Please Send Us Your Feedback on the AODA Alliance’s Draft Brief to the Health Care Standards Development Committee on the Disability Barriers in Ontario’s Health Care System


Accessibility for Ontarians with Disabilities Act Alliance Update

United for a Barrier-Free Society for All People with Disabilities

Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

Please Send Us Your Feedback on the AODA Alliance’s Draft Brief to the Health Care Standards Development Committee on the Disability Barriers in Ontario’s Health Care System

July 23, 2021

            SUMMARY

Did we get it right? Let us know!

We’ve been busy as can be, writing a brief that we plan to submit by August 11, 2021 to the Health Care Standards Development Committee. The Ontario Government appointed that Committee back in 2017 to come up with recommendations on what the promised Health Care Accessibility Standard should include. The Health Care Accessibility Standard is a law that is to be enacted under the Accessibility for Ontarians with Disabilities Act to tear down the barriers that obstruct people with disabilities in Ontario’s health care system.

We’ve come up with a draft brief. We want your feedback on it to help us finalize it.

Back on May 7, 2021, the Ford Government made public the initial report of the Health Care Standards Development Committee. That initial report makes a series of recommendations on what the promised Health Care Accessibility Standard should include. The Government is inviting public feedback on that initial report up to August 11, 2021. The Health Care Standards Development Committee will be given all that public feedback. It can use that feedback to finalize its recommendations to the Government. We want our brief to give as much help as possible to the Health Care Standards Development Committee.

Below we set out a summary of what our draft brief to the Health Care Standards Development Committee recommends. We applaud and agree with most of what the Health Care Standards Development Committee wrote. However, we make a number of recommendations on how it can improve its report.

Our draft brief builds upon all the feedback we have received over the years about disability barriers in the health care system. You can download our draft brief by visiting https://www.aodaalliance.org/wp-content/uploads/2021/07/July-23-2021-Draft-AODA-Alliance-brief-on-health-Care-Standards-Development-Committee-initial-report.docx

Please send us your suggestions on our draft brief by August 1, 2021. We will then have to rush to turn our draft brief into a finished product.

Here are resources that you might find helpful:

  1. The Health Care Standards Development Committee’s initial report, recommending what the promise Health Care Accessibility Standard should include.
  1. A captioned talk by AODA Alliance Chair David Lepofsky two years ago about disability barriers in the health care system.
  1. A captioned talk earlier this year by AODA Alliance Chair David Lepofsky about the disability discrimination in Ontario’s critical care triage protocol that is now embedded in Ontario hospitals.
  1. The AODA Alliance website’s health care page, which documents our advocacy efforts over the past decade to make health care services accessible to people with disabilities.

A long 904 days ago, the Ford Government received the blistering final report of the Independent Review of the AODA’s implementation by former Lieutenant Governor David Onley. It called for urgent action to speed up and strengthen the AODA’s implementation and enforcement. Since then, the Ford Government has announced no comprehensive plan of action to implement that report.

            MORE DETAILS

Summary of the July 23, 2021 Draft AODA Alliance Brief to the Health Care Standards Development Committee

  1. a) The Health Care Standards Development Committee should recommend more concrete actions to ensure that disability barriers are removed and prevented, rather than instead giving primary emphasis to individually accommodating patients with disabilities and having hospitals plan for accessibility.
  1. b) The Health Care Standards Development Committee should more forcefully address all barriers in the hospital sector and the broader health care system.
  1. c) The Health Care Accessibility Standard should ensure that all disability barriers are removed and prevented in hospitals, not just those the Accessibility Minister asked the Standards Development Committee to focus on.
  1. d) The Health Care Accessibility Standard should not assume that smaller hospitals always need more time to comply.
  1. e) The initial report incorrectly understates the role of the Health Care Standards Development Committee.
  1. f) The proposed long-term objective of the Health Care Accessibility Standard should be strengthened.
  1. g) The initial report’s vision of a barrier-free health care system should be strengthened.
  1. h) Additional recommendations are needed to ensure accountability for accessibility within a hospital or other health care provider’s organization.
  1. i) Specific requirements for accessibility of health care facilities’ built environment are needed.
  1. j) Specific actions should be recommended to ensure that diagnostic and treatment equipment are accessible.
  1. k) Specific actions are needed to ensure the accessibility of health records.
  1. l) The initial report’s recommendations on training of health care providers should be strengthened.
  1. m) Detailed recommendations are needed to protect the right of patients with disabilities and of any patients’ support people with disabilities to physically get to health care services.
  1. n) Action is needed to guarantee the right of patients with disabilities to the privacy of their health care information.
  1. o) Additional recommendations are needed to help ensure the rights of patients with disabilities and of patients’ support people with disabilities to accessible information and communication in connection with health care.
  1. p) The initial report’s recommendations should be strengthened to effectively protect the right of patients with disabilities to the support services they need to access health care services.
  1. q) Additional measures should be recommended to ensure right of patients with disabilities to identify their disability-related accessibility needs in advance and to request accessibility/accommodation from a health care provider or facility.
  1. r) Patients with disabilities and support people with disabilities should be assured accessible complaint processes at health care providers’ self-governing colleges, and to have those colleges ensure that the profession they regulate are trained to meet the needs of patients with disabilities.
  1. s) Systemic accessibility safeguards should be built into the health care system from top to bottom.
  1. t) The experience and expertise of people with disabilities working in the health care system should be harnessed to expedite the removal and prevention of barriers facing patients, and those facing their support people with disabilities.
  1. u) The Health Care Standards Development Committee should endorse the K-12 Education Standards Development Committee initial report’s health care recommendations.
  1. v) Further steps should be recommended to supplement the initial report’s recommendations arising from the covid-19 pandemic.
  1. w) The initial report’s recommendations on strengthening AODA enforcement are heartily applauded.t



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Canadians with long COVID: Sick and, increasingly, worried they’ll go broke – National | Globalnews.ca


Adriana Patino, 36, has been battling COVID-19 since December 2020.

First, the virus made her very sick, prompting several trips to the ER when her blood-oxygen levels had dropped dangerously low. Then the long-term symptoms set in: palpitations, difficulty breathing, overwhelming fatigue, and concussion-like cognitive issues.

“I have memory issues, it takes me a while to retain information or follow up conversation or I misspell words constantly,” says the North Vancouver-based consultant.

Patino, once a competitive swimmer who represented Canada at the FINA World Aquatics Championship, says she’s been housebound for more than six months. Minor physical or mental exertions lead to debilitating exhaustion or violent headaches. Carrying out her job, she says, is impossible.

Read more:
‘I’ve progressed very, very slowly’: B.C. COVID-19 ‘long-hauler’ shares recovery story

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But while Patino says her employer has been very supportive, getting her long-term disability (LTD) insurance claim approved is taking longer than expected. Patino, who has exhausted her short-term Employment Insurance (EI) sickness benefits, says she was hoping her LTD coverage would kick in around a month after she filed the claim in early April. Instead, the insurance company keeps coming back with new requests for medical records, she says.

In the meantime, Patino says her financial situation is rapidly deteriorating. After raiding her personal savings, she had to borrow from her mother. Her friends raised funds through a GoFundMe account.

But if her workplace benefits don’t come in soon, she says she’ll have to start selling some of her possessions to make ends meet.

“We don’t have anything else to rely on,” she says.


Click to play video: 'Millions continue relying on COVID-19 benefits'







Millions continue relying on COVID-19 benefits


Millions continue relying on COVID-19 benefits – Mar 15, 2021

More than half of COVID-19 patients might be suffering from long-term symptoms more than 12 weeks after testing positive, according to a new review by the Public Health Agency of Canada. To date, 1.39 million Canadians have contracted the virus and survived, according to official statistics.

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But many of the country’s COVID long-haulers say they’re falling through the cracks of both private workplace insurance benefits and government income supports.


Workplace disability benefits often denied

Only 12 million Canadians have disability insurance, according to the Canadian Life and Health Insurance Association. But even those who, like Patino, have coverage, aren’t necessarily able to access the benefits when they suffer from long-term COVID symptoms, also known as long COVID.

The lingering effects of the virus manifest as a bewildering array of symptoms. The common ones include fatigue, difficulty breathing, cognitive problems often described as “brain fog,” cough, muscle pain or headache, sleep problems, cardiac issues and trouble sleeping.

Read more:
Canadians with lifelong disabilities can lose disability tax credit

The pandemic is leaving millions of COVID-19 survivors chronically ill, creating what science magazine Scientific American recently called a “tsunami of disability.”
But long COVID has all the hallmarks of an illness for which it’s difficult to claim workplace disability benefits. What’s causing those often debilitating symptoms doesn’t always show up in diagnostic testing. Patino, for example, says she has undergone a barrage of tests, most of which came back normal. Only a few tests revealed issues with her lungs, blood and heart, she says.

