Legislative Assembly of Ontario

 

Assemblée législative de l'Ontario

 

SELECT COMMITTEE ON DEVELOPMENTAL SERVICES

Final Report

Inclusion and Opportunity:
A New Path for Developmental Services
in Ontario

1st Session, 41st Parliament
63 Elizabeth II


 

 

ISBN 978-1-4606-4169-9 [English] (Print)
ISBN 978-1-4606-4172-9 [French] (Print)
ISBN 978-1-4606-4171-2 [English] (PDF)
ISBN 978-1-4606-4174-3 [French] (PDF)
ISBN 978-1-4606-4170-5 [English] (HTML)
ISBN 978-1-4606-4173-6 [French] (HTML)

 


 

Legislative Assembly of Ontario

 

Assemblée législative de l'Ontario

 

Letter from the Members of the Select Committee on Developmental Services

The Select Committee on Developmental Services is pleased to present its final report and recommendations. We hope that our work as summarized in this report will help to immediately inform public policy on developmental services.

The Members of the Committee come from all three of the province’s political parties. All of us volunteered to serve out of a commitment to address the needs of individuals with developmental disabilities or a dual diagnosis across the province. Despite our political differences we share a conviction that Ontario must meet its responsibility to provide an appropriate level of services and supports to some of the province’s most vulnerable people. We make our recommendations in this spirit of consensus.

We thank the Committee Clerk and staff from the Legislative Research Service for their dedication and hard work. The Committee was given a very broad mandate—and an extremely short timeframe—and their assistance was essential to helping the Committee develop its final report.

We express our thanks and appreciation to the many people who shared their personal experiences with us. We were deeply moved by these first-hand accounts, and impressed by the passion and commitment shown by those who are involved in the developmental services sector. We learned a great deal from their presentations and submissions, and developed our recommendations in response to their concerns.

At public hearings across the province many people recalled the painful legacy of the large government-run institutions where people with developmental disabilities were warehoused and excluded from the broader society. The closure of these institutions and the government’s apology for how people with developmental disabilities were treated in the past were important steps, but we must not stop there. We hope that this report will bring us closer to achieving the goal of inclusion for all Ontarians.


Select Committee on Developmental Services

Comité spécial des services aux personnes ayant une déficience intellectuelle

Toronto, Ontario M7A 1A2

 

Legislative Assembly of Ontario

 

Assemblée législative de l'Ontario

 

The Honourable Dave Levac, MPP

Speaker of the Legislative Assembly

 

 

Sir,

 

 

Your Select Committee on Developmental Services has the honour to present its Final Report entitled "Inclusion and Opportunity: A New Path for Developmental Services in Ontario" and commends it to the House.

 

 

 

 

 

 

 

Laura Albanese, MPP
Chair of the Committee

Queen's Park

July 2014


Select Committee on Developmental Services

Comité spécial des services aux personnes ayant une déficience intellectuelle

Toronto, Ontario M7A 1A2

SELECT COMMITTEE ON DEVELOPMENTAL SERVICES

 

Membership List

 

1st Session, 41st Parliament

LAURA ALBANESE

Chair

 

CHRISTINE ELLIOTT

Vice-Chair

BAS BALKISSOON

CHERI DINOVO

SYLVIA JONES

Jack MacLaren

Cristina Martins

MONIQUE TAYLOR

SOO WONG

 

 


 

 

Trevor Day

Clerk of the Committee

 

Erica Simmons and Heather Webb

Research Officers

 

 


SELECT COMMITTEE ON DEVELOPMENTAL SERVICES

 

Membership List

 

2nd Session, 40th Parliament

LAURA ALBANESE

Chair

 

CHRISTINE ELLIOTT

Vice-Chair

BAS BALKISSOON

CHERI DINOVO

MITZIE HUNTER

ROD JACKSON

SYLVIA JONES

MONIQUE TAYLOR

SOO WONG

 

 


 

 

Trevor Day

Clerk of the Committee

 

Erica Simmons and Heather Webb

Research Officers

 

* Jack MacLaren regularly served as a substitute member of the Committee.

 



Contents

List of Abbreviations   1

Committee Mandate   2

Introduction   3

Guiding Principles   4

No More Waitlists  4

Oversight and System Accountability  4

Empowering Individuals, Families, and Communities  4

Building Capacity  4

Inclusion and Opportunity  4

Oversight  4

System Accountability   5

Developmental Services Ontario Organizations  5

Data Collection   7

Empowering Individuals, Families, and Communities   8

Person-Directed Planning and Individualized Life Plans  8

Supported Decision-Making  8

Independent Planning  8

Eligibility  9

Direct Funding  10

Service Agencies in the Community  10

Building Capacity   11

Dual Diagnosis  11

Primary and Dental Care  12

Fetal Alcohol Spectrum Disorder (FASD) and Autism
Spectrum Disorder (ASD) 13

FASD   13

ASD   13

Remote and Rural Communities  14

First Nations Communities  14

Inclusion and Opportunity   15

Education (Primary and Secondary) 15

Postsecondary Education and Skills Training  16

Employment 17

Housing  18

Respite  19

Day Programs  20

Conclusion and Follow-up   20

Consolidated List of Recommendations   21


 

Appendix A   26

Preceding Developments  27

Committee Meetings  27

Appendix B   29

Schedule of Public Hearings  30

List of Witnesses and Submissions  31

Appendix C   43

List of Developmental Services Ontario Offices  44

 

DO NOT REMOVE


List of Abbreviations

Abbreviation

Organization/Individual

ASD

Autism Spectrum Disorder

CAMH

Centre for Addiction and Mental Health

CCAC

Community Care Access Centre

CICE

Community Integration through Co-operative Education

DSO

Developmental Services Ontario

EA

Educational Assistant

FASD

Fetal Alcohol Spectrum Disorder

IMCDS

Inter-Ministerial Committee on Developmental Services

MCSS

Ministry of Community and Social Services

ODSP

Ontario Disability Support Program

QAM

Quality Assurance Measures

SIPDDA

Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008

SSAH

Special Services at Home


 

Committee Mandate

On October 3, 2013, the Legislative Assembly of Ontario gave unanimous consent to a motion to appoint a Select Committee on Developmental Services that would consider and report to the House its observations and recommendations with respect to the urgent need for a comprehensive developmental services strategy to address the needs of children, youth and adults in Ontario with an intellectual disability or who are dually diagnosed with an intellectual disability and a mental illness, and to coordinate the delivery of developmental programs and services across many provincial ministries in addition to the Ministry of Community and Social Services. In addition, in developing its strategy and recommendations, the Committee would focus on

·          the elementary and secondary school educational needs of children and youth;

·          the educational and workplace needs of youth upon completion of secondary school;

·          the need to provide social, recreational and inclusionary opportunities for children, youth and adults;

·          the need for a range of available and affordable housing options for youth and adults;

·          the respite and support needs of families; and

·          how government should most appropriately support these needs and provide these opportunities.


 

Introduction

The Select Committee on Developmental Services is pleased to present its final report. Investigation of developmental services began when the Select Committee was created in October 2013.[1] Over the months that followed, the Committee heard from more than 140 presenters at 14 public hearings and received over 300 submissions ranging from handwritten letters and emails to reports, articles, and videos. Our March 2014 Interim Report summarizes what the Committee heard.

The public hearings and submissions received by the Committee illustrate the range of challenges and successes experienced across this province by persons with developmental disabilities and their families. We were humbled by the extraordinary people who shared their personal struggles to obtain the services and supports needed for family members with developmental disabilities or a dual diagnosis. Presenters described serious barriers to support across the province including long waitlists for many services; repeated, onerous, and invasive assessments; the abrupt termination of children’s services at the age of 18 and school-based services at age 21; unmet health needs due to inadequate primary and dental health care; and a serious lack of services and supports in northern, remote, and First Nations communities.

Above all, the Committee heard repeatedly that individuals and families who need developmental services and supports are in crisis. We heard that after struggling to obtain services and enduring waitlists for years, many families feel pushed to the brink of disaster. Only when they are forced into crisis are they able to access desperately needed assistance. When that happens, others are bumped further down the waitlists.

The Committee recognizes that the situation is urgent. We are deeply troubled and alarmed by the range of barriers confronting persons with developmental disabilities or a dual diagnosis. We firmly believe that everyone has the right to full social inclusion, and to receive the services and supports they need without delay. We note that this right was recognized by the Ontario Legislature when it passed the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008 (SIPDDA).

The recommendations we have made in this report touch upon almost every aspect of the developmental services sector. We recognize that government initiatives are already underway in relation to some of the recommendations below, including recent announcements designed to enhance the provision of developmental services. Nevertheless, we believe that further improvements must be made in order to achieve better outcomes for the people of this province.

Guiding Principles

In developing our recommendations, the Members of the Committee were guided by five inextricably linked principles.

