STANDING COMMITTEE ON ESTIMATES
COMITÉ PERMANENT DES BUDGETS DES DÉPENSES
Wednesday 17 May 2006 Mercredi 17 mai 2006
The Acting Chair (Mr. Wayne Arthurs): I call the meeting to order. We have approximately two hours left. That will leave us two rotations for each of the three parties of 20 minutes each, starting with the official opposition.
Mr. Frank Klees (Oak Ridges): I would like to address two specific issues -- one relates to board and lodging and the other is the special diet allowance -- either to the minister or the deputy. I'm aware the minister has only been in her position for a short time and these are rather technical questions.
I'll deal first of all with the board and lodging issue. It seems to me, and I've mentioned this to the deputy, that there seems to be perhaps a breakdown in communication out in the field on this issue. There have been recurring circumstances brought to my attention where application was made for a change in status from board and lodging to renter, and there either is not an understanding on the part of some of the caseworkers in the field about this ability to transition from one definition to the other, or there's simply an administrative breakdown.
Let me give you an example. I have a letter here from Mr. John Dowson, who works exclusively with the disability market. The name of his company is LifeTRUST Planning. I have a copy of a letter here dated April 12, 2006. It was addressed to Cliodhna McMullin, director of the Ontario disability support program, and it outlines one of these cases. I'm going to read this into the record because I think it's important for us to understand the circumstances here.
"One of the greatest issues facing people with a disability, parents, community supports and the Ministry of Community and Social Services, are aging parents and aging people with a disability. A recent study published in the United States declared that 30% of the people with a disability live with a parent or parents over the age of 75. As a board member of a community living association and a life planner for parents of a person with a disability for the past 17 years, I believe that the statistics published in the USA also reflect the situation here in Ontario. For many of these aging parents the role of the caregiver has been reversed: their child with a disability is now the caregiver for their parent or parents.
"Last year I met with an 82-year-old woman with severe arthritis. She is being cared for by her 53-year-old daughter, who has Down syndrome. Her daughter receives the usual board and lodge ODSP benefit of $730 a month. Their combined annual income is less than $20,000. Her daughter shops for their food and cooks and prepares all of the family meals. In addition her daughter has been paying her mother $500 a month. I mentioned to the woman that since her daughter purchases and prepares her own food and the meals for her mother, she may be considered a renter and her ODSP shelter allowance could be increased.
"To facilitate a request to increase her daughter's ODSP shelter allowance, a lease agreement between her and her daughter was drawn up, and her mother wrote a letter to the ODSP regional office explaining her daughter's change of status from room and board to a renter. I drafted a covering letter requesting an increase in her daughter's shelter allowance and forwarded the change of status letter, the lease agreement and copies of the past three months' rent, and a letter signed by her daughter authorizing me to act on her behalf to the local ODSP branch office."
Mr. Kevin Costante: I can't speak to the specific circumstances of the case, obviously, but normally when somebody notifies the office that they've moved from a board and lodging situation to a rental situation and they provide evidence of the lease, that triggers the worker then to move that person from the one category to the other. That should be the normal piece. Sometimes if there is a backlog, we will then backdate the granting of the change, back to the date when we were first notified of it.
I can look into the circumstances of this particular case. What we'll also do is talk with our York region office about the need to review the policies around room and board. It's not used as much as it once was, so our workers may just need a reminder about what the rules are.
Mr. Klees: Okay. Let me go on with this letter to show you what is happening. I'm not at all suggesting that this is happening all the time, but it is a very specific example here. I'm hopeful that it's not recurring, and if it is, perhaps there is some additional work the ministry has to do to clarify this for your front-line workers in terms of how these cases should be handled.
"One month passed without a response or an increase in her ODSP benefit. We waited another month and there was still no response. I called the office and was told they had never received the documents and I was asked to fax copies of the documents to the ODSP branch. Another three months passed and there was still no communication from the ODSP branch. In spite of repeated telephone calls and voice messages from me and the ODSP recipient's mother, she has not received any communication from the local ODSP branch.
"Five months after submitting the request to increase her daughter's ODSP shelter allowance, she telephoned the ODSP office again and was finally connected to an income specialist. The income specialist told her that there was no change in her daughter's status so her ODSP benefit would not be increased. In spite of constant pleadings from her mother that there was indeed a change in status and that her daughter was looking after her, the income specialist repeatedly interrupted her and said there has been no change in her status because she's still living at home, therefore she's not going to receive any more money unless she moves out of the house, and with that the conversation was ended."
