objective setting process with the budgetary process
of the Ministry. A document entitled "Setting
Objectives: A Manager's Guide" was produced to assist
Ministry staff in developing sound objectives.
• Provincial Rehabilitation Study - This study, aimed at
reviewing the rehabilitation services within B.C., began
in 1980. Initial organization and terms of reference
were developed and a consultant, Dr. Joyce MacKinnon, was
appointed to conduct the major review.
Planning and Development was also involved in the following
projects or studies:
Two Hospice Projects (Vancouver, Victoria).
Position papers  on consultation  services  within  the
Ministry, alternative health care systems, interns and
residents.
Review of health care boundaries.
Development of a "Data Handbook" for the Ministry of
Health.
Review of vision care services on the Queen Charlotte
Islands.
Development   of   geo-coding    units    for    Ministry    of    Health
data collection.
Development    and   monitoring    of    assessment    and    treatment
centres.
Review of the objectives and operational procedures of
the B.C. Health Care Foundation.
A number of changes were made in the representation on the
Health Manpower Working Group (H.M.W.G.), which reflected more
emphasis on policy orientation. The research unit of the
H.M.W.G., located in the University of B.C., was engaged in the
following projects on behalf of the Ministry:
• 'Difficult-to-Fill' Monitoring,
o    Post Basic Nursing Study.
• Rehabilitation Personnel (PT/OT).
178
 • Physician's   directory   and    GMSS    (General    Manpower    Stock
Simulator).
• Ultrasound technicians.
• Health record personnel.
In order to better define and clarify the roles and
responsibilities of Planning and Development Services, a
document describing these roles and responsibilities was
prepared at the end of 1980 and circulated to senior managers
within the Ministry.
179
 Vital Statistics
The Division of Vital Statistics administers the Vital
Statistics Act, the Name Act, the Marriage Act, and the Wills
Act, Part II, and provides a centralized statistical service to
various community health programs within the Ministry, and to
certain other health  agencies.
REGISTRATION   SERVICES
Although registration services constitute the major part
of the Division1s responsibilities, they are not detailed in
this report. An outline of these activities, together with
extensive statistical data, is presented in the statutory
Annual Report of  the Division of Vital Statistics.
A substantial part of the Division's responsibilities is
connected with the administration of the Vital Statistics Act,
which governs the registration of births, stillbirths,
marriages, deaths, adoptions and divorces, as well as the
issuance of documentation from the registrations on file, in
accordance with the conditions laid down in the act. The total
number of registrations accepted and certificates issued under
this Act  continued to rise steadily in  1980.
Under the Marriage Act, the Division registers ministers
and clergymen of recognized religious denominations for
purposes of the solemnization of marriage in this Province, and
administers the issuance of marriage licences in accordance
with the prescribed requirements of the Marriage Act, as well
as the solemnization of marriages by civil contract throughout
the Province.
Under the provisions of the Name Act several thousand
residents of the Province changed their given names or
surnames, and the names of their children. The recent steady
increase in numbers of applications under this Act continued
during   1980.
The Registry of Wills Notices is maintained under the
provisions of Part II of the Wills Act, whereby a testator may
file with this division a notice indicating the existence of a
will and its location, and information therefrom may be
released after decease of the testator. The number of wills
notices   filed maintained  its   steady  increase   in   1980.
 Table    6     shows     the    number    of    registrations of    vital
events,    and    the    number    of    certificates    and    other forms    of
documentation     issued    under     the    acts     administered by     this
division,   for  the years  1979 and  1980.
BIOSTATISTICAL SERVICES
Research offices in Victoria and the Health Surveillance
Regis try in Vancouver, under the superv is ion o f the ass is tant
director, provided a wide range of statistical information as
well as extensive collaborative and independent research.
Recipients of these services included divisions within Planning
and Development Services, sectors of Community Health Services,
other sectors of the provincial and federal governments,
universities  and hospitals,   and members of  the general public.
In 1980, the research and data processing sections were
relocated adjacent to other Ministry research and data
processing services. This required a change of technology from
IBM card machines to Mohawk key-on-tape methods. Data control
functions of the division were also integrated with Ministry
data control functions in the Victoria offices. These moves
and changes necessitated considerable adjustment regarding
communication and function but did not delay the Division's
essential services   to  the  public.
This was the first year annual runs were accomplished on
the Honeywell computer following the 1979 conversion of the 35
divisional information sys terns by B.C.S.C. from the IBM to the
Honeywell mainframe computer. Special maintenance and extra
study was required among the more complicated systems (e.g. the
legal registers and the Health Surveillance Registry), but,
except in the case of the community care system, service was
not disturbed to any  appreciable extent despite  the conversion.
The Health Surveillance Registry office in Vancouver
received approximately 15,500 reports of cases in 1980.
Fifty-six percent of these were reports on new cases of birth
and genetic defects, the remainder being follow-up reporting on
cases which were already on file. A major task, the conversion
of the medical codes on particular cases from the eighth to the
ninth revision of the International Classification of Diseases,
was completed during this year and a paper was published in
Medical Informatics concerning the methodology inherent in
converting such a large historical file. The Registry office
in Vancouver was moved by the B.C. Building Corporation from
the Public Health building to 660 West Seventh Avenue. A
report for year-end statistics for 1978 for the Registry was
published and distributed.
 The Cancer Register, a longtime responsibility of the
Division of Vital Statistics, was transferred to the Cancer
Control Agency of B.C. as of April 1, 1980. A statistical
report of cancer in B.C. for 1977 was produced and distributed
to interested clinicians and agencies.
The Health Surveillance Registry provided information in
a number of areas, including statistics on the prevalence of
mental retardation, data on rubella syndrome, foetal alcohol
syndrome, as well as on a variety of genetic conditions
including Huntington's Chorea and Down's syndrome. It provided
prevalence statistics regarding the full range of disabilities
for particular parts of the province for concerned agencies,
both within and beyond the confines of the Ministry. A sample
from some 35 subjects on which the Registry was called upon to
contribute follows: provincial handicapped study, Usher's
syndrome, multiple sclerosis, arthritis, diabetes, cerebral
palsy, musculoram deformans, an amniocentesis register,
X-linked mental retardation, pyloric stenosis, neural tube
defects, retinitis pigmentosa, frequency of the coincidence of
visual and hearing impairment, etc. The growing interest in
monitoring and surveillance of birth defects, and also of
chronic and handicapping diseases, continued, with requests for
information from 15 other geographical locations. This was a
reflection of the wider recognition that the Registry has
achieved beyond the province. UNICEF, an agency of the United
Nations, made one of these inquiries.
The staff of the research office in Victoria fulfilled a
heavy demand for perinatal and mortality information, based on
information that is provided to the divison by the registration
of vital events. They offered consultation services in the
areas of the feasibility of particular research problems, as
well as in the design and planning of particular studies being
attempted by health officers, health educators, nutritionists,
and others, including those in the Division of Occupational
Health. They ass is ted in the improvement of research
applications, as well as in the correction and improvement of
other Ministry and government files, through the provision of
regular lists and statistics pertaining to vital files. They
performed a study to assess the appropriateness of Table
Producing Language (TPL), a computer "package" which can be
used by research officers to analyze and create tabulations of
vital events.
Reports and tabulations were regularly provided to
Statistics Canada, the Drug and Poison Information Centre,
medical health officers on the status of communicable diseases,
public health inspection, public health nursing, Home Care, the
182
 G.F. Strong Centre, and Community Care. The office maintains a
rheumatic fever prophylaxis register for use by private
physicians  through the  local health district office.
Individual research Officers gave service to the Inter-
Ministerial Children's Committee, the health record
Administration project, and to the Task Force on Geocoding and
Geographic Boundaries.
The Victoria office maintained files on some 97,000
individuals who have had tuberculosis or who are at high risk
of getting this disease. Indexes and an annual statistical
report were produced, as well as information relevant to a
number of research questions, such as the association of
tuberculosis  to the condition of silicosis.
The research section contributed to the Perinatal Program
of B.C. through an executive member on the continuing advisory
sub-committee. Concerns in 1980 included the high rate of
caesarian section, Sudden Infant Death Syndrome, teenage
pregnancy, low birth-weight babies, and perinatal mortality.
The prevention of stillbirths was the subject of two articles
published in the B.C. Medical Journal. A new revision of the
Physician's Notice of Birth was introduced on January 1, 1980,
and the data provided on this form is used to assess the
validity of information which is being provided on abortion,
and on the stimulation of respiration immediately after birth.
A standard package of perinatal records to be used by
physicians throughout the province was devised and was under
development at  the year  end.
Three studies concerning water quality reached completion
in 1980. One of these studies monitored the effects of
treatment facilities on the bacteriological content affecting
the water in the Columbia-Kootenay Rivers in the Trail-Nelson
area over a period of 12 months. A second study of the
bacteriological content of water at the major bathing beaches
in the Okanagan Basin was done in collaboration with the
Okanagan Basin Implementation Board. The report identified
sources of contamination and other problems that diminish the
quality of the bathing beaches. A third study concerning the
water in Christina Lake was completed in response to local
concern over the effects of growth and development around the
lake. This study, done in collaboration with the Ministry of
Environment, and the Regional District of Kootenay Boundary,
analyzed the bacteriological, chemical and biological aspects
of the water and additionally obtained information on sewage
disposal practices, aquatic plant infection, and residency
patterns.