No More Waitlists

The Committee firmly believes that all people have a right to appropriate and timely supports and services throughout their lives. The provision of developmental services and support should be mandated and waitlists eliminated. The elimination of existing waitlists must be the top priority for government.

Oversight and System Accountability

The developmental services system must be accountable to the people of Ontario while also being responsive to their needs. We heard repeatedly during the hearings that there should be “more service, less system” in the provision of developmental support. To this end we have made a number of recommendations aimed at improving system oversight and accountability while emphasizing client-focused service.

Empowering Individuals, Families, and Communities

The United Nations Convention on the Rights of Persons with Disabilities recognizes that persons with disabilities have the right to individual autonomy and independence, including the freedom to make their own choices. Many people who spoke to the Committee used the phrase “nothing about us without us” to describe their desire to plan for the future and make decisions about their own lives. Individuals and families want more autonomy in designing their services and supports while communities want to create innovative solutions to meet local needs. The recommendations in this report aim to empower individuals, families, and communities by providing them with more flexibility to create individualized, culturally and linguistically appropriate, and community-based solutions.

Building Capacity

The developmental services sector is currently unable to meet demand and capacity must be built in a number of areas. This requires not only an injection of funding, but also a more appropriate allocation of resources. We have made recommendations to build capacity in primary care, housing, employment, education, and other areas, so that support is available in the right place at the right time.

Inclusion and Opportunity

People with developmental disabilities want, and have the right to expect, social inclusion; that is, they have the right to contribute to and be full participants in society. The Committee recognizes that social inclusion means ensuring that people with developmental disabilities have opportunities for education, employment, and housing, as well as social and recreational activities.

Oversight

The developmental services sector is complex, involving the provision of a wide variety of services and supports, delivered by ten different ministries.  Integration and coordination of the developmental services sector must begin at the very top; therefore it is crucial that one minister assumes responsibility for oversight of developmental services. We believe that only a committee at the ministerial level will have the resources, perspective, and incentive to accomplish the goals set out below.

The first priority for this ministerial committee is to eliminate all waitlists for developmental services and supports.

The Select Committee therefore recommends that:

1.      A new Inter-Ministerial Committee on Developmental Services (IMCDS) be created with the mandate of implementing the recommendations in this report.

The Minister of Community and Social Services be answerable for the progress of the IMCDS and the implementation of the recommendations in this report.

In addition to the Minister of Community and Social Services, the IMCDS be comprised of the

a.       Minister of Children and Youth Services;

b.      Minister of Health and Long-Term Care;

c.       Minister of Education;

d.      Minister of Municipal Affairs and Housing;

e.       Minister of Aboriginal Affairs;

f.       Minister of Community Safety and Correctional Services;

g.      Minister of Training, Colleges and Universities;

h.      Minister of Economic Development, Trade and Employment; and

i.        Attorney General.

The IMCDS convene immediately and as its first task eliminate all waitlists for developmental services and supports within 12 months, and outline an achievable plan, including goals and timeframes, for the implementation of the other recommendations in this report.

The IMCDS report on its progress to the Legislative Assembly within 18 months and every 12 months thereafter; and that these reports be permanently referred to the Standing Committee on Social Policy.

System Accountability

Developmental Services Ontario Organizations

In 2004 the government of Ontario embarked on a process of transforming the adult developmental services sector, aiming to streamline service delivery and provide more equitable access to people across the province. One of the key elements of this transformation was the establishment of nine regional Developmental Services Ontario organizations (DSOs). The DSOs were created to provide a single-window point of access to adult developmental services throughout the province, using consistent criteria for eligibility and needs-based assessments.

In spite of this vision, the Committee heard repeatedly that the implementation of the DSOs has not resulted in better or easier access to support. In fact, many families feel that the DSOs are duplicating assessments and impeding access to support. Agencies and individuals told us that the establishment of the DSOs has severed long-standing connections between families and local agencies, making it harder for families to navigate the system and for agencies to provide flexible solutions tailored to individual needs.

In the Committee’s view, the DSOs should be robust clearinghouses for information and resourcesthe channel through which individuals, families, and their independent planners access information about the full range of both publicly and privately-funded services and supports. At the same time, the DSOs should act as “system navigators” that connect individuals and their families to these services and supports. The DSOs must reflect, and be sensitive to, the diversity of the communities they serve. Above all, the DSO mandate should be redefined with the goal of becoming more client-centred, focusing on person-directed planning and individualized support.

The Select Committee therefore recommends that:

2.      The mandate and operations of the DSOs be realigned to emphasize system navigation, building connections between families and community agencies, and information dissemination.

3.      As system navigators, the DSOs must work closely with youth developmental service providers so that young adults are seamlessly connected to transitional and long-term support before they age out of the school system.

4.      As part of the realigned DSO mandate, the Quality Assurance Measures (QAM) include evaluations of efficiency and client-centred effectiveness, and a new mechanism be established for public reporting of regular Quality Assurance reviews.

5.      An appeals process be established so that DSO decisions regarding an individual’s diagnosis, eligibility for support, and allocation of funding can be appealed.

We recognize that the DSOs face a number of operational impediments that hinder their ability to fulfill their mandate. In particular, the Committee heard that almost three years after the creation of the DSOs, the database meant to assist DSOs and local communities with service planning is still not fully operational.

The Select Committee therefore recommends that:

6.      The Ministry of Community and Social Services resolve outstanding operational issues affecting the DSOs immediately.

7.      The Ministry of Community and Social Services resolve operational issues with the provincial database immediately and provide appropriate training to DSO staff in use of the database.

Data Collection

The Committee was frustrated by the lack of available, reliable data in almost every area of the developmental services sector. We were surprised to hear that there is no coordinated data collection between the many ministries involved in providing developmental services and even more troubled to hear that even where such data is collected, it is rarely shared between ministries.

Comprehensive, coordinated, and timely data collection is essential to effective planning and delivery of supports and services. Without such information, it is impossible for the ministries to accurately assess demand for developmental services and how well needs are being met.

The Select Committee therefore recommends that:

8.      Comprehensive data related to the demand for and provision of developmental services from across Ministries, DSOs, and service agencies be collected, harmonized, and shared within and beyond the sector.

9.      The annual collection of data from the entire province (especially northern and remote communities) specifically include the following:

·          the number of adults with developmental disabilities;

·          the number of adults with a dual diagnosis;

·          the number of children with developmental disabilities;

·          the number of children with a dual diagnosis;

·          the length of waitlists for specific services and supports;

·          the number of people with developmental disabilities or dual diagnosis who are incarcerated;

·          the number of people with developmental disabilities inappropriately housed (for example, in hospital or long-term care beds); 

·          the number of “abandonment” cases; and

·          the cultural and linguistic diversity needs of the province.

Empowering Individuals, Families, and Communities

Person-Directed Planning and Individualized Life Plans

The Committee recognizes that there can be no one-size-fits-all approach to providing developmental services; rather, individuals have the right to appropriate support to chart their own paths in all areas of their lives. This person-centered approach recognizes the basic principles of self-determination and social inclusion for people with developmental disabilities.

To achieve this, we believe that there should be a fundamental shift in the way that support is offered to people with developmental disabilities. Rather than the current approach of forcing people to choose from a limited slate of options available through direct funding and agency-based support, we believe that every person should be entitled to an individualized life plan customized to meet their specific needs, including cultural and linguistic needs where relevant. Individualized life plans enable people to design the support model they feel provides them with the best opportunity for inclusion. The Committee notes that versions of this model have been adopted in other jurisdictions, including British Columbia and Britain.

Supported Decision-Making

The concept of supported decision-making is a key element in the discussion of person-directed planning. As recognized by the United Nations Convention on the Rights of Persons with Disabilities, the supported decision-making model allows persons with developmental disabilities to retain and exercise their legal decision-making capacity with the support of a trusted person or network of people. The Law Commission of Ontario is currently studying potential reforms to Ontario’s laws regarding capacity and guardianship and is exploring, among other issues, greater use of partial guardianship and alternatives to the current guardianship system (under both supported and substituted decision-making models).

The Select Committee therefore recommends that:

10.  The IMCDS develop an implementation plan for the Law Commission of Ontario’s recommendations with respect to supported decision-making once they are released.

Independent Planning

The Committee heard repeatedly that with adequate planning support, many individuals and their families are able to define and prioritize their own needs. However, we also heard feedback from families that affordable and independent planning support is not readily available. Without it, they feel pushed toward inappropriate options and discouraged from developing their own creative solutions.

The Committee feels there is a need to connect individuals and their families with an independent planner as early as possible, at the point when a developmental disability diagnosis is made. The independent planner would help individuals with developmental disabilities and their families construct their own custom-built plan, guiding them through key transition points so that the individual is supported throughout the course of his or her life. It is essential that the services of the independent planner be affordable, culturally appropriate, and without any vested interest in the services and supports being proposed.

