10 thoughts on the Ontario Autism Advisory Panel Report
The Ontario Autism Advisory Panel Report is quite the read, all 63 pages worth of it. It’s a significant document that outlines the key design elements of the to-be program. It does not however get into the operational mechanics of the program or provide details on key things of interest like funding allocations or service caps. Rather the panel recommends these details be determined by an implementation committee.
Here are my initial 10 thoughts upon reading the report:
1. Better days are ahead. This is a huge improvement from the Childhood Budgets scheme. The thoroughness of these recommendations puts some faith in my heart that we’re heading in a better direction. I read this report at the same time the story broke about the Warren Kinsella media group providing free media training for the anti-ABA group Autistics 4 Autistics (A4A), which provided some perspective on how far we’ve come since the crass Lisa MacLeod held her self proclaimed title of Minister of Tears.
Speaking of free, that’s exactly how the government got this report. In what may seem like a thankless job, the members deserve kudos for serving in this capacity, and sacrificing massive amounts of their summers to get it done.
2. Where are the specifics? My initial reaction when reading the report was oh man, these are recommendations only, they stopped short on designing the program. I know many in the community were looking for specifics on how this program will work. To be totally fair to the panel, given the mandate and the short time they were together, the breadth of what they produced was significant. Also, no offence to the panel here, but the expertise required to develop program numbers, including service caps, requires subject matter expertise that some on the panel didn’t have. So, an expert working group really is needed to come up with these specifics.
3. Nothing to address the current mess. It appears the panel was not asked to make recommendations on addressing current state issues like the randomness of getting childhood budgets or fully utilized childhood budgets. Can you imagine being a parent who knew their child was near the top of the waitlist under the legacy Liberal program and has received nothing? Their children truly are languishing! Meanwhile, the government interim plan allows others to skip the line, where some of the early recipients are now forced to stop their service as they’ve fully used up their budget. These situations are just wrong, and the government needs to address this now rather than letting it slide to whenever the Todd Smith program goes live.
4. No costing, no approval. Because the report is focused on big picture recommendations, the report as it stands is unlikely something that can be approved by the government. Put it this way, you can’t put this in front of treasury to seek financial approval. The mechanics of the program and how it will stay within the $600M budget are absent. Yet curiously several panel members have stated that their recommendations will work within the budget constraints. Was there a costing analysis conducted yet was omitted from the report?
5. The stars will have to align to implement these recommendations by April 2020. The breadth of the recommendations almost guarantees that many elements cannot be implemented by April 2020. Some recommendations may not even get implemented by the end of the Ford term! Expect the implementation committee to come up with a phased program roll out, and separate out the core program versus inter-ministerial recommendations.
My recommendation is that the implementation start with building upon the legacy Liberal plan, rather than trying to design and set-up the end state program. Why? Well, one just needs to look at how long it took to set-up a system to simply send out childhood budget cheques. I just can’t see how they can design the program specifics, set up the infrastructure, hire and train the staff, for an April 2020 kick-off.
6. Beware the Care Coordinator. The panel recommends a process to “forecast each child’s support needs to the ministry, to enable other children to be moved off of the waiting list.” The panel had to tackle waitlist management given the finite budget and today’s service capacity limitations, so I get why this was recommended. The concern is when implemented, this function can be abused beyond the intention the report laid out. In the pre-Coteau autism program, the psychologists working for the AIPs enabled waitlist churn, transitioning children out of service and into the schools. Too often these were decisions that were in the best interest of moving along the waitlist, not in the best interest of the child.
7. OAP administrative costs may skyrocket. It stands to reason that the more process that’s introduced to the OAP to handle the variety of services, that the administrative overhead will increase. Every dollar spent administrating is one less dollar going to direct services for the child. There’s no getting around this, the question is just how much of a bite out of the $600M will it be?
8. Very detailed and extensive education recommendations. It looks like some panel members may have been auditioning for a gig on their suggested education advisory committee on autism. Reform to the education system will be crucial to getting positive long-term outcomes for children and youth on the spectrum. Will the government and school unions make progress here? Perhaps, but my bet is that it will take years to just make some baby steps. Therefore, in parallel to these reforms, the government should look at investing in alternative solutions such as ABA-based schools. This will give many children the support they need in an educational environment that is much more cost effective than electing one-on-one ABA over the prospect of attending under resourced public schools. Many of these schools exist in Ontario already, and can follow a similar funding model the Quebec government did with the Summit School in Montreal.
9. Greater urgency is required to address the capacity issues generated by the government. Making immediate recommendations may be outside of the panel’s scope, but that does not mean the government should sit back and wait for implementation before addressing the numerous layoffs felt across the ABA sector, especially in the north. Without a plan to address this, it’s possible more layoffs could occur, and could be compounded should efforts to have the new program live by April 2020 fall short.
10. The age 18 age-cap continues to be ignored. I realize this falls outside the scope of the panel’s mandate, but autism doesn’t end at 18. For too long jurisdictions have focused autism services solely at youth, but that trend is changing. In the United States, age caps for accessing autism services are being removed. It’s high time that Ontario address the age-18 services cliff.
