Erik
Good evening everyone and thank you for joining us tonight.
Welcome to the Ministry of Children and Youth Services province- wide telephone TownHall on the Ontario Autism Program. This evening we will be answering questions from families, including families currently receiving $8,000 and $10,000 payments. This is our second telephone TownHall this year. Tonight, we are live with the Minister of Children and Youth services, Michael Coteau. And he is joined by Sarah Hardy, the Director of the Ontario Autism Program Project Team. Together they will answer any questions you may have. My name is Erik and I will be the moderator of the TownHall this evening. You can ask Minister Coteau and Sarah Hardy a question at any time by pressing three on your phone's keypad.
Tonight, we want to hear your thoughts and your family's questions about the Ontario Autism Program. The Ministry of Children and Youth Services chose this format tonight as it is the most interactive way to conduct a TownHall via conference call and to hear all of your questions and experiences. Also, so you are all aware, tonight's TownHall is being recorded and the recording will be made available to the public on the Ministry's website at ontario.ca/autism. A transcript of the telephone TownHall will also be made on the website. To respect your privacy, we will only be using first names during the TownHall and we will not be discussing individual cases. Tonight, we encourage you to get involved and to ask some questions. I will ask that you try and keep your questions as brief as possible so we can hear from as many of you as possible this evening. You can ask Minister Coteau and Sarah Hardy a question at any time by pressing three on your telephone's keypad. That will allow you to enter the question queue, basically a virtual line up, so you're able to ask your questions. Now for everyone just joining us, once again, welcome to the Ministry of Children and Youth Services province-wide telephone TownHall meeting on the Ontario Autism Program. Tonight, you are live with the Minister of Children and Youth Services, Michael Coteau, and Sarah Hardy, the Director of the Ontario Autism Program. My name is Erik and I'll be the moderator for the TownHall event. Tonight, we want to hear your thoughts, your experiences and your family's questions about the Ontario Autism Program. Throughout tonight's TownHall we want to remind you that you can ask questions at any time by pressing three on your telephone's keypad. That will allow you to enter the question queue, basically a virtual lineup of so you're able to ask the Minister your question. If you would like more information at any time, we encourage you to visit our website ontario.ca/autism where you can find information on the Ontario Autism Program, including the new program changes that are now in place. To get the TownHall started, it's my pleasure to introduce Minister Michael Coteau. Minister, welcome.
Minister Coteau
Thank you very much, Erik. And I want to thank everyone for joining us here tonight at this provincial-wide tele TownHall on the Ontario Autism Program. My name is Michael Coteau and I am the Minister
responsible for children and youth here in the province of Ontario.
I'm here tonight to talk about the Ontario Autism Program, otherwise known as the OAP, and the new program changes that we introduced last December that are now in effect. I'd also like to hear from you and to answer some of your questions. This is our second TownHall this year and the fourth in total. I hear tonight we have about 350 people joining us on the line. Last week we had 600 people registered. And we know that some of you are currently receiving $8,000 and $10,000 payments and may have questions about the new changes and what they mean for you. So tonight we want to focus on providing as much information as we can for you. We also recognize that many other families have questions. And so we want to remind you that this forum is open to everyone, no matter what their situation is, and we're happy to take as many questions as we can.
Minister Coteau
With me tonight to help answer some of those questions is Sarah Hardy. She's the Director of the Ontario Autism Program Project Team at the Ministry of Children and Youth Services. And I want to take a moment just to thank her and her team for the work that she's been doing. They've been working quite hard over the last year with me while we've been making these changes, about a year- and-a-half now. And I want to make sure that you have all the information you need to access the OAP service as seamlessly and smoothly as possible. I'd like to start by giving you a quick outline of the program and the changes that we've introduced. Our focus has been to offer services that are flexible, individualized and based on the needs and strengths of children and youth, regardless of their age. We've also placed great emphasis on supporting families to be actively engaged in their child's care. Last June we introduced the OAP and families began entering the program through a single access point in their area. This past December, we now said we're providing families of children and youth with autism with choice, consistency and confidence, by providing a direct funding option for evidence-based behavioral services and making program enhancements that will deliver effective services. So as of January 15th my Ministry has: increased the maximum hourly rate for evidence-based behavioral services; communicated new qualifications for clinical supervisors; implemented an independent clinical review process, and changed accountability and clinical oversight for behavioral services. Your family's entry into the OAP may be different, depending on whether your child or youth is newly accessing services, waiting for services or already receiving OAP services. We are committed to supporting families of children and youth with ASD to enter the program as smoothly and seamlessly as possible. As you plan to enter the OAP, you'll be able to choose between receiving direct services at a regional provider or receiving direct funding to purchase services. On this call we can talk about what these options mean for you and your family. This program has been shaped by the voices of parents and caregivers.
And we have a strong program that will allow young people with autism to succeed here in our province. So, I want to say thank you
to everyone who's been with us on this journey, for your advocacy, your dedication, your perseverance and your patience. So, I don't want to take up too much more time. I want to hear from you. So, I'll turn it over to Sarah to say a few words and then we'll go back to Erik. Sarah.