The Select Committee therefore recommends that:

11.  The Ministry of Community and Social Services support independent planning organizations whose role is to guide individuals–with the help of their families, friends, and support network–through key transition points so that the individual is supported throughout the course of his or her life.

Eligibility

DSOs determine a person’s eligibility for developmental support based on the SIPDDA definition of “developmental disability.” A person has a developmental disability under SIPDDA if he or she has significant limitations in both cognitive functioning and adaptive functioning, provided that those limitations originated before the person turned 18, are likely lifelong in nature, and affect areas of major life activity.

The general regulation under SIPDDA incorporates the use of standardized intelligence testing–that is, an IQ test–in defining a “significant limitation in cognitive functioning.” Individuals will meet this requirement where

·          their overall IQ score is 70 or below;

·          their scores in two IQ test areas are less than 70 and they have a history of needing rehabilitative support; or

·          a clinical determination by a psychologist or psychological associate finds that they demonstrate significant cognitive limitations and they have a history of needing rehabilitative support.

Parents and caregivers across the province consistently expressed concern to the Committee about the methodology used to assess a person’s eligibility for adult developmental services. They said that eligibility criteria based on cognitive limitation unfairly excludes individuals who have an IQ above 70 but poor adaptive functioning abilities.

We agree. A person with a developmental disability or dual diagnosis should be eligible for developmental services and supports if he or she needs assistance to participate fully in the community.

The Select Committee therefore recommends that:

12.  The definition of developmental disability and eligibility for support be based solely on an assessment of adaptive functioning and not on cognitive functioning or IQ.

Direct Funding

The Committee heard a number of concerns about direct funding. Special Services at Home (SSAH) direct funding is abruptly terminated when individuals turn 18 even though, as families across the province told us, children’s needs do not suddenly change on their 18th birthday. Families must then apply for new funding from the Passport program, even though both the SSAH and Passport programs are offered through the MCSS. We heard that families want the autonomy to use Passport funding flexibly in ways that best meet their needs, such as for transportation, for example. The Committee also heard that sections of the SIPDDA setting out the operation of new direct funding agreements, and the direct funding entities designed to administer them, have still not taken effect.

The principles of person-directed planning and individualized life plans indicate that individuals and families need flexibility and autonomy to decide how best to use the direct funding they receive. Our recommendations aim to enhance the flexibility and portability of direct funding.

The Select Committee therefore recommends that:

13.  The IMCDS ensure that recipients of SSAH funding not lose that funding before Passport funding is in place and an individualized life plan has been completed with the independent planner.

14.  There be more flexibility in allowable uses of Passport funding to meet individual needs.

15.  The implementation of full direct funding options be fast-tracked.

Service Agencies in the Community

The Committee heard that the ability of service agencies to deliver effective support to families is compromised by a variety of systemic issues, such as proxy pay equity obligations, which are creating a wage gap between agencies offering the same services within the sector.[2]

The Committee also heard from staff who provide care to people with developmental disabilities in a variety of settings, including day programs and residential care. They told us that low staffing ratios can compromise their health and safety and that of the people for whom they care, as well as the agency’s ability to offer some programs.

Community agencies told the Committee that the rigid application of prescribed Quality Assurance Measures (QAM) compromises the quality of service they provide to families, while some agencies questioned the applicability of the QAM to the work that they do. Finally, the Committee heard that the single-year funding commitments made by the MCSS make it difficult for service agencies to build appropriately staffed and sustainable programs over the long term.

The Select Committee therefore recommends that:

16.   A plan be developed to ensure that legal pay equity obligations are met.

17.  A framework be developed to evaluate the QAM applying to service agencies with a view to increasing their relevance, practicality, and flexibility.

18.  Best practices for staffing ratios in long-term care and group homes be evaluated to ensure the safety of residents and staff.

19.  The MCSS implement long-term multi-year funding commitments to service agencies.

Building Capacity

Dual Diagnosis

An estimated 40 percent of people with developmental disabilities have a concurrent mental health diagnosis, also known as a “dual diagnosis.” The Committee heard that individuals with a dual diagnosis have complex needs but often fall through the cracks: the developmental services sector is unable to accommodate their mental health needs, and mental health services are not equipped to accommodate people with developmental disabilities.

The Committee believes that when developing and providing services and supports for people with developmental disabilities it is vital to build capacity to address the specific needs of people with a dual diagnosis.

The Select Committee therefore recommends that:

20.  Capacity for providing care be built that meets the specific needs of dually diagnosed individuals through increased programs and services, and professional training of primary care, dental care, and direct service providers.

21.  The use of mental health courts and other alternative diversion mechanisms be encouraged for individuals with a dual diagnosis in the justice system.

22.  The recommendations made in the Joint Policy Guideline for the Provision of Community Mental Health and Developmental Services for Adults with a Dual Diagnosis be implemented.[3]

Primary and Dental Care

The Committee heard from medical researchers and specialists who explained that people with developmental disabilities or a dual diagnosis face significant barriers to appropriate health and dental care. As a consequence, this population is less likely to receive preventative care and has unmet health needs.

The situation is compounded by a growing number of seniors with developmental disabilities or a dual diagnosis. The current geriatric care system has limited experience caring for patients with developmental disabilities, and the developmental services sector has difficulty meeting the needs of older people.

Medical experts explained that the standard of care is interdisciplinary care offered by inter-professional health teams. They noted the importance of building capacity in primary care and of the need for specific recognition of those with complex developmental needs in provincial health, mental health, and social services. It is equally necessary to have better access to early identification, diagnosis, and timely treatment and services for all Ontarians, with particular attention to those living in remote and smaller communities.

The Select Committee therefore recommends that:

23.  The IMCDS develop an integrated provincial strategy to build capacity and coordinate services in primary and dental care for people with developmental disabilities or a dual diagnosis throughout the lifespan, from early diagnosis to geriatric care, including

a.       benchmarks and targets for the number and types of health professionals required;

b.      general knowledge of and training in developmental disabilities and dual diagnosis to primary care and dental care professionals;

c.       more interdisciplinary, inter-professional health teams; and

d.      collaboration between interdisciplinary health teams, early years centres, family health care teams, family literacy centres, children’s treatment centres, schools, dental clinics, and health clinics at postsecondary institutions.

Fetal Alcohol Spectrum Disorder (FASD) and Autism Spectrum Disorder (ASD)

While all the recommendations in this report apply equally to FASD and ASD, the Committee heard from many presenters about some specific challenges posed by these diagnoses. We have therefore made some additional recommendations aimed at building capacity in these areas.[4]

FASD

A number of presenters focused on FASD which is one of the most common developmental disabilities (thought to affect an estimated 130,000 children and adults in Ontario). Caused by maternal alcohol use during pregnancy, FASD—unlike other developmental disabilities—is entirely preventable. Presenters from the Registered Nurses’ Association of Ontario noted that Ontario is the only province without a strategy to tackle FASD and warned that it is important to act now before the rising rates of binge drinking among young people result in higher rates of this disorder.

The Committee emphasizes the importance of ensuring access to early diagnosis and intervention to all Ontarians, and of recognizing FASD as a developmental disability in all sectors including the education, health, and justice systems.

The Select Committee therefore recommends that:

24.  There be a coordinated provincial strategy to address FASD through appropriate and timely support services in all communities and regions, including a province-wide public health campaign to raise awareness of the dangers and impact of maternal alcohol use.

25.  The use of mental health courts and other alternatives be encouraged for individuals with FASD in the justice system.

ASD

ASD is also one of the most common developmental disorders, affecting an estimated one in 68 children according to the most recent research from the United States. The Committee heard evidence that early diagnosis and intervention is highly cost effective. It improves educational and social outcomes, and reduces the need for ongoing intensive services throughout the lifespan. However, many presenters noted that there is wide variation in the services and supports available to people with ASD depending on where they live in the province.

Presenters explained that individuals with ASD face some unique challenges. Because the features of this diagnosis may be subtle, people with ASD are sometimes described as an “invisible population.” Many of these individuals are refused services by the developmental disability sector because they have an IQ over 70, and by the mental health sector because of their developmental disability. Presenters stressed that even with an IQ over 70 many people with ASD still need access to a range of developmental services and supports.[5]

The Select Committee therefore recommends that:

26.  There be a coordinated provincial strategy to address ASD through appropriate support services for individuals in all communities and regions, including

a.        access to early diagnosis and interventions;

b.       professional accreditation for autism service providers; and

c.       consistent evaluations and benchmarks for implementation of ASD therapeutic interventions.

