Tuesday 20 June 2017

My Thoughts On Ontario's New Autism Program

On June 8th, Ontario announced its new autism program.  This program is supposed to integrate existing programs and services under one program to make it easier for families and avoid gaps in service.  This is a laudable goal but after more than a decade of hearing how the broken system is about to be fixed, I am skeptical.  Often these announcements have led to bureaucratic hoops with little or no improvement in the actual services.

The program has several new features:

- A single point of access.  There will be one entry point to the OAP in each of the nine service areas to make it easier for families to access services for their child.

This is a great feature and one that's been long overdue.  Rather than having to apply at a dozen different agencies (with the risk of paperwork being lost or confused), now there is one point of application.  When discussions were originally being aired, there was also talk of having a single point of contact.  I'm disappointed to see that the single point of contact is not included in the new OAP, but a single point of access is still a great improvement.

- Family-centred decision making.  As key partners in their child's care, families will be actively engaged in the assessment, goal-setting and intervention planning process for their child.

Again, this sounds good.  Often the parents are left out of the loop when it comes to the publicly funded services.  And parents should be treated as active partners, as they are the ones who know their children best.  What worries me about how this is phrased is that I'm concerned that the burden of decision and research will be put on the parents with the system raising its hands and saying "You figure it out."

- Collaborative approach to service.  A foundation of the new OAP will be the collaborative approach taken by community support service providers, clinicians and educators to support children's needs at home, during service and in school.

This statement is legalese which boils down to promising very little since it is both vague and talking about intention rather than action.  The intent seems to be that everyone will have to work together, which would be awesome.  However, if "collaborative approach" means that everyone will have to agree, then I foresee issues.  My recent experiences with Alex's school shows how the system can be used to drag the process out to avoid having to make changes.  

- Service based on need.  Services will be flexible and individualized.  The intensity and duration of the services a child or youth receives is based on their needs and strengths, regardless of age.  Each child's service plan will be determined by clinical assessment.

This one is very encouraging to me since it has a clear plan of action.  Prior to this, services were determined by whether or not the child qualified for the single program offered by the government.  If a child was too high or low functioning, or too old or young, they didn't qualify.  However, I would like to know what services will be offered and if the government is expecting the private sector to fill in the gaps.  Right now, the private sector is drowning in families who were given money and told to find services.  Without preparation to make sure that appropriate services are available, this could end up being an issue.

- A direct funding option.  A new direct funding option will be implemented by the end of this year.  This will provide all families with a choice between receiving direct service or receiving funding to purchase their child's service.

This implies that the government will be relying the private sector to fill in the gaps.  And doesn't address the issue of whether or not the entire cost of private programs will be covered.  Under today's program, direct funding covers about a third to half of the cost of a private ABA program, which still leaves parents with a hefty bill.  Hopefully this will be explained to parents when they are making their choice.

- Safe, effective autism services.  The province intends to regulate ABA practitioners to help ensure families receive safe, high-quality services, have confidence in their providers and know where to go if they have a concern.

Again, this statement has good intent but is vague on action.  This is absolutely necessary as we are already seeing people with minimal or no credentials setting themselves up as ABA providers to take advantage of the government money flooding the private sector.  But depending on how the regulation is handled it could be a joke, a straight-jacket or, as intended, a way to weed out those seeking to take advantage.  

I believe the government has good intentions and truly wants to help families with autism.  But too often, those good intentions have not been followed up with the planning and preparation needed to make sure that things were improved.  Sometimes it has felt like the government was more interested in the press conference and the press release than in the actual implementation, rushing ahead with something that sounded good but with no idea how to make it work: eg: millions of dollars in promised funding that vanished into organizational bureaucracy without reaching the families or providing families direct funding without making sure there were services available.

Hopefully the OAP will be different.  Hopefully having everything under one program will make it harder for agencies to wash their hands of a child and leave them in limbo or have too many agencies trying to dictate the course of action.  Hopefully it will bring greater accountability to the agencies in question, forcing them to show effectiveness.

We won't know for several years.  If this is done right, it could be of huge benefit to families, taking a massive burden off them.  If it isn't, it will be more money and time wasted.  We'll just have to see.

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