Why the OAP will take YEARS to become effective
Todd Smith took over as the Minister responsible for the Ontario autism program in the summer of 2019.
At first, families tried to be hopeful that better times were coming.
Before that, Lisa MacLeod spent months defending her horrendous plan.
Todd Smith promised things would be different. The community would be getting a needs-based program, where kids would (hopefully) receive the level of support they actually required, and not just a cheque for some random amount based on their age. It was going to take time, though.
All through the summer/fall of 2019, when questioned about the future changes of the program, Todd Smith would consistently defer to the OAP Advisory Panel and their eventual report— They would be the ones designing this new great hypothetical program that would stop making the Ontario PC Party look so bad for sticking with Lisa for as long as they did, despite universal outrage for her plan. After his PR listening tour was done, Todd stood back, and quietly hid behind the panel.
It was on October 30th, 2019 that the Panel’s report was released.
What the Panel made clear was that they were providing the necessary program concepts, but work would still need to be done to iron out some of the specifics. The foundation was there, and the Ministry would have been well aware of what the panel had been working on all summer. The content of the report should not have come as a surprise to MCCSS when it was received.
Ministry staff should have been working right away to start hiring Care Coordinators, and putting together the necessary committees being discussed by the panel to complete the job. Work should have been well underway.
Here’s Todd Smith’s full statement about the panel report:
It included the following statements:
“Our government has made the redesign of the Ontario Autism Program one of our top priorities.”
“I am confident the panel’s recommendations will serve as a strong foundation for the new Ontario Autism Program. Implementation of the new program is planned for April 2020.”
April. 2020.
Here we are, a whole year later, with no program, and no real comfort that the ministry will actually finish it on time.
Back when the report came out, the whole community thought this program was going to be ready for April 2020. The Minister even said so specifically.
It wasn’t until last December 2019, just days before Christmas, that Todd Smith dropped the bomb that it wouldn’t be ready until 2021.
The Minister legitimately made people cry that day.
Will it be ready for April 2021?
Maybe. Maybe not.
The Ministry certainly isn’t shying away from blaming COVID-19 for all their delays this year. Can they still work on the program remotely? Of course they can.
Long story short, Todd Smith and his Ministry have been making excuses for over a year as to why they’re taking so much time to work through all this, but the waiting that families have been forced to do is only just getting started.
So how will they chose who gets to enter the new program?
The Panel advocated for bringing kids into the program in order from when they applied (as opposed to whatever ridiculous algorithm they used to select kids for Childhood Budgets invitations).
The kids still in the old version of the program (the “legacy” kids) were promised a seamless transition into core services of the new program, so I think we can assume they’ll be transitioned in the first group.
“If you have an existing behaviour plan, it can be extended up to its current level of intensity, or less where clinically appropriate, until you transition into core services in the new needs-based autism program.”
How many kids are actually still in that cohort? Good question. The Ministry hasn’t been transparent on this detail, but I’d estimate it at anywhere from 3,000–6,000. Keep in mind that over 10,000 kids were receiving needs-based and professionally guided therapy at the beginning of the 2019/2020 fiscal year, but under Todd Smith’s “leadership” we have seen that number plummet by half while we all wait in limbo for the new program.
The ~38,000 kids not in this legacy group are all technically still on the waitlist. Whether they received a Childhood Budget, an Interim One-time Funding cheque, or both, they’re all considered to be in one big group at this point, arranged by the date they applied for the OAP. The Ministry will need to start working through that list one-by-one, and fold these kids into the new program. Knowing how this government operates, that won’t happen quickly.
How many kids can the new program serve at one time?
Good question.
It’s not easy to answer either, because it’ll all depend on how far the money goes. The OAP budget is (in theory) $600 million/year, but the Ministry has been unable to even come close to spending the whole amount in either the last fiscal year, or the current one … because they don’t have a real program to put kids into.
We won’t know what the program capacity will be until they start plugging kids in, and see how far they can go with it.
The FAO report tried to estimate how many kids might be able to be served based on data from previous years, but with a whole new type of program, the average cost per child is still completely TBD. It could be anywhere from $15,000-$35,000, to put down a broad estimate on it. If we pick the middle of that as an average, and subtract about $100 million of the total budget for “other” costs:
$500,000,000 available to spend / $25,000 avg per kid = ~20,000 kids in service
If the spend was just a little bit lower per child, at say a $20,000 average:
$500,000,000 / $20,000 = ~25,000 kids
The only way to get all 40,000+ kids service at the same time is if the average spend is closer to $12,000 per child, which is in Childhood Budget territory. Not good.