Remote and Rural Communities

The Committee heard that there are too few services and supports available locally to people living in smaller communities. Many presenters noted the challenges presented by geography and costly transportation, including the seasonal costs of transportation for remote communities. Presenters highlighted the need for more day programs, respite care, and residential options to enable people with developmental disabilities to stay in their home communities.

The Select Committee therefore recommends that:

27.  The IMCDS encourage the development of local support options to meet the needs of people with developmental disabilities living in northern and remote communities.

First Nations Communities

There is considerable overlap in the challenges faced by people living in northern, smaller, and remote communities and people living in many First Nations communities. The Committee heard that there are few formal developmental services and supports available at the community level, and no provision for community-based case management in remote and northern First Nations communities. Because there is no statistical information available to assess local needs, it is extremely difficult for communities to build a case for support. At the same time, organizations in regional centres serving the north do not have adequate resources to meet the developmental service needs of First Nations communities.

Without access to assessment and early diagnosis, people with developmental disabilities in remote First Nations communities are not eligible for services and supports such as ODSP, Special Services at Home, or Passport funding; special education programs, or other special needs accommodations in the community or in homes. The Committee heard that the impact of this lack of services is devastating to individuals and communities, resulting in a high rate of family and foster home breakdown, and in parents having to relinquish custody of their high needs children.

In Moose Factory, the Committee visited the Billy Bayou Program which provides one-on-one personal support workers for adults with developmental disabilities. The Billy Bayou Program is an example of a community-led initiative that enables people with developmental disabilities to stay in their home communities, near their families.

The Select Committee therefore recommends that:

28.  The IMCDS work collaboratively with First Nations to design and implement a strategic and coordinated community-based response to developmental service needs.

Inclusion and Opportunity

Education (Primary and Secondary)

There is widespread support for the inclusion of children and young people with developmental disabilities in the educational system. Many schools offer special education classrooms. Educational Assistants (EAs) who provide one-on-one support make it possible for children with developmental disabilities to be included in mainstream classrooms. Some district school boards offer the option of specialized schools designed specifically to meet the needs of children with developmental disabilities.

Presenters identified a number of areas where inclusive education could be strengthened to ensure that children with developmental disabilities get the support they need to succeed in school. Many presenters noted that teachers, EAs, and other school administrators and staff need more awareness and understanding of developmental disabilities in general, and especially about the two most common developmental disabilities: FASD and ASD.

Parents expressed frustration with the transition their young children experience as they enter primary school. The Community Care Access Centres (CCAC) are currently contracted to offer in-school therapeutic interventions for children with developmental disabilities. This means that professionals from some Children’s Treatment Centres are often not permitted to continue providing early intervention therapies to children in the classroom once these children enter primary school. This disrupts the child’s pre-established relationships and continuity of care. The Committee heard from the Ministry of Child and Youth Services that in cases where Children’s Treatment Centres are permitted through the CCAC to work in schools, there is a much smoother transition into school for young children and their families.

Further, while transition planning is a required component of Individual Education Plans, the Committee heard requests from many families for more assistance with planning for the transition out of secondary school.

The Committee therefore recommends that:

29.  EAs be provided for all children assessed as needing an EA, and that EAs have knowledge and training appropriately matched to a child’s individual needs.

30.  Professional development and training be provided to EAs, teachers, and other school staff to increase awareness about developmental disabilities, including FASD and ASD, as well as about dual diagnosis.

31.  The Ministry of Education definitions of “exceptionalities” be modified and updated to include FASD.

32.  Direct care service providers and Children’s Treatment Centres be permitted to provide in-school services to children.

33.  Better information and resources about postsecondary opportunities be provided to school guidance counsellors, school staff, families, agencies and others involved in helping young people to plan for the transition out of secondary school.

34.  Parent representatives be allowed to sit on their local Special Education Advisory Committee (SEAC) without having to be members of local associations.[6]

Postsecondary Education and Skills Training

The Committee heard that many young people with developmental disabilities want postsecondary education and skills training. Presenters spoke positively of the many benefits of Community Integration through Co-operative Education (CICE) programs, which enable adults with developmental disabilities to attend college. They asked for more CICE programs in colleges across Ontario, and more spaces for students in these programs.

The Select Committee therefore recommends that:

35.  The Ministry of Training, Colleges, and Universities fund a sufficient number of spaces in CICE programs to meet regional demand; actively promote the benefits of CICE programs to Ontario colleges and potential students; and ensure that students have assistance with transportation and other supports they need for successful participation in CICE programs.

Employment

The Committee heard that many people with developmental disabilities are eager to participate in the workforce but that their rate of unemployment is high, even for those individuals with skills training and postsecondary credentials. At the same time we heard a strong business case in favour of hiring employees with developmental disabilities from employer Mark Wafer, a member of the federal Panel on Labour Market Opportunities for Persons with Disabilities.

We strongly believe that many barriers to employment in this area are attitudinal and that employer education and engagement is necessary to taking down these barriers. We recognize that government has a role to play in promoting these activities. Above all, young people must have opportunities to obtain co-op placements and summer jobs, so that they can develop job skills and build their résumés early.

The Committee was also interested to hear about a number of social enterprises that employ people with developmental disabilities or a dual diagnosis.

The Select Committee therefore recommends that:

36.  A formal program be developed by the Ministry of Economic Development, Trade and Employment, in concert with the Ministry of Training, Colleges and Universities and Infrastructure Ontario, to educate employers about the economic benefits of hiring employees with developmental disabilities, support private and public employer engagement programs, support social enterprises, and provide online job resources to help match potential employees and employers.

37.  The Ministry of Economic Development, Trade and Employment, the Ministry of Education, the Ministry of Training, Colleges and Universities, and Infrastructure Ontario include people with developmental disabilities in youth summer employment and support co-op placements for young people with developmental disabilities during secondary school.

The Committee was concerned to hear that systemic barriers sometimes discourage people from seeking employment. If individuals earn an income their Ontario Disability Support Program (ODSP) may be clawed back or lost altogether. If individuals leave a day program in order to take a job, and then lose the job, they have to return to the bottom of the waiting list for a day program. Given that employment is a vital element of social inclusion we believe that people should not be penalized for seeking employment and that the disincentives for those who wish to work must be removed.

The Select Committee therefore recommends that:

38.  The IMCDS assess the interaction of ODSP, Employment Insurance (EI), and developmental services programs with a view to eliminating disincentives and barriers to employment for people with developmental disabilities.

Housing

Of all the issues falling within this Committee’s mandate, the lack of appropriate housing for adults with developmental disabilities is one of the most critical, causing a chain reaction reaching far beyond the developmental services sector. The urgency of the housing shortage for people with developmental disabilities or a dual diagnosis is recognized in the Housing Study Group’s Ending the Wait report and related recommendations.[7]

Without supported housing options, aging parents are pushed to the breaking point of physical and emotional exhaustion as they continue to care for adult children at home. Individuals who are ready to go home after a hospital stay remain in a hospital bed—sometimes for years—because there is nowhere else for them to go. Long-term care homes are pressured to accommodate young and middle-aged people with developmental disabilities without any medical need for this type of care or any training to support this group of clients. A lack of supported housing also means that some individuals are trapped in a cycle of homelessness and repeated incarceration.

These situations undermine the principles of person-directed planning and social inclusion. The Committee also notes that it costs much more to accommodate people in inappropriate long-term care or hospital beds than it would to provide supported housing options, and removes the bed from those who need the specialized care.  

Individuals and families told the Committee that housing is a transition issue and it is very important to ensure they can plan and prepare for a gradual and safe move out of the family home into an independent or supported living arrangement. The Committee was pleased to hear about a number of innovative housing solutions developed by families and agencies. The Committee believes that such solutions, where they embody the principles of inclusion, person-directed planning, and individual choice, should be supported rather than discouraged.

The Committee notes that prior to the dissolution of the Legislature in May 2014, an inter-ministerial Housing Task Force was appointed to seek solutions for individuals with developmental disabilities.[8] We have specific suggestions regarding the mandate of this Task Force.


 

The Select Committee therefore recommends that:

39.  The recommendations from the Ending the Wait report be fast-tracked.

40.  The Housing Task Force collaborate with the IMCDS, Infrastructure Ontario, municipalities across the province, and concerned individuals, families, and community groups.

41.  The Task Force begin work immediately to explore innovative, individualized, affordable, and flexible family- and community-led housing solutions for persons with developmental disabilities and/or a dual diagnosis, with a strong focus on the specific housing needs of older adults. This includes

a.       developing both short-term and long-term supporting housing models;

b.      developing support and capital funding for purchase and ongoing maintenance of existing residences; and

c.       developing successful pilot programs for supported housing.

