8 things the government can do to course correct the interim Ontario Autism Program plan
Why are you still protesting? It’s a question many autism advocates were asked when there were province-wide protests outside of Ontario PC MPP offices on August 6. Just 9 days earlier on July 29, the Ontario government announced it was backtracking on its aged-based financial supplement “Childhood Budgets” scheme making way for a newly designed needs-based program. If the autism community got what it wanted, why are you protesting?
It’s a fair question. While each person may have their own reasons, I believe the crux of the matter is the long-drawn-out uncertainty that comes with the April 2020 timeline to design the new program. The general consensus is the government can do better in the interim. But with so few details on how the next 9 months will play out, people are simply left wondering what’s going on?
The uncertainty brings fear, the fear brings anxiety, and the anxiety brings stress. Under these circumstances, parents cannot suitably plan for their child. Service providers are trying to keep the lights on but cannot plan as they don’t know if they’ll need to cut or grow. The lack of details also leads many to be cynical and simply not trust the government will deliver.
Ah trust. Yes trust. Trust they say is earned. Minister Smith has stated that he is committed to building trust with the community. The key word being “building”. For a community so burnt by the actions and tone of the previous minister, we’re not quite there yet with the trust.
It does appear though that the government is doing several things right to start building that trust. For one, so many people in the community have welcomed the complete change in tone and approach since MacLeod was replaced with Smith. Adding MPP Jeremy Roberts to the team is also a very good sign. Smith has been accessible, is travelling to all parts of the province to meet with the autism community, and he even issued an apology, something unfathomable with the previous minister:
“It’s clear to me that we didn’t get the redesign right the first time. I’m here to tell you we will now,” He added: “We are certainly sorry for the anxiety this has caused parents across Ontario.”
While this is all very welcomed, the timelines to fix the mess, and the questionable interim plan means more anxiety for parents across Ontario.
In my July 29 article, I raised serious concerns on the interim program of rolling out Childhood Budgets at a rate of 1,000 a month. Aside from the fact that Childhood Budgets discriminate based on age and are not needs-based, the uptake based on the first round of implementation has been a colossal failure. Smith has indicated that only about 400 people applied for the first 2,000 Childhood Budgets application letters sent out. That’s a 22.5% uptake. Something is terribly amiss. One of my thoughts was why not enroll waitlist children into the legacy program as an interim solution and forget about the Childhood Budgets altogether?
I had an opportunity to speak with government officials and advocates about this, plus other things the government can do to clear the air going forward. Here are my 8 things the government can do right now to course correct and clear the air:
1. Make the interim program needs based. When asked why not enroll children into the legacy needs-based program, I was told that there was an administrative capacity issue to process the old program and that the ministry is prepared for Childhood Budgets. While I question that and wonder why the regionals can’t process new entries, I say fine, then remove the age-based funding criteria and make the Childhood Budgets renewable within the interim period so those that need meaningful therapy can actually get it. Back in 2016 when the previous government needed an interim plan, the renewable $8,000/$10,000 scheme did not cause a money management problem for the government, and the uptake on renewing those budgets was low. This comes to no surprise to therapy providers as most families will only spend based upon the need balanced with other competing family matters.
2. Address the poor uptake on Childhood Budgets. If the first 2,000 Childhood Budget letters were a pilot on your new process, I’m pretty sure a 22.5% success rate wouldn’t pass the mark to rollout the program further. Yet the program is being implemented. Therefore, if the ministry has a handle on why the first-round numbers were so abysmal, and knows what they’re going to do differently to ensure greater success this time around, then they should communicate that. Otherwise the 8,000 interim Childhood Budget letters may wind up with only 1,800 children getting their cheques.
3. Illustrate the interim plan up to April 2020. If there’s a plan, we wouldn’t know it. All we know is that the government needs “the necessary time to design a new needs-based autism program by April 2020.” Is there a high level plan? If so, show it. It’s not that hard.
For example, Panel Recommendations targeted for September 30, Government Review completed by October 31, Treasury and Cabinet approval by some target date, followed by implementation by the civil service with a targeted go-live of April 2020.
Post the milestones for the community to know you have a plan, be transparent about its progress, and plan for progress reports. The worst thing the government can do is put this target of April 2020 out there, then hide behind closed doors, only to fail to meet the April 2020 go-live date.
4. Communicate the April 2020 program scope and manage expectations. We know the government is collaborating with Education and Health on this initiative, but how so? If the collaboration is of any substance, for instance therapists in schools and regulation of the ABA, then that scope is unlikely to be implemented by April 2020. The scope of the panel is broad and multifaceted. Whatever the design ends up being, the implementation will likely require multiple phases beyond April 2020. The government should be transparent about what’s in scope for April 2020 and manage those expectations accordingly.
5. Make the Ontario Autism Program website the trusted source for information. This may seem obvious, yet it needs to pointed out that the government has been slow to update their OAP website with up to date and accurate information. There are probably several reasons why there’s a problem. I’ve heard excuses of a lot of red tape with the ministry’s web publishing process. However, I’m going to guess that part of the issue is with MPPs and staffers informally providing information to various stakeholders, which then spreads across social media before the civil service is even aware. All that being said, it’s about building trust. Have your website be your authoritative source for the latest and greatest info on the OAP, not the social media rumour mill.
6. Address the waitlist(s) issue with greater clarity. The following has been published on the OAP website:
While this is a good step, one of the things I commonly hear is confusion on the state of waitlist management.
In the past you could call up your regional provider and find out where you sit on the waitlist. Has the ministry created a master list, or are regional providers still maintaining their legacy waitlists, while the ministry handles net new applicants? If there’s a master list, how can I verify that the valid intake date information has been merged into a master list? Does the government have the ability to re-institute a “first-come, first-serve” waitlist? Then of course is the infamous algorithm. If there’s an algorithm, then the model can predict when you should come off the waitlist. Why isn’t this information available?
7. Release a summary of the Ontario Autism Consultation Online Survey results. Final submissions were at the end of May 2019. When can we expect transparency on the survey results?
8. Do not have a permanent autism advisory panel. I’ve heard several people throw out the concept of keeping the panel going after their mandate is complete. Terrible idea. If the government needs short term stakeholder advice, then go out and seek it with the specific mandate. But this idea of having a permanent panel in place is a scary thought. If you’re trying to build trust, you don’t do that by having a permanent advisory panel working with NDAs. Where’s the public accountability with a set-up like that? As someone recently reminded me, RAPON was an unelected body of experts, which inevitably led to undesirable self-serving decisions. You have a public service, many of which I’m sure are highly paid. Enable them.