Sarah Hardy
Thank you, Minister, and good evening everyone. Thank you so much for taking the time to join us tonight on the TownHall. I'm honored to be here with the Minister on what is our fourth tele- TownHall to answer some of your questions. I've had the privilege over the past couple of years to work on the design and implementation of the New Ontario Autism Program and this work has really presented me with the opportunity to connect with many families, our service providers, members of our advisory committee, the clinical expert committee, who have both devoted an enormous amount of time to this work, as well as other stakeholders and experts. These conversations, these opportunities and the advice that we've received, have really shaped where we are today. Last June, we introduced the New Ontario Autism Program. And this new program really represents a significant shift in how we deliver autism services in Ontario. This past Monday we also met another milestone and started the implementation of a number of other key changes, including a direct funding option for families. While the program may be still considered fairly new and many families are still transitioning, we're very proud of the progress we've made so far. And we look forward to continuing to hear from you and from other experts as we strive to continuously improve the OAP. So, thank you for your honesty, your advocacy and your input along this journey. And thank you again for joining tonight. Erik, I think we're ready to start taking some questions.
Erik
We do have our first live question ready to go. Thank you, Minister, thank you, Sarah, for opening up the TownHall. Now I do quickly want to remind everyone that tonight is the Ministry of Children and Youth Services province-wide telephone TownHall on the Ontario Autism Program. We're taking your questions, at any time over the course of the TownHall, press three on your phone’s keypad to ask a question of your very own. We're going to start with Kelly from Thunder Bay who has a live question. Kelly, welcome to the TownHall. Please, go ahead.
Kelly
Hi there. My question is, currently in the north Center-Based IBI, who is the regional provider, has been the only option for intensive services. The availability of private practitioners to utilize direct funding is very limited. We've been told that Center-Based IBI will no longer be provided in the north. What will be provided with the new OAP and the regional providers for the children who would benefit from the effective intensive services that IBI provides?
Minister Coteau
Well thank you very much, Kelly, for the question. It's interesting, as we went across the province and spoke to people in different regions, the issue around system capacity is constantly being
something that is being brought up. I know that in rural Ontario and northern Ontario sometimes there's more challenges trying to find the right match for a young person when it comes to delivery of those services. But I think two points I need to make is, number one, I know you asked around the question around intensive services. We know that if a young person needs X amount of hours they will receive the amount of hours that they need. So, the intensity of the program will depend on the diagnosis and approach that that specialist has taken for that young person. In regards to system capacity, I think that as the program continues to move along, what we need to do, as a Ministry, is to monitor where those gaps are and work with advanced education, work with different providers, work with individuals who may be looking for career choices and options. To make sure that we can continuously fill those gaps by making sure that there's a connection between our demand and what the academic programs are offering in different regions. So, we'll continue to do that. Sarah, I don't know if there's anything else you wanted to add to that?
Sarah Hardy
Well, just to pick up on a couple of points. One, with respect to the intensity of service as the Minister referenced, every child or youth in the OAP will have an OAP behavior plan. And that behavior plan will be based on an assessment of your child or youth needs and built around that. So, the intensity, the duration, the scope of the services will really be reflective of your child's needs. So, if it is determined that your child does need intensive service, that's what your child will receive in the OAP. The other thing I'd mention is we've had very much ongoing conversations about capacity across the province, as the Minister referenced, particularly in the north. And we do have very strong representation from the north on our advisory committee and this point is often brought forward to our attention. And it is something very much, particularly with the introduction of the direct funding option, we will be looking at very much in terms of where that capacity is needed and how do we start to build that capacity. The other point I'd just like to pick up on, in terms of the center-based IBI, that is definitely one option for service delivery. But through the OAP, what we're really trying to build on is the principle of accessibility and coordinated service. So, we want children to receive service in different ways, whether that's center-based IBI, whether that's in their homes or in a community setting. That will all be part of the child's behavior plan, in terms of what setting makes the most sense for that child, dependent on the services. So quite a long answer and a number of points. So hopefully, we've been able to hit most of them. Thanks, Erik.
Minister Coteau
Thanks, Erik. Thanks, Kelly.
Erik
Kelly, thank you again for that question. We have another live question ready to go. This one is coming up from Laurie. Laurie from Mississauga, you're joining us live. Please go ahead.
Laurie
Hi. My question is, I understand that the DFO stops after March 31st
but you've also said that direct funding is still available. What exactly is going to happen after March 31st? My son currently goes somewhere where he gets IBI services five days a week. Would he be taken away from that and put on the wait list and kind of waiting in limbo until he gets a spot, or do we leave him where he is?
Minister Coteau
Laurie, are you on the 8K/10K program?
Laurie
Yes, I am.
Minister Coteau
Okay. Last week I was pretty clear when folks were listening and the same question came up. I'll be very quick because there's going to be a lot more questions. But we will not disrupt any services for your son or anyone who's following that model until they're in the new program. So, I guess, just to be a little bit more clear, there will be no interruption of services. That date that we've chosen is our date that we would like to transition people over into the program. But if people go beyond the date, they'll continue to receive those services. Thanks, Laurie.
Erik
Laurie, thank you again for that question. We're quickly going to go to our next live question. This one's going to be from Daniel. Daniel from Burlington. Daniel, welcome to the TownHall. You're joining us live.