I'll not continue. I will provide you with a copy of this letter and ask you to please look into this case for us. But I think more important is that there be a clear communication to ODSP workers across the province in terms of this particular issue.
Hon. Mrs. Meilleur: I think you're right. We see that more often. I also have a few cases that I have in mind in my community. Thank you for bringing it to our attention. I think it's important that the ministry review these situations so that it's clear what they should do with a similar case in another situation.
Mr. Klees: Thank you. I'll move on to the special diet allowance issue. We're aware that a new ODSP directive -- I believe it was on November 5, 2005 -- changed the way the special diet allowance is calculated. Recipients used to get the doctor to advocate for an amount that the doctor felt reflected the foods that he or she was asking the patient to buy to help them with their illness. I understand that now there's a very formalized process that has to be submitted, a checklist of items.
I have two examples within my constituency. Again, my sense is that if I have two, there may well be two in other places, and who knows how many across the province. One is Ms. Lori Goldstein. She is an anorexic and used to get $250 a month to purchase Ensure, which is a life sustenance that is quickly absorbed by the body to ensure that she receives adequate nutrients. Lori's doctor recommends that she should be spending about $254 a month on Ensure. She was asked for a new letter from her doctor, which she did provide. Subsequently, her special diet allowance was reduced to $150, but she was unaware of that change until she received the cheque.
The issue here is that one would expect that if there is going to be a change in someone's cheque that they receive in the mail, there would be a pre-warning. In this case, the submission was made. Obviously it was reviewed, or wasn't reviewed; I don't know that. But what we do know is that the recipient received a cheque that was less than she expected, and it came as a shock to her.
So my question is: With regard to the procedure, what is the expectation -- how can I put this? Does the minister believe that that is an appropriate way for this to be handled? Should there not be a pre-notice to the recipient: "Your file has been reviewed. You will be receiving a reduction"? Shouldn't there be at least a month of notice given that in the next month, or 60 days out, your cheque will be reduced by such-and-such amount, or at least allow the recipient to provide additional information if for some reason the doctor's recommendation wasn't clear enough?
Hon. Mrs. Meilleur: The procedure -- I'll ask my assistant deputy to complete the answer. When there was a decision to review the special diet allowance -- this decision was taken after a large increase, a dramatic increase, in the number of people on either social assistance or ODSP asking for this special allowance -- a letter was sent to those whose special diet allowance was to be reviewed, asking that a form be filled out by their medical professional, not necessarily the doctor, but it could be a midwife, a dietitian or a nurse. They had a certain time to get the information back to the office. I'll ask the ADM to complete the answer, but my understanding was that people were advised that their file was to be reviewed and they were given the opportunity to send the necessary information.
The minister's description is absolutely correct. I believe we give people 90 days to get the new form completed. We wanted to give that length of time, recognizing that access to health professionals can be challenging for all of us, particularly in certain parts of the province. We have not notified everyone who might have their special diet reviewed. There are a large number of cases, so we're doing this in phases. We're reviewing first some of the oldest cases or cases that have a very high level of special diet.
That review having been completed, I'm not aware whether a notice is given to the individual that their special diet is going to be reduced. I understand that, in fairness, it would be desirable. It may be an issue of adequacy of staff resources. I'd be very pleased to look into this and find out what notice is given and what we can do to make this a more transparent process for that client.
Hon. Mrs. Meilleur: I agree with your comment. We're going to look into it and, yes, the individual should be advised that the allowance will be amended or reduced. We'll take this back and correct this.
Mr. Klees: Thank you. I'd like, again for your enlightenment and for positive purposes here, to read another letter into the record, which I'll leave with you as well. It's from a constituent who is experiencing some difficulty as a result of this. The letter reads as follows:
"I would like to know how in all good conscience and without any prior notice being given by the Liberal government that a directive could be passed severing vital funds previously allotted for special dietary needs. I am presently receiving $94 per month and prior to that I was receiving $250 per month, a difference of $156 per month.
"I would like to think that you and your political party would find it important enough to work on constructing a new directive that would provide a more realistic amount of money that people could live with, and not just merely exist on.
