How much is MCCSS going to spend in the next fiscal year?
With the latest announcement from Minister Todd Smith, we know a little more about how core services are going to work in the autism program, as well as their plan to offer more interim funding while they slowly roll out the new program.
It’s time to estimate how much they’re going to spend (or more likely, under spend) this coming fiscal year.
How has the funding changed through the years?
This becomes easy to do thanks to the latest FAO report on Autism Services.
The program has been in a constant state of flux lately, and the spending profile has changed right alongside it.
In the 2015/16 year, the spending consisted of just 2 components: ABA therapy funding, and “other” – described as “respite services, school supports for students on the autism spectrum, diagnostic hubs and other programs.”
In the 2016/17 year, there was a new category, labelled by the FAO as “transitional funding.” This represents the beginning of the 8k/10k bridge funding that Coteau had put in place during the Liberal autism program changes. The $8,000 offered to kids of a certain age was initially labelled as “One-Time Direct Funding,” but then later was followed by successive $10,000 payments to hold those families over until they entered the updated Liberal program. It was a way to try and provide continuity of service. With it being renewable, it functioned almost like a needs-based interim program (only the kids that needed more, got more, etc).
The 2017/18 spending was structured the same as the previous year, but with a bigger overall spend. The 8k/10k funding was phased out at the end of that fiscal year, and all kids in service at the time were transitioned into the new version of the Liberal program.
2018/2019 marked the first year under the Conservative government, and the spending profile was rolled back to just the main therapy total, and then ‘other.’ Changes were coming.
The whole thing became a mess the next year (2019/20), with Childhood Budgets now a thing, interim one-time funding starting up near the end of that fiscal year, kids still in the old program receiving extensions, and a serious misrepresentation of the spending by the Ontario government, highlighted by the FAO report (and later confirmed by the Auditor General).
Here’s a spending summary I put together in table form, with the most recent year estimated by me (see more on that here).
For the two most recent fiscal years, 2019/2020–2020/2021, the total promised spend is $1.2 billion, but by my estimations it can’t be much higher than 1 billion.
“Our government will be spending a combined $1.2 billion over the 2019–20 and 2020–21 fiscal years to support children and youth during the transition to the new Ontario Autism Program.” – Todd Smith
It’s likely that the government is going to be leaving $200 million unspent due to a lack of available programming to even put the money into.
Projected OAP spending for the 2021/2022 fiscal year can be broken down into the following groups:
- Continued extensions of kids still in behaviour plans under the old program (“Legacy kids”)
- IOTFs (the second round)
- Core services (NEW PROGRAM)
- Other (Foundational services, Admin, etc)
Legacy program spending
It’s still unclear how many kids are even left in the old program. It’s likely in the range of 4,000. The FAO said that the average spend per child under this program was $29,900/year.
COVID may be limiting how many hours these kids can still access for therapy, especially if their therapy is in-person. It’s also likely that needed hours of therapy may have deceased gradually over time, as goals have been achieved, and the need for intensive therapy reducing. Not for all, but for some.
The theory is that we’ll see a transition of kids out of this cohort soon, and into Core Services under the new program. Once assessed, their new funding allocation will count towards spending in the core services pocket of the spending profile.
Even at full spending to maintain the full year of their previous plans, the cost would be in the ballpark of $120 million.
It almost certainly won’t be that high, so I’ll put a guess in at $100 million, which is likely being very generous.
Other
With increased Foundational Services, and the administration costs behind things like the new Independent Intake Orgaization, I think we can expect an increased spend in this category compared to the previous years.
I’m estimating $125 million.
More Interim funding cheques (IOTF part 2)
We’re still waiting on further details about how this will work, but we do know they’ve finally set a deadline to be eligible for the first round of IOTF.
“We will continue to provide interim one-time funding to all new applicants whose registration forms and supporting documents are submitted by March 31, 2021.”
The original deadline was March 31 2020, but it was pushed back “due to the impacts of COVID-19.” (But also so they had an avenue to spend all the money they promised they would, but didn’t have a finished program ready for).
So the theory will be that if you apply for the OAP before the new deadline, you’d be eligible for ‘round one’ of the IOTF, then potentially another round after that (if you haven’t been called into the new program … which will almost definitely not happen in the near future).
Kids who previously received a Childhood Budget were eligible to get the first IOTF a year after their CB funding period started. No word yet about how long you’ll have to wait before being eligible for your second round of the interim funding payments.
Is it one year again? Can you apply as soon as your first IOTF is spent and reconciled?
This will be crucial information for families to know, but is not yet available.
As of the January 15th numbers update, 28,784 kids had received invitations for IOTF. It’s highly unlikely that every single one of those families followed through with the process and actually received funding.
How many received the first IOTF? How many will need a second payment?
Many families are struggling to even know what to do with their cheques. It’s not enough to put together a meaningful ABA therapy program (especially with only a $5,000 cheque), and capacity took a major hit during this horrendous transition period of the OAP. Even if you wanted to spend it, there’s no guarantee you can even find a therapist with availabilty to take in your child, especially in non-urban centres.
The Ministry’s track record for doing things quickly has not been great either, so I doubt we’ll see any more than about 1,000 invites per month at the high end.
My guess is they don’t hand out any more than ~10,000 2nd round IOTFs, and I think that’s even being generous.
At an average spend of $10,000 (based on age distribution data), that would account for maybe $100 million.
Core Services (New)
Approximate per-kid costs of previous programs were as follows:
- Coteau OAP ~$29,900
- Childhood Budgets ~$10,000
Each program had their issues. The Coteau program lacked limits, causing the spend per child to be on the higher end, reducing the number of kids they could have in the program at one time. This resulted in the huge waitlist problem. The budget was also too limited.
Childhood budgets provided insufficient funding to meet needs, making meaningful therapy nearly impossible for most. It was also wasteful, giving some more than they needed, and others much less than what would be required.
A happy medium is what’s needed – one that can reduce the waitlist, while still providing the possibility of meaningful therapy. By ensuring the funding allocation is needs-based, the program can also reduce waste. The increased available budget compared to the liberal program certainly increases the possibility of success, if spent well.
From age distribution data, along with severity approximations, we can try an estimate the approximate spend per child in the new core services program.
Based on my estimations, the average overall spend per child likely will be in $18,000–22,000 range. This was calculated by looking at the available funding windows, and estimating allocation based on severity in each category. Younger kids will average above 20k, with older kids averaging less than that.
Using $20,000 as an overall average spend per child, it actually places this new funding model exactly in the middle of the other two programs (10k & 30k).
It’s a 3 bears situation, and the goal is to get it just right.
If the Ministry hopes to get 8,000 kids into core services in the first year, we can estimate the cost to be:
8,000 kids x $20,000/kid average = $160 million
Let’s put that all together
- Legacy kid spending — $100 million
- Transitional funding — $100 million
- New Core services — $160 million
- “Other — $125 million
Add that together, and we’re only at $485 million
Each component could be a little higher than estimated, but I don’t think by that much (certainly not to the tune of $115 million). There’s also likely some double counting of spending here too, as kids in previous funding situations who are called into core services this year would either need to use up their previous funding or pay it back before receiving a new funding allotment. Not sure yet how this will work.
I think it’s highly likely this Ministry will under-spend on the autism program. Again.
If Todd Smith wants to keep using the line that they’re “taking the time to get this right,’ they can’t also claim they’re spending their whole budget.
It’s just not possible.
