It has been over a month since Minister Todd Smith delivered his February 2021 update on the Ontario Autism Program (OAP). In it he revealed what his pilot program will look like for 600 kids and what he is doing in the interim for everyone else, however there were many details missing. No further details have emerged since then, leaving many in the autism community on edge and wondering what will happen next.
The lack of urgency from this government to fix the program is alarming when there’s so many in the community in crisis. It is also disconcerting to see the government twist the Advisory Panel’s recommendations into their own agenda and try to sell it as though they’re following the recommendations to the tee. The autism community is a highly astute, and we are not buying the used car salesman schtick.
Here are 6 things the government can do to fix the OAP:
1. Ease near-term fears by providing eligibility details on the interim funding renewals.
Parents need to know what date will be used to determine age eligibility and when they can they apply for this “two time interim funding”.
Here’s what the government announced: “If you have already received interim one-time funding, you may be eligible to receive an additional payment of $20,000 or $5,000 based on your child’s age.”
The key here is “based on your child’s age”.
Here’s how the original round of funding evaluated age: “The amount you are eligible to receive is based on your child’s or youth’s age as of April 1, 2020.”
Will April 1, 2020 be used again for the two-time funding? Or perhaps will the government move this to April 1 2021? This impacts parents ability to plan for their kids as you could move from the $20,000 bracket to $5,000, and the older kids may no longer be eligible for any funding.
Come clean on this so parents can plan appropriately.
2. Clarify if this years 8,000 kids in the new program are all from the waitlist.
Vague language was used at the February 2021 announcement on how many kids will be in the new program by the end of the year. 8,000 kids in the program is not the same as the mandate to move a minimum of 8,000 children off the waitlist into core services in the first full year of the new program. The expectation is that there is 8,000 kids from the waitlist + kids with existing behavioural programs which I estimate to be at 4,300, totaling 12,300.
Keep in mind that in July 2019 there were 10,191 kids in behavioual programs. So if the government only plans on having 8,000 total, they’ve decreased the number of kids in service. At best they’ll only increased the total by 2,000 kids. Either way the waitlist has increased as 892 days have passed since the Ford government froze waitlist entry into services during the Fall of 2018.
3. Implement the Care Coordinator role as defined by the Ontario Autism Advisory Panel as a forecaster of need.
The Panel recommended that a Care Coordinator forecast the level of need for waitlist management purposes and that clinicians would report back the actual service plan. At the February 2021 press conference Minister Smith referred to the Care Coordinators as your tour guides to the new system. Fine, let them be tour guides and leave the determination of needs to the professionals.
4. Implement electronic practice management software to manage spend over hiring an army of Care Coordinators.
There’s far more efficient and cost effective ways to ensure that spend is managed. Electronic practice management software should be used to ensure line by line ethical billing. There are even vendors that specialize in ABA programs such as Central Reach and NPA works.
Note to fiscal conservatives and PC Party supporters: you should be questioning why the government is creating a bloated bureaucracy with their made in Ontario plan when other jurisdictions have already figured out how to do this including using cost effective software to manage it! Why is the government mismanaging Ontarian taxpayer dollars like this?
5. Place caps at the service level, rather than age-based caps.
The following is how the Ontario government’s age-based caps will be structured:
Patrick Monaghan astutely pointed out that there shouldn’t be a minimum in the funding brackets. Why allocate a minimum amount when legitimately some children and youth may not require any of these core services?
There really is no need for these age caps at all. This is the result of the program prioritizing government control over the needs of the children and youth. Followers of how autism insurance programs have played out in the US will be familiar with this. They started with extensive caps, over time loosed those caps up, and now they realize that their cost fears were unfounded and many States have removed the age and dollar caps altogether. We all know that autism doesn’t end at 18, nor should the OAP!
The caps should be enforced through defined reasonable and customary fees per service. Anyone with extended health insurance sees this with dental, but it’s also enforced within OHIP covered services except we just don’t see the dollar value behind those limits.
6. Prepare to transfer the program to the Ministry of Health.
By implementing points 3–5 and by moving forward with the regulation of ABA, the program will be structured as a healthcare program, therefore the province should move it out of social service and into health where it belongs.