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Click to play video: 'COVID-19 ‘long-haulers’ describe shakes, trouble breathing weeks after testing positive'







COVID-19 ‘long-haulers’ describe shakes, trouble breathing weeks after testing positive


COVID-19 ‘long-haulers’ describe shakes, trouble breathing weeks after testing positive – Feb 19, 2021

Also, researchers still have a limited understanding of COVID’s long-term effects and family doctors often don’t recognize the condition. A recent study in the British Journal of General Practice, for example, suggested that general practitioners in England may be grossly under-diagnosing long COVID. Researches found less than 24,000 records of formal diagnoses of long COVID, a number that is nearly 100 times smaller than the two million adults thought to have had long COVID in England.

“It’s an invisible illness, it’s much like … chronic fatigue syndrome, (that is) myalgic encephalomyelitis,” says Susie Goulding, a floral designer based in Oakville, Ont. She’s a COVID long-hauler who founded COVID Long-Haulers Support Group Canada, which has almost 14,000 members.

Read more:
These Canadians say they suffered COVID-19 symptoms for months

Many COVID long-haulers in the group have been denied long-term disability benefits, she says.

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“People are being turned away because they just can’t prove it in black and white on paper that they are as ill as they are saying that they are,” she says.

Because there is still little research around long COVID, it’s easy for insurance companies to dismiss disability claims due to “insufficient medical evidence,” says Nainesh Kotak, a Mississauga, Ont.-based disability and personal injury lawyer, who has recently been retained for a long COVID case.

Read more:
‘We were counting pennies’: When disability insurance won’t pay because doctors can’t tell what’s wrong

“It’s no different than dealing with a chronic fatigue case or even a chronic pain case. What is more difficult, though, is certainly the newness of the impairments,” he says.

It’s important for long COVID sufferers to build medical evidence by relying on their family physician to record their symptoms and provide referrals to specialists as needed, Kotak says.

“The important thing, of course, is to have your physicians as an ally,” he notes.

But that’s often a challenge for long-haulers in Canada, where not everyone has access to a family physician. The head of the Canadian Medical Association recently called on the federal government to boost access to family doctors for long-haulers.


Click to play video: 'The struggles of COVID-19 ‘long-haulers’'







The struggles of COVID-19 ‘long-haulers’


The struggles of COVID-19 ‘long-haulers’ – Oct 20, 2020

In the absence of that, long-haulers should consistently use the same walk-in clinic for appointments, which makes it easier to gather evidence, Kotak says.

But besides providing a full picture of long COVID patient’s symptoms, it’s key that doctors identify how the condition limits the patients’ ability to function in their jobs, he adds.

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Still, it doesn’t help that, unlike the U.K., Canada has yet to establish a clinical definition of long COVID.

And some long-haulers face yet another mystifying obstacle: they can’t prove they ever had COVID-19.

Read more:
Cancer patient was cut off from work disability benefits for 10 months — his story has warning for everyone

Many long-haulers who caught the virus in the first wave, when Canada was rationing a limited number of available tests, don’t have a positive COVID-19 test result to show for it, Goulding says. For example, many COVID-19 symptomatic patients weren’t given tests if a family member had already tested positive, she adds.

“They were assumed to have a positive case as well, but then they didn’t get a positive … test, so then they’re left trying to prove themselves,” she says.

In a recent survey of more than 1,000 COVID long-haulers in Canada by Goulding’s COVID Long-Haulers Support Group Canada, Viral Neuro Exploration and Neurological Health Charities Canada, less than 60 per cent of participants said they had received a positive test.


COVID government-benefits safety net not enough for long-haulers

For those who don’t have or can’t access long-term disability benefits, there’s little in the way of a social safety net.

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Chantal Renaud says she began suffering from crippling symptoms, including severe difficulty breathing, tachycardia and profound fatigue in April 2020. When her LTD insurance claim was rejected, she says she accessed EI sickness benefits. But after exhausting the 15-week maximum eligibility period for the program, she says she found herself without any income.

In the end, Renauld says she was forced to sell her house to survive financially.

“I have financially contributed to this country for more than 32 years and I should never have lost my house because I fell ill,” Renaud recently told the House of Commons’ Human Resources committee. “No Canadian should ever have to experience that.”

Read more:
On East Coast, exhausted COVID-19 ‘long haulers’ hope specialized clinics will emerge

Renaud had been called to testify about Bill C-265, a private member’s bill sponsored by Bloc Quebecois MP Claude DeBellefeuille proposing to extend the maximum period for receiving benefits to 50 weeks.

Federal budget legislation recently extended the maximum number of weeks for receiving EI sickness from 15 to 26, but the changes are expected to take effect only in the summer of 2022.

The office of Human Resources Minister Carla Qualtrough did not respond to a question about whether the federal government is considering a further extension of the maximum benefits period.

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“The Government of Canada recognizes that this continues to be a difficult time for many workers in Canada. We will continue to monitor how the labour market rebounds and the needs of Canadians as we move forward on the path to recovery,” Employment and Social Development Canada said via email.

Patino, for her part, says she’s hoping her story helps people and policymakers appreciate the impact of long COVID.

“I want people to take this seriously and I want the government to take us seriously.”




© 2021 Global News, a division of Corus Entertainment Inc.





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ArriveCAN app for cross-border travel includes hurdle for blind Canadians: advocate – National | Globalnews.ca


The federal government’s new ArriveCAN travel app is inaccessible to some Canadians with disabilities, raising questions of fair treatment and practical border-crossing concerns.

Robert Fenton, a board member of the CNIB — formerly known as the Canadian National Institute for the Blind — says he found a major bug when using the Apple VoiceOver screen reader on his iPhone as he tried to access the app, which is playing a pivotal role for those wishing to enter Canada by land, sea or air.

The obstacle arises when would-be users try to add the verification code sent to their email address after starting to set up their account.

“There’s no way to add the number without sighted help,” Fenton said in an interview.

“As people who are blind, we run into this problem frequently with all levels of government when trying to access public services.”

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Read more:
Canada’s new border rules have kicked in. Here’s what to know

Travellers to Canada must use the ArriveCAN app or online portal to submit their vaccine information and the results of a negative COVID-19 test taken no more than three days before departure.

Trouble accessing an app essential to international travel in the pandemic era could pose a real barrier to entry for Canadians with disabilities.

The federal law enforcement agency responsible for border control acknowledged the problem.

“The Canada Border Services Agency (CBSA) is aware that there is a gap between the addition of new features to the ArriveCAN app and when it is fully accessible, and we apologize for any inconvenience this may be causing for users. We are working hard to resolve this issue as quickly as possible,” agency spokeswoman Jacqueline Callin said in an email.


Click to play video: 'Minister Bill Blair outlines updated requirements for fully vaccinated Canadian travellers at the border'







Minister Bill Blair outlines updated requirements for fully vaccinated Canadian travellers at the border


Minister Bill Blair outlines updated requirements for fully vaccinated Canadian travellers at the border – Jun 21, 2021

Unlike the app, the web-based version of ArriveCAN does meet federal accessibility requirements and can be used via desktop, smartphone and other devices, the agency said. It is encouraging travellers who rely on text-to-voice technology to use the online portal until the app store versions are updated.

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The Accessible Canada Act, passed in 2019, aims to remove barriers in areas under federal jurisdiction, such as transportation and telecommunications as well as federally run programs.

“It’s time now for the federal government at least to live up to its obligations in that legislation, and that includes making their websites and apps and other services they offer to Canadians fully accessible,” Fenton said.

The Canadian Press has confirmed the glitch in the app.

Read more:
COVID Alert app cost feds $20M but results ‘did not meet expectations’: new data

Fenton says it follows another problem that prevented blind and partially sighted Canadians from moving beyond the privacy screen that pops up when the app is opened, and which he said the Canada Border Services Agency recently fixed.

“We couldn’t get past the first screen,” he said, “so none of us would know about the second problem.”

The latest problem is particularly urgent as athletes gear up to travel to Tokyo for the Paralympic Games this summer.

Fenton is asking the Canada Border Services Agency to make the app accessible by July 23.





© 2021 The Canadian Press





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At the AODA Alliance’s Request, CTV Commendably Corrects an Inaccurate Online News Report About Ontario’s Critical Care Triage Plans


Accessibility for Ontarians with Disabilities Act Alliance Update

United for a Barrier-Free Society for All People with Disabilities

Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

At the AODA Alliance’s Request, CTV Commendably Corrects an Inaccurate Online News Report About Ontario’s Critical Care Triage Plans

June 8, 2021

            SUMMARY

Who watches the watchers? Once again, the AODA Alliance has had to do so, when it comes to monitoring media coverage or lack of coverage of the danger since the start of the COVID-19 pandemic of disability discrimination in access to life-saving critical care in Ontario hospitals.