183 -
 A great deal of assistance was given to Dental Health
Services in the execution of a province-wide children's dental
health survey. Ten thousand children were sampled from 12
different areas and detailed dental charts were created for
each child. Data was analyzed and a comprehensive report was
being prepared at the year end.
An evaluation of the Kelowna Coronary Exercise Group
produced neutral or positive answers to the questions asked of
this study. The final report of this study of the effects of a
defined exercise program upon cardiac patients was under
consideration in December. A previous program evaluation
concerned witn parenting roles was presented to the Canadian
Psychological Association.
Monthly and annual reports were compiled and presented to
the Divison of Venereal Disease Control.
The Research Office responded to a diverse number of
requests and inquires for vital and population data from the
general public.
 r
TABLE   I -  REGISTRATIONS,   CERTIFICATES,   AND OTHER DOCUMENTS PROCESSED BY
DIVISION OF VITAL STATISTICS,   1979 AND  1980
jegistration accepted under Vital  Statistics Act —                                                      1979 19801
Birth registrations         39,077 39,860
Death registrations         19,282 20,510
^Karriage registrations 22,136 23,960
Stillbirth registrations            312 320
i^Edoption orders        1,6102 2,220
MSivorce orders        8,2832 8,580
Delayed registrations of birth            320 260
Jegistrations  of wills notices accepted under Wills Act         50,854 53,750
Total registrations  accepted 141,874 149,460
legitimations  of birth effected under Vital  Statistics
Act        289 270
Il^&rations of given names  effected under Vital  Statistics Act        372 350
laange of name applications granted under Change of Name Act 3,827 3,900
iaterials  issued by the Central Office —
M&rth certificates 102,437 146,330
Death certificates        8,859 8,370
Marriage certificates         12,189 10,560
Baptismal certificates              13 13
Change of name certificates           3,419 3,440
Divorce certificates ■            298 240
Photographic copies       -         13,876 14,750
Wills notice certification 12,374 13,050
Total  items  issued 153,465 196,753
Isnrevenue searches   for Government ministries by the Central Office  .   .   .     10,976 28,210J
j-tal revenue        $660,396 $940,222
.    Preliminary     (excepting Wills Notices  Registrations).
.    Preliminary.
Commencing  in 1980,   includes  free searches relating  to church marriage registers,
numbering about  14,300 in  1980.
-  185
 MEDICAL SERVICES COMMISSION
On July 1, 1968, the Government established the Medical
Services Plan of British Columbia, which is administered and
operated in accordance with the Medical Services Act and
regulations, under the supervision of the Medical Services
Commission. The Commission is empowered to function as the
public authority, appointed by the Government of the Province,
to be responsible to the Minister in respect of the
administration and operation of the plan established under the
regulations.
The Medical Services Plan of British Columbia provides
prepaid medical coverage upon uniform terms and conditions for
all residents of the Province and their dependents. Insured
services under the plan are paid for insured persons regardless
of age, state of health, or financial circumstances, provided
the premiums fixed by the Commission are paid. Payment for the
services provided is made, on a fee-for-service basis,
according to a tariff of fees approved or prescribed by the
Commission, or on a salaried, sessional, or contract basis at
levels  approved by  the Commission.
Medical   Services   Commission Highlights
During the year the Commission continued to provide a
high quality of service to residents of the Province,
with emphasis on prompt payment of practitioners, and
improved relations with  the public  and health professions.
The taxable income ceiling for premium assistance was
raised during  the year  from $1,720 to $1,770.
The total expenditure for insured benefits under the
Medical Services Plan rose 14.11 percent to $431,471,022
in   1979/80,   from $378,130,607   in   1978/79.
The increased costs to the Medical Services Plan were a
result of upward revisions to the fee schedule, increased
utilization of benefits, changes in the
practitioner/population   ratio,    and    increased   population.
 Si
S 6
i's
gill
o os w o
a < Yi a
f* a > 8
gSa§
EEȣ
s
o
a
oi
w
g
o
w
-_
CO
H
o
P_
|
J
s
g
•J
2
O H
<
O
£
O
0-
to
co
Ed
D
>
o
E-<
oi
Ed
co
2
O
00
to
Q_
g
CU
5 o O CO
zoo
mS2
<
E-
2:
<
5
E-t
W
_J
s
D
o_
E^
2
O
o
<
>
P<_i3
OS
o
OS
tJ
03
OS
o
3
2
a
<
w
J
CO
<
§g
w
w
Ed
cj
O
EC
>
&.
os
o
Ed
«.
■^ 3 £2
O
2
O
_3
0_
Ed
£
j
c
<
3
i
04
E-«
CO
_§
%
E>
£
3
S
Ed
Pi
Oh
Ph
- 187
 Benefits Under the Plan
BASIC MEDICAL SERVICES
The Medical Services Plan provides insurance coverage for
all medically required services rendered by medical
practitioners, including osteopathic physicians, in British
Columbia, and certain surgical procedures of dental surgeons
where necessarily performed in a hospital as provided under the
Medical Care Act (Canada).
Until March 31, 1977, funds were received from the
Government of Canada under shared-cost programs. Commencing
April 1, 1977, these programs were replaced by transfers to the
Province under new Federal-Provincial fiscal arrangements, and
the Province now' provides the entire Government contribution to
the Medical Services Plan.
ADDITIONAL BENEFITS
In addition to payment for the above services, additional
benefits, when rendered in the Province, are provided without
extra premium by the Government of British Columbia. All
payments are paid only at a tariff of fees approved by the
Commission. "Year" means calendar year. A brief description of
these additional benefits (1979) follows:
Chiropractic - Payment for the services of a registered
chiropractor is limited in any one year to a total of $75 per
patient under the age of 65 years, and $100 per patient 65
years of age or over. There is no payment for X-rays taken by
a chiropractor.
Na turo pa th ic - Payment for services of a naturopathic
physician is limited in any one year to a total of $75 per
patient under the age of 65 years, and $100 per patient 65
years of age or over. There is no payment for X-rays taken by
a naturopathic physician.
Orthoptic treatment - Payment for orthoptic treatment is
limitedto $50 per patient in any one year, and a maximum of
$100 per family in any one year, when rendered to an insured
person on the instructions of, or referral by, a medical
practitioner.
Physiptherapy - Payment for the services of a registered
phys io therapis t on the ins true t ions of, or re ferra1 by, a
 medical practitioner, where performed other than in general or
rehabilitative hospitals, is limited in any one year to a total
or $75 per patient under the age of 65, and $100 per patient 65
years of age or over. Out-patient physiotherapy services in
general hospitals or in rehabilitative hospitals, on referral
by the medical practitioner, are benefits provided by Hospital
Programs.
Podiatry - Payment for services of a registered
podiatrist is limited to $50 per patient in any one year, and a
maximum of $100 per family in any one year, when rendered other
^friuv on the instructions of, or referral by, a medical
practitioner within the year. There is no payment of X-rays
taken by a podiatrist.
Optometry - Services of registered optometrists are
approved for required diagnostic optometric services, to
determine the presence of any observed abnormality in the
visual system. The plan does not pay for the fitting or cost
of lenses.
Orthodontic - Service provided by a dental surgeon for an
insured person 20 years of age or younger, and which is
consequentially necessary in the case of a cleft lip and/or
cleft palate, is paid only where that service arises as part
of, or following, plastic surgery repair performed by a medical
practitioner. There is no payment for dentures, appliances,
prostheses, or for general dental services, other than those
referred to under basic medical services involving certain
medical procedures of dental surgeons, where necessarily performed in a hospital.
The extended role services of a registered nurse where:
(a) an arrangement for the rendering and for the payment of
these services is approved by the commission, and
(b) these services are rendered in an area of the province
where a medical practitioner is not normally available.
No payment is made for any of the additional benefits
when the service is performed outside the Province of British
Columbia.
Services Excluded Under the Plan
Services which are provided under other Federal or
Provincial Acts, such as the National Defence Act (Canada), the
Hospital Insurance Act, and the Workers' Compensation Act of
the Province.
 Pathology, radiology, and/or electrodiagnostic services,
performed within the Province at a laboratory that, at the time
the service is rendered, is not an approved laboratory for the
performance of the service.
Services which are not considered to be medically
required by the patient, e.g., cosmetic services, examinations
at the request of a third party, medico-legal services, advice
by telephone, travel charge of a practitioner.
While unexpected medical services arising when an insured
person is temporarily absent from British Columbia are covered
at British Columbia rates, prior authorization in writing from
the senior medical consultant of the plan is required where the
insured person elects to seek medical attention outside the
Province.  Otherwise payment may not be made under the plan.
Premium Rates and Assistance
For those persons having maintained a permanent residence
in British Columbia for the 12 consecutive months immediately
prior to making application, and who otherwise qualify as
eligible under the Medical Services Act regulations, premium
assistance is available as follows:
(a) Applicants who had a taxable income (combined taxable
income of subscriber and spouse) for the immediately
preceding taxation year, not in excess of a specified
amount determined each year, qualify for a subsidy of 90
per cent of the full premium rate. (This amount was
$1,770 for the 1979 tax year.)