42.  The Task Force report its findings publicly within 12 months and every 12 months thereafter.

43.  ODSP reductions for unrelated individuals with developmental disabilities who share accommodation be eliminated.

Respite

The Committee heard from many parents who care for their children (including adult children) on a full-time basis and need some respite support in order to continue doing so. Access to local respite care options, even for a couple of hours a week, may mean the difference between stability and crisis for many families. The Committee heard that flexible and readily available respite care is critical in avoiding family breakdown, income loss, unnecessary hospitalizations, and inappropriate placements in long-term care.

We were concerned to hear that along with facing extremely limited affordable respite options, some presenters felt stigmatized for even requesting respite support. The Committee believes that there should be no stigma in using respite care which provides a much-needed break for parents and families.

For many young adults with developmental disabilities, respite helps to ease the eventual transition out of the family home. In the Committee’s view, it is important to extend respite options as part of a housing solution. Presenters told the Committee about a range of individualized respite solutions they would like to see, such as week-on week-off respite, overnight weekend respite, and month-on month-off respite. Building capacity for these kinds of flexible models is essential.


 

The Select Committee therefore recommends that:

44.  The IMCDS build more capacity for affordable, flexible, age-appropriate, and needs-appropriate respite care spaces; and collaborate with families and community agencies in the development and support of locally-based respite initiatives.

45.  Families be able to access respite programs through referrals from professionals such as educators and family physicians.

Day Programs

The lack of affordable day programs for young adults transitioning out of secondary school was identified as another serious gap by families. For those individuals who do not enter postsecondary education or the workplace, there must be opportunities to continue their social, physical, emotional, and intellectual development in their community taking into consideration their age, interests, and abilities.

The Committee was encouraged to hear about successful day program initiatives in communities across the province. We believe in removing barriers to the development of more community-led day programs offering meaningful activities in an inclusive environment.

The Select Committee therefore recommends that:

46.  The IMCDS collaborate with families and community agencies to develop and support locally-based day programs. These programs must be affordable and regionally available, and tailored for a range of age groups, interests, activity levels, and needs.

Conclusion and Follow-up

In closing, we wish to express our sincere gratitude to the many individuals, families, agencies, and organizations who generously shared their experiences and suggestions with the Select Committee. We share their expectation that the crisis in the developmental services sector must be addressed immediately. We look forward to the progress that will be made by the Inter-Ministerial Committee on Developmental Services as it implements the recommendations in this report.


 

Consolidated List of Recommendations

The Select Committee recommends that:

1. A new Inter-Ministerial Committee on Developmental Services (IMCDS) be created with the mandate of implementing the recommendations in this report.

The Minister of Community and Social Services be answerable for the progress of the IMCDS and the implementation of the recommendations in this report.

In addition to the Minister of Community and Social Services, the IMCDS be comprised of the

a.       Minister of Child and Youth Services;

b.      Minister of Health and Long-Term Care;

c.       Minister of Education;

d.      Minister of Municipal Affairs and Housing;

e.       Minister of Aboriginal Affairs;

f.       Minister of Community Safety and Correctional Services;

g.      Minister of Training, Colleges and Universities;

h.      Minister of Economic Development, Trade and Employment; and

i.        Attorney General.

The IMCDS convene immediately and as its first task eliminate all waitlists for developmental services and supports within 12 months, and outline an achievable plan, including goals and timeframes, for the implementation of the other recommendations in this report.

The IMCDS report on its progress to the Legislative Assembly within 18 months and every 12 months thereafter; and that these reports be permanently referred to the Standing Committee on Social Policy.

2. The mandate and operations of the DSOs be realigned to emphasize system navigation, building connections between families and community agencies, and information dissemination.

3. As system navigators, the DSOs must work closely with youth developmental service providers so that young adults are seamlessly connected to transitional and long-term support before they age out of the school system.

4. As part of the realigned DSO mandate, the Quality Assurance Measures (QAM) include evaluations of efficiency and client-centred effectiveness, and a new mechanism be established for public reporting of regular Quality Assurance reviews.

5. An appeals process be established so that DSO decisions regarding an individual’s diagnosis, eligibility for support, and allocation of funding can be appealed.

6. The Ministry of Community and Social Services resolve outstanding operational issues affecting the DSOs immediately.

7. The Ministry of Community and Social Services resolve operational issues with the provincial database immediately and provide appropriate training to DSO staff in use of the database.

8. Comprehensive data related to the demand for and provision of developmental services from across Ministries, DSOs, and service agencies be collected, harmonized, and shared within and beyond the sector.

9. The annual collection of data from the entire province (especially northern and remote communities) specifically include the following:

·          the number of adults with developmental disabilities;

·          the number of adults with a dual diagnosis;

·          the number of children with developmental disabilities;

·          the number of children with a dual diagnosis;

·          the length of waitlists for specific services and supports;

·          the number of people with developmental disabilities or dual diagnosis who are incarcerated;

·          the number of people with developmental disabilities inappropriately housed (for example, in hospital or long-term care beds); 

·          the number of “abandonment” cases; and

·          the cultural and linguistic diversity needs of the province.

10. The IMCDS develop an implementation plan for the Law Commission of Ontario’s recommendations with respect to supported decision-making once they are released.

11. The Ministry of Community and Social Services support independent planning organizations whose role is to guide individuals–with the help of their families, friends, and support network–through key transition points so that the individual is supported throughout the course of his or her life.

12. The definition of developmental disability and eligibility for support be based solely on an assessment of adaptive functioning and not on cognitive functioning or IQ.

13. The IMCDS ensure that recipients of SSAH funding not lose that funding before Passport funding is in place and an individualized life plan has been completed with the independent planner.

14. There be more flexibility in allowable uses of Passport funding to meet individual needs.

15. The implementation of full direct funding options be fast-tracked.

16. A plan be developed to ensure that legal pay equity obligations are met.

17. A framework be developed to evaluate the QAM applying to service agencies with a view to increasing their relevance, practicality, and flexibility.

18. Best practices for staffing ratios in long-term care and group homes be evaluated to ensure the safety of residents and staff.

19. The MCSS implement long-term multi-year funding commitments to service agencies.

20. Capacity for providing care be built that meets the specific needs of dually diagnosed individuals through increased programs and services, and professional training of primary care, dental care, and direct service providers.

21. The use of mental health courts and other alternative diversion mechanisms be encouraged for individuals with a dual diagnosis in the justice system.

22. The recommendations made in the Joint Policy Guideline for the Provision of Community Mental Health and Developmental Services for Adults with a Dual Diagnosis be implemented.

23. The IMCDS develop an integrated provincial strategy to build capacity and coordinate services in primary and dental care for people with developmental disabilities or a dual diagnosis throughout the lifespan, from early diagnosis to geriatric care, including

a.       benchmarks and targets for the number and types of health professionals required;

b.      general knowledge of and training in developmental disabilities and dual diagnosis to primary care and dental care professionals;

c.       more interdisciplinary, inter-professional health teams; and

d.      collaboration between interdisciplinary health teams, early years centres, family health care teams, family literacy centres, children’s treatment centres, schools, dental clinics, and health clinics at postsecondary institutions.

24. There be a coordinated provincial strategy to address FASD through appropriate and timely support services in all communities and regions, including a province-wide public health campaign to raise awareness of the dangers and impact of maternal alcohol use.

25. The use of mental health courts and other alternatives be encouraged for individuals with FASD in the justice system.

26. There be a coordinated provincial strategy to address ASD through appropriate support services for individuals in all communities and regions, including

a.       access to early diagnosis and interventions;

b.      professional accreditation for autism service providers; and

c.       consistent evaluations and benchmarks for implementation of ASD therapeutic interventions.

27. The IMCDS encourage the development of local support options to meet the needs of people with developmental disabilities living in northern and remote communities.

28. The IMCDS work collaboratively with First Nations to design and implement a strategic and coordinated community-based response to developmental service needs.

29. EAs be provided for all children assessed as needing an EA, and that EAs have knowledge and training appropriately matched to a child’s individual needs.

30. Professional development and training be provided to EAs, teachers, and other school staff to increase awareness about developmental disabilities, including FASD and ASD, as well as about dual diagnosis.

31. The Ministry of Education definitions of “exceptionalities” be modified and updated to include FASD.

32. Direct care service providers and Children’s Treatment Centres be permitted to provide in-school services to children.

33. Better information and resources about postsecondary opportunities be provided to school guidance counsellors, school staff, families, agencies and others involved in helping young people to plan for the transition out of secondary school.

34. Parent representatives be allowed to sit on their local Special Education Advisory Committee (SEAC) without having to be members of local associations.

35. The Ministry of Training, Colleges, and Universities fund a sufficient number of spaces in CICE programs to meet regional demand; actively promote the benefits of CICE programs to Ontario colleges and potential students; and ensure that students have assistance with transportation and other supports they need for successful participation in CICE programs.