This is Part 2 of our own coverage on this important question. The June 7, 2021 AODA Alliance Update described how CBC’s flagship national daytime current affairs radio program “The Current” has failed to cover the dangers of disability discrimination in critical care triage during the COVID-19 pandemic. Today, we look to another network and another story—one with an eventual  happy ending.

Back on April 28, 2021, CTV’s nightly national TV news program commendably covered the danger of critical care triage in Ontario. It is good that its report included a reference to disability concerns.

However, CTV’s online news report on this issue (unlike its shorter broadcast TV news item) inaccurately stated as a fact that under Ontario’s critical care triage protocol, people with disabilities are to be treated no differently than others. It stated:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

That statement of fact was absolutely and provably incorrect. We were not contacted by CTV before that story ran.

This story appeared to the AODA Alliance to possibly be one that the physicians at the centre of planning the Ontario critical care triage protocol may have brought to the media. It has the focus and sound of the message that they espoused.

On April 30, 2021, the AODA Alliance reached out by email to CTV news. We showed how that statement was factually wrong. To its credit, after some back-and-forth exchanges, at our request CTV news removed that harmfully inaccurate statement from its online report. We very much appreciate that this story was corrected.

Around May 6, 2021, CTV updated this online story in response to our concerns. However, the change was not an effective solution. The line, quoted above, was revised to read as follows, which was also factually inaccurate:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population…”

As well, the following was commendably added later in the story:

“Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.”

On May 18 and 19, 2021, AODA Alliance Chair David Lepofsky again wrote CTV about this story. While appreciating CTV’s effort to correct it, CTV was told that it was still inaccurate for the story to state as a fact that people with pre-existing disabilities are not to be treated any differently than the rest of the population under Ontario’s critical care triage protocol. Shortly after that, CTV again revised the online story to remove the entire unfactual statement. The following words were removed from it:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

As well the online CTV story now includes a link to the AODA Alliance’s detailed February 25, 2021 report on disability discrimination in Ontario’s critical care triage protocol.

Below you can read the following:

  1. a) the original version of this CTV story as posted online on April 28, 2021.
  1. b) the AODA Alliance’s April 30, 2021 email to CTV news.
  1. c) The revised CTV online story as of May 6, 2021.
  1. d) The May 18 and 19, 2021 emails from the AODA Alliance to CTV, and
  1. e) The final version of the story as it now appears online.

We applaud CTV for correcting this story, and for being open to our feedback on it. We have urged CTV’s national news to do a story specifically focusing on the disability discrimination problems with Ontario’s critical care triage protocol. They have not yet done so. It remains an immediate and important story. Things are better in Ontario, but there has been no public accounting for the disability discrimination now embedded in hospital training across Ontario. As well, Manitoba is facing an immediate danger of possible critical care triage.

In contrast, CBC TV’s The National commendably ran a 7-minute story on that topic on 18, 2021. That was a very lengthy story for a national TV news program.

Who watches the watchers? The AODA Alliance and people with disabilities must do so!

For more background on this issue, check out:

  1. The online captioned video talk on this issue by AODA Alliance Chair David Lepofsky, seen over 1,000 times, and
  1. The AODA Alliance website’s health care page.

1          MORE DETAILS

 CTV News April 28, 2021

Originally posted at

https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Avis Favaro

Medical Correspondent, CTV National News

@ctv_avisfavaro

Elizabeth St. Philip

CTV News

@LizTV

Ben Cousins

CTVNews.ca Writer

@cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

intensive care admissions

As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

April 30, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

CTV’s online April 28, 2021 online news report on the issue of critical care triage in Ontario, entitled “Ontario hospitals on the verge of enacting ‘last resort’ triage protocols”, includes a seriously inaccurate and deeply disturbing statement that needs to be rectified. It states:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

In fact, and contrary to what CTV reports, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports.

For example, if a cancer patient needs critical care, they will be deprioritized if a patient is “Completely disabled and cannot carry out any self-care; totally confined to bed or chair”. As another example, if a patient needing critical care is over 65 and has a progressive disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. In both examples, this is disability discrimination, pure and simple.

This is not open to factual debate. The secret January 13, 2021 Critical Care Triage Protocol has been posted on the AODA Alliance website for over three months. No one has disputed that those two features are in the protocol. They can also be found in the terrifying online calculator that we made public, and that critical care doctors are being told to use if critical care triage takes place.

The presence of disability discrimination in the January 13, 2021 Critical Care Triage Protocol has led leading disability organizations to publicly demand that this disability discrimination be removed from it. See our efforts on this at www.aodaalliance.org/healthcare It has led the Ontario Human Rights Commission to raise serious concerns. As well, fully six members of the Ontario Government’s own advisory Bioethics Table have been publicly critical of the January 13, 2021 Critical Care Triage Protocol. This is all documented in detail at www.aodaalliance.org/healthcare

It is good that your story quotes Prof. Jeff Preston as being concerned about the triage protocol. The entire passage, excerpted above, states:

“The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

It is good that the CTV report notes that people with disabilities are terrified. However, the substantial misstatement of fact to which we here point is not corrected by that aspect of the CTV report. The reader is left with the uncontradicted categorical statement that

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

At best, the triage protocol says that people with certain stable disabilities are not thereby to be assessed by the Clinical Frailty Scale that measures their ability to perform the eleven tasks of daily living, listed above, without assistance. However, the protocol goes on to apply that disability-discriminatory Scale to people with progressive disabilities (e.g. MS or arthritis, to name a few).

Especially in a national online news story dealing with a life-and-death issue, and its dangerous implications for society’s most vulnerable, it is essential for CTV to get its facts right. This is all the more so since people with disabilities disproportionately have born the brunt of COVID-19 and disproportionately died from it. It is also especially so since it has been so hard to get the media to cover this story. We’ve been trying for over a year, with success for the most part taking place only very recently.

It would be one thing for your report to include our position and then any defence the Ford Government wishes to offer. CTV did not do so. Instead, it categorically states as objective fact something which is 100% incorrect, and which your reporters on this story did not reach out to us to discuss. Our position on these issues has been widely publicized to the media, including to CTV, via news releases and Twitter.

In marked contrast to the April 28, 2021 CTV online report, on the same day, Global TV News Toronto aired a story commendably bearing the accurate headline: “Ontario’s COVID-19 triage protocol ‘discriminates because of disability,’ advocates say”.

We know from the January 23, 2021 online webinar that Critical care Services Ontario conducted for hospitals that the Government or its proxies planned to do some sort of public media strategy on the critical care triage protocol. Your story corresponds in large part to the core messages of that strategy. That could very well be a coincidence, and CTV may well have not known about those media relations strategic plans.

We urgently ask you to do a national report on the disability discrimination that is explicitly included in the Ontario critical care triage protocol, the bogus arguments that have been made on the Ontario Government’s behalf to defend it, and the objections to it from the disability community, the Ontario Human Rights Commission and some members of the Government’s own advisory Bioethics Table. We would be please to assist you in any way in such a story.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

CTV News Online Report Updated by May 6, 2021

Originally posted at https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Medical Correspondent, CTV National News

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins, CTVNews.ca Writer

Contact @cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Networkemergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per dayby the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

intensive care admissions

As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

May 18, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

To: CTVNews

From: David Lepofsky

Date: May 18, 2021

I regret that I must write to again raised concerns about the factual inaccuracy of CTV News’ online April 28, 2021 news report regarding Ontario’s critical care triage protocol. On April 30, 2021, I wrote to alert you to the fact that there was a serious factual error in that report, where it stated the following:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.“

In my April 30, 2021 email to CTV news, I explained that contrary to what CTV reported, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports. That is disability discrimination.

I very much appreciate that as a result, CTV reporter Avis Favaro spoke to me about this issue and that CTV news looked into our objection.

As a result, CTV News made two changes to the online CTV News report, on or around May 6, 2021. I regret that the first of those changes included a serious factual inaccuracy. The first change was simply to add the word “pre-existing” before the word “disabilities” in the inaccurate statement in the original April 28, 2021 CTV news report. Report’s The revised statement now reads:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

Second, the May 6, 2021 version later adds this accurate sentence:

“Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.”

It is good that CTV attempted to correct it’s inaccurate April 28, 2021 news report. However, CTV has replaced one serious inaccuracy with another serious inaccuracy. The January 13, 2021 Critical Care Triage Protocol does not specify that “people with disabilities” are not treated any differently than the rest of the population (as the inaccurate April 28, 2021 report originally claimed) or that people with pre-existing disabilities are not treated any differently than others (as the May 6, 2021 revision to that article claims. To the contrary, under that critical care triage protocol, if a cancer patient with pre-existing cancer needs critical care, they will be deprioritized if a patient is “Completely disabled and cannot carry out any self-care; totally confined to bed or chair”. That is disability discrimination, up front. Under that protocol, if a patient needing critical care is over 65 and has a progressive pre-existing disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. That too is disability discrimination, pure and simple, including disability discrimination based on a pre-existing disability. CTV’s insertion of the word “pre-existing” into the inaccurate statement did not reduce or correct its complete and demonstrable inaccuracy.