Monthly premiums payable by subscribers, effective July
1, 1979, are as follows:
If Qualified for -
Full 90 per cent
Premium Subsidy
$ $
One person        7.50 0.75
Family of two      15.00 1.50
Family of  three or more      18.75 1.87
(b) Temporary premium assistance is available for a
three-month period under unusual circumstances which, by
reason of  illness,  disability,  unemployment,  or  financial
_
 hardship, render an eligible person unable to pay his
currently required premium for coverage under the plan.
Temporary premium ass is tance is at 90 per cent of the
full premium rate.
Laboratory Approval
A six-member Advisory Board on Laboratories, appointed by
the Commission, continued to provide advice and recommendations
to the Commission with regard to its determination of approval
of laboratories for the performance of insured services, under
the regulations set down by the Lieutenant-Governor in Council
in September, 1971. The Commission is responsible for ensuring
the reasonable availability of quality laboratory services for
insured persons throughout the Province, for controlling the
expansion of facilities or provision of new facilities until
there is reasonable utilization of existing facilities, and for
requiring that, where approved public facilities provide
service of equal quality and availability, priority
consideration be given to the services provided by such
approved public facilities.
Professional Review Committees
As in the past, the Commission continued to work closely
with the peer review committees of physicians and other
practitioners providing services under the plan.
The Commiss ion provides data to the professional
licensing authorities, or other relevant practitioner bodies,
with respect to the volume and type of services rendered under
the plan, and various other statistical information on an
annual basis. The commission also provides various statistical
information to them on a request basis.
Salaried and Sessional
While most medical services in British Columbia are paid
for on a fee-for-service basis, there is, nevertheless, a
substantial volume of services paid on a salary or sessional
fee basis.
Apart from the Provincial Government, which employs
phys ic ians in this way, there are many o ther organ i zations
within the Province which make arrangements with physicians to
- 191
 provide   insured   services   on   this   basis,    and   arrange   with   the
Medical  Services Commission  for reimbursement of their costs.
When the Medical Services Commission reimburses an
organization which employs a doctor performing insured services
on a salaried basis, a payment is made to the organization for
the shareable portion of the doctor's salary; that is, the
proportion of the approved salary which represents the time he
spend on providing insured services to individuals. An
additional amount is paid to cover the relevant overhead costs
of  the organization employing  the doctor.
A sessional fee is a payment of a set amount of money for
the part-time services of a physician for half a day (three and
one-half hours), and the sessional fee includes, where
pertinent, a payment for overhead to compensate the physician
for continuing overhead costs in his or her additional private
practice.
In the year 1979/80 the total expenditure on insured
services by the Medical Services Commission was $431,471,022,
of which $408,270,633 was in the form of fee-for-service
payments,   and $23,200,389  for  salary and sessional payments.
Statistical  Highlights
The total expenditure for insured services under the
Medical Services Plan for the 1979/80 fiscal year was
$431,471,022, up $53,340,415, or 14.11 percent, from the
prior year.
A similar increase was reflected in the per capita costs
for insured services, which rose from $149.53 in 1978/79
to $167.93  in  1979/80,  an increase of 12.3 percent.
Administration costs at $19,883,088, representing 4.41
percent of total plan costs for 1979/80, showed little
change  from the previous  year.
.Since all statistical tables related to claims payments
for the two years were compiled on a cash basis, the data
is not truly comparable.
-   192
J
 SUBSCRIBER STATISTICS
TABLE I - Registrations and Persons Covered^- by Premium
Subsidy Level at March 31, 1980.
Subsidy
(Per Cent) Subscribers Pe
90     271,221   424,120
50           	
Nil    932,099   2,169;582
Total   1,203,320   2,593,702
TABLE II - Persons Covered by Age-group at March 31, 1980.
Age-Group Persons
Under 1  33,324
1-4  148,532
5-14  400,417
15-24  460,947
25-44  759,737
45-64  508,210
65-69  99,830
70-79  119,990
80-89  46,962
90 and over  9,820
Unknown  5,933
Total 2,593,702
1.  Coverage data do not include members of the Canadian Armed
Forces, RCMP and inmates of Federal penitentiaries.
- 193 -
 TABLE III- COVERAGE BY FAMILY SIZE AT MARCH 31, 1980
Family Size Number of
(Persons) Families
1    542,324
2    290,412
3    134,358
4    149,317
5    61,439
6    18,628
7  4,644
8  1,477
9 or more  721
Total  1.203.320
19b
 MEDICAL  SERVICES  COMMISSION
FEE-FOR
-SERVICE  PAYMENTS
MEDICAL  PRACTITIONERS
AND DENTAL  SURGERY  IN HOSPITAL
E.E  IV - Distribution of Fee-For-Service Payments  for Medical Ser
/ices  (Sh
ireable)
SPECIALTY
PERCENTAGE
COST PES
PERSON
AMOUNT PAID"-1'
OF  TOTAL
(2)
1978/79
1979/80
1978/79
1979/80
1978/79
1979/80
$
$
|
i
neral Practice
140,155,866
158,141,797
42.47
41.77
55.4239
61.5505
Irmatology
3,812,576
4,298,941
1.16
1.14
1.5077
1.6732
lurology
2,580,532
3,043,580
0.78
0.80
.     1.0205
1.1846
Inch ia try
9,407,347
10,328,785
2.85
2.73
3.7201
4.0201
■Bropsychiatry
273,477
304,089
0.08
0.08
.1081
.1184
Istetrics and Gynaecology
11,816,717
13,513,293
3.58
3.57
4.6728
5.2595
Hhthalmology
12,213,994
13,933,539
3.70
3.68
4.8299
5.4231
lolaryngology
5,505,183
6,242,783
1.67
1.65
2.1770
2.4298
IS,  Ear,  Nose,  Throat
33,075
147,775
0.01
0.04
.0131
,0575
Igeral  Surgery
19,085,898
21,353,556
5.78
5.64
7.5474
8.3110
IBrosurgery
1,708,942
2,028,378
0.52
0.54
.6758
.7895
Ithopaedic   Surgery
8,747,494
10,267,676
2.65
2.71
3.4591
3.9963
■as tic  Surgery
2,364,869
2,821,731
0.72
0.75
.9352
1.0983
■eracic  Surgery
1,971,525
2,404,774
0.60
0.64
.7796
.9360
l^logy
5,106,208
5,724,521
1.55
1.51
2.0192
2.2280
l.diatrics
6,939,687
7,687,211
2.10
2.0-3
2.7443
2.9919
■eernal Medicine
21,539,981
25,440,626
6.53
6.72
8.5179
9.9018
liiology
24,222,560
27,760,750
7.34
7.33
9.5787
10.8048
llhology
30,312,532
37,725,287
9.18
9.96
11.9869
14.6831
liesthesiology
12,641,778
14,722,177
3.83
3.89
4.9991
5.7300
■E,ical  Medicine
450,160
545,440
0.14
0.14
.1780
.2123
J)lie Health
93,033
99,686
0.03
0.03
.0368
.0388
Inrobiology
	
15,575
0.00
0.00
.0000
.0061
lital Surgery  In Hospital
1,342,282
1,467,182
0.41
0.39
.5308
.5710
Bieopathy
316,588
259,830
0.10
0.07
.1252
.1011
fplear Medicine
540,887
684,686
0.16
0.18
.2139
.2665
R'.lassif ied
6,822,768
7,595,621
2.06
2.01
2.6980
2.9563
TOTAL
330,005,959
378,559,289
100.00
100.00
130.4990
147.3395
■Includes only  those payments which have
been made duri
ng  the re
spective
fiscal per
iods.
■Based on insured population as  at Octob
:r   1,   as derive
d  from St
atistics
Canada Dal
a
(October  1,   1978 = 2,528,800;     October
L,   1979 = 2,569
,300).
-  195 "
 TABLE V     - DISTRIBUTION OF MEDICAL  FEE-FOR-SERVICE PAYMENTS  AND  SERVICES,   BY TYPE OF  SERVlt
Number of Services
Type of  Service
General Practitioner.
Complete  examination  	
Partial  examination.   . •*
Subsequent office visit ■   •
Night,   Sunday,   holiday,   or  emergency vis
First house visit	
Subsequent house  visit   	
Hospital  visit    .   .   .   •   .   .   .
Subtotals   	
Spec in I is t s
Consultation       •   •■•••.••
House visit *••.»•*•
Office visit   •••••«*••*•••■
Hospital  visit	
Subtotals   	
Other  Medical
Anaesthesia.   ......   	
Obstetrics	
Surgery	
Special procedures  ..•••■•■*..
X-ray	
Laboratory .«••■..•••••■••
Common office procedures  ........
Psychotherapy ••••«••■
Elect rodiagnosis ••....