Daniel
Thank you. Thank you. Minister, thank you for taking the time to take on our questions and provide your answers—
Minister Coteau
Well, thank you.
Daniel
—so directly and kindly. So similar to the previous person, my son is receiving IBI and we also are doing direct funding. We did get a letter in the mail announcing that, essentially, the closing of the program in March. But there was no further instruction given to us in terms of what we must do to transition into the new program. I'm very comforted by the fact that we have your assurance that the program will continue. But, in terms of the mechanics of the process, it's not clear who we need to contact and what we need to do in order to maintain our payments and maintain our program?
Sarah Hardy
Hi, Daniel. It's Sarah speaking. Are you currently receiving the 10,000 as well?
Daniel
Yes, that is correct. We are on that program. That is correct.
Sarah Hardy
Okay, thank you. Just to be clear, and to pick up on the Minister's point, absolutely we want continuous service and the continuity of the service that you're receiving. Families that are currently accessing $10,000 payments, your regional provider is going to work with you to discuss the OAP and what the next steps are for your family. So, they will be reaching out to you. And at this discussion, what they will support you in doing is making a choice. And that choice will be either entering the OAP at your next reconciliation point or receiving another $10,000 payment. And you may continue to access those $10,000 payments until March 31st. So that's where the transition point comes in and then another choice. Following March 31st, we will be issuing no additional $10,000 payments and we will support you to move into the OAP. If you want to continue working with your current provider, that you are currently purchasing service through in terms of the $10,000, you will also be supported in that choice. And in doing so, what that would mean is that you would be moving into the new direct funding option and your services would be funded at $55 an hour. A behavior plan will be created for you working with your clinical supervisor and the other supports that go with that. But I think, the most important point to understand right now is, you will be supported to make that choice between what you want to do between now and March 31st. And, sir, I don't know if there's anything else [crosstalk]?
Minister Coteau
No, no, that's it. Again, no one will be cut off from the current program until they're in the new program and if we need to send out some further instructions, or as you phrased it, "the mechanics behind the transition," we'll do that. Thank you.
Erik
Daniel, thank you very much for that question. We're going to go to another question in just a second. We're still having new people join us and I want to welcome them to the Ministry of Children and Youth Services province-wide telephone TownHall on the Ontario Autism Program. We are taking your questions. Tonight, we are live with the Minister of Children and Youth Services, Michael Coteau, and he is joined by Sarah Hardy, the Director of the Ontario Autism Program Project Team. Together we are answering your questions. Press three on your phone's keypad at any time to ask a live question. We're going now to a live question from Dana, from Toronto. Dana, welcome.
Dana
Hi guys.
Minister Coteau
Hi.
Dana
Hi. I just had a question from last week. I tuned into that— the transcript came out and I read it. And you guys didn't really answer one of the questions so I'm hoping maybe today you can do that. So how much money, like actual funds, has been budgeted for the new OAP until June of this year and how much has been projected for the full year? The Ministry must have that figure as it's dispersing funds to the regional providers. And again, I'm asking the total amount of funds for the OAP for this— until the projected amount for the full 2018. And if the Ministry doesn't know that number, right off hand, when can we get that figure?
Minister Coteau
Hi. Thank you so much. I don't recall someone asking the direct amount last week, but if we missed it I apologize. It's always good to have a second chance to answer a question. We allocated $500 million of additional funding over a five year period. It goes up and down but it's roughly just say $100 million per year. But that's in addition to the base funding we were allocating prior to that. Sarah, do you know roughly what that number is?
Sarah Hardy
Roughly it's about $190 million a year.
Minister Coteau
So, is that total or [crosstalk]?
Sarah Hardy
Each year, that's our base.
Minister Coteau
Base?
Sarah Hardy
Yup.
Minister Coteau
Plus the additional hundred?
Sarah Hardy
And then plus addition each year.
Minister Coteau
So that's almost $300 million per year, roughly. So, $290 million a year of funding. So, it's not like that new money eliminated any existing funding. Does that answer your question?
Dana
Yeah, that's good. Thank you.
Minister Coteau
Okay. Thank you.
Erik
Dana, thank you very much for that question. We have another live question ready to go. This one is coming from Stephanie. Stephanie from Burlington, welcome. You're joining us live on the TownHall.
Stephanie
Hi, Michael and Sarah. I would like to ask— I know you guys have met with people across the province in depth and listened to stories about kids in depth. And one of those stories that we hear clearly is about the need for different angles of therapy, which include speech and OT. I just want to have a clear reason why you guys have not included it into the OAP, other than just tackling one thing at a time.
Minister Coteau
Yeah, thank you so much. And that's a very fair question that comes up always. When we went out there and we looked at the system and we spoke to people. The biggest challenge in the system was the current delivery model for the ABA, the IBI, just the behavioral therapy. The biggest challenge was those programs, they had the most demand for those specific programs and they had an overwhelming wait time to get to those programs. The system was in such challenge— there was such challenges within the system that people were getting assessed, going onto a wait list and then the assessment would run out and then they would have to go get reassessed again before they would actually access the service. The system was negatively feeding on itself. There were cases where I've talked to parents, where they were telling me that they've gone through two, three different assessments before getting services. Or there would be interruption of services, where they would get a unit of services and then there would be a pause for four or five months and they would have to wait and get back on to it. My job was to fix the basic structure of the problem and it was looking for a way to make sure that I could eliminate that wait list. What we're doing here today is using our resources to provide what I see as the very core need out there when it comes to services for young people and for families with autistic children. So, I wanted to put in place a system that would work, that would eliminate wait time and get people into the system. I've always committed that our government, after we accomplish this, we would look at all other aspects.