"Mr. Klees, I would appreciate if you would forward the appropriate documentation, i.e., Dr. Goldenberg's letter and my letter to you, attached hereto, to the proper channels as soon as possible for consideration and review.
I regret any political overtones in the letter. Obviously this is an individual who is very concerned. I bring this to your attention for your purposes, Minister, so that you can see some of the practical implications of this policy, and would ask you to look into this matter. I sent a covering letter to your attention on April 19, enclosing all this information, but I'll certainly provide you with this copy before I leave as well and ask you look into this issue.
I think that many times there are unintended consequences to some of the policy directives government gives and decisions that are made, but the key is that we respond to those issues and take whatever corrective action is needed.
Yes, I am appealing to you on behalf of these specific cases, but on the broader policy issues I wonder if I could have your undertaking to review this to see what we can do to ensure that these unintended consequences are not hurting people we're trying to help.
Hon. Mrs. Meilleur: First, let me answer this question or do this follow-up on your comment. These special diet allowances are there for a reason. It's because they have a medical condition that requires a diet. That's why this review is being done, and we are doing it with the co-operation of the Ontario Medical Association. They're telling us what medical conditions require a diet. Depending on the diet they have to follow, there is an amount that is attached to the medical condition, but I have to tell you that the amount has not been reviewed for some time. We are going to review both. We're going to review the list of medical conditions -- that was done recently, but we realized after some comments and some doctors calling us that we have to review it, so we're going to review it during the summer -- and we are also going to review the amount that is allowed for each of these medical conditions, to make sure that they are realistic. We're going to do it.
Mr. Klees: I want to thank the minister for her undertaking. I think, particularly with regard to this issue, as you're reviewing it, could you give consideration to the efficacy of recommendations being made by a doctor specifically to a patient? I think where we run into difficulty is when we create a grid. That grid may well be what the Ontario Medical Association thinks would be appropriate in 90% or 95% of the cases, but where you have specific issues -- one of these young ladies who I'm personally familiar with has an anorexic problem. She's been very close to death on too many occasions. So for us to rely strictly on a template that would guide the amount of nutrition that is allowed her I think falls short of what I know the government's intention is with regard to the program. So if as part of your review, you might allow for a medical doctor's recommendation to override what that template is, I think it would serve us all well.
Hon. Mrs. Meilleur: The review is going to be done in conjunction with the professionals, so it's the professionals who are going to tell us what the medical condition would be, and also help us to evaluate how much each condition should be provided to make sure they have the proper diet.
Mr. Michael Prue (Beaches-East York): I'll start on a new field that hasn't been touched yet by anyone, the FRO software. You've hired a company called Themis, a subsidiary of Maximus, an American corporation. Can you tell us why you chose this company?
Mr. Costante: We did go through a competitive process for the selection of the software for the Family Responsibility Office. A number of firms put in bids. There were criteria for assessing those, and we chose Themis. Themis also has a history of building software for this particular field and had designed the system used in BC, which is considered to be one of the leading systems in Canada.
Mr. Prue: Maximus corporation has what can only be described as a terrible history in the United States -- absolutely abysmal. I'm going to go through each one of the states and the problems they've had. Did you investigate any of these?
Mr. Prue: Okay, let's just go through some of these things and just tell me if you weren't aware or you didn't look at them. In the state of Wisconsin, there was an audit done. They found that Maximus staff travelled and worked on out-of-state projects from September 1997 through March 2000. Forty-six staff in the Milwaukee office also worked on other Maximus projects that were unrelated to their work and what they were being paid for. In total, 724 hours of these staff were incorrectly billed to W-2 -- that is the Wisconsin program -- resulting in overcharges of $51,000.
Mr. Prue: Were you aware that in Wisconsin -- let me just give you some of the questionable transactions found by the auditor of Wisconsin -- there was an overpayment charge of $40,178 made to a vendor that provided Maximus telephone systems to an office supply store, and the overpayments were not noted for computer purchases? Were you aware of that one?
Mr. Costante: Can I state that I understand that when we first started this process in Themis, they were not owned by this company. It's our understanding that that took place midway through. Our contract is with Themis, not with this American company.
Mr. Prue: That's the information I have here, that it was bought in 2002. I want to go on to some of the other shenanigans. I just want to make sure that we're not getting ripped off here, because I have a feeling that we may be ripe for getting ripped off.