I would add that unless I am mistaken or missed something, nothing on the CTV web page displaying this report acknowledges that there previously was a factual inaccuracy in it. In contrast, newspapers regularly print corrections to earlier stories, that are entitled “correction”, to ensure that the reader is aware that an earlier report had been inaccurate. No one reading the original April 28, 2021 story would know that it was erroneous. No one reading the same report, as revised on or around May 6, 2021, would know that CTV had attempted to correct it. Of course, no one would know from that report that it is inaccurate where it states as a fact that under the protocol, people with pre-existing disabilities are to be treated like everyone else.

We would very much appreciate this story being corrected so that it is accurate. We also would again encourage CTV to run a story that reports specifically on this disability discrimination issue that is anchored in the very wording of the January 13, 2021 Critical Care Triage Protocol. Ontario is not out of the woods, even though ICU cases and overall new COVID-19 cases are reducing. This remains a live issue for your viewers and readers, including the many with disabilities. The newsworthiness of this disability discrimination standing alone is important. The inaccuracy on the CTV website makes the case for a further report even more compelling.

We would be delighted to assist in any way we can. Please stay safe.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance Twitter: @davidlepofsky

May 19, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

Thank you for asking what correction or clarification to the April 28, 2021 CTV News story we would recommend. We respectfully propose that the sentence that requires a change is this:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

May we propose two alternatives. The first and preferable alternative would read:

“The triage guidelines do not ensure that people with pre-existing disabilities are not treated any differently than the rest of the population. Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

The second and less desirable alternative would be to simply delete the inaccurate words “The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but”. The paragraph would therefore read

“Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

You asked for a link to the AODA Alliance website. We again offer two alternatives. The more specific link to our report that exhaustively details the disability discrimination in the Ontario critical care triage protocol is https://www.aodaalliance.org/whats-new/a-deeply-troubling-issue-of-life-and-death-an-independent-report-on-ontarios-seriously-flawed-plans-for-rationing-or-triage-of-critical-medical-care-if-covid-19-overwhelms-ontario-hospitals/

The more general link to all our posts on this issue is www.aodaalliance.org/healthcare

We Hope this helps. If a phone call would assist, let me know.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

CTV News Online Report As Revised Again on May 19, 2021

Originally posted at: jhttps://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

CTV News

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Avis Favaro, Medical Correspondent

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins , CTVNews.ca Writer

Contact @cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

Last Updated Wednesday, May 19, 2021 9:14AM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

Related Links

Accessibility for Ontarians with Disabilities Act Alliance on triage protocols

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

Preston is skeptical of the triage guidelines in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

Correction:

A previous version of this story suggested triage guidelines



Source link

With CBC’s Strong Commitment to Diversity and Equity in Its Programming, Why Won’t Its Flagship National Radio Program “The Current” Cover Disability Discrimination Dangers in Critical Care Triage Plans During the COVID-19 Pandemic?


Accessibility for Ontarians with Disabilities Act Alliance Update

United for a Barrier-Free Society for All People with Disabilities

Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

With CBC’s Strong Commitment to Diversity and Equity in Its Programming, Why Won’t Its Flagship National Radio Program “The Current” Cover Disability Discrimination Dangers in Critical Care Triage Plans During the COVID-19 Pandemic?

June 7, 2021

            SUMMARY

Who watches the watchers? The AODA Alliance has had to do so, when it comes to monitoring media coverage or lack of coverage of the danger since the start of the COVID-19pandemic of disability discrimination in access to life-saving critical care in Ontario hospitals.

Since this danger was first revealed by disability advocates in early April 2020, we and others have been trying hard to get the media to cover this story. From the start, it has had all the hallmarks of a compelling news and public affairs story that is immediate, important and interesting. It has serious ramifications for millions of vulnerable people.

It is a life-and-death topic. It deals with secret Government policies and plans. It raises important human rights issues. Media scrutiny is an important way to hold public officials accountable.

For over a year, it has been an extremely uphill battle to get the media to cover this story. After months of effort, we managed to get some good local and national coverage in recent weeks. That shows how newsworthy it is. Yet the difficulties in even belatedly getting that coverage is itself worthy of attention and scrutiny.

The media often portrays itself as the public’s watchdog, but who watches the watchers? We offer an important illustration in this update.

As a powerful example, CBC’s flagship current affairs radio program “The Current” has refused to cover this story. That program has a great track record on diversity issues, such as those relating to women, Indigenous Peoples, racialized communities, and LGBT issues. It has chronically had a far worse record on covering disability issues. Its stated reasons for refusing to cover this story, documented below in an email from its executive producer to AODA Alliance Chair David Lepofsky, are transparently unpersuasive. One is left wondering what is really going on there. Read on.

In pointing to this example, we acknowledge with thanks that a number of news organizations have covered the issue of disability discrimination in Ontario’s critical care triage plans. Moreover, a number of journalists have tried to get their own media organizations to cover this issue, only to run into disturbing resistance. Moreover, some other CBC programs later did cover this story, though some gave it lesser or no examination.

This critical care triage issue remains a current story (pun intended). The Current should cover it, as should other news and public affairs programs that have not yet looked into it. Even with infection rates dropping in Ontario, there has still been no proper public accounting for the disability discrimination that has been embedded in Ontario hospitals and potentially in emergency ambulance services. With the pandemic’s surge in Manitoba, people with disabilities there now face the same dangers that Ontarians with disabilities have feared for months.

CBC at all levels needs to now carefully investigate and reflect upon its own troubling track record on covering disabilities issues, as it is serious failure to meet CBC’s commendable public commitment to diversity and equity in its coverage. This Update provides one stark and clear illustration of this broader failure. By this we don’t mean that CBC never covers disability issues. Rather, its attention to them pales in comparison to its coverage of other equity and diversity perspectives, as this Update’s example exemplifies.

To learn more about this issue, and to read the media coverage that we have managed to secure, check out the AODA Alliance’s health care page. You can also watch our newest captioned video on the critical care triage issue, which has been seen over 1,000 times in its first four weeks online.

 More Details

 1. The Current Is Certainly Not Current When It Comes to Disability Issues

Some two years ago, when the previous host of CBC’s program The Current was soon to retire, CBC held focus groups to get input into the future of The Current. AODA Alliance Chair David Lepofsky was invited to take part in one of those focus groups, to offer a disability perspective on the program. In preparation for that focus group, Lepofsky conducted a detailed review of months of broadcasts of The Current.

At this focus group (which looked at The Current from a wide range of perspectives), Lepofsky explained that this excellent CBC public affairs program does a great job of fulfilling CBC’s important public commitment to diversity in its coverage when it comes to some equity-seeking groups, such as racialized communities, Indigenous Peoples, women and the LGBTQ+ community. However, it has a poor record of far less attention to disability issues. Equity for some is in reality equity for none. No one disputed the observation that CBC’s The Current program has not given disability issues the kind of attention that it has repeatedly given other equity-seeking groups.

Sadly, nothing has significantly improved at The Current since that focus group two years ago, from the disability perspective. This is so even though we have sent the program any number of story ideas both before and after that focus group session.

The Current’s failure to address the disability issues in critical care triage during the COVID-19pandemic at any time over the past 15 months is a blistering illustration of this systemic failure. That program has commendably covered the pandemic from a multitude of perspectives. AODA Alliance Chair David Lepofsky sent The Current’s executive producer Raj Ahluwalia a detailed email on January 4, 2021, (set out below. It described this story idea, explained its importance, and offered to help the program look into it.

Raj Ahluwalia replied by email on January 5, 2021 (also set out below). He rejected the story as a topic for The Current. That rejection has never changed.

On January 8 and 18, 2021, AODA Alliance Chair David Lepofsky wrote him back (see below). He refuted The Current’s reasons for rejecting the story. Mr. Ahluwalia did not answer those emails. After this email exchange, The Current never reached out to the AODA Alliance to investigate the possibility of covering disability issues in critical care triage.