Pulmonary  function  	
Miscellaneous	
Subtotals
TOTALS
1978/79
1,012,441
5,525,403
1,705,156
569,289
117,823
46,772
1,459,770
10.481.654
918,500
9,989
489,264
608.049
086
56
466
74 3
181
,572
,192
198
45
25
15
,612
,002
,236
,536
,870
,020
,658
,582
,870
,664
,803
Amount Paid
584,853
1979/80
1978/79
1,078,055
5,902,427
1,675,979
604,699
119,771
46,655
1,513,018
22,879,223
61,583,091
11,114,876
14,578,519
2,295,510
714,542
9,415,535
10.940,604
122.581.296
981,533
12,598
509,275
671,237
2,174,643
2,173,584
59,459
490,450
801,200
1,199,295
8,359,432
1,229,612
207,926
64,978
32,788
17,071
14,635,795
27,751,042
37,107,785
379,597
4,585,093
5.874.640
47,947,115
15,520
9,093
40,578
13,417
22,314
36,986
7,805
7,250
2,279
309
3,921
159,477
,742
,187
,248
,304
,634
,381
,471
,994
,461
,788
,338
,548
330,005,959
19798-
ll
26,218!
70,79*
11,37|
16,28
2,45
76
10,64
138,56!
42,9«
59
5,U
6,94
51
55
17,7(1
10,4(1|
45,415
15,7lk
24,3;n
45,1:B
8,9:1
8,l«l
3,5:|
4(»
4,5:3
184,4;.:
378,5!]
196 -
 ADDITIONAL BENEFITS
FEE-FOR-SERVICE PAYMENTS
SABLE VI - Distribution of Fee-For-Service Payments  for  Insured Services,  Additional Benefit
of Service
Amount Paid (1)     (2)
1978/79
i
1979/80
i
Percentage of
Total
1978/79    1979/80
Coat Per Person (3)
1978/79
$
1979/80
S
Jpial Nursing	
■mrian Order of Nursing
iinpractic	
jaropathic	
ihiotherapy  (Office) .   .
Sriotherapy   (Hospital) .
ir.jptic   .	
*ltry	
Pietric	
.'idontic   .......
eussified	
Totals
2,060
2,274
14,636
8,924,459
407,686
3,985,386
3,295
2,155,797
4,916,627
110,470
9,520
710
322
4,242
9,970,672
430,704
4,770,381
1,926
2,497,322
5,420,004
134,133
4,392
0.01
0.01
0.07
43.46
1.98
19.41
0.02
10.50
23.95
0.54
0.05
.00
.00
.02
42.91
1.85
20.53
.01
10.75
23.33
.58
.02
0.0008
0.0009
0.0058
3.5291
0.1612
1.5760
0.0003
0.0001
0.0017
3.8806
0.1676
1.8566
0
0013
0
0008
0
8525
0
9720
1
9442
2
1095
0
0437
0
0522
0
0038
0
0018
20,532,210
23.234,808
100.00
100.00
8.1193
>Includes only those payments which have been made during the respective fiscal periods.
(These amounts are fee-for-service payments made under the plan only, and in no way reflect
-the total for the services of these practitioners.
j Based on insured population as at October 1, as derived from Statistics Canada Data
! 1978 = 2,528,800; 1979 = 2,569,300).
197
 TABLE VII- Summary of Expenditures,   1969/70 to 1979/80.
Medical
Salaried  and
Additional
Fee-Por-Service
t
Sess ional
S
Benefits
S
Admin is t ra tion
i
Total
$        |
1969/70
105,700,011
3,677,387
6,929,779
5,687,035
121,994,2121
1970/71
122,818,267
4,375,798
6,611,815
6,030,059
139,835,939b
1971/72
127,000,505
4,788,365
5,534,520
6,567,847
143,891,237ft
1972/73
139,532,341
6,022,920
7,897,244
7,320,137
160,772,642ft
1973/74
159,614,356
7,991,062
8,963,080
8,581,794
185,150,2921
1974/75
190,452,494
10,424,602
11,089,892
12,501,015
224,468,003ft
1975/76
250,026,093
15,437,520
15,045,516
12,659,521
293,168,6501,
1976/77
268,496,749
14,880,410
17,090,707
13,040,063
313,507,929,:
1977/78
298,900,495
17,749,957
17,436,161
13,207,188
347,293,8011
1978/79
337,513,465
19,484,932
21,132,210
16,856,376
394,986,9831
1979/80
384,735,825
23,200,389
23,534,808
19,883,088
451,354,Uo|
Whereas  preceding  statistical   tables  are prepared on a cash basis,   the above  summary   is
compiled on an accrual basis.
 CHART   I    - COVERAGE BY AGE-GROOP AT MARCH  31,   1980
Under 1 1-4 5-14        15-24       25-44       45-64 65+        Unknown
199
 CHART II   - COVERAGE  BY  FAMILY SIZE AT MARCH 31,   1980
Number of Registrations  (100,000)
Family Size (Persons)
542,32-
390X12
49,317
34,356
61,439
18,628
p- 1         4,644            1,477              721
8      9 or More \
Family Size (Persons)
 EMERGENCY HEALTH SERVICES COMMISSION
On July 1, 1974 the Emergency Health Services Commission
was es tablished under the Emergency Health Services Act,
Chapter 30, Statutes of British Columbia, 1974. With the
consolidation of Provincial statutes in 1979 the name of the
Act was changed to Health Emergency Act, Chapter 162, R.S.B.C.
1979. The Commission comprises five members, one of whom is
appointed Chairman. During 1980, Mr. P.M. Breel was appointed
Chairman, replacing Mr. D.H. Weir, who retired. In addition,
Mr. Breel was appointed Executive Director of the Commission,
replacing Dr. P.M. Ransford, who was^ appointed a member of the
Commission, as well as Senior Medical Specialist to the
Commission.
While the primary concern of the Commiss ion s ince its
inception has been to provide ambulance service throughout the
Province, it also has the powers and authorities:
• To provide emergency health services in the Province;
• To establish, equip, and operate emergency health centres
and stations in areas of the Province that the Commission
cons iders advisable;
• To assist hospitals, other health institutions and
agencies, municipalities and other organizatons and
persons, to provide emergency health services, and to
train personnel to provide services, and to enter into
agreements or arrangements for that purpose;
• To establish or improve communications systems for
emergency health services in the Province;
• To make available the services of medically trained
persons on a continuous, continual, or temporary basis,
to those residents of the Province who are not, in the
opinion of the Commission, adequately serviced with
existing health services;
• To recruit, examine, train, register and license
emergency medical assistants;
• To perform any other function related to emergency health
services as the Lieutenant-Governor in Council may order.
During the year the Commission assumed responsibility for
the medical aspects of disaster planning, as well as
responsibility for the maintenance, inspection, replacement and
storage of Federal emergency medical supplies which are
stockpiled in various locations around the Province. To meet
these added responsibilities a nurse consultant, a specialist
in public health planning, and a storesman were employed to
assist the director in establishing long range disaster plan
programs as they relate to health.
201
 In 1980 two fu 11-time crew members were pos ted to Dawson
Creek, where the service had been totally operated by the
Dawson Creek Fire Department; a second full-time crew member to
100 Mile house and Fernie; and one full-time crew member to
each o f the following: Hous ton, Cumber land, To fino, Enderby,
Osoyoos, Creston and Fraser Lake. New stations operated by
part-time personnel were opened at Bridge River (Shalalth),
Whistler and Willis Point. Twenty crew members were also added
to  the Greater Vancouver and Victoria areas.
The Vehicle Modification Depot in Victoria produced
fifty-one standard ambulances and four 4-wheel drive units,
enabling the Commission to retire some of the older, high
mileage units  from service.
Mechanical inspectors were placed in Prince George and
Cranbrook, to provide regular inspection and establish better
maintenance programmes for the ambulance fleets operating in
the Northern and Kootenay zones.
All aspects of training ambulance crews, both full-time
and part-time, were "subcontracted" to the Justice Institute of
British Columbia in September. Commission instructors now
operate out of the Justice Institute in Vancouver. Two
Emergency Medical Assistant I and XI courses were held at the
new location, with sixty candidates graduating. During the
year additional crews graduated from the Advanced Life Support
program, enabling the Commission to expand this specialized
service to the public with the result that there are now four
Advanced Life Support teams operating on a 24-hour basis in the
Lower Mainland area; two 24-hour crews in Victoria; one 24-hour
crew in Kamloops, and one Advanced Life Support team member
available on a 24-hour basis  in Chilliwack.
In 1980 the air ambulance service was extensively used
for the movement of patients, involving 3,432 flights and 3,577
patients—an  increase of 30  per  cent over  the previous year.
Road ambulance call volume also increased with
appoximately 201,000 patients being carried—an increase of 10
percent over   1979.
Adequate station accommodation for crews and ambulances
continued to present problems to the Commission. However,
during the latter part of the year additional funds were made
available to alleviate this situation, and progress was made
toward improving accommodation at several locations. In
addition, ten prefabricated garages were constructed at the
Vehicle Modification Depot, designed to allow the Commission to
provide   temporary   cover    for   ambulances.      Three    10-by-28    foot
202
 office trailers were acquired and are being modified into self
contained ambulance stations for placement in those locations
where permanent accommodation is currently not available.