Some of the more egregious things Wisconsin found were: $15,741 in expenditures that benefited Maximus or its employees, including a meeting held in the Interlaken Resort; a holiday party at the Milwaukee Clarion Hotel; hotel rooms in Lake Geneva; corporate memberships; and agency-sanctioned parties and other social events. Is Themis allowed to do any of these things?
Mr. Costante: What I'd like to do is ask the assistant deputy minister for the Family Responsibility Office to talk about the checks and balances we have in the contract and how we operate this to assure you that -- we can never be 100% sure, I think everyone knows that, but as much as possible, we make sure that public money is used appropriately, accounted for, and there is no wrongdoing going on.
Ms. Sharon van Son: My name is Sharon van Son and I'm the assistant deputy minister with the Family Responsibility Office. I would just like to answer Mr. Prue's question a little bit in terms of the process we went through to obtain Themis as the vendor for this project. It was a very rigorous process, and I would say that it established a very high standard to ensure that we did not run into the issues you are talking about at this point. We retained a fairness commissioner who obviously oversaw the entire process to ensure that everything we did was appropriate, met the OPS standards and that there was fairness at every step of this process.
There was a pre-release of a posting of a draft RFP for approximately four weeks to the vendor community to seek out whether there were vendors who were interested. Then there was the actual posting of the RFP. All the documentation prior to this posting was reviewed by this fairness commissioner. This was referred to as a blind review, so as we were going through the vendors' proposals, we did not know whose proposals we were reviewing, and as a result, fairness was ensured. They had to meet a strict number of criteria before we would award the contract. The RFP, if I may say, is probably one of the best that has been developed in government in recent times and was actually noted by the centre as being a best practice, because of the due diligence that was put into this process.
There were mandatory requirements that every vendor had to meet. The evaluation of criteria was sound and focused on three areas in terms of the solution functionality of the proposal that was being put forward. There was a strict evaluation of an implementation plan, and obviously an evaluation of the proponents' experience and their qualifications. At the end of all those written reviews, the vendors then had to demonstrate their solution and were also interviewed. At that time, for the vendors that were successful in passing the mandatory criteria, there was again a very in-depth evaluation, reference checks, and then a final decision-making that was again reviewed in its totality by the fairness commissioner.
We have our contract with Themis Consulting. The contract is a deliverable-based contract, so they do not get paid unless they meet the terms and conditions of the contact and deliver on all aspects of the contract as required in the RFP.
I'm quite confident in this process because, like you, Mr. Prue, we certainly do not want to be in a situation where we have a vendor that does not have integrity or does not deliver as they are required to do.
Ms. van Son: I'm unaware of the controversial aspect of them, but we work there on-site. There is a team from Themis that is on-site, and has been on-site with us since July of last year. We meet. There is a whole governance structure in place. They have met with the deputy on a regular basis. There are deliverables that they must meet and we are holding them to those. The contract, if you look at the RFP, is quite clear in terms of what they must do in terms of their work with us.
Mr. Prue: I would take it that to date there has been no experience such as that found in the United States. Most states that have contracted Maximus, the parent company, have got out of it: Colorado; Arizona, I understand, is trying to get out of it or has got out of it; most of the others as well. You've not had any difficulty whatsoever?
Ms. van Son: I think we've done our homework. We attended public accounts, and one of the things we talked about was the necessity of having a proper process in place and due diligence, and we have met that criterion. I would like to think very much that we have done our due diligence and have a contract that can stand up with confidence.
Mr. Prue: Some of the places in the United States found out their costs actually increased. Have we done a cost-benefit analysis to see whether or not we're saving any money with Themis, or is it too early?
Ms. van Son: We're still in the process of developing the system, but certainly the system we currently have in place, which is an old mainframe system written in COBOL, a 15-year-old financial accounting system, is inefficient and not cost-effective. One of the reasons we went to a new system was to create a system that was much more flexible, had greater efficiencies both in terms of productivity and cost.
Mr. Prue: The reams of paper that I have here on this company and everything they have done illegally, immorally and everything in the United States is really quite shocking. Would you be interested in looking at this company we've contracted with?
Ms. van Son: It's very worrisome in terms of what you have said, in terms of Maximus, but I just want to confirm with you that our contract is with Themis and that they are the sole signing authority throughout this contract. Certainly, if there is material you'd like us to read, I'd be happy to read it, but I have to say our experience is anything but that.
