Doug Ford’s New Autism Program May Take Key Decisions Out of the Hands of Medical Experts, Advocates Warn

Advocates are warning that the Ontario government’s latest plan for managing support services for autistic children could take key decisions over care and funding out of the hands of medical professionals and parents.

In December 2020, Ford’s Ministry of Children, Community and Social Services released guidelines for independent agencies looking to secure contracts to run Ontario’s autism program, including managing waitlists, funding allocations and a “needs-based assessment process.”

It says families accessing the program “will participate in the Determination of Needs process conducted by an OAP Care Coordinator.” This process, the document explains, will assess the child’s strengths, weaknesses and needs, “to determine a child’s profile of support need and associated OAP funding allocation.”

The document adds: “Once a child / youth’s profile of support need is determined by their OAP Care Coordinator, families will receive a corresponding funding allocation that can be used to purchase eligible core clinical services.”

Ministry of Children, Community and Social Services

While the “determination of needs” will be “clinically informed,” the document explicitly states medical professionals will not make final decisions:

“The determination of needs process is separate and distinct from the clinician-based assessment that would be completed by a clinician as a first step of core clinical service provision.”

Ontario Autism Coalition president Laura Kirby-McIntosh, who was a member of the government’s 2019 advisory panel, told PressProgress the Ford government’s guidelines run contrary to the panel’s recommendations.

“If we’re doing a needs-based system and clinicians determine need, what the hell are these public servants doing?” Kirby-McIntosh asked.

While Kirby-McIntosh said the panel agreed a “care coordinator” may be useful in helping families navigate the system, the intention was for medical experts to make decisions about what autistic children need.

“The ministry took a very hardline position that in order the manage the system it needed to predict the level of need for forecasting purposes, their churn of kids moving in and out of the system,” Kirby-McIntosh explained.

“We agreed to the creation of a Care Coordinator whose job would be to forecast needs, to look at any assessments that are already in place, using a tool that must be developed by clinicians to forecast the needs of that kid.”

Kirby-McIntosh also noted the document says these care providers will be responsible for the “lead determination” of children’s needs.

It also offers funding for an “estimated one day training” for Care Coordinators.

Ministry of Children, Community and Social Services

Ontario’s Ministry of Children, Community and Social Services did not respond to multiple requests for comment from PressProgress.

The Ford government’s autism program has been a cause of controversy for some time. After promising to get kids more support more quickly, the previous Social Services Minister changed the existing system of ongoing support to a staged lump sum that left some families digging out of pocket for support that could cost up to $80,000 per year.

That change was soon scrapped, but not before Premier Ford was loudly booed at the Special Olympics.