Raj Ahluwalia’s written reasons for rejecting this story are seriously flawed, both for reasons that David Lepofsky gave at the time, and in light of subsequent events. For example:

  1. Mr. Ahluwalia told us that the critical care triage topic is not suited for the format of The Current. Yet Just 13 days later, on January 18, 2021, The Current devoted a segment of its program to the critical care triage issue. Moreover, as David Lepofsky pointed out to Mr. Ahluwalia, TVO’s The Agenda with Steve Paikin, a very similar TV public affairs program, devoted a 30-minute segment on January 13, 2021 to the disability issues in critical care triage. If it is suitable for The Agenda, it is hard to see why it would be unsuitable for The Current.
  1. When The Current did discuss the critical care triage issue on its January 18, 2021 program, it did not include any disability experts or advocates. It only included physicians. The host Matt Galloway had a great record covering disability issues earlier when he had been the host of CBC’s Toronto radio program Metro Morning. However, in this edition of The Current, he asked no questions of the physicians he interviewed, that raised any of disability issues.
  1. Mr. Ahluwalia wrote on January 5, 2021 that the disability critical care triage issue was not suitable because it was hypothetical i.e. No one had died from a critical care triage decision. Yet that reason did not stop The Current from interviewing physicians about critical care triage just 13 days later on its January 18, 2021 program. Moreover, as David Lepofsky pointed out to Mr. Ahluwalia, The Current has elsewhere covered hypothetical topics.

We point to this example not to single out this one senior, very experienced CBC executive. Rather, we point it out because it is the best, and possibly the only example where a refusal to cover this important disability issue is based on reasons that were put in writing for us. When the reasons given are so transparently unconvincing, one is left to wonder whether there were other reasons at play, even unconsciously.

We urge CBC at the highest levels to look into this, and to consider why it has failed to live up to its commitment to diversity in its coverage in the disability context, especially when it has done so much better at implementing its diversity goals for certain other equity seeking groups. We are encouraged that CBC weeks later gave more coverage on some other programs to the disability-related critical care triage issue. However, that coverage was the product of months and months of efforts by us and others to get CBC to cover it at all.

As stated earlier, equity for some is equity for none. Diversity for some, is diversity for none. Equality for some is equality for none. It merely replaces and old hierarchy with a new one. In the new one, just as in the old one, those left at or near the bottom, like people with disabilities, remain wrongly languishing at the bottom.

 2. January 4, 2021 Email from AODA Alliance Chair David Lepofsky to CBC The Current Executive Producer Raj Ahluwalia

Happy new year Raj! In a nutshell, the story I’m proposing is summarized in the news release set out below. We can supply it to your program based on on-the-record and publicly-posted sources and multiple on-the-record people.

The issue is this: If the surging pandemic exceeds hospital capacity to provide life-saving critical care to all the patients who need it, who will be refused that care, and thus, who will die from a lack of health care? Who will decide who will be denied that care? What rules or standard will govern that life-and-death decision? Will there be any independent check is in place to protect patients, like an independent appeal process? Is there any foundation in law for any of this to take place in Ontario?

This is an important issue now. South of the border, NPR has done excellent investigative work revealing terrifying and appalling disability-based discrimination in access to critical care. Check out https://www.npr.org/2020/12/21/946292119/oregon-hospitals-didnt-have-shortages-so-why-were-disabled-people-denied-care

People with disabilities are already fearful of going to hospital, even if no critical care triage is now going on, because they fear the danger of being de-prioritized now or in the near future.

We and other disability advocates have been waging an incredibly frustrating uphill battle on this issue for months. In the past weeks, it has gotten very little media coverage, including from CBC. We have no idea why. On the rare occasion that an opposition MPP or reporter probes the Ford Government on this issue, the Government scrambles, dodges or prevaricates. The whole record on this is available to you at

www.aodaalliance.org/healthcare

People with disabilities are especially vulnerable here. They are disproportionately bearing the brunt of COVID-19 and are disproportionately dying from it. It would be a cruel irony indeed for them, of all people, to be exposed to the risk of disability-based discriminatory critical care triage. Happy to fill in the details any time. … Please do not leave any voice mails on that number.

****

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

NEWS RELEASE – FOR IMMEDIATE RELEASE

Just-Revealed Previously Secret Recommendations for Rationing Critical Medical Care in Ontario that the Ford Government is Considering Are Frightening for People with Disabilities

December 21, 2020 Toronto: Could it soon be that if COVID-19 overwhelms Ontario hospitals, doctors could be told to decide to select some critical care patients to be taken off life-saving critical care that the patients are receiving, still need and want, on the ground that these services must be rationed and given to some other patients? Could a patient who objects to critical care being withdrawn from them be denied a right of appeal to an independent court or tribunal, even though their life is endangered? Could the health professionals making such decisions be insulated from any liability for their actions?

Despite excitement over new vaccines, frightening unreported new details have emerged that would allow all of this to happen, if the record-breaking surge in COVID-19 cases requires hospitals to ration or “triage” life-saving critical care services and beds. The Ford Government is considering a recommendation, made public on the AODA Alliance website, to direct doctors to remove life-saving critical care from some patients already in intensive care who don’t consent to this, if triage becomes necessary. This is even worse than rationing scarce unfilled critical care beds when more patients need them than there are available services.

“Ford’s Government hasn’t shown it has legislative authority to take the drastic, highly-objectionable actions that it is considering,” said David Lepofsky, Chair of the non-partisan AODA Alliance that allies with other disability advocates to protect patients with disabilities against discrimination if triage becomes necessary. “Triage recommendations that Ford’s Government is considering just came to light in the past days, and only because disability advocates campaigned for three months to get the Government to reveal those secret recommendations.”

In those newly revealed September 11, 2020 recommendations, the Government’s external advisory Bioethics Table commendably called on the Government to rescind the Government’s controversial earlier March 28, 2020 critical triage protocol that it had sent Ontario hospitals last spring, because that protocol discriminated against patients based on their disabilities – a concern disability advocates have pressed since April. But last Thursday, at a rushed roundtable that the Ontario Human Rights Commission held with disability, racialized and Indigenous communities’ representatives, those community representatives said the newly revealed triage recommendations, while an improvement, also have numerous human rights problems, even though the recommendations say that human rights should be respected.

These new triage recommendations would give patients, whose lives are in jeopardy, no appeal beyond the health care system (e.g., to an independent tribunal or court). They would insulate health care professionals against liability for refusing or withdrawing life-saving critical care.

On October 29, 2020, the Government, under pressure from people with disabilities and seniors, belatedly rescinded its discriminatory March 28, 2020 triage protocol, but put nothing in place to fill the vacuum. The time when critical care triage may be needed is rapidly getting closer. Health Minister Christine Elliott hasn’t answered any of the six successive AODA Alliance letters to her extensively detailing our concerns.

At last Thursday’s roundtable, a Government representative spoke up for the first time, revealing more disturbing news. A member of the Ford Government’s internal “Critical Care Command Table” responded to feedback at the roundtable, saying that a new approach to triage, addressing human rights concerns raised at the roundtable (with which he seemed to find merit), would have to wait until after this pandemic is over.

“That’s like saying we can be given an umbrella only after the rain has stopped. After months of the Government delaying, refusing to talk to us, and hiding behind its external advisory Bioethics Table for months, we cannot accept that it is now too late to ensure that critical care triage, if necessary, cannot be done without disability discrimination,” said Lepofsky. “We need the Ford Government to speak directly to us, and to obey the Ontario Human Rights Code and Charter of Rights.”

Contact: AODA Alliance Chair David Lepofsky, [email protected]

For more background on this issue, check out:

  1. The Government’s external advisory Bioethics Table’s September 11, 2020 draft critical care triage protocol, finally revealed days ago.
  2. The December 3, 2020 open letter to the Ford Government from 64 community organizations, calling for the Government to make public the secret report on critical care triage from the Government-appointed Bioethics Table.
  3. The AODA Alliance’s unanswered September 25, 2020 letter, its November 2, 2020 letter, its November 9, 2020 letter, its December 7, 2020 letter, its December 15, 2020 letter and its December 17, 2020 letter to Health Minister Christine Elliott.
  4. The August 30, 2020 AODA Alliance submission to the Ford Government’s Bioethics Table, and a captioned online video of the AODA Alliance’s August 31, 2020 oral presentation to the Bioethics Table on disability discrimination concerns in critical care triage.
  5. The September 1, 2020 submission and July 20, 2020 submission by the ARCH Disability Law Centre to the Bioethics Table.
  6. The November 5, 2020 captioned online speech by AODA Alliance Chair David Lepofsky on the disability rights concerns with Ontario’s critical care triage protocol.
  7. The AODA Alliance website’s health care page, detailing its efforts to tear down barriers in the health care system facing patients with disabilities, and our COVID-19 page, detailing our efforts to address the needs of people with disabilities during the COVID-19 crisis.

 3. January 5, 2021 Email from CBC The Current’s Executive Producer Raj Ahluwalia to AODA Alliance Chair David Lepofsky

Thanks for bringing it to my attention.

I’ve looked through some of what you’ve included here. And while I appreciate and understand your concerns and see that there may be a news story here but it doesn’t work for The Current.

Please allow me to explain.