203
 FORENSIC PSYCHIATRIC SERVICES COMMISSION
The Forensic Psychiatric Services Commission operates two
out-patient clinics, located in Vancouver and Victoria, and the
Forensic Psychiatric Institute, a 130 bed secure hospital
situated on Crown land within the District of Coquitlam. All
of the Commission's services to the courts and mentally
disordered persons  emanate  from these three components.
During 1980, the Vancouver and Victoria Clinics provided
assessment and treatment of persons charged/convicted of
offenses, upon receipt of a court order* Travelling clinics to
Duncan, Nanaimo, Courtenay, Campbell River, Port Alberni,
Prince George and Kamloops were maintained on a weekly to
monthly basis as  required.
The numbers of court referrals to both clinics showed a
slight increase over 1979. Persons conditionally discharged
from the Forensic Psychiatric Institute were supervised closely
by both clinics, with the Vancouver Forensic Psychiatric Clinic
providing follow-up for the majority. The on-going problem of
not having Commission supervised transition rehabilitation
settings, coupled with a lack of appropriate and adequate
community housing, added to the adjustment and integration
problems facing those patients whose hospitalization period was
lengthy.
The number of remand admissions to the Institute, for
psychiatric assessment of fitness to stand trial, continued to
increase during the year. However, the number of persons
admitted by the courts as unfit to stand trial decreased.
Numbers of persons admitted to hospital, because of a court
finding of not guilty by reason of insanity,  remained stable.
In 1980 there was a marked increase in legal challenges
relating to commitment and treatment of mentally disordered
offenders. The Supreme Court of British Columbia ruled that
persons serving sentences in correctional centres, who became
certifiably mentally ill under the Mental Health Act, could be
transferred from a prison to a mental health facility only by
Lieutenant Governor's Order as per Section 25 of that Act.
NeitherBritishColumbia'sMentalHealthlegislation,northe
Criminal Code of Canada, provide authority to treat persons
admitted under this particular section who are also too ill to
provide informed consent. The Commission therefore, faced the
dilemma of having statutory responsibility to provide
treatment, without any statute which authorizes other persons
to consent on behalf of a patient.
-  204 -
 The Commission recognized the problems confronting
personnel of the justice system dealing with individuals whose
behaviour causes concern about their mental condition, and the
telephone consultation service was increased to 24 hours, seven
days a week to help meet  this need.
Education and research activities expanded and became
more refined in 1980. In-service and inter-agency educational
programmes were further developed, without adding to the
staff. An educational committee consisting of representatives
of the Commission, Federal and Provincial Corrections, was
formed under the chairmanship of the Commission's Co-ordinator
of Forensic Education. This committee organized monthly
workshops for staff in forensic facilities in the Lower
Mainland. The demanding nature of forensic psychiatric work
was reflected in the number of direct care staff enrolled in
advanced training programmes. Twenty-five percent of the
Services' professional staff were participating in advanced
post-basic courses, most of which required heavy commitments of
off-duty time. Partial or total financial assistance was
approved in all these instances. Commission staff continued to
lecture regularly at the Justice Institute, Douglas College,
the British Columbia Institute of Technology, and the
University of British Columbia.
During the year work continued on the joint research
project with Simon Fraser University.' s Criminology Research
Centre on fitness to stand trial, and funding was received from
the Federal Department of Justice and the Solicitor General of
Canada. The University of Toronto, through its affiliation
with Metropolitan Toronto Forensic Services (METFORS) and the
Clarke Institute of Psychiatry in Toronto, agreed to
participate. In a year marked by east-west dichotomy, it was
gratifying to be part of a British Columbia-Ontario
collaboration which is unique in the history of forensic
psychiatry in Canada.
In May, the Commiss ion organized a national conference on
the current status of research in forensic psychiatry.
Approximately twenty delegates were expected, since only a
handful of persons are actively involved in this research
field. Instead, fifty persons of national and international
repute attended. An 85 percent return of evaluation forms
showed a unanimous opinion that such a meeting of minds should
occur annually,  with provinces   taking  turns hosting the event.
In August, five persons were appointed to replace
outgoing Commissioners who had served a three year term. Dr.
John   Duffy   was   named   Chairman   of   the   Commission,    as   well   as
 Executive Director of the Service. Dr. Frederick Tucker, the
former Chairman who had served since the first Commission was
formed in 1974, was named Vice-Chairman. The six members of
the reconstituted Commission represent a cross-section of the
public and private sector.
The model of delivery of forensic psychiatric services
developing in British Columbia continued to attract
international interest. Visitors to the service came from
Australia, New Zealand, Japan, England and the United States,
and from several Canadian provinces.
During the year many of the legitimate requests for
expanded forensic psychiatric assistance could not be met.
However, in keeping with Commission philosophy of providing
services in exemplary fashion, activities will be expanded only
as staff are trained and programmes are funded■
- 206
 ALCOHOL AND DRUG COMMISSION
1980 was a year of both accomplishment and review for the
Alcohol and Drug Commission. The number of patients in the
alcohol programs increased, while the quality of service
throughout British Columbia continued to improve. A detailed
peer review of all programs was continued throughout the year
in order to develop recommendations for service improvements.
Two residential treatment programs, Crossroads in Kelowna
and Pacifica in New Westminster, moved into new facilities
during the year. These programs acquired permanent homes in
first rate accommodation, consistent with the need to treat
alcoholism as a condition that affects individuals in all walks
of life.
The Drug Treatment Program continued to offer treatment
to individuals with a wide variety of drug problems who entered
treatment voluntarily or on referral from the courts.
Caseloads in the program increased steadily. Modifications of
the program at Brannan Lake resulted in a better retention of
clients and stabilization of the caseload at 45 clients.
Throughout the year, preventive programs continued to be
emphasized. During the first quarter of the year, the
Commission developed a television campaign promoting moderation
in alcohol consumption. An independent survey confirmed that
the message was recognized by a high proportion of British
Columbians. In the last quarter of 1980, a campaign which
promoted consumption of non-alcoholic beverages in licensed
premises and at private parties received the wholehearted
support of the hospitality industry.
The programs and structure of the Commission were
thoroughly reviewed during the year resulting in a change in
the structure of the Commission and a renewed mandate for its
programs. As a result of this review, an independent
Commission will be created to advise government on policy and
program development. The treatment services will be integrated
and more emphasis will be placed on providing services through
funded agenc ies.
In 1980, H.F. Hoskin resigned as chairman of the
Commission. While serving in this capacity between February
1976 and April 1980, Mr. Hoskin was responsible for the
development of many new programs for the residents of British
Columbia.
Alcohol and drug abuse will continue to be a major
problem in the foreseeable future in British Columbia.  While
207
 the tremendous impact that these problems have on individual
health, families, the health care system, the criminal justice
system and other institutions is still not fully appreciated,
the potential benefits of effective prevention and treatment
are substantial.
Support Services
MEDICAL SERVICES DIVISION
Throughout 1980, the salaried and sessional physicians
associated with the Commission continued to provide medical
evaluation and treatment services to patients with alcohol
and/or drug dependencies. Services included outpatient care,
detoxication and residential treatment. The physicians held
regular meetings to provide a forum for discussions of medical
recommendations to the Commission and to update them on recent
advances in the medical treatment of dependencies.
During the year, the Commission continued to develop a
working relationship with physicians practising in British
Columbia. Several initiatives were undertaken to achieve this
goal, including a letter sent to all physicians outlining the
programs operated by the Commission and explaining the new
direct referral system for drug dependent clients. In
addition, the chairmen of the British Columbia Medical
Association's drug dependency and alcohol dependency committees
were invited to a conference which was designed to develop a
more co-operative effort in the treatment of those suffering
the effects of chemical dependency. Also, the medical staff of
the Commission participated in an interdisciplinary committee,
which examined possible solutions to problems created by the
abuse of prescription drugs.
PROFESSIONAL DEVELOPMENT DIVISION
Throughout the year, the Professional Development
Division continued to develop educational and training
workshops for professionals and para-professionals, whose work
brings them into contact with alcohol and other drug dependent
people.
In 1980, the Division made 264 community presentations,
lectures and consultations. Over 1,500 people attended 64
training workshops  in every region of  the  province.   In
 addition,     staff    were     involved
Commission staff and agencies.
many     consultations    with
The Division continued to emphasize the promotion and
development of employee assistance programs. Services provided
to employers and unions included 158 presentations and
consultations, an increase of 300 percent over 1979. The
Division also organized 15 training programs, developed new
contacts with 17 organizations and maintained contact with
es tablished programs.
In 1980, the Nanaimo Employee Assistance Program began
operation with S>25,000 allocated through the Commission and
additional funds from five participating employers and unions.
In addition, Inter lock Vancouver, Interlock Prince George, and
the MacKenzie Community Rehabilitation Society received funding
for  similar  services.
The major emphasis during the year was the organization
of the Conference on Occupational Programming Assistance (COPA
'80), which the Commission hosted in October. Outstanding
speakers from New Orleans and Toronto, in addition to experts
from British Columbia, gave a variety of talks and workshops.
The conference was attended by 150 participants from a variety
of organizations.
INFORMATION AND  EDUCATION SERVICES   DIVISION
During the past year, the Information Services Division
of the Alcohol and Drug Commission performed a variety of tasks
designed to increase public awareness of problems created by
alcohol and other drug abuse, and the services provided by the
Commission and  its   funded agencies.