Because, in additional to speech therapy, there are so many other pieces that people have asked about, alternative forms of therapy. They've asked for the transition connection to school. People have talked about just different programming. So, I just want to get this fixed and get this right and then open up the questions for how we enhance the system in the future. So that's where I'm coming from and that's what I've been asked to do. Erik.
Erik
Stephanie, thank you very much for that question. We have another live question ready to go. This one's coming up from Candice, who's from Ottawa. Candice, you're joining us live. Please go ahead with your question.
Candice
Hello, Michael and Sarah. I'm a speech-language pathologist in private practice. Actually, following this question kind of makes sense after the other one. So currently we have a number of children that we are servicing through this lump fund sum, through these sums. We are providing the speech-language services implemented with the behavioral analysis principles. We have a number— as you know with autism, and you were talking about core needs, the core needs for most children with autism is communication-based or communication-related. We're providing an essential service for these clients and the relationships are in place and the children are progressing well, the focus is social communication, social functioning. We are wondering what is going to happen, considering, as you've mentioned, you were talking about the public speech-language pathology services and how limited they are in terms of treatment and continual treatment that these children deserve. How is it once you alter it to the $55 limit that these families are going to be continued to be able to get services, communication services, for their children's functional communication once the $55 limit is in place?
Minister Coteau
Sarah. I'm sorry, Candice. I didn't really get the question but Sarah, I think, has the answer.
Sarah Hardy
So thanks, Candice. There's a couple of things that I just wanted to clarify about the ongoing relationship that you, as a speech- language pathologist, may have with the children who are currently receiving the $10,000 payments. And once those families transition into the new OAP and as they continue to choose the direct funding option and continue to work with you. You can continue to do that. There are a couple of different ways that you could continue to provide behavioral services to these children through the OAP. One is if you, as a speech-language pathologist, has or is working towards the new qualification requirements for clinical supervisors. So, this might be a case where you as an SLP is also a BCBA or you're working towards your BCBA. So, you could continue to be involved with that family in clinically supervising those behavioral services.
And those behavioral services very much may be addressing communication goals and skills. The other scenario might be where you, as a speech language pathologist, is actually being supervised by an OAP clinical supervisor to deliver the behavioral components of a behavior plan. This would be a situation where you, as an SLP, you have behavioral service experience and you're working under the supervision of a BCBA or a psychologist. The third scenario where you may be involved is if you are an expert in a particular behavioral service and you may be partnering with a clinical supervisor to actually deliver that component of a behavior plan. So, there are a number of different ways where you, as a speech- pathologist, may continue to be involved with the families that you are working with. I think the last component of your question might be with respect to the rate. I know there are different rates in terms of the service, but the rate that we're funding is up to a maximum of
$55 an hour for the services as identified in a child's behavior plan. Erik, I'll turn it over to you.
Erik
Candice, thank you very much for that question. We are going to go to another live question. This one is from Elizabeth from Whitby.
Elizabeth, you're joining us live. Please go ahead with your question for the Minister.
Elizabeth
Good evening, Minister. Good evening, Sarah. My—
Minister Coteau
Good evening, Elizabeth.
Elizabeth
—question was— thank you for taking my question. My question was for the direct funding option. My son has been on the ABA wait list since 2014, I believe. Just wondering if this direct funding option is available for ABA because, from what I get, it seems to be only [inaudible] to people with using IBI. And he was assessed at Kinark in Markham and they had said that he would benefit more from ABA instead of IBI.
Minister Coteau
So, this is that— well, thank you for your question. This is for all funding in relation to ABA. Most people know, who are involved with autism services, that IBI is just an Ontario name for an ABA program. It's just that the intensity level. But it is an Ontario-made program, IBI. The way we're looking at it is that all the programming is going to be designated to ABA, just the intensity levels of— how many hours a young person is allocated will differ based on need.
Just to answer your question the most direct is, yes, the new program will include ABA funding. And Sarah just wants to add one other thing.
Sarah Hardy
So just to clarify, the families that were on the IBI and ABA wait list have all now been added to the OAP wait list, based on their date of referral. So, there are no longer distinct wait lists for IBI and ABA. Just to be clear that once your spot becomes available in the program, you will have the option of choosing to receive your services either through a regional provider or through direct funding. And you will have that choice point regardless if you were previously waiting for IBI or ABA. That choice point is available for all families once their spot becomes available in the OAP. Thanks, Erik. I'll turn it back to you.
Erik
Elizabeth, thank you for that question. Just a quick reminder for everyone joining us that we still have about 30 minutes of question time remaining. We're going to go to our next live question. This one is from Gregg from Toronto. Greg, welcome. You're joining us live.