36. A formal program be developed by the Ministry of Economic Development, Trade and Employment, in concert with the Ministry of Training, Colleges and Universities and Infrastructure Ontario, to educate employers about the economic benefits of hiring employees with developmental disabilities, support private and public employer engagement programs, support social enterprises, and provide online job resources to help match potential employees and employers.

37. The Ministry of Economic Development, Trade and Employment, the Ministry of Education, the Ministry of Training, Colleges and Universities, and Infrastructure Ontario include people with developmental disabilities in youth summer employment and support co-op placements for young people with developmental disabilities during secondary school.

38. The IMCDS assess the interaction of ODSP, Employment Insurance (EI), and developmental services programs with a view to eliminating disincentives and barriers to employment for people with developmental disabilities.

39. The recommendations from the Ending the Wait report be fast-tracked.

40. The Housing Task Force collaborate with the IMCDS, Infrastructure Ontario, municipalities across the province, and concerned individuals, families, and community groups.

41. The Task Force begin work immediately to explore innovative, individualized, affordable, and flexible family- and community-led housing solutions for persons with developmental disabilities and/or a dual diagnosis, with a strong focus on the specific housing needs of older adults. This includes

a.       developing both short-term and long-term supporting housing models;

b.      developing support and capital funding for purchase and ongoing maintenance of existing residences; and

c.       developing successful pilot programs for supported housing.

42. The Task Force report its findings publicly within 12 months and every 12 months thereafter.

43. ODSP reductions for unrelated individuals with developmental disabilities who share accommodation be eliminated.

44. The IMCDS build more capacity for affordable, flexible, age-appropriate, and needs-appropriate respite care spaces; and collaborate with families and community agencies in the development and support of locally-based respite initiatives.

45. Families be able to access respite programs through referrals from professionals such as educators and family physicians.

46. The IMCDS collaborate with families and community agencies to develop and support locally-based day programs. These programs must be affordable and regionally available, and tailored for a range of age groups, interests, activity levels, and needs.

Appendix A

Preceding Developments and Committee Meetings


 

Preceding Developments

The Committee appreciates the important research and reports that have preceded its own consideration of developmental services in Ontario. Recent relevant work includes the 2007, 2011, and 2013 Annual Reports of the Office of the Auditor General of Ontario; the Ministry of Community and Social Services report, Opportunities and Action: Transforming Supports in Ontario For People Who Have a Developmental Disability, released May 2006; the 2010 Final Report of the Select Committee on Mental Health and Addictions, Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians; Rethinking Disability in the Private Sector (Report from the Panel on Labour Market Opportunities for Persons with Disabilities), released in January 2013; the Initial Report of the Housing Study Group (Developmental Services Sector–Ministry of Community and Social Services Partnership Table), Ending the Wait: An Action Agenda to Address the Housing Crisis Confronting Ontario Adults with Developmental Disabilities, released in September 2013; and Yona Lunsky et al., Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario (Centre for Addiction and Mental Health & Institute for Clinical Evaluative Services), released in December 2013.

When the transformation of developmental services was first announced in 2004, a Joint Developmental Services Partnership Table was established to represent both the Ministry of Community and Social Services  and the Ministry of Children and Youth Services, as well as associations of self-advocates, families, and service providers in the sector. Some of those who made presentations to the Committee have been involved in the Partnership Table.

On May 16 2013, a motion by Christine Elliott (Whitby–Oshawa) that the Legislative Assembly immediately establish a Select Committee “to develop recommendations on a comprehensive developmental services strategy to address the needs of children, youth and adults in Ontario with an intellectual disability or who are dually diagnosed with an intellectual disability and a mental illness” was debated during Private Members’ Public Business. The motion carried unanimously.[9]

Committee Meetings

The Committee met for the purpose of organization and to discuss business matters in October and early November 2013. Public hearings were held in Toronto and other locations around Ontario beginning on November 13, 2013 and ending on January 21, 2014.

The November hearings included presentations by government ministries involved in delivering services and supports to people with developmental disabilities, including the Ministry of Community and Social Services, the Ministry of Children and Youth Services, the Ministry of Education, the Ministry of Municipal Affairs and Housing, the Ministry of the Attorney General, the Ministry of Training, Colleges and Universities, the Ministry of Community Safety and Correctional Services, the Ministry of Health and Long-Term Care, the Ministry of Aboriginal Affairs, and the Ministry of Economic Development, Trade and Employment. The Committee also heard from the Provincial Advocate for Children and Youth.

Representatives of stakeholder groups also attended as invited guests. In the weeks following, the Committee heard from people across Ontario with a range of perspectives including self-advocates (people with developmental disabilities), family members, health care and social service professionals, advocates for people with developmental disabilities, and many representatives of stakeholder organizations.

The Committee heard from agencies and organizations that provide a wide range of services including respite care, residential care, day programs, intensive therapy for autistic children, and advocacy and support to families.

Some stakeholder organizations focused on the needs of those with specific conditions such as Autism Spectrum Disorder (ASD) or Fetal Alcohol Spectrum Disorder (FASD), and people with a dual diagnosis. Clinicians, parents, and advocates urged that Ontario develop provincial strategies on ASD and FASD.

A number of medical professionals spoke to the Committee about a lack of capacity in the system to address the needs of those with developmental disabilities or a dual diagnosis.

During its travels, the Committee also made a site visit to the Billy Bayou Centre in Moose Factory, where the Moose Cree Education Authority operates a day program for adults with developmental disabilities.

Along with written submissions, many individuals and organizations sent the Committee reports and studies that they feel relate to the Committee’s work, and many also brought to the Members’ attention examples of jurisdictions that have managed to eliminate waitlists and provide inclusive education, meaningful apprenticeships, and better social integration for people with developmental disabilities and/or a dual diagnosis.


 

Appendix B

Schedule of Public Hearings

List of Witnesses and Submissions


 

Schedule of Public Hearings

Public hearings were held in Toronto and various other locations on the dates listed below.

Toronto                      October 30; November 13, 20, and 27;

December 4, 11, and 18, 2013;

January 20 and 21, 2014

London                       January 13, 2014

Thunder Bay                         January 14 and 15, 2014

Ottawa                        January 17, 2014

The Hansard transcripts of the proceedings for each Committee meeting are public documents available through the Legislative Assembly.


 

List of Witnesses and Submissions

Organization/Individual

Date of Appearance / Written Submission

Abilities Centre

January 20, 2014 and written submission

Adult Protective Service Association of Ontario

January 21, 2014 and written submission

Kathy Alaee

Written submission

Eliza Ali

Written submission

Diana Alves

Written submission

Salvatore Amenta

Written submission

Faith Anderson

Written submission

John & Sharon Anderson

Written submission

Anita

Written submission

ARCH Disability Law Centre

January 21, 2014 and written submission

Wilma Arthurs

December 11, 2013

Autism Ontario

December 4, 2013 and written submission

Jennifer & Andy Ayotte

Written submission

Angela Bach

January 21, 2014

Giselle Baillargeon

Written submission

Lee Ann Baker

Written submission

Joyce Balaz, Bill Hiltz, Ann Row

January 13, 2014 and written submission

Laurie Barbeau

Written submission

John Barker

Written submission

Teresa Beal

Written submission

Patricia Benoit

Written submission

Karen Bensen

Written submission

Nancy M. Bermingham

Written submission

Deryle Bond

January 15, 2014 and written submission

Greg Bonnah

January 14, 2014

Bowen and Associates Inc.

Written submission

Susan Bowles

Written submission

Sandra Boyes

January 15, 2014 and written submission

Brenda Boylan

Written submission

Diana Brammall

January 14, 2014 and written submission

Cate Breaugh, Tim Grantham

Written submission

Harold & Debbie Brennan

January 21, 2014 and written submission

Helen Brock

Written submission

Orlena & Jefferson Broomes

January 20, 2014 and written submission

Judy Brown

Written submission

Mari Brown

Written submission

Christina Buczek

January 21, 2014 and written submission

Stephanie Burnett

Written submission

Colleen & Michael Butler

December 18, 2013 and written submission

Carmen Bycok

Written submission

Silvana Cacciatore, Brian Jacques, Ken Maclam

January 14, 2014

Carol Cain

Written submission

Catherine Calligan

Written submission

Kaycee Campbell

Written submission

Canada Fetal Alcohol Spectrum Disorder Research Network (CanFASD)

Written submission

Canadian Association of Muslims with Disabilities

January 21, 2014 and written submission

Canadian Mental Health Association  (CMHA) Waterloo Wellington Dufferin 

January 13, 2014

Canadian Union of Public Employees (CUPE) Ontario

November 13, 2013 and January 20, 2014 and written submission

Cheryl Card

Written submission

Career Services of Brockville

Written submission

Casa de Angelae

Written submission

Robin Caslick

Written submission

Catulpa Community Support Services

Written submission

Nancy Ceci

Written submission

Centre for Addiction and Mental Health  (CAMH)