The situation you describe is hypothetical. Unless there is an actual case of someone, disabled or not, who’s denied care in this manner, I have a hard time “seeing” where a story could editorially go.

I’m also not keen in comparing much from the U. S healthcare system with that of Canada’s. That’s not to say that we’re better than them, it’s just that

the systems are so different that any comparisons are inaccurate.

As you may know our stories run anywhere from 12-to 20-minutues, usually through a series of interviews. And unless there were to be an actual case, as I mentioned, any real discussion of the issues you bring up won’t sustain that length of time on our program.

I will, however, keep your suggestions in mind should there be such a case.

 4. January 8, 2021 Email from AODA Alliance Chair David Lepofsky to CBC The Current’s Executive Producer Raj Ahluwalia

Thank you for taking the time to explain why you do not consider the critical care triage story to be appropriate now for The Current. Exceptional as this may be, may I invite you to reconsider.

You said this story is hypothetical until triage of critical care actually takes place, leading a person to die from a refusal of critical care. Yet this issue is not hypothetical.

The top story on CBC national radio’s January 5, 2021 “The World at 6” (within hours of your writing me) reported that in some Ontario cities, intensive care units are full and tents are being erected. The first line of that newscast reported that the health care system is stretched beyond capacity. It reported that urgent measures are being taken because the system reached the breaking point. Moreover, the US mainstream media is reporting that critical care triage is in fact happening in some US venues.

It is therefore not hypothetical that our society and health care system must ensure that it is ready to administer critical care triage in this pandemic, even if such triage has not taken place. It is not hypothetical that this is a difficult issue and that Ontario has no prior experience triaging life-saving critical care.

It is not hypothetical that the Ontario Government had a secret protocol prepared last spring for this very purpose. It is not hypothetical that the Government was eventually driven to rescind that protocol just weeks ago. It is not hypothetical that it was only rescinded after it was criticized as disability-discriminatory by disability advocates, by the Ontario Human Rights Commission and, eventually, by the very Bioethics Table that initially designed it.

It is not hypothetical that the Government has not announced a new protocol, and that it has been very secretive about this issue. The Government has not answered any of our letters this fall raising such concerns. It is similarly not hypothetical that some people with disabilities are afraid to seek out the health care system, for fear that they could end up being the victims of triage.

In any event, even if it were hypothetical, this should not be a reason to consider this story inappropriate for The Current. The Current has covered issues that are, by your terms, clearly hypothetical. On December 10, 2020, your program aired an item entitled: “Trump Could Push Baseless Election Cheating Claims Well Past Inauguration, Says Journalist.” Of course, that was an important topic to cover. However, by your definition of “hypothetical”, that story should not have run until after inauguration, and until Trump actually repeats his baseless claims at that time.

This story is well-suited for your program’s format, with which I, as a listener, am well familiar. Your program does not inflexibly always require an initial interview with a victim before an important issue is addressed. This meaty issue can fill your typical program time allocation with a great deal still left unaddressed. Ontario’s flagship provincial public affairs program, “The Agenda with Steve Paikin” aired a 26 minute item on the issue (with no disability advocates) back on April 14, 2020 that ran for a full 26minutes https://www.tvo.org/video/deciding-who-lives-ethics-in-a-pandemic

There is much more to say about the subject now, more than 8 months later. As one example, look at the coverage that has just gone online from one local Mississauga online publication, https://thepointer.com/article/2021-01-08/already-in-crisis-mode-ontario-hospitals-have-no-protocol-for-who-gets-priority-treatment-human-rights-advocates-say

There are a number of people on different sides of this issue worth speaking to. We would be happy to assist your program in learning about those issues and seeking out people with whom to speak.

We regret that CBC news has, until now, not covered our issues that we have raised for months on this issue, despite numerous news releases, and tweets directed at CBC. As Canada’s public broadcaster, its failure to do so is troubling and puzzling.

We will continue to try to raise this with CBC news, but it remains a story that is extremely well-suited for The Current. Please let me know if you might reconsider, and if we can help.”

 5. January 18, 2021 Email from AODA Alliance Chair David Lepofsky to CBC The Current’s Executive Producer Raj Ahluwalia

Dear Raj,

It is good that The Current today included a discussion of the COVID-19 critical care triage issue, as this is an immediate and important story. The item included a discussion with two doctors expressing their views and concerns on this issue.

Could your program now consider including a discussion of this issue from the perspective of people with disabilities? That would provide a much-needed balanced look at it, especially since we have identified and documented serious disability human rights concerns with Ontario’s brand new secret triage protocol (one which we have posted on line). It is vital that this issue not be seen or treated as some preserve of doctors and bioethicists. People with disabilities are disproportionately bearing the hardships of COVID-19 and its harshest impact. They are at risk of the cruel irony of facing discriminatory deprioritization if they need critical care, once triage begins.

Two years ago, CBC invited me to take part in a focus group on the future of The Current. At that meeting, I detailed how The Current does an excellent job of addressing a spectrum of important issues on the issue of diversity from the perspective of a number of equality-seeking groups, for which it should be strongly commended. However, it is far weaker at covering important disability issues.

For you to get a good sense of how this story merits the disability perspective, and not just the medical/bioethics perspective, please check out the panel on which I participated last Wednesday on The Agenda with Steve Paikin, available at https://www.youtube.com/watch?v=qkq1NmaXLwk&feature=youtu.be

I’d be happy to do whatever I can to assist your program.

Stay safe.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance



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In a Detailed Report Card Delivered During National AccessAbility Week, the Ford Government Gets a Blistering “F” Grade for Its Three Year Record Since Taking Office on Action to Make Ontario Accessible for 2.6 Million Ontarians with Disabilities


ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

NEWS RELEASE – FOR IMMEDIATE RELEASE

In a Detailed Report Card Delivered During National AccessAbility Week, the Ford Government Gets a Blistering “F” Grade for Its Three Year Record Since Taking Office on Action to Make Ontario Accessible for 2.6 Million Ontarians with Disabilities

May 31, 2021 Toronto: During National AccessAbility Week, the non-partisan grassroots AODA Alliance releases a report card (set out below) on the Ford Government’s record for tearing down the barriers that people with disabilities face, awarding the Government an “F” grade.

When he was campaigning for votes in the 2018 election, Doug Ford said that our issues “are close to the hearts of our Ontario PC Caucus” and that:

“Too many Ontarians with disabilities still face barriers when they try to get a job, ride public transit, get an education, use our healthcare system, buy goods or services, or eat in restaurants.”

Yet three years after taking office, people with disabilities are no better off, and in some important ways, are worse off, according to today’s new report card. Passed unanimously in 2005, the Accessibility for Ontarians with Disabilities Act requires the Ontario Government to lead this province to become accessible to people with disabilities by 2025. Ontario is nowhere near that goal with under four years left. The Ford Government has no effective plan to meet that deadline.

This report card’s key findings include:

  1. The Ford Government has no comprehensive plan of action on accessibility, 851 days after receiving the Report of David Onley’s AODA Independent Review.
  1. The Government has not ensured that public money will never be used to create new accessibility barriers.
  1. The Ford Government has failed to enact or strengthen any accessibility standards under the AODA.

 

  1. The Ford Government has announced no new action to effectively ensure the accessibility of public transportation.

 

  1. The Ford Government imposed substantial and harmful delays in the work of Five important AODA Standards Development Committees that was underway before the Government took office.

 

  1. The Ford Government has repeatedly violated its mandatory duty under the AODA to make public the initial or final recommendations of a Government-appointed Standards Development Committee “upon receiving” those recommendations.

 

  1. The Ford Government has failed for 3 years to fulfil its mandatory duty to appoint a Standards Development Committee to review the Public Spaces Accessibility Standard.

 

  1. The Ford Government has made public no detailed plan for effective AODA enforcement.

 

  1. In a waste of public money, the Ford Government diverted 1.3 million dollars into the Rick Hansen Foundation’s controversial private accessibility certification process. This has resulted in no disability barriers being removed or prevented.

 

  1. The Ford Government unfairly burdened Ontarians with disabilities with having to fight against new safety dangers being created by municipalities allowing electric scooters.

 

  1. The Ford Government’s rhetoric has been harmfully diluting the AODA’s goal of full accessibility.

 

  1. The Ford Government has given public voice to false and troubling stereotypes About disability accessibility.

 

  1. The Ford Government has failed to effectively address the urgent needs of Ontarians with disabilities during the COVID-19 pandemic.

 

  1. The lives of vulnerable Ontarians with disabilities are endangered by the Ford Government’s secret plans for critical care triage during the COVID-19 pandemic, If hospitals cannot serve All critical care Patients.

“We keep offering the Ford Government constructive ideas, but too often, they are disregarded,” said David Lepofsky, chair of the AODA Alliance which campaigns for accessibility for people with disabilities. “Premier Ford hasn’t even met with us, and has turned down every request for a meeting.”