Greg
Hi, good evening. Thanks for taking my question. I just wanted to ask the Minister. How do you plan on ensuring that the delivery of services amongst regional providers is consistent? More specifically, has the Ministry sat down with the clinical directors of the various regions to ensure that the interpretation of the new OAP is consistent amongst the various regions in Ontario?
Minister Coteau
Well, thank you very much for the question. That question you just asked is such an important question because we can, from Queen's Park, from our government building, get a lot of words on paper.
But to really test to see if the program is effective, it's going to have to be by looking and reviewing the work that's taking place across the province. I, as the Minister responsible for this file, hold myself, and the people of Ontario hold me directly responsible, to ensure that it's an effective program. We will be working with all of our regional partners and even with our private partners to ensure that the right types of standards and the people are following the process in the new program that we've laid out. But there are some quality assurances pieces that will be put in place as well. And I'll just turn it over to Sarah to get into those specifics.
Sarah Hardy
Thanks so much, Greg, for the question. Many of the changes that we've actually introduced and that became effective in January, on Monday actually, really speak to looking for increased consistency and really enhancing accountability in the system. So things such as the clinical supervisor requirements, a behavior plan template, those types of things, we're really trying to introduce that consistency and service delivery. No matter if you chose your service through a regional provider or a direct funding provider, it doesn't matter. Regional providers and direct funding providers are providing OAP services. The quality assurance piece that the Minister just referenced, it is something actually that we are currently working on and currently designing. The purpose of it really will be to monitor the quality of OAP behavior plans and we are looking for this implementation in spring 2018. And what it will essentially entail is that OAP behavior plans, so these are the plans that will outline the services that your child will be receiving, developed by both direct funding providers and regional providers, will be randomly selected for independent clinical reviews by a team of third-party clinical reviewers. And this is really important in terms of understanding, A, the quality of the behavior plans, and really understanding the consistency in how they're being developed and delivered. So that is a really important mechanism that will be in place come spring 2018. One of the other things that we are introducing, that will be made public in 2018, is an OAP provider list. So, this will really help families to select a qualified OAP service provider. There will be a process for providers to apply to the list and there will be a process where their qualifications will be verified. So again, really trying to introduce some consistency, no matter whether it's direct service or direct funding. Families understand that they are receiving quality services from knowledgeable and qualified clinicians. So those are just a couple of things, in addition to the changes that have become effective on Monday, a couple of the other things that we're introducing for the spring. Thanks a lot for your question and I'll turn it back over to you, Erik.
Erik
Great. Thank you again for that question. We have another live question. Now this one is from Rob who is from Toronto. Rob, you are joining us live. Please go ahead with your question.
Rob
Good evening. Thank you for taking the questions. My question is, my son's 11 years old. He's been on a waiting list for a little while. I was wondering how long the actual waiting lists are at the current time?
Background Speaker
Who are you talking too? Can I talk to nurses?
Rob
Thank you.
Sarah Hardy
Sorry, I didn't get that last part. Sorry about that.
Rob
I was wondering how long the actual questions— sorry, how long the actual waiting lists are at this time?
Minister Coteau
It depends on which region you are. Different wait times in different regions, but right now I believe the number— we have on wait list, right across the province, I think it's around 20,000. So about 20,000 people who are on wait lists across the province and to me that's completely unacceptable. And that's why we're changing this program to make sure that we can— we've invested the money.
We'll make sure there's accountability measures in place. We'll streamline those services to ensure that people are getting the services as quickly as possible. But in different regions, you'll have longer wait times. In some regions, it's much easier to access those programs. And what we'll be doing is working with our regional partners and also the private partners. Because you could essentially, in some areas, not have enough capacity to deliver those services so we'll be coordinating with different regions to see how we can assist on making sure that young people are getting exactly what they need to find success. Thank you. Erik.
Erik
Rob, thank you again for that question. Now, quick reminder for everyone joining us, if you have a live question that you would like to ask, we do want to hear from you. At any time, you can press three on your phone's keypad. Someone will take your name and place you in the question queue, which is a virtual line up where you will be while waiting to ask your question. We're now going to go to Lindsey, from St. Thomas, for another live question. Lindsey, you're joining us live. Please go ahead.
Lindsey
Hi, Minister. Thanks for taking my question. I'm working currently as a BCBA in southwestern Ontario with families, delivering ABA and IBI. Historically, for us, there's been a real difficulty in working collaboratively with schools to develop goals and service children. I just wondered if you guys had any plans to work with the Ministry of Education to deliver ABA and IBI collaboratively with school teams?
Minister Coteau
Oh, thank you so much. This is, again, a very, very popular question. There has been a strong commitment from me and the Minister of Education. Well, today we have a new Minister of Education, so with a new Minister obviously comes new opportunities as well. But the previous Minister was very dedicated on looking for how to strengthen those programs within the school setting. Some of the challenges that we have in front of us is there are different boards, there's different processes, there's different co-active agreements. We do have our regional providers, private partners. We need to look for ways to better streamline those services. The world is built around that young person and not necessarily that young person trying to adapt to different worlds. We do have an internal discussion that's happening between the officials, the bureaucrats, to look for ways to better streamline those services. I've always committed to looking for ways to formalize that process and looking for ways to bring people in to help us, community members. So that's something that we're looking at. We want this program to begin and the next phase, I believe, is looking at all the services, including how we integrate these services into the educational settings. And there are some school boards that are doing some remarkable things. Sarah, is there anything else you wanted to add to that?