The 1979 Alcohol Awareness campaign was extended to March
of 1980 with considerable success. The theme of the campaign:
"You Can Say No to the Drink You Don't Need" achieved its
purpose to the extent that a Gallup Poll showed public
awareness of the theme increased from 62.2 to 83.3 percent
between October   1979   and  April   1980.
The 1980 Alcohol Awareness campaign, which started in
November and will continue in 1981, promoted the serving of
non-alcoholic drinks in licensed premises. In co-operation
wi th Na t iona1 Health and Weifare, the Div is ion dis tr ibu ted
150,00 copies of recipe pamphlets for "The Great Entertainers",
non-alcoholic cocktails and punches which can be served at
social  functions.
209
 In addition, two television commercials were developed,
as well as posters for bus shelters in the Vancouver area and
tear off recipe sheets posted on the billboards of public
transportation. A number of articles on a variety of topics
related to treatment of alcohol and drug problems were also
written and distributed to the media.
Editorial and writing services were provided by
Information Services to other divisions of the Commission.
This included the preparation of letters directed to every
physician in the province regarding the growing problem of the
abuse by patients of over-the-counter and prescription drugs.
In addition, articles were prepared and published in the
British Columbia Medical Association newspaper, as well as the
British Columbia Government News and other publications
outlining the problem and listing the referral and treatment
services available through the Commission and its agencies.
The Division handled media arrangements for the
Conference on Occupational Programming Assistance, which was
held in Vancouver during the month of October. This consisted
of preparing and placing advertising in the media announcing
the conference, preparation of copy and biographical material
for distribution to the media, arranging press, radio, and
television interviews in advance of and during the course of
the conference.
The Division also handled media arrangements for the
opening of Crossroads in Kelowna and the Pacifica Treatment
Centre in New Westminster.
An early intervention program, initiated and funded in
1979 and designed to identify and refer elementary school
students at risk of developing drug problems, was continued in
1980. The Western Education Development Group project, funded
in 1979 to prepare four teachers' guides and two parents'
manuals on home drugs, was also continued. The grades four and
five trial teachers' guides were completed and are ready for
pilot testing. The Information Services Division also
continued to act as the liaison in the matter of youth and
education initiatives within the Commission and on behalf of
the Commiss ion.
The Information Services library continued to serve as an
important resource to Commission and treatment agency staff, as
well as to students, professionals and the general public. The
increase in the number of book orders, reference questions,
general information inquiries, and circulation in 1980 was
conservatively estimated at 35 percent.
As  well  as  printed  materials,  the  Division  was
 responsible    for    the    purchase,    maintenance    and    allocation    of
audio-visual materials  and equipment.
RESEARCH DIVISION
In 1980, the Research Division worked on a variety of
projects. A number of internal reports were prepared for other
Divisions, and several major projects continued throughout the
year.
The Epidemiological Research Section continued its work
on a comprehensive data base of health, social, criminal
justice, and demographi c indicators. This project, called the
Geographic Profiles, contains data on a school and regional
district basis and will be used for long-range planning
purposes. A report on long-range trends in alcohol and drug
use entitled Alcohol and Drug Statistics for Canada and British
Columbia: 1955-1976, completed in late 1979, was released in
1980. Other reports published were PCP: A Review of Current
Knowledge; Trends in Heroin Use; and Fastfacts III: A Summary
of Answers to Frequently Asked Questions. Work was continuing
on Gallup Poll data, and on a project examining the costs of
alcohol use for British Columbia.
The Evaluative Research Section worked on a large number
of internal reports for other Divisions related primarily to
treatment and training and also undertook a comprehensive
evaluation of the Commission's 1979/80 advertising campaign. A
survey of the Directors of treatment agencies funded by the
Commission was conducted, regarding the Commission's Alcohol
Awareness Week, and the report Evaluation of the ADC
Advertisement Campaign: II Survey of Directors on Alcohol
Awareness Week was published. A summary of this report was
sent to ail participating agencies. Work was continuing on an
extensive survey of expectant parents' responses to the
advertising campaign, and a report on this project will be
released in the spring of  1981.
The Monitoring and Data Systems Section continued work on
the commission's two major information systems: the
Client/Agency Monitoring System, and the Drug Treatment Program
Information System. The existing backlog of data was completed
and progress was made on programming master files for both data
systems, which will enable analysis of the characteristics and
outcomes of clients in treatment, as well as their movement
within the Commission's network of treatment services. Work
also continued on the development of a new, integrated data
system for  the Commission's   treatment services.
 The Commission's research director was one of two
provincial research representatives on the Expert Committee on
Alcohol Statistics, a national committee with representatives
from provineial commiss ions and foundations, the federal
government and the academic community. The paper Issues
Related to Information Systems was presented at Symposium I on
Alcohol Information Systems in Canada, sponsored by the Expert
Committee. These and the other major addresses were reproduced
and published in the journal Toxicomanias.
AGENCY RELATIONS DIVISION
Throughout the year, the Agency Relations Division
continued to serve as the communicating link betwen the Alcohol
and Drug Commission and the Boards and staff of the 50 funded
programs.
The twice yearly regional workshops which began in 1979
proved invaluable in the continued orderly development of the
system of care treatment, network, providing interagency
co-operation and better referral networks.
Significant senior staff turnover in funded agencies
increased board requests for assistance in selecting and
evaluating appropriate staff.
STAFF DEVELOPMENT AND TRAINING DIVISION
The Staff Development and Training Division serves as a
consultant to the programs funded by the Alcohol and Drug
Commission in identifying training needs related to specific
programs. During 1980, activities included organizing sessions
of the Cardio-Pulmonary Resuscitation Course, as well as a
program on working with the alcoholic client in detoxication
centres.
Other  activities  included  developing  workshops for
hospital workers  providing  a detoxication service  to the
community and community people providing follow—up services for
hospital clientele.  These workshops will be available in
package form.
PROGRAM DEVELOPMENT AND EVALUATION DIVISION
the co-ordinator of Program Development was
 involved in investigating the need for services, as well as
evaluating existing services throughout the province. The need
for service in the Port McNeill/Port Hardy area was
investigated, and direct service was commenced in the area with
priority activities at the St. George's Hospital in Alert Bay.
A review of service was conducted for the Vanderhoof/Fort St.
James area, and service needs were assessed in the Terrace area
and  the Burns Lake/Vanderhoof area.
In Fort Nelson, the Fort Nelson General Hospital became
responsible for the administration of a new service. Extensive
reviews of existing services were conducted in Kelowna and
Merritt and plans were concluded for the opening during fiscal
1981-82 of a "detoxication holding  facility"  in Kamloops.
During the year, other areas investigated for service
needs and expansion included the Richmond/Delta area as well as
the East and West Kootenay areas.
The Division co-ordinated two workshops for detoxication
supervisors, which resulted in an extensive review of the
existing components of service. A detoxication resource manual
will be  produced with  the advice of  this  group.
The development and evaluation of the Round Lake
Treatment Centre for native people continued to have a high
priority.
The evaluation of out-patient services funded by the
Alcohol and Drug Commission was commenced in the East and West
Kootenays. This process will continue with the evaluation of
all out-patient services.
Of special interest was the development and promotion of
closer co-ordination between hospital, medical and out-patient
services throughout the province. Areas involved included
Kelowna, Salmon Arm, Kamloops, Fort Nelson, Alert Bay, and the
Queen Charlottes.
Direct Treatment Services
ALCOHOL AND  DRUG  COUNSELLING  SERVICE
The Commission provided alcohol and drug out-patient
counselling through clinics in Vancouver, Burnaby and Kelowna.
The isolated Kelowna unit was moved into the program direction
of the Greater Vancouver units, to provide closer liaison and
unified        direction        for that        service. The former
 hypnotherapy unit in Vancouver, which had operated under the
Drug Treatment Program, was shifted into the Alcohol Program
and integrated into the out-patient counselling services. The
year's experience attested to the value of this level of
co-ordinated program planning for greater thrust and service
integrity*
The Kelowna unit doubled its over all client case load
with an increase of referrals from the general hospital and
corrections services. This was a direct consequence of the
liaison agreement worked out with the hospital to provide
assessment and counselling back-up to their detoxication
experiment. The project with corrections, and the impaired
drivers courses, provided closer co-ordination of these two
government  services.
The Greater Vancouver out-patient service continued to be
the focus of an increasing demand for direct service for
clients and liaison with the funded agencies within the system
of care. In order to maintain quality and effectiveness of
service, i t was necessary for the fir s t t ime in the progr am' s
history to establish a waiting list. This meant that new
client referrals had a three to four week waiting period for
assessment and on-going service. Since the point of referral
is often a critical period for the individual, the family, and
frequently, the employer, these waiting periods often result in
interim intervention, which may  lead to further complications.
The out-patient units began the year with 530 active
clients. During the year, a further 776 cases were opened, for
a total of 1,306 clients served. Also served were many
families, collaterals, industrial representatives, other health
and social service agencies, as well as medical, legal, and
training institutions*
The 14 counsellors in the three units provided a total of
6,193 individual and family treatment sessions. In addition,
these clients received  5,541 group treatment hours.