November 27, 2013 and written submission

Champlain Local Health Integration Network (LHIN)

Written submission

Dee Charlton

Written submission

Children's Aid Society (CAS) of Toronto

Written submission

Sylvia Chitty

Written submission

Christian Horizons

December 18, 2013 and written submission

Citizens with Disabilities Ontario

Written submission

Erin Claeys

Written submission

Mary-Ellen Clare

Written submission

Traci Clarke

Written submission

Nancy Clyne

Written submission

CNIB

Written submission

Coalition des familles francophones d’Ottawa (CFFO)

Written submission

Sherri Collins

Written submission

Community Living Brampton Caledon

Written submission

Community Living Elmira District

Written submission

Community Living Essex County

December 4, 2013 and written submission

Community Living Kawartha Lakes

Written submission

Community Living Kenora

Written submission

Community Living London

January 13, 2014

Community Living Middlesex

Written submission

Community Living Mississauga

Written submission

Community Living Norfolk

Written submission

Community Living Ontario

November 13, 2013 and written submission

Community Living Owen Sound and District/Walkerton and District

January 13, 2014

Community Living St Mary's and Area

January 13, 2014

Community Living Thunder Bay

January 15, 2014

Community Living Tillsonburg

January 13, 2014  and written submission

Community Living Toronto

December 4, 2013 and written submission

Community Living Toronto Central Regional Council

Written submission

Community Living Welland Pelham

Written submission

Community Networks of Specialized Care

Written submission

Kelly Coons,  Shelley Watson, Jenna Pepper, Alexandra Clement

Written submission

Betty Cornelius

Written submission

Nicole Thérèse Corrado

Written submission

Maggie Cotter

Written submission

Leisha Coyle

Written submission

Irene Cranstone

Written submission

Crossing All Bridges Learning Centre

January 13, 2014 and written submission

Adrienne Crowder

Written submission

Mary K. Cunningham, Shiona Watson

Written submission

Nancy Dawdy-Curley

Written submission

Ethel & Percey de la Penotiere

Written submission

DeafBlind Ontario Services

Written submission

Patricia Deline

Written submission

Brian & Shelley Delorey

Written submission

Deohaeko Support Network

January 20, 2014 and written submission

Monique DeRepentigny

Written submission

Developing and Nurturing Independence (DANI)

January 20, 2014 and written submission

Developmental Services Ontario (DSO) Provincial Network

February 26, 2014 and written submission

Developmental Services Toronto Council

January 20, 2014 and written submission

Brian & Denise Dickie

Written submission

Leah Dolmage

Written submission

Marilyn & Jim Dolmage, Marie Slark, Patricia Seth

November 27, 2013 and written submission

Janis Dominato

Written submission

John Doughty

Written submission

Down Syndrome Association of Ontario

December 18, 2013 and written submission

Dufferin Child & Family Services

Written submission

Dundas Living Centre

January 14, 2014

Wayne Eastabrook

Written submission

Easter Seals Ontario

Written submission

Lynda Edmondson

Written submission

Elementary Teachers’ Federation of Ontario (ETFO)

Written submission

Debbie Eyraud

Written submission

Faith and Culture Inclusion Network

January 21, 2014

Families for a Secure Future

January 21, 2014 and written submission

Families from St. Marys and Area

Written submission

Families Matter Co-operative

January 17, 2014 and written submission

Family Alliance Ontario

January 17, 2014 and written submission

Family and Children’s Services of Frontenac, Lennox and Addington

Written submission

Family Directed Alternative Support Services

Written submission

Family Service Toronto

January 20, 2014 and written submission

Heather Fawcett

Written submission

Mitchell Feinman

January 21, 2014 and written submission

Fetal Alcohol Spectrum Disorder (FASD) Group of Ottawa

January 17, 2014 and written submission

Fetal Alcohol Spectrum Disorder Network of Elgin, London, Middlesex, Oxford (FASD-ELMO)

January 13, 2014 and written submission

Fetal Alcohol Spectrum Disorder Ontario Network of Expertise (FASD ONE)

January 21, 2014

and written submission

Yvette Fiala, Betty Midgley

January 21, 2014 and written submission

Barry Finlay

Written submission

Duane Flynn

Written submission

Julie Flynn

Written submission

Nicole Flynn

January 20, 2014

Cindy Forster (MPP)

Written submission

Nick & Elia Forte

Written submission

Leona Foster

Written submission

Patricia Franks

Written submission

Tracy Fuchs

Written submission

Margery & David Fulton

Written submission

Alison Galley

December 18, 2013

Patricia Gallin, Dana Lowry, Wendy Richardson

January 13, 2014

Taddese Ghebrekidan

Written submission

Kathleen Gifford

January 13, 2014 and written submission

Ben Goldberg

Written submission

Janice Lynne Goldthorpe

Written submission

Nancy Gowing

Written submission

Karen Graham

Written submission

Great Lakes Society for Developmental Services of Ontario

Written submission

Grey Bruce Family Network

Written submission

Linda Griffith, Doug Cowan

Written submission

Carrie Groulx

January 14, 2014 and written submission

Lois Hacio

January 14, 2014 and written submission

Lynn Hainer

January 13, 2014

Gregory & Joanne Hall

Written submission

Halton Special Needs Family Network

January 20, 2014 and written submission

Brian Hamill

Written submission

Susan Buro Hamm

January 13, 2014 and written submission

Connie Harrison

January 14, 2014

Colleen Heald

Written submission

Health Care Access Research and Developmental Disabilities Program (H-CARDD)

December 18, 2013 and written submission

Maggie Helwig

January 14, 2014

Highland Shores Children’s Aid (CAS)

Written submission

Sylvia & Edward Hohol

Written submission

Holloway House

Written submission

Ted Holmes

Written submission

Hub for Beyond 21 Foundation

January 17, 2014

Ann Hucal

Written submission

Michael F. Humes

Written submission

Brenda Hunter

Written submission

Imagine Respite Services

Written submission

Inclusion Initiatives Corp.

January 21, 2014

Individualized Funding Coalition for Ontario

Written submission

Jim & Sue Irvin

December 18, 2013 and written submission

Suzanne Jacobson

Written submission

Franke James

January 21, 2014 and written submission

Linda Jensen

Written submission

John Howard Society of Sudbury

Written submission

Debra Johnsen

January 15, 2014 and written submission

Sandi Johnston

Written submission

Anne & Dušan Jovanović

Written submission

Susanna Joyce

Written submission

Justice for Children and Youth

January 21, 2014

Bharathy Kavallappa

Written submission

Urszula Kazmierski

Written submission

Kerry’s Place Autism Services; Autism Ontario

December 18, 2013 and written submission

Keys to the Studio

Written submission

Chris King

Written submission

Mick Kitor

January 14, 2014 and written submission

Sherri Kroll

Written submission

Gava Lamont

Written submission

Jeff & Patti Latty

Written submission

Helen Leask

January 14, 2014

Mark & Jennifer Lederman

Written submission

Laura Lee

Written submission

Marilyn Leiterman

January 14, 2014

Judith Leyshon

Written submission

Sian Leyshon-Doughty

Written submission

LIGHTS

December 18, 2013 and written submission

LiveWorkPlay.ca

Written submission

Donna Lougheed

Written submission

Jody Lowrie

Written submission

Luso Canadian Charitable Society

Written submission

Lutheran Community Care Centre

January 15, 2014

March of Dimes Canada

Written submission

Michele Masters

Written submission

Bruce McCreary

Written submission

Susan McGowan

Written submission

Wendy McGowan

Written submission

Coleen McLaughlin

Written submission

Brian McLellan

Written submission

Rita Miceli

Written submission

Ministry of Aboriginal Affairs

November 20, 2013 and written submission

Ministry of Children and Youth Services

October 30, 2013 and written submission

Ministry of Community and Social Services

October 30, 2013 and written submission

Ministry of Community and Social Services Partnership Table Housing Study Group

January 20, 2014 and written submission

Ministry of Community Safety and Correctional Services

November 13, 2013 and written submission

Ministry of Economic Development, Trade and Employment

November 27, 2013 and written submission

Ministry of Education

November 13, 2013 and written submission

Ministry of Health and Long-Term Care

November 20, 2013 and written submission

Ministry of Municipal Affairs and Housing

November 13, 2013 and written submission

Ministry of the Attorney General, Office of the Public Guardian and Trustee

November 13, 2013 and written submission

Ministry of Training, Colleges and Universities

November 13, 2013 and written submission

Cindy Mitchell

January 21, 2014

Moose Cree Education Authority

Written submission

Moose Cree First Nation

Written submission

Alison & Bob Morse

Written submission

Sandra & Jillian Mothersell

January 13, 2014 and written submission

Steve Muir

Written submission

Michelle Mulima

Written submission

Peter Mykusz

Written submission

Multidimensional Assessment of Providers and Systems (MAPS)