Sarah Hardy
I think the only thing I'd like to add is, we're working very closely with an advisory committee on the design. And we do actually have two, three members who represent the education system. So that perspective is often brought forward, in terms of how do we enhance that collaboration, how do we look at transitions between our programs and school, and how do we work collaboratively as a system to support kids and students with autism. We know that the majority of the children that we're serving through the OAP are of school age. So it's really important to be looking at that collaboration as part of our program design. The only other thing I'll mention is, you may be aware that the Ministry of Education recently launched a pilot in 18 school boards to really improve school-based supports for children with autism and are piloting two different approaches. One is providing dedicated space for autism services on the school site and offering targeted education assistant training in those boards, as well, to better support children and youth with autism. So, we're making some initial steps, I would say, more work to be done, absolutely. But that voice is very much at the table and at the center of our design. Thanks a lot for the question, Lindsey. Erik.
Erik
Lindsey, thank you again for that question. We have our next live question ready to go. This one is going to be from Anna. Anna, from Toronto, welcome to the TownHall. Please go ahead.
Anna
Thank you. Good evening. My nephew came up on the list for DSO here in Toronto at Surrey Place. But we were not given the option for DSO services. He is currently getting at-home therapy and has been for approximately six months and we do not want to disrupt his program. And we were wondering why we weren't given that option?
Minister Coteau
Sorry, just as a classifier. You're saying your son was not given the option for the new program?
Anna
That's right, for direct funding.
Minister Coteau
Okay. So our program started January 15th, so two days ago, officially. So, I'm assuming that the next time, I guess, the exit or entry point into that allocation of time and those options will be provided to you. What I would also suggest is that you go into your service provider and ask the question around the transition into direct funding so you can have that choice. But the program is officially two days old. This is the new program and your service provider should have more information for that. And you can also visit ontario.ca/autism to find out more details about how the program actually works across Ontario and more specifically you can find out about your region. Thank you.
Erik
Anna, thank you very much for that question. We have another live question. This one is coming from Amanda from Perth. Amanda, welcome to the TownHall. Please go ahead.
Amanda
Hi there. Thank you very much. My first question is regarding having my child reassessed. Under the FAQ it states that my child will be reassessed at least every six months by the guidance of the clinical supervisor. I just want to confirm that this process happens if I take the direct service option or the direct funding option, so it happens in either option that is taken.
Sarah Hardy
Hi, Amanda. It's Sarah speaking. So the short answer to your question is, yes. So, it doesn't matter if you choose the direct service option or the direct funding option. The OAP guidelines and the OAP clinical framework, which is where I think you were reading about the six-month progress assessment. That six-month progress assessment happens regardless of your service options. So, children and youth will be assessed for their behavioral services by the clinical supervisor that they're working with and this will be either in the DSO or DFO option. And that clinical supervisor will be making recommendations about your child's services. Assessments happen at various stages, but what you see through our guidelines and our clinical framework is that six-month reference. And again, just to reiterate, that happens no matter if you're receiving services through direct service or direct funding. So, I hope that's helpful. Erik.
Erik
Amanda, thank you for that question. We're going to go now to Jennifer from Ajax for a live question. Jennifer, welcome.
Jennifer
Hi and thank you for taking my question. I think maybe partially it's been answered since I requested a spot but you mentioned a couple of times about the behavior plan. And my question was around who develops that and determines the number of hours a child is eligible for? My child currently does not receive any funding. I'm not part of the 10,000 program that you've referenced and I've been funding therapy myself. I'm just curious as to who determines the number of hours and what that plan entails?
Minister Coteau
Thank you. Thank you very much for the question. I'm going to turn it over to Sarah but I just wanted to just focus on one point of your question. I hear a lot from parents out there who are funding the program themselves. And there's a lot of parents out there that are borrowing money or leveraging assets, like their homes, to do so. And I just want people to know on the line that, I don't think that's a fair approach here in Ontario. We want to make sure— and this is why— you know the amount of money that we've put into support autism services in Ontario is the largest amount in the history of anywhere in North America. But my job now is, now that we have the resources, to make sure that those resources are being spent in the most effective way that give young people and families the best return on that investment. I'm sorry that you've been paying for that yourself. My hope is that, as we move along, that we eliminate that weight lift and your child can move into a program that's paid for by your taxes. So, I'll turn it over to Sarah to specifically answer the question around the technical side of the question.