AODA Alliance Chair David Lepofsky has had to resort to a court application (now pending) to get the Ford Government to fulfil one of its important duties under the AODA, and a Freedom of Information application to try to force the Ford Government to release its secret plans for critical care triage if the COVID-19pandemic worsens, requiring rationing of critical care.

Contact: AODA Alliance Chair David Lepofsky, [email protected]

Twitter: @aodaalliance

 A Report Card on the Ford Government’s Record, After Three Years in Office, on Achieving Disability Accessibility

May 31, 2021

Prepared by the AODA Alliance

 Introduction

This year’s National AccessAbility Week takes place when Ontario’s Ford Government is completing its third year of a four year term in office. This is an especially appropriate time to take stock of how well the Ford Government is doing at advancing the goal of making Ontario accessible to people with disabilities by 2025, the deadline which the Accessibility for Ontarians with Disabilities Act enshrines in Ontario law.

It is with a strong sense of frustration that we award the Ford Government a failing “F” grade for its record on this issue.

The Ontario Public Service includes quite a number of public officials who are deeply and profoundly dedicated to the goal of tearing down barriers impeding people with disabilities, and preventing the creation of new disability barriers. They have commendably found quite a number of willing partners within the disability community (both individuals and disability organizations), and among obligated organizations in the public and private sectors. These partners are also committed to the goal of accessibility, and have in their spheres of influenced tried to move things forward. To all these people we and people with disabilities generally are indebted.

For example, several Standards Development Committees have been appointed under the AODA to craft recommendations on what enforceable AODA accessibility standards should include to be strong and effective. They have invested many hours, trying to come up with workable recommendations.

As well, over the past three years, the Ontario Government has continued to operate voluntary programs that have existed for years to contribute to the goal of accessibility. The Ford Government has also, we believe, improved things by freeing its Standards Development Committees from excessive involvement by Public Service staff. This has enabled those staff to support the work of those committees, while leaving them free to do their own work, devising recommendations for the Government.

However, all of that cannot succeed in bringing Ontario to the goal of an accessible province by 2025, without strong leadership by the Ontario Government and those who steer it. This has been the conclusion of three successive Independent Reviews, conducted under the AODA, by Charles Beer in 2010, by Mayo Moran in 2014 and by David Onley in 2018.

Over the past three years, we regret that that leadership has continued to be lacking. The result is that Ontario is falling further and further behind the goal of an accessible province by 2025. Less and less time is available to correct that.

This report details several of the key ways that the Ontario Government has fallen far short of what Ontarians with disabilities need. As the Government’s mandatory annual report on its efforts on accessibility back in 2019 reveals, the Government’s prime focus has been on trying to raise awareness about accessibility. As has been the Ontario Government’s practice for years, that 2019 annual report was belatedly posted on line on the eve of the 2021 National AccessAbility Week, two years after many of the events reported in it.

Decades of experience, leading to the enactment of the AODA in 2005, has proven over and over that such awareness-raising and voluntary measures won’t get Ontario to the goal of accessibility by 2025, or indeed, ever. As always, the AODA Alliance, as a non-partisan coalition, remains ready, willing, able, and eager to work with the Government, and to offer constructive ideas on how it can change course and fulfil the AODA’s dream that the Legislature unanimously endorsed in May 2005.

1. The Ford Government Has No Comprehensive Plan of Action on Accessibility, 851 Days After Receiving the Report of David Onley’s AODA Independent Review

We have been urging the Ford Government to develop a detailed plan on accessibility since shortly after it took office, to lay out how it will get Ontario to the AODA’s mandatory goal of becoming accessible to people with disabilities by 2025. It has never done so.

In December 2018, the Ford Government said it was awaiting the final report of former Lieutenant Governor David Onley’s Independent Review of the AODA’s implementation and enforcement, before deciding what it would do regarding accessibility for people with disabilities. On January 31, 2019, the Government received the final report of the David Onley Independent Review of the AODA’s implementation and enforcement. Minister for Accessibility Raymond Cho publicly said on April 10, 2019 that David Onley did a “marvelous job.”

The Onley report found that Ontario is still full of “soul-crushing” barriers impeding people with disabilities. It concluded that progress on accessibility has taken place at a “glacial pace.” It determined that that the goal of accessibility by 2025 is nowhere in sight, and that specific new Government actions, spelled out in the report, are needed.

However, in the 851 days since receiving the Onley Report, the Ford Government has not made public a detailed plan to implement that report’s findings and recommendations. The Government has staged some media events with the Accessibility Minister to make announcements, but little if anything new was ever announced. The Government repeated pledges to lead by example on accessibility, and to take an all-of-Government approach to accessibility. But these pledges were backed by nothing new to make them mean anything more than when previous governments and ministers engaged in similar rhetorical flourishes.

2. The Government Has Not Ensured that Public Money Will Never Be Used to Create New Accessibility Barriers

In its three years in office, we have seen no effective action by the Ford Government to ensure that public money is never used to create new disability barriers or to perpetuate existing barriers. The Ontario Government spends billions of public dollars on infrastructure and on procuring goods, services and facilities, without ensuring that no new barriers are thereby created, and that no existing barriers are thereby perpetuated.

As but one example, last summer, the Ford Government announced that it would spend a half a billion dollars on the construction of new schools and on additions to existing schools. However, it announced no action to ensure that those new construction projects are fully accessible to students, teachers, school staff and parents with disabilities. The Ontario Ministry of Education has no effective standards or policies in place to ensure this accessibility, and has announced no plans to create any.

3. The Ford Government Has Enacted or Strengthened No Accessibility Standards

In its three years in power, the Ford Government has enacted no new AODA accessibility standards. It has revised no existing accessibility standards to strengthen them. It has not begun the process of developing any new accessibility standards that were not already under development when the Ford Government took office in June 2018.

As one major example, the Ford Government has not committed to develop and enact a Built Environment Accessibility Standard under the AODA, to ensure that the built environment becomes accessible to people with disabilities. No AODA Built Environment Accessibility Standard now exists. None is under development.

This failure to act is especially striking for two reasons. First, the last two AODA Independent Reviews, the 2014 Independent Review by Mayo Moran and the 2019 Independent Review by David Onley, each identified the disability barriers in the built environment as a priority. They both called for new action under the AODA. Second, when he was seeking the public’s votes in the 2018 Ontario election, Doug Ford made specific commitments regarding the disability barriers in the built environment. Doug Ford’s May 15, 2018 letter to the AODA Alliance, setting out his party’s election commitments on disability accessibility, included this:

  1. a) “Your issues are close to the hearts of our Ontario PC Caucus and Candidates, which is why they will play an outstanding role in shaping policy for the Ontario PC Party to assist Ontarians in need.”
  1. b) “Whether addressing standards for public housing, health care, employment or education, our goal when passing the AODA in 2005 was to help remove the barriers that prevent people with disabilities from participating more fully in their communities.”
  1. c) “Making Ontario fully accessible by 2025 is an important goal under the AODA and it’s one that would be taken seriously by an Ontario PC government.”
  1. d) “This is why we’re disappointed the current government has not kept its promise with respect to accessibility standards. An Ontario PC government is committed to working with the AODA Alliance to address implementation and enforcement issues when it comes to these standards.

Ontario needs a clear strategy to address AODA standards and the Ontario Building Code’s accessibility provisions. We need Ontario’s design professionals, such as architects, to receive substantially improved professional training on disability and accessibility.”

4. The Ford Government Has Announced No New Action to Effectively Ensure the Accessibility of Public Transportation

Just before the 2018 Ontario election, the Ontario Government received the final recommendations for reforms to the Transportation Accessibility Standard from the AODA Transportation Standards Development committee. Since then, and over the ensuing three years in office, the Ford Government announced no action on those recommendations. It has not publicly invited any input or consultation on those recommendations. At the same time, the Ford Government has made major announcements about the future of public transit infrastructure in Ontario. As such, barriers in public transportation remained while the risk remains that new ones will continue to be created.

 5. The Ford Government Imposed Substantial and Harmful Delays in the Work of Five Important AODA Standards Development Committees that was Underway Before the Government Took Office

When the Ford Government won the 2018 Ontario election, the work of five AODA Standards Development Committees were all frozen, pending the new Minister for Accessibility getting a briefing. Any delay in the work of those committees would further slow the AODA’s sluggish implementation documented in the Onley Report.

Those Standards Development Committees remained frozen for months, long after the minister needed time to be briefed. We had to campaign for months to get that freeze lifted.

Over four months later, in November 2018, the Ford Government belatedly lifted its freeze on the work of the Employment Standards Development Committee and the Information and Communication Standards Development Committee. However it did not then also lift the freeze on the work of the three other Standards Development Committees, those working on proposals for accessibility standards in health care and education.