The medical component provided a further 666 treatment
sessions in the out-patient clinics, in addition to
consultation. Also, regular daily coverage at Maple Cottage
Detoxication accounted for a further 628 treatments in that
facility.
YOUTH AND  FAMILY COUNSELLING SERVICES
The   Youth   and   Family   Counselling   Services    in   Vancouver
continued   to   maintain   an   active   caseload   of   young   people   and
214
 r
family members, while operating as the major early intervention
program of the Commission. In 1980, the program was utilized
by over 330 individuals and their family members. Most service
users were engaged on an intensive basis, with about 45 percent
of the clients receiving family counselling an average of two
to three times per month, and about 10 percent receiving
individual counselling an average of twice per week. The
remaining 40 percent were involved with the agency's
comprehensive services, which included tutorial assistance,
group work, and social skills development, in addition to the
basic individual and family counselling.
During the year, the Youth and Family Counselling
Services made many adjustments in the program's attempt to
provide back up and consultative services to other community
and governmental youth services. Support to Lower Mainland
youth services and other Alcohol and Drug Commission programs,
which have regularly worked together with the program in the
past, was reduced by approximately two-thirds due to a shortage
of four staff members.
In 1980, requests for brief services and family problem
intervention increased significantly, compared to the same
period during 1979. During the last quarter of 1980, the
service was required to implement a family service waiting
list, while attempting to develop multiple family group
programs in an effort to maintain responsiveness to families
requiring ass is tance.
MAPLE COTTAGE DETOXICATION CENTRE
During 1980, Maple Cottage Detoxication Centre provided
service to approximately 1,500 people. Throughout the year,
the proportion of females rose from 20 percent to 24 percent.
The majority of clients, 58 percent, remained in the Centre an
average of two and two-third days. About 21 percent stayed for
an average of six days, and 80 percent of this group continued
treatment elsewhere following withdrawal.
It was encouraging to note that 60 percent of all clients
admitted to the Centre accepted a referral to on going
treatment services. Of all treatment referrals made, 42
percent were to agencies funded wholly or in part by the
Alcohol and Drug Commission.
The daily exercise program, weekly groups, and relaxation
sessions were continued and were well received. In addition,
medical backup for the program continued to be provided through
regular visits by physicians.
 PENDER DETOXICATION CENTRE
As a detoxication program within the system of care, the
Pender Detoxication Centre provides the first phase of a
comprehensive program aimed at the treatment of alcoholism and
other addictions. The primary goal is to provide
around-the-clock supportive care for clients suffering from the
toxic effects of alcohol or other addictive drugs. The
secondary goal is to help motivate these clients, as they
recover from the physical illness, to seek further treatment
for their addictions*
Clients are encouraged to seek long term treatment for
their alcoholism or other addictions through small group
discussions, films , tapes, 1iterature on chemical dependencies,
and client staff interaction. Most clients stay in the centre
for an average of four days. During this time, the staff
attempt to create an atmosphere of acceptance, accentuating
possible strengths, and helping clients to face reality.
Group discussions focus on helping clients deal with
emotional problems, with the goal of having an individual
accept greater responsibility. These approaches are useful in
a short term group setting in a detoxication centre.
Two and a half years ago, an Alcoholics Anonymous closed
discussion group began as a pilot project one evening a week.
This group was increased to two evenings each week for
interested clients who were either in detoxication, or had been
discharged from the Centre* The intention was to try and
encourage clients to become aware of Alcoholics Anonymous as a
resource both for continued involvement, and while awaiting
entry to a treatment centre, supportive recovery centre, or
out-patient program. Between 20 and 48 individuals
participated in this group on a weekly basis.
During the year, 1,390 clients were admitted to the
Pender Detoxication Centre. Of these, 65 percent were referred
to continued treatment within the System of Care. In addition
to clients admitted to the facility, there were 247 drop-ins
(individuals who utilized the service for a short period of
time but left prior to being admitted) whose average length of
stay was 5.9 hours.
Funded Treatment Programs
The majority of the Commission's treatment services are
provided by private societies, which are registered under the
 r
Societies Act and funded by the Commission.
Residential detoxication programs were provided by:
Salvation Army (Vancouver),
Drug and Alcohol Rehabilitation Society (Victoria),
Parents Alert Society (Kamloops),
Prince George Regional Hospital Board, and
Nicola Valley Friendship and Counselling Society
(Merritt - This service was terminated on
October 31, 1980).
Residential treatment programs were provided by:
Fraser Valley Alcoholism Society (New Westminster),
Victoria Life Enrichment Society,
Crossroads Treatment Centre Society (Kelowna),
Prince George Regional Hospital Board,
Maple Ridge Halfway House Society,
Aurora House Society (Vancouver),
Dallas House Society (Victoria),
Kakawis Family Development Centre (Tofino),
Round Lake Native Alcohol and Drug Treatment
Centre Society (Armstrong),
Fraser House Society (Mission),
Charlford House Society (Burnaby),
Kiwanis House Society (Kamloops),
Charlottes Alcohol and Drug Society (Tlell),
M.S.A. Halfway House Society (Abbotsford)
217 -
 Outpatient counselling programs were provided by:
Native Courtworkers and Counselling Association of
British Columbia (Vancouver),
Chilliwack Community Services,
Richmond Alcohol and Drug Abuse Team Society,
Surrey Alcohol and Drug Program,
Upper Island Chemical Dependency Society (Courtenay
and Campbell River),
Nanaimo Chemical Dependency Centre Society (Nanaimo
and Duncan),
Port Alberni Friendship Centre,
Port Alberni Family Guidance Association,
Powell River Civil Liberties Society,
Drug and Alcohol Rehabilitation Society (Victoria),
St* George's Hospital Board (Alert Bay),
Parents Alert Society (Kamloops),
Central Okanagan Indian Friendship Society (Kelowna),
Nicola Valley Friendship and Counselling Society
(Merritt),
Nelson District Community Resources Society,
East Kootenay Union Board of Health (Cranbrook),
South Okanagan Alcohol Education and Rehabilitation
Program (Penticton),
Salmon Arm Society for Shuswap Alcohol and Drug
Programs (Salmon Arm and Revelstoke),
Prince George Community Resources Society,
Dawson Creek and District Hospital Society (Dawson
Creek and Fort St. John),
Fort Alcohol and Drug Society (Fort St. James),
- 21?
 Terrace & District Community  Services  Society
(Terrace,  Prince Rupert and Kitimat),
Cariboo Indian Friendship Society  (Williams Lake),
Alcohol  and Drug Counselling  Service (Fort Nelson),
Drug Treatment Program
During 1980, the Drug Treatment Program continued to
offer rehabilitation services for the treatment of a variety of
drug abuse clients in British Columbia. The Drug Treatment
Program also continued to treat the methadone maintenance
clients previously cared  for by the Narcotic Addiction Services.
All clients coming into treatment were voluntary.
Clients were either self-referrals or were referred from
various community agencies, physicians or the criminal justice
system.
Clients first arriving for treatment presented themselves
at regional centres located in Vancouver, Kelowna, Prince
George, Nanaimo, and Victoria. They underwent a complete
assessment to determine their drugs of abuse, their current
physical and psychological status, and whether treatment should
take place on an in-patient or out-patient basis. The approach
of the Drug Treatment Program was completely drug-free, except
for the initial detoxication procedures. Only the remaining
Narcotic Addiction Services clients received methadone.
In-patient care took place at the Brannan Lake
Residential Treatment Centre near Nanaimo. The Brannan Lake
facility is a 150 bed hospital for clients who require extended
detoxication regimens and for those individuals who benefit
from the maximal support present in a residential treatment
setting away from the stresses of their own community.
Out-patient care occurred at the community clinics throughout
the province: four in the Lower Mainland; three on Vancouver
Island in Victoria, Nanaimo and Campbell River; and one each in
Kelowna and Prince George. Treatment consisted of a structured
approach emphasizing counselling, physical and psychological
health, vocational training, social skills, and effective use
of leisure  time.
The final phase of the program emphasized the re-entry
and integration of the client back into the community, with the
support of community workers.
219
 Backing up the treatment services were the laboratory and
pharmacy. The pharmacy provided the medication used in the
medical management of drug addiction. The laboratory provided
analysis of urine specimens for a variety of drugs of abuse.
This urinalysis was crucial in the diagnosis, treatment, and
follow—up of drug abuse clients. The urinalysis service was
also used occasionally by physicians, corrections officials,
and other social agencies in the province*
220 -
 r
TABLE I
STATEMENT OF EXPENDITURES
FOR THE FISCAL YEAR
1979-80
EMERGENCY HEALTH SERVICES COMMISSION
Salaries $16,959,444.
Travel Expense 384,803.
Professional and Special Services 1,792,559.
Office Expense 132,278.
Office Furniture and Equipment 13,422.
Advertising and Publications 8,095.
Materials and Supplies 1,752,120.
Motor Vehicles 1,112,893.
Rentals 671,961.
Acquisition/Construction Land, Buildings and Works 10,329.
Acquisition/Construction Machinery and Equipment 676,956.
Other Expenditure (Employee Benefits) 2,848,503.