Sarah Hardy
Thanks a lot. So in terms of the question around assessments and who conducts those assessments. Assessments in the OAP are conducted by a clinical supervisor and you may have seen on Monday we did release the revised OAP guidelines. And within the OAP guidelines are required staffing requirements for clinical supervisors. So, the role of the clinical supervisor is to assess, to develop and to recommend appropriate behavioral services for your child. That being said, families will also be involved in this process, in the assessment, the goal setting and the intervention planning process for their child. And assessments in the OAP will happen at various stages. For example, an assessment will happen when a child first enters service. So, a clinical supervisor that you've chosen to work with will assess your child to inform those behavioral services, your goals, your strategies. And assessments, as we talked about in the previous answer, are also conducted on an ongoing and regular review interval period - so that might be the six months - as a way to assess the child's progress and really set goals and inform the next steps forward. When that assessment is done, what that will form is the development of your OAP behavior plan. And the OAP behavior plan is a detailed description of the behavioral services that your child will receive in the OAP. And, as I mentioned, it's based on feedback from you and it's based on a clear understand of your expectations, your capacities, your priorities for your child, as well as the clinical recommendations that come from the clinical supervisor. And an OAP behavior plan is required for every child and youth, who are receiving behavioral services in the OAP. Part of the materials that we've released on Monday includes instructions for the development of the behavior plan. And our expectation is that the behavior plans are being developed, following the approach outlined in our clinical framework, our OAP guidelines, as well as the specific instructions that were released. I will turn your attention to another document that we released on our website on Monday and it's a family guide that really tries to answer a number of questions that families may have about the development of the behavior plan, as well as what the required qualifications are for clinical supervisors, and some of the anticipated questions you might have as you start to embark on this process. So, I'd encourage you to visit the website to look at some of these materials and hopefully that helped answer that question. Thanks so much. I'll turn it back to Erik.
Erik
Jennifer, thank you very much for that question. Just so everyone on the line is aware, we have a little bit less than 15 minutes remaining for questions. We're going to go now to Rannie from Ottawa.
Rannie, welcome. You're joining us live. Please go ahead.
Rannie
Yes. Hi, Minister and Sarah. I would like to know from what age to what age that children and youth can have these services?
Minister Coteau
Up to 18. That's going to be my shortest answer of the evening. Thanks, Erik.
Erik
Rannie, thank you very much for that question. We have another live question ready to go from Dana from Toronto. Dana, welcome to the TownHall. You're joining us live on the line. Please go ahead.
Dana
Hi, again. If there's $290 million in funding then that means there's only 3,000 kids that will get intensive services this year. So if all the 8K Payment kids get service and all the IBI kids get service, then there's no new kids that will get service this year and you're also putting the kids' futures in the hands of under-qualified and unregulated professionals at this time. Your documents say that's all they have to have is a vulnerable police record check and anybody can be a BCBA in this province. That's something that should be looked into. Thank you.
Minister Coteau
So, $190 million was the— let's just go back a couple of years before we actually made the investment like last year, year-and-a-half ago. It was actually $190 million-plus that was being spent on autism services in Ontario. We've added an additional 100 million on average per year, so 500 million over five years. So right there, it's a one-third increase in investment. Now, the assumption that only 3,000 young people would benefit from that is based on the assumption that everyone's taking intensive services. That's not necessarily the case. Young people may require a couple of hours a week. They may require 25 hours a week. So there's a variance that occurs across the system. To say 3,000 would only benefit from the
192. The first problem is, is— well it's not 192 or 194 or whatever you said. It's actual 100 million more on average, 500 million over five year period. So that's a one-third instant capacity build. And then the second assumption is that you just assumed that everyone is taking intensive services. There are people who come into the system, and I meet many families, where a young person gets one or two units over a few months. It may be a couple of hours a week and then they no longer require the services again. It varies between child. And one thing I've learned about autism, everyone is different and the needs are so different. And that's why the assessment process and the allocation of the right hours that match the actual need is so important. Thanks, Erik.
Erik
Dana, thank you very much for that question. We're going to go now to Kim from Ottawa for a question. Kim, you're joining us live. Please go ahead.
Kim
Good evening, Minister and Sarah. Thanks for taking my question. My question is, I'm currently on the 8 to 10K program where we get— basically where we reconcile our receipts. Once we reach the 10K and then we're cut funds for the next few months of therapy. So, my question is, once we submit these new behavior plans with the new financial plan attached to them, when are the funds allocated to us? Are they allocated before the therapy takes place or do we still have to reconcile receipts? Thank you.
Sarah Hardy
Thanks a lot for your question. It will be slightly different than the $10,000 but I think the principle that we're absolutely operating within is no break in service and we wouldn't want the flowing of funds to jeopardize the continuity of service. So the way that we've positioned it in our guidelines and through the budget template is that families will be advanced three months’ worth of the total budget that was submitted by their clinical supervisor. So that you will have funds in advance so that you're not out-of-pocket. Erik.
Erik
Kim, thank you very much for that question. We are now going to go to Karen from Peterborough for a question. Karen, you're joining us live. Welcome.
Karen
Hi. Good evening. The last person who asked the question about the funding, so the individual families that are receiving the funding, just to clarify, will they then still be handing it out to the therapist and the senior clinical therapist, who's supervising our child's program?
Minister Coteau
So [inaudible]— oh, sorry. I didn't mean to cut you off. Did you finish your question?
Karen
That's okay. I think that was it.
Minister Coteau
Okay. Thank you. I'm going to pass it over to Sarah but we've got just a couple of minutes left, actually, probably like maybe three or four minutes max. We're going to go through as many questions as possible as quickly as possible. So, Sarah.
Sarah Hardy
Currently the way that the funding will work is the funding will go direct to the parent who will then be responsible for paying the service provider that you are working with. I do want to commit because we are looking at options for how that may be different, depending on family choice and whether there's options to do things more electronic transfer-based and/or directly to your providers, but we're not quite there yet. How it will be currently operated is that money will go directly to the parents.