Here’s something to think about though. The old program is filled with mostly younger children, who often need more intensive supports. When the OAP was opened up to all ages, there was a large increase to the number of kids registered for the program. These newly registered kids are less likely to need intensive therapy, and would probably only be in need for a smaller amount of support. The average spend per child, when considering all age groups, will almost certainly be less than it used to be in the Coteau version of the program, but hopefully higher than it was with Childhood Budgets. With the right controls, the new program should be capable of helping a lot of kids at once, while still having their needs met.
Implementation Working Group Mandate
Taken from the OAP website:
In terms of numbers, they list a goal to
“move a minimum of 8,000 children off the waitlist into core services in the first full year of the new program”
Let’s say they only move 8,000 kids into the program in the first year, at our previously used estimate of $25,000/kid, that would only mean them spending ~$200 million of the program budget on therapy.
They certainly have the money to do much more than that, but if the ministry’s performance of processing/handling of childhood budget & one-time funding cheques tells us anything, it’s to expect they’ll do it very poorly.
Even if they can transition 10,000 kids into the program in the first year, that still leaves over 30,000 kids waiting, with no idea whatsoever of when they might be granted access to funded core services.
Case examples
Let’s work through a few examples to help think about what kind of wait kids might be dealing with, starting from April 2021. These are only rough estimates, and we can only hope the wait will be shorter than expected.
1. Legacy kids
These kids would have spent a few years already on the waitlist before entering service, had their therapy maintained (if appropriate and still needed) though the transition, and should expect to enter the program in the first year.
Expected wait: < 1 year
2. Childhood Budget kids
Since kids were chosen by a ministry-determined algorithm, some may have been on the waitlist a long time prior to receiving their funding cheque, while others perhaps much shorter.
- Early intake dates: For a kid who may have registered for the program several years ago, say 2017, their intake date should make it more likely they’ll make the first cut into the program
Expected wait: < 1 year
- Later intake dates: There were some lucky kids who received a Childhood Budget cheque, when others who had been waiting for much longer were passed over if they didn’t get chosen by the algorithm. Since there are kids registered prior to them, who did not receive a CB cheques, the wait for this group will be longer.
Estimated wait: 1 year, likely more
3. Interim one-time funding kids
- Early intake dates: For the unlucky kids in this group, they were unfairly passed over in the first round of funding cheques, missing the boat on childhood budgets, but then later getting a IOTF cheque (perhaps only just very recently). Their intake date will put their priority ahead of some kids who received a childhood budget
Estimated wait: < 1 year (hopefully)
- Later intake dates: For kids who have been registered for the program for less than 2 years, it’s really hard to know when they may see funding again. Ahead of them in line are well over 10,000 kids who will have priority (legacy kids, CB kids, early intake IOTF). Until the ministry figures out how to process the new program, and expand the numbers of kids it can serve, kids in this groups are going to be stuck waiting.
Estimated wait: 1-2 years, maybe more
4. Newly diagnosed kids, or fairly new registrants to the OAP
Until the program has a chance to start providing service to all the kids ahead of them, there’s clearly not enough money in the program (or service capacity for that matter) to provide kids in this group with support yet, other than their initial interim one-time funding cheque.
Estimated wait: >2 years
Regardless on which group a child falls into, they’re destined to spend years waiting for help either way.
It’s important to remember that Lisa MacLeod blew up the whole system, rather than working with what was there and trying to improve it. They could have increased the amount of kids receiving needs-based support using the new higher budget, while at the same time working on some needed changes. Todd Smith also had a chance early on to come up with better interim plan, but he decided to stick with Lisa’s plan, even though he admitted they got it wrong. The Ontario PC government chose to do it their way, putting tens of thousands of families into unnecessary hardship.
This will be their legacy.
Todd Smith and his ministry need to get things together soon, because the longer they delay, the longer families wait for meaningful support.
This new program won’t be running smoothly for quite some time. To think otherwise is going to lead to disappointment. It’s giving this ineffective government way too much credit. I imagine the rollout will be slow, and filled with poor government decisions.
There are families out there who have only received a $5,000 cheque, and could be waiting now for years before they receive any additional funding from the government to support their vulnerable child. Years.
Despite pledging openness and transparency last summer, Todd Smith has not exactly been forthcoming with details on the current status of the program.
Will they be ready to start moving kids into the program quickly and efficiently next year?
I’m extremely doubtful, but I sure hope they prove me wrong.
