How the Ontario Autism Program can stop wasting money
Waste.
That has been the theme of the Ontario Autism Program under the Ford government.
Wasting time.
Wasting money.
That second point should concern Doug Ford, even if the first point doesn’t.
Ford and his revolving door of Ministers might like to boast about the increased budget for the autism program, but not only are they consistently under-spending the budget they have, what they are spending is being used in the most wasteful way possible.
Childhood Budgets (CB)
Lisa MacLeod’s failed Childhood Budget scheme was their first demonstration of irresponsible spending on autism supports.
From the OAP website:
There were only two funding options possible, completely age-based, and with absolutely no consideration of need.
If you were under 6 you got $20,000.
If you were 6 or older you got $5,000.
No questions asked.
It didn’t matter if the child had minimal need for therapy, or if they had severe autism and desperately needed more comprehensive supports. Lisa MacLeod decided clinical details were irrelevant — you got what you got, and you should just thank her and move on.
Anyone with a lick on sense understood that this system was outrageous.
It leaves the most vulnerable children high and dry, while rewarding other families with a small windfall that potentially over-funds their children’s needs.
Understandably, there are families out there that may have been waiting for a few years already for support, that gladly accepted their CB cheques because it was “better than nothing,” to borrow the phrase from MPP Jeremey Roberts. For some, this money was all they needed. There would absolutely be families out that that liked Childhood Budgets, because compared to receiving $0, an annual cheque of $5,000 may sound really good.
Please don’t forget about the other kids, though. These are the kids that Lisa MacLeod , and ultimately Doug Ford, chose to leave behind.
Ask a family whose child was recommended therapy at a cost of $80,000/year how supported they would be under the MacLeod system.
Ignoring need in favour of volume/ease was never going to be the right choice.
Interim One Time Funding (IOTF)
After Lisa MacLeod was demoted, and Todd Smith brought in, change was promised, but never actually delivered in a meaningful way during his time on the file.
After receiving the OAP Advisory Panel Report on October 30th 2019, at first the community was hopeful.
That hope was extremely short-lived.
“Todd Smith announced that a needs-based program will be phased in over two years, instead of being up and running in April [2020] as previously promised.”
Not only would the new program be severely delayed, as written by this reporter:
“… families will be invited to apply by March for interim funding of either $20,000 or $5,000 to pay for services, depending on their child’s age _ the maximum annual amounts they were to get under a failed plan announced earlier this year.”
The Ford government implemented stall payments in the EXACT SAME WASTEFUL FORMAT AS CHILDHOOD BUDGETS.
Did they learn anything from their failures the last time?
Age-based payments that completely ignore need were going to continue … Todd Smith just changed the name.
Consider this — A 5 year old child with mild autism, who maybe requires minimal special support, if any at all, was to be eligible for $20,000, while a severely autistic 6 year old who needs around-the-clock and one-on-one support can only get $5,000 because of when their birthday is.
That first family may feel great about their situation, while the second family is likely living in a near constant state of crisis.
Todd Smith had other options, but he chose the easy way. He chose to continue Lisa MacLeod’s wasteful program and put a bow on it.
Here was my proposal:
I think Todd Smith was hoping for a quicker build of the new program, but when it was clear that wasn’t going to happen, he did nothing to try and improve the situation.
The new Core Services Program
The Ministry finally revealed their new funding plan in February 2021, with the first details of how core services would work.
Here’s a screenshot from part of the press release:
We’ll get to the problems with the funding brackets in a minute, but first please note that by renewing IOTFs, again, in its original amounts and age breakdown, THEY’RE ESSENTIALLY STILL RUNNING LISA MACLEOD’S CHILDHOOD BUDGET PROGRAM.
Without the ability to get kids moved into the new program quickly, the Ford government elected to put zero effort into improving their interim plan, and instead chose to continue the wasteful payments completely unaltered.
Age brackets
A system that limits funds based on age is not needs-based. Full stop.
With 4 age groupings instead of 2, and a range for each one, it’s technically an improvement from Lisa’s plan, but is still very problematic.
What’s more, the Ford government is responsible for the fact that kids have been waiting longer to enter service, so will fall into the older brackets because of Doug Ford. Kids are going to be penalized with less potential funding because of this government's inability to get their “world leading” program up and running.
There should be NO age-specific caps.
Minimums?
On the day of the announcement, this was the problem piece I noticed first.
Each funding window has a minimum, ranging from $6,600 to $10,900, depending on age. This means that even if a child requires very little support, say like a couple hours of occupational therapy a month, they will receive a cheque for more than they need, limiting what’s available for kids who may need much more.
Minimums guarantee waste.
There should be NO set minimums.
No sliding scale
Here’s a more detailed chart of the age brackets from the Ministry website:
This system is so messed up.
Each age group comes with a few different possible funding levels. Depending on how well you do on your “determination of need” phone call with the Care Coordinator (which is a whole other problem), you get a funding envelope that apparently meets your child’s needs … as determined by this one phone call, and a person who has never met your child.
The original brackets shown in the press release were not a sliding scale like many maybe thought, but rather a range bracket consisting of a few set amounts.
The worst example of this is the youngest age group (3 and under), which only has 2 options — either you get $10,900 or $65,000, and nothing in between.
If your 3 yr old child was diagnosed with autism by a psychologist, and after a clinical needs assessment it was recommended they receive ~10-15 hours a week of ABA. Let’s say that the programming this family is able to find at their local therapy centre would cost them $40,000/year. The funding they will receive from the Core Services program will either be way over or way short to cover the actual needs of the child.
How is that responsible spending of taxpayer’s money?
Just like the Childhood Budget system, the new funding plan is setup to be both wasteful and insufficient at the same time.
How it SHOULD work
The government doesn’t need to make this complicated.
Fund the need.
That’s it. That’s the program.
If a child is recommended X number of therapy hours, and that costs Y, issue a payment of Y directly to the providers.
This could be a combination of multiple different therapies (ABA, SLP, OT), but it should be broken down into how much is needed for each piece and distributed accordingly. Issuing a single lump sum payment for everything without specifying what it is designated for is irresponsible and doesn’t make sense.
There can be reasonable caps in place for each therapy type to keep contracts from ballooning to unrealistic funding amounts, just as the OAP Advisory Panel recommended, but these caps should not be tied to age.
Need must be the driving factor for this program.
There are many other factors to be worked out, determination of need being a really big one, but the point of this article is to highlight the waste weaved into all the Ford government offerings so far on the Ontario Autism Program.
By fixing these problematic elements, the Ministry can ensure they have as much available capital in their budget to get as many kids as possible into true needs-based therapy.
