Ford government confirms autism program needs assessments will not come from expert clinicians
Those that tuned into the Government of Ontario’s live stream of Minister Todd Smith’s autism program announcement on February 3 were left baffled as the live stream came into an in-progress press announcement. 2 minutes later there were no further questions and the live stream ended.
The timing of this announcement cannot be understated as it falls 3 days from the 2 year anniversary of Lisa MacLeod’s Ontario Autism Program overhaul to a financial supplement “Childhood Budget” program. The autism community is been waiting 2 years to fix this mess and get a needs-based program, instead they received a convoluted made-in-Ontario system that takes away the prescription of therapy from expert clinicians and into the hands of 1-day trained Care Coordinators. It’s like going to the hospital, having the receptionist make you fill out a survey, and based on the results they inform you how much money can be spent on you by the healthcare workers.
Here’s 6 things we learnt from the news release published on the government’s website.
- Confirmed today by Todd Smith, Care Coordinators will determine the level of a child’s need, not a clinician. This flies in the face of the Advisory Panel’s recommendation that a Care Coordinator forecast the level of need for waitlist management purposes and that clinicians would report back the actual service plan. The government doesn’t seem to get that needs-based therapy must be prescribed by clinicians. Sure, service parameters to ensure there isn’t abuse or excess hours being prescribed is necessary, but the intensity of service needs to come from a clinician.
- Age based funding is still a thing! Yes, you read that right. One of the strongest objections to the Childhood Budget scheme was the discrepancy of funding based on age ($20,000 under age 6, $5,000 for ages 6–17). Here’s the new scheme:
So the government has devised that need is associated with a child’s age. The change from Childhood Budgets is that the higher bracket is now up to $65,000 a year until age 9. No doubt this is better than Childhood budgets, however it does not address those most severe needs, where their level of needs often enters the $80,000 — $120,000 range. Given that services are fee based, this will lead to continued discrepancies where those that can afford the top up will, where as others cannot. It also perpetuates the all too often scenario of families draining their savings and going into crushing debt just to get the services their child requires.
3. 600 kids will to go into new Core Services model starting in March means Childhood Budget and Interim One-Time funding renewals. Can’t say I’m surprised by this. The government has been dragging it’s feet in getting a program up and running, and meeting Minister’s Smith mandate of 8,000 new kids in service is a stretch. The answer? Extend the interim solution of payments. Rather than 1 year budgets, they’ll stay with the 18 month period introduced when Covid hit. As for those “legacy program” kids, their behavioural plans will be extended until the new program is up and running beyond a pilot.
4. The 600 kids are a pilot group to test out the new “standardized tool”. The government is saying this will begin in March 2021, yet they haven’t even awarded the Independent Intake Organization contract that will employ the Care Coordinators. For the time being the government is having the Child and Parent Resource Institute to oversee the pilot. The creation of a “standardized tool” is where the government has gone astray. Far be it that this is a recognized standardized tool, rather this is a marketing name for their Care Coordinator assessments to sound legit. The announcement did reveal areas the Care Coordinators will assess:
- Communication
- Social interaction
- Play and leisure
- Activities of daily living
- Motor skills
- Cognitive skills
- Sensory system
- Mental health
5. No information on how children will come off the waitlist. Previously the government said that children will come off the waitlist based upon their entry date, as opposed to the algorithm that Lisa MacLeod’s Childhood Budgets scheme used. Is this still the case given that the government has surprisingly created age-based funding brackets?
6. The one good news item today was that the Government is proceeding with regulating ABA. “The government intends to regulate ABA as a new profession under the College of Psychologists of Ontario, beginning with providers in supervisory and assessment-focused roles.” This is a good step forward in moving ABA towards healthcare recognition that it receives in other jurisdictions such as the United States where ABA is covered under health insurance programs like Medicaid and private health insurance.