January 17, 2014 and written submission

National Association of Dual Diagnosis (NADD) Ontario

Written submission

New Vision Advocates

Written submission

New Visions Toronto

Written submission

Linda Nilson-Rogers

January 17, 2014 and written submission

Nishnawbe Aski Nation

January 15, 2014

Cora Nolan

January 17, 2014 and written submission

Tanya Northcott

Written submission

Karen M. Ogston

Written submission

Ontario Agencies Supporting Individuals with Special Needs (OASIS)

January 20, 2014 and written submission

OASIS Sensory Partners

Written submission

Ontario Association of Children’s Rehabilitation Services (OACRS)

January 21, 2014 and written submission

Ontario Association of Residences Treating Youth (OARTY) and Partners in Parenting

January 14, 2014

Ontario Community Services Coalition

Written submission

Ontario Dental Association

Written submission

Ontario Medical Association, Pediatrics Section  (Pediatricians of Ontario)

Written submission

Ontario Partnership for Adults with Aspergers and Autism

Written submission

Ontario Public Service Employees Union (OPSEU) 

November 13, 2013 and written submission

Ontario Residential Care Association

January 17, 2014 and written submission

Ontario Shores Centre for Mental Health Sciences

Written submission

Opportunities for Mississauga 21 Plus

January 21, 2014 and written submission

Options Northwest Thunder Bay

Written submission

Ottawa-Carleton Association for Persons with Developmental Disabilities (OCAPDD)

January 17, 2014 and written submission

Judy Pakozdy

January 20, 2014

Giovanni Palumbo

Written submission

Barb Pare

Written submission

Margaret Parlor

Written submission

Brenda Parris

January 14, 2014

Participation House Project (Durham Region)

January 13, 2014 and written submission

Participation House Support Services London and Area

Written submission

Partners for Mental Health

January 17, 2014 and written submission

Party for People with Special Needs of Ontario

Written submission

Peel Children’s Aid Society (CAS)

December 18, 2013

Peel Planning Group

January 20, 2014 and written submission

Heidi Penning

Written submission

People First of Ontario

January 17, 2014 and written submission

Elaine M. Peters

Written submission

LeeAnn Poisson

Written submission

Monica Popovici

Written submission

Sara Pot

Written submission

Doris Power

Written submission

Provincial Advocate for Children and Youth

December 4, 2013

Provincial Executive Directors Group, Community Living Ontario

December 18, 2013

Provincial Network on Developmental Services

Written submission

Queen’s University Department of Psychiatry

January 17, 2014 and written submission

Anne Rahming

January 17, 2014

Christina Ranieri

Written submission

John Redins

Written submission

Registered Nurses’ Association of Ontario (RNAO)

January 13, 2014 and  written submission

Andy & Diane Regnerus

Written submission

Rosanne Renzetti

January 21, 2014

Joyce Rivington

January 17, 2014 and written submission

Dawn Roper

Written submission


Heather Rose

Written submission

Barbara Ruaux

Written submission

Linda Russell

December 18, 2013

Ryerson University: Reimagining Parenting

January 15, 2014

Rygiel Supports for Community Living

January 20, 2014 and written submission

George Saarinen, Cheryl Duce

January 15, 2014 and written submission

Jennifer Saunders

Written submission

Lynda & Dean Sayles

Written submission

Scarborough Residential Alternatives

Written submission

Mike & Faye Schofield

Written submission

Yvonne Schunk

Written submission

Nancy Tew Seberras

Written submission

Iman Seifeldin

January 17, 2014 and written submission

Elaine Shea

Written submission

Geoffrey Shea

January 14, 2014

Helen Shearer

Written submission

Dawn Shepard

Written submission

Simcoe Community Services Self Advocates Council

Written submission

Simcoe County Children’s Aid Society (CAS)

Written submission

Sioux Lookout First Nations Health Authority

January 14, 2014 and written submission

Joanne Sluzar

Written submission

Joanne Small-Greenall

Written submission

Beth Smith

Written submission

Darlene Smith

January 13, 2014

Joanne Smithers

January 13, 2014 and written submission

Kyle Snider

Written submission

Shelley Sobkowich

Written submission

Ivan Solano

January 14, 2014

Special Needs Advocacy Group (Moose Factory)

Written submission

Special Services at Home and Passport Coalition

January 13, 2014 and written submission

Spindel and Associates

Written submission

Andrea Stadhard

January 17, 2014 and written submission

Lynda & Ray Stanczak

Written submission

Barry Stanley

January 21, 2014 and written submission

Karin G. Steiner

January 17, 2014 and written submission

Storm

Written submission

Shanti Stuber

Written submission

Surrey Place Centre, Medical Services

December 18, 2013 and written submission

Tamir

Written submission

Peggy Ann Tate

Written submission

Margaret V. Taylor

Written submission

Philippe Etienne Telford

Written submission

The Ottawa Rotary Home

December 11, 2013

Thinking in Pictures Educational Services (TIPES)

January 14, 2014 and written submission

Thinking in Pictures Educational Services (TIPES) and Collective Autism Service Providers Association (CASPA)

January 17, 2014

Susan Thoms 

January 15, 2014 and written submission

Donna Thomson

January 17, 2014 and written submission

Thunder Bay Family Network

January 15, 2014 and written submission

Toronto Developmental Services Alliance

January 21, 2014 and written submission

Krista Trulsen

Written submission

Shirley Turner

Written submission

United Families of Eastern Ontario

January 17, 2014 and written submission

Kathryn Van Dorp

Written submission

Henrietta Vandriel

Written submission

Mark Wafer

March 5, 2014

Lillian Wagman

Written submission

Cindy Walker

January 14, 2014 and written submission

Ryan & Sue Walker

January 20, 2014

Walking In My Shoes Parent Group

Written submission

Laurie Watt

January 20, 2014 and written submission

Barb Wentworth

January 14, 2014 and written submission

Diane L. White

January 13, 2014 and written submission

Windsor Essex Family Network

Written submission

Mary Jo Winkler-Callighen

January 13, 2014

Maria Wojewnik

Written submission

Woodview Mental Health and Autism Services

January 21, 2014 and written submission

Ron & Val Yorksie

Written submission

Patty Zimmermann, Jan Hudyma

January 14, 2014 and written submission

 


 

Appendix C

List of Developmental Services Ontario Offices


 

List of Developmental Services Ontario Offices

DSO Hamilton-Niagara Region

Administered by Contact Hamilton

DSO South West Region 

Administered by Community Services Coordination Network

DSO South East Region

Administered by Extend-A-Family

DSO North East Region

Administered by Hands – TheFamilyHelpNetwork.ca

DSO North Region

Administered by Lutheran Community Care Centre

DSO Eastern Region

Administered by Service Coordination services

DSO Central West Region

Administered by Sunbeam Residential Development Centre

DSO Toronto Region

Administered by Surrey Place

DSO Central East Region

Administered by York Support Services Network



[1] Information about the Committee’s history and public meetings are presented in Appendix A. Its schedule of public hearings and a list of witnesses and submissions are found in Appendix B.

[2] As a tool to address the gender wage gap in Ontario, proxy pay equity obligations allow public sector organizations to compare their wage scale to another public sector employer with similar job classes. One agency that became a pay equity proxy employer in the 1990s was compared to hospital workers in the health care sector. The wage gap at that time being about 28%, it was to take 28 years to meet the 1%-a-year pay equity requirement. This agency told the Committee that it is in arrears and has no ability to respond to this obligation.

[3] Ministry of Health and Long-Term Care and Ministry of Community and Social Services, Joint Policy Guideline for the Provision of Community Mental Health and Developmental Services for Adults with a Dual Diagnosis, December 2008.

[4] Please see the “Education (Primary and Secondary)” section of this report for additional recommendations regarding the needs of students with FASD and ASD.

[5] Please see the “Eligibility” section of this report for recommendations regarding IQ and eligibility criteria.

[6] A SEAC for a district school board is composed of representatives from up to 12 local associations. The local associations must be affiliated with associations or organizations that are incorporated; operate throughout Ontario; further the interests and well-being of one or more groups of exceptional children or adults; and, do not represent professional educators (Ministry of Education, “SEAC Membership,”  May 15, 2013).

[7] Housing Study Group (Developmental Services Sector—Ministry of Community and Social Services Partnership Table), Ending the Wait: An Action Agenda to Address the Housing Crisis Confronting Ontario Adults with Developmental Disabilities, September 2013.

[8] MCSS, Spotlight on Transformation, February 2014.

[9] Ontario, Legislative Assembly, Official Report of Debates (Hansard), 2nd Sess., 40th Parl. (16 May 2013): 2173.