Mr. Prue: All right. But just with that system, was there anything we learned from Accenture? This was the computer that couldn't calculate a 3% increase, wasn't it? Is this the one? I'm trying to think back. I think that's the one. The government contracted and paid millions of dollars to a computer company, and what any kid's calculator could do, this computer couldn't do.
Mr. Costante: One of the things we learned, which we didn't do with FRO, was that the method of procurement for the Accenture contract, which was originally Andersen Consulting, was a common purpose procurement, where we didn't specify in great detail exactly what we wanted.
In this one, and Sharon can correct me if I'm wrong, we specified exactly the requirements we wanted and we issued an 800-page RFP spelling out exactly, whereas with Accenture, the nature of the contract was that you hired a partner and they were to develop it. So it was a much looser type of contract. This one was very specific in terms of what the deliverables were to be and how much the contract was for. Those are very specific. If you read the RFP, you'll see how detailed it is. So that's one very important thing we learned from the Accenture/Andersen experience.
Mr. Prue: I just want to be clear. The fault for the computer was as much a fault of Accenture as it was the bureaucracy? I mean, it was everybody's fault? You didn't say what they had to do and they didn't build in something that was so common any calculator could do it with ease?
Mr. Costante: I would say that there were problems with the procurement method and that there was fault on the part of the ministry and the government in terms of being specific about what the needs were, yes.
A couple of other sort of unrelated things dealing with the ministry. The ministry is responsible for and has done, I think, a fairly good job on the Ontarians with Disabilities Act. You know that we supported it in the House. But one of the things the community is asking for deals with elections. There are no sign interpreters in elections. I've been approached by some members of the deaf community, and I know the minister probably has. Has there been any government movement, any ministry movement on making signers for the deaf available in elections?
Mr. Costante: I don't think we've dealt with that particular topic. How the new legislation works is that we've set up standards development committees. The minister has established two: one on transportation and one on customer service. We've started, with them, to look at developing standards that will be put into regulation that all sectors would have to comply with. This may be a legislative issue, because I think Elections Ontario actually reports to the Legislature. I could check into it, Mr. Prue, and get back to you.
Hon. Mrs. Meilleur: If I may add, the ministry of democratic renewal is reviewing elections and everything on the elections. I think it would be a good topic to refer to them and make sure that when they negotiate with Elections Ontario, this is put into their guidelines and procedures.
M. Gilles Bisson (Timmins-Baie James): Madame la ministre, c'est bien de se voir ici aujourd'hui. Comment ça va? Vous savez qu'on a eu une chance de discuter un peu hier et à l'Assemblée les journées précédentes de toutes les questions de ce qui se passe avec les diètes spéciales. Comme vous le savez, on a beaucoup d'exemples dans mon comté comme dans d'autres où ceux qui ont besoin de diètes spéciales qui ont été données par le ministère, qui ont accordé les prestations nécessaires --
Mr. Bisson: Just to the clerk in English, because we don't have translation, I understood there was going to be translation today. That's why I came today, because I understood today, in a conversation with the minister yesterday, there would be translation. I took her at her word, and I know she didn't mess up. Ministers never mess up.
Mr. Wayne Arthurs (Pickering-Ajax-Uxbridge): Procedurally, we're not prepared at this point to simply adjourn for the day and extend the minister and her staff into a further day. Estimates are going to take us a considerable amount of time to get through. We're certainly willing to discuss it collectively, through the subcommittee, but Mr. Wilkinson is not here.
Mr. Bisson: I'm not going to lose my time because I'm not allowed to ask questions in French for constituents in my riding. So I'm asking that we adjourn and come back after. Don't get me going on this one.
Mr. Bob Delaney (Mississauga West): On a point of order, Mr. Chair: Is it possible -- est-il possible pour M. Bisson de poser ses questions en français et en anglais, et pour les réponses d'être en anglais et en français?
The Vice-Chair: We can carry on with this all afternoon, ladies and gentlemen. I think, with the situation -- if you're insisting on speaking in French and you want the translation put in place, I'm going to make a ruling right now that we will be adjourning for the day, and we'll have to come back at the first available opportunity.
Hon. Madeleine Meilleur, minister
Mr. Kevin Costante, deputy minister
Ms. Lynn MacDonald, assistant deputy minister, social policy development division
Ms. Sharon van Son, executive director, Family Responsibility Office