Recoveries (Non-Revenue) 199,799.CR
TOTAL EXPENDITURE $26,163,564.
- 221
 TABLE II
MINISTRY OF HEALTH REPORT, 1980
EXPENDITURE BY PRINCIPAL CATEGORIES IN THE MINISTRY OF HEALTH FOR FISCAL
YEAR 1979/80
Total Expenditure
Fiscal Year Ended
March 31, 1980
$
174,320
21,042,258
33,691,485
194,634,730
16,803,417
700,643,828
451,354,110
26,163,570
4,213,117
12,330,546
26,221,233
2,904,400
Minister's Office
Administration & Support Services
Preventive & Special Comtiunity Services
Direct Care Comnunity Services
Mental Health Services
Hospital Programs
Medical Services Commission
Emergency Health Services Ccnmission
Forensic Psychiatric Services Corrmission
Alcohol & Drug Commission
Building Occupancy Charges
Computer & Consulting Charges
Statutory
Refugee Settlement Program of B.C. Act
(1)
1,490,227,014
325,294
TOTAL
1,490,552,308 (1)
SEE ATTACHED SHEET FOR CHART
Footnote:
(1) The expenditure of $451,354,110 shown for Medical Services Commission is the
gross operating cost as shown in the detailed statements in Section F of the
Public Accounts. The actual charge to Vote 134 was $289,000,000 and covered the
subsidy by the Province for low-income residents and the estimated deficits not
covered by premiums and other revenues.
As approximately half the expenditures of the Financial Services office were I
made on behalf of the Ministries of Provincial Secretary and Government Service™
and Tourism and Small Business Development, 50% of the expenditure of the
Financial Services office - $456,658 has been deducted from the total expendi-1
ture of the Ministry of Health as shown in Section D of the Public Accounts.
 TABLE III
DETAILED EXPENDITURE BY PRINCIPAL CATEGORIES IN THE
MINISTRY OF HEALTH
FOR THE FISCAL YEAR 1979/80
Total Expenditure
Fiscal Year Ended
March 31, 1980
$
Minister's Office
174,320
Administration & Support Services
21,042,258
Preventive & Special Community Services:
Preventive Programs             24,035,396
Special Health Services           9,656,089
Total
33,691,485
Direct Care Cornnunity Services:
Long Term Care                 143,011,017
Government Hospitals            51,673,713
Total
194,684,730
Mental Health Services
16,803,417
Hospital Programs:
Adnunistration                 4,459,302
Payments to Hospitals etc.
Claims                      660,982,515
Grants in Aid of Equipment        8,247,803
Capital s Debt Service          26,954,208
Total
700,643,828
Medical Services Commission:
Benefits
Medical Care                 407,936,214
Additional Benefits            23,534,808
431,471,022
Administration                  19,883,088
Total
451,354,110
Emergency Health Services Ccnmission
26,163,570
Forensic Psychiatric Services Ccntnission
4,213,117
Alcohol & Drug Commission
12,330,546
conti nued
- 223 -
 TABLE III
DETAILED EXPENDITURE BY PRINCIPAL CATEGORIES IN THE MINISTRY OF HEALTH
FOR THE FISCAL YEAR 1979/80 - Continued
Total Expenditure
Fiscal Year Ended
March 31, 1980
$
Building Occupancy Charges 26,221,233
Computer & Consulting Charges 2,904,400
Statutory
Refugee Settlement Program of B.C. Act             325,294
TOTAL,  MINISTRY OF HEALTH 1,490,552,308
- 224
 MEDICAL SERVICES PLAN
Financial Statement
AUDITOR'S REPORT
To the Chairman of the
Medical Services Commission of British Columbia, and
To the Minister of Health
Province of British Columbia:
I have examined the statement of financial position of
the Medical Services Plan of British Columbia operating under
the direction and control of the Medical Services Commission of
British Columbia as at 31 March 1980 and the statement of
operations and working capital deficiency for the year then
ended. My examination was made in accordance with generally
accepted auditing standards, and accordingly included such
tests and other procedures as I considered necessary in the
circumstances.
In my opinion, these financial statements present fairly
the financial position of the Plan as at 31 March 1980 and the
results of its operations for the year then ended in accordance
with generally accepted accounting principles, as modified by
note 1 to the financial statements, applied on a basis
consistent with that of the preceding year.
ERMA MORRISON, C.A.
Auditor General
Victoria, B.C.
6 June 1980
- 225
 TABLE IV EXHIBIT A
MEDICAL SERVICES PLAN OF BRITISH COLUMBIA
OPERATED BY AND UNDER THE
MEDICAL SERVICES COMMISSION OF BRITISH COLUMBIA
STATEMENT OF FINANCIAL POSITION
31 MARCH 1980
1980 1979
Cash $ 4,197,353 $  828,880
Accounts receivable 1,588,640 1,842,049
Due from the Province of
British Columbia - 16,200,000
$ 5,785,993    $18,870,929
LIABILITIES
Bank overdraft . $   - $14,111,966
Accounts payable 527,503 318,978
Premiums received in advance 15,923,522 15,457,223
Estimated liability for
unpresented and unprocessed
benefit claims 52,500,000 45,500,000
68,951,025     75,388,167
WORKING CAPITAL DEFICIENCY
- EXHIBIT B 63,165,032     56,517,238
$ 5,785,993    $18,870,929
The two accompanying notes are an integral part of these
financial statements.
Approved by the Commission:
D.H. WEIR, CHAIRMAN.
226
 TABLE V
EXHIBIT B
MEDICAL SERVICES PLAN OF BRITISH COLUMBIA
OPERATED BY AND UNDER THE
MEDICAL SERVICES COMMISSION OF BRITISH COLUMBIA
STATEMENT OF OPERATIONS AND WORKING CAPITAL DEFICIENCY
FOR THE YEAR ENDED 31 MARCH 1980
1980 1979
REVENUE
Subscribers' premiums (Note 1)  $155,217,061 $148,424,227
Province of British Columbia
premium assistance            31,456,261 31,531,322
Interest income                   - 150,332
EXCESS OF OPERATING EXPENDITURE
OVER REVENUE
CONTRIBUTIONS
Province of British Columbia
19
883
088
451
354
110
264
680
788
258
032
994
186,673,322 180,105,881
EXPENDITURE     	
Benefits
Medical care                                             407,936,214 356,998,397
Additional benefits                                 23,534,808 21,132,210
431,471,022 378,130,607
Admin is tr a t ion
Salaries and employee benefits 10,750,191      9,903,520
Data processing expenses 6,356,216      5,285,151
General office expenses 1,723,919      1,667,705
Occupancy expenses (Note 2) 1,052,762
16
856
376
394
986
983
214
881
102
195
342
053
6,647,794     19,539,049
WORKING CAPITAL DEFICIENCY -
beginning of year 56,517,238     36,978,189
WORKING CAPITAL DEFICIENCY -
end of year - EXHIBIT A       $ 63,165,032   $ 56,517,238
227
 TABLE VI
MEDICAL SERVICES PLAN OF BRITISH COLUMBIA
OPERATED BY AND UNDER THE
MEDICAL SERVICES COMMISSION OF BRITISH COLUMBIA
NOTES TO FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 1980
1. Significant Accounting Policies
These financial statements have been prepared in accordance
with generally accepted accounting principles except that:
(i)  Premiums from individual subscribers are included in
revenue only when cash is received.  Premiums from
other sources are recognized as revenue on an accrual
basis.
(ii) The cost of furniture and equipment is charged to
administration expenses in the year of acquisition.
(iii)  No accrual for holiday pay is provided for salaried
employees.
2. Occupancy expenses
Occupancy expenses reflect charges by the British Columbia
Buildings Corporation for the space occupied by the Medical
Services Plan.  In prior years these charges were absorbed
by the Ministry of Health.
228
 FORENSIC PSYCHIATRIC SERVICES COMMISSION
STATEMENT OF EXPENDITURES FOR THE PERIOD
APRIL 1, 1979 to MARCH 31, 1980
Expenditure by Standard Classification:
Salaries 3,502,959
Temporary Assistance 253,648
3,756,607
Travel Expense 42,469
Professional & Special Services 577,521
Office Expense 21,437
Office Furniture & Equipment 18,810
Materials & Supplies 283,835
Acquisition - Machinery & Equip. 7,558
Grants, Contributions & Subsidies 45,181
Less Transfers
Salary Adjustments       509,398
Pre-retirement Leave       30,903
4,753,418
540,301
S 4,213,117
229
 CHART I - EXPENDITURES BY PRINCIPAL CATEGORIES IN THE
MINISTRY OF HEALTH FOR THE FISCAL YEAR 1979/80
Emergency Health Services
/$26.2 million
Mental Health
$16.8 million
—Preventive Services
$33.7 million
^Alcohol & Drug
$12.3 million
 Administration
$50.7 million
^Forensic
$4.2 million
TOTAL HEALTH SERVICES
IN 1979/80 - $1,490.6 Million
230 -

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            data-media="{[{embed.selectedMedia}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
https://iiif.library.ubc.ca/presentation/cdm.bcsessional.1-0368888/manifest

Comment

Related Items