Minister Coteau
Okay, Erik. We'll keep going through as many questions as possible. Thank you.
Erik
Karen, thank you. We have a question from Sylvia from Woodbridge. Sylvia.
Sylvia
Hi, good evening everybody. So I'd like to ask specifically about therapies like Pivotal Response Training, The Early Start Denver Model, DIR Floortime. These are evidence-based ABA therapies, one of which my son has made [inaudible] with PRT. I'm wondering if the OAP is committed to funding these therapies?
Minister Coteau
Sarah.
Sarah Hardy
Yes. There isn't a completely short answer to that. But I think what we want to be clear about is that the OAP is funding evidence-based behavioral services. And last week, if you were listening, we did get some questions about what does evidence-based mean and what does behavioral mean. So behavioral, when we think about that, it refers to services that teach children use of skills that they need to participate at home, at school and the community. And there's a wide variety of services with different names, different methods. You mentioned a few of them that we would consider as behavioral or behaviorally-based. Many of those interventions are based on the science of ABA and it really is the responsibility of your clinical supervisor, who is considered an expert in the science of ABA and who is responsible for developing your behavior plan, to understand what is evidence-based. So what behavioral services have proven to be effective and it is their responsibility for recommending services as appropriate as part of your behavior plan. It's not a short answer and it's certainly a complicated area. The field of autism is continuously moving. Research is continuing to evolve, but it is your clinical supervisor who is considered an expert in the science of ABA who will be making those recommendations.
Minister Coteau
Erik, I think, we can probably take one or two more questions, depending on the length of the question and answer.
Erik
We have one more question that we can get to. Yes, it's going to be from Tara from Brampton. Tara, you're joining us live. Please go ahead.
Tara
Hi. I'll try to make this question as quick as possible. My son is currently with a DFO provider. And I'm wondering between every six-month assessment, do they go on a wait list during that period before they're assessed again?
Minister Coteau
Sarah, do you know the answer to that, the details to that.
Sarah Hardy
Sorry, could you just repeat the question?
Minister Coteau
Yeah, it was hard hearing [crosstalk].
Tara
Basically—
Sarah Hardy
You're cutting out a little bit.
Tara
Oh, if they're being assessed every six months through the DFO provider, do they go on a wait period between therapy sessions?
Minister Coteau
There should be no disruption of services. In the new program, once you're in the program, there should be a continuation of services without interruption. That's the approach that we've adopted.
Sarah, is there anything else you want to add?
Sarah Hardy
Yeah, so the only other thing I will add is we have eliminated the concept of discharge. So, once you're in the OAP, you're in the OAP. And there will be periods of time when your child is actively working on their behavior plan and their behavioral services. And then there will be periods where your child is maintaining those skills that they've developed in their natural settings. So, there are different periods of intervention and your clinical supervisor will be working with you to determine what those are, what those look like and, obviously, through the support of a family support worker. If new needs arise or new challenges arise, that is who you would contact to discuss.
Minister Coteau
Okay, Erik. I think that's the last question. I just want to say a few words before we finish up here. First of all, I want to thank you, Erik, for facilitating the TownHall this evening. I want to thank Sarah and her entire staff for all the work they've done to get us to this point in the last two sessions. We've had almost a thousand people register. To me, we've come a long way. We're having a very productive, constructive conversation about how to position young people for success. I want to apologize for anyone who's on the phone currently who didn't get their question in, but you can go to ontario.ca/autism to get some answers for any additional questions or you can also contact the Ministry. I would suggest that people follow the Ministry's Twitter account. Do a search for myself or for the autism program and get onto our website and stay connected.
In our work here to make sure that young people get the best services that they need, we will be monitoring this program. We will continue to have a continuous conversation Ontario so we can continue to build the best program in the country and in North America. I want to just turn it over to Sarah for some final words but I just want, again, thank parents for everything and advocates and everyone on the phone tonight. We couldn't have done it without you and we're going to make sure that this program is a program that you're going to be proud of.
Sarah Hardy
I would just also like to say thank you for your time. As I mentioned in my opening remarks, this truly has been a privilege and it's an honour to be here with the Minister to answer your questions. I've learned a lot over these last couple of years as we designed the Ontario Autism Program and most of that learning has come from you, your experiences, your honesty, your advocacy. So, I thank you very much. I think the new program is very much a collective design process, building in the perspective and the voices from the broader community. It's something that I'm very proud of and very proud to be a part of. So, thank you so very much. Erik.
Erik
Thank you, again, to everyone for joining us on the Ministry of Children and Youth Services province-wide telephone TownHall on the Ontario Autism Program. We were live with Minister of Children and Youth Services, Michael Coteau, of course also Sarah Hardy, the Director of the Ontario Autism Program Project Team. If you still have any questions about the Ontario Autism Program, you can visit our website at ontario.ca/autism or call Service Ontario at 1-888- 284-8340 - again 1-888-284-8340 - to find the contact information for your single point of access or for the Ministry of Children and Youth Services regional office in your area. Thank you again for joining us this evening and have a great night.