We had to keep up the pressure for months. The Ford Government waited until March 7, 2019 before it announced that it was lifting its freeze on the work of the Health Care Standards Development Committee and the two Education Standards Development Committees. It was as long as half a year after that announcement that those three Standards Development Committees finally got back to work.

In the meantime, the many unfair disability barriers in Ontario’s education system and Ontario’s health care system remained in place, while new ones continued to be created. The final enactment of new accessibility standards in the areas of health care and education was delayed commensurately, as was the enactment of revisions to strengthen Ontario’s 2011 Information and Communication Accessibility Standard and Ontario’s 2011 Employment Accessibility Standard.

6. The Ford Government Has Repeatedly Violated Its Mandatory Duty Under the AODA to Make Public the Initial or Final Recommendations of a Government-Appointed Standards Development Committee “Upon Receiving” Those Recommendations

Section 10(1) of the AODA requires the Government to make public the initial or final recommendations that it receives from a Standards Development Committee, appointed under the AODA “upon receiving” those recommendations. The Ontario Government under successive governments and ministers has wrongly taken the approach that it can delay making those recommendations public for months despite the AODA‘s clear, mandatory and unambiguous language.

The Ford Government has certainly taken this troubling approach. It delayed some two years before making public the final recommendations of the Employment Standards Development Committee earlier this year. It delayed some six months before making public the final recommendations of the Information and Communication Standards Development Committee last year. It delayed over five months before making public the initial recommendations of the Health Care Standards Development Committee earlier this month. It has delayed over two months so far in making public the initial recommendations of the K-12 Education Standards Development Committee and Post-Secondary Education Standards Development Committee.

As a result, AODA Alliance Chair David Lepofsky has brought a court application, now pending, to seek an order compelling the Ford Government to obey the AODA. This is especially disturbing, because the Government is leading by such a poor example when it comes to the AODA. Its delay in complying with s. 10 of the AODA slows the already-slow process of developing and enacting or revising accessibility standards under the AODA.

7. The Ford Government Has for 3 Years Failed to Fulfil Its Mandatory Duty to Appoint A Standards Development Committee to Review the Public Spaces Accessibility Standard

The AODA required the Ontario Government to appoint a Standards Development Committee to review the Public Spaces Accessibility Standard by the end of 2017. Neither the previous Wynne Government nor the current Ford Government have fulfilled this legal duty. This is a mandatory AODA requirement.

The Ford Government has had three years in office to learn about this duty and to fulfil it. We flagged it for the Government very soon after it took office in 2018.

8. The Ford Government Has Made Public No Detailed Plan for Effective AODA Enforcement

During its three years in office, the Ford Government has announced no public plan to substantially strengthen the AODA’s weak enforcement. Three years ago, the Ford Government inherited the previous McGuinty Government’s and Wynne Government’s multi-year failure to effectively and vigourously enforce the AODA. What little enforcement that took place fell far short of what people with disabilities needed, as is confirmed in both the 2015 Moran Report and the 2019 Onley Report. The failure to effectively enforce the AODA has contributed to Ontario falling so far behind the goal of becoming accessible to people with disabilities by 2025.

 

9. In a Waste of Public Money, the Ford Government Diverted 1.3 Million Dollars into the Rick Hansen Foundation’s Controversial Private Accessibility Certification Process

The only significant new action that the Ford Government has announced on accessibility over its first three years in office was its announcement over two years ago in the April 11, 2019 Ontario Budget that it would spend 1.3 million public dollars over two years to have the Rick Hansen Foundation’s private accessibility certification process “certify” some 250 buildings, belonging to business or the public sector, for accessibility. In two years, this has not been shown to lead to the removal or prevention of a single barrier against people with disabilities anywhere in the built environment. It has predictably been a waste of public money.

The Ford Government did not consult the AODA Alliance or, to our knowledge, the disability community, before embarking on this wasteful project. It ignored serious concerns with spending public money on such a private accessibility certification process. These concerns have been public for well over five years. The Ford Government gave no public reasons for rejecting these concerns.

A private accessibility certification risks misleading the public, including people with disabilities. It also risks misleading the organization that seeks this so-called certification. It “certifies” nothing.

A private organization might certify a building as accessible, and yet people with disabilities may well find that the building itself, or the services offered in the building, still have serious accessibility problems. Such a certification provides no defence to an accessibility complaint or proceeding under the AODA, under the Ontario Building Code, under a municipal bylaw, under the Ontario Human Rights Code, or under the Canadian Charter of Rights and Freedoms.

If an organization gets a good -level accessibility certification, it may think they have done all they need to do on accessibility. The public, including people with disabilities, and design professionals may be misled to think that this is a model of accessibility to be emulated, and that it is a place that will be easy to fully access. This can turn out not to be the case, especially if the assessor uses the Rick Hansen Foundation’s insufficient standard to assess accessibility, and/or if it does not do an accurate job of assessing the building and/or if the assessor’s only training is the inadequate short training that the Rick Hansen Foundation created.

For example, the Ford Government got the Rick Hansen Foundation to certify as accessible the huge New Toronto Courthouse now under construction. Yet we have shown that its plans are replete with serious accessibility problems. The Rick Hansen Foundation’s assessor never contacted the AODA Alliance to find out about our serious concerns with the courthouse’s design before giving it a rating of “accessible.”

The Rick Hansen Foundation’s private accessibility certification process lacks much-needed public accountability. The public has no way to know if the private accessibility assessor is making accurate assessments. It is not subject to Freedom of Information laws. It operates behind closed doors. It lacks the kind of public accountability that applies to a government audit or inspection or other enforcement. For more details on the problems with private accessibility certification processes, read the AODA Alliance’s February 1, 2016 brief on the problems with publicly funding any private accessibility certification process.

10. The Ford Government Unfairly Burdened Ontarians with Disabilities with Having to Fight Against New Barriers Being Created by Municipalities Allowing Electric Scooters

It is bad enough that the Ford Government did too little in its first three years in office to tear down the many existing barriers that impede people with disabilities. It is even worse that the Government took action that will create new disability barriers, and against which people with disabilities must organize to battle at the municipal level.

When the Ford Government took office in June 2018, it was illegal to ride electric scooters (e-scooters) in public places. In January 2019, over the strenuous objection of Ontario’s disability community, the Ford Government passed a new regulation. It lets each municipality permit the use of e-scooters in public places, if they wish. It did not require municipalities to protect people with disabilities from the dangers that e-scooters pose to them.

Silent, high-speed e-scooters racing towards pedestrians at over 20 KPH, ridden by an unlicensed, untrained, uninsured joy-riders, endanger people with disabilities, seniors, children and others. Leaving e-scooters strewn all over in public places, as happens in other cities that permit them, creates physical barriers to people using wheelchairs and walkers. They create tripping hazards for people with vision loss.

Torontonians with disabilities had to mount a major campaign to convince Toronto City Council to reject the idea of allowing e-scooters. They were up against a feeding-frenzy of well-funded and well-connected corporate lobbyists, the lobbyists who clearly hold sway with the Ontario Premier’s office.

Unlike Toronto, Ottawa and Windsor have allowed e-scooters, disregarding the danger they now pose for people with disabilities. Some other Ontario cities are considering allowing them.

Thanks to the Ford Government, people with disabilities must now campaign against e-scooters, city by city. This is a huge, unfair burden that people with disabilities did not need, especially during the COVID-19 pandemic. It is a cruel irony that the Ford Government unleashed the danger of personal injuries by e-scooters at the same time as it has said it wants to reduce the number of concussions in Ontario.

11. The Ford Government’s Rhetoric Has Been Harmfully Diluting the AODA’s Goal of Full Accessibility

A core feature of the AODA is that it requires Ontario become “accessible” to people with disabilities by 2025. It does not merely say that Ontario should become “more accessible” by that deadline.

Yet, the Ford Government too often only talks about making Ontario more accessible. In fairness, the previous Ontario Liberal Government under Premier Dalton McGuinty and later Premier Kathleen Wynne too often did the same.

This dilutes the goal of the AODA, for which people with disabilities fought so hard for a decade. It hurts people with disabilities. It is no doubt used to try to lower expectations and over-inflate any accomplishments.

 

12. The Ford Government Has Given Public Voice to False Troubling Stereotypes About Disability Accessibility

 

Two years ago, the Ford Government publicly voiced very troubling and harmful stereotypes about the AODA and disability accessibility during National AccessAbility Week.

In 2019, during National AccessAbility Week, NDP MPP Joel Harden proposed a that the Legislature pass a resolution that called for the Government to bring forward a plan in response to the Onley Report. The resolution was worded in benign and non-partisan words, which in key ways tracked Doug Ford’s May 15, 2018 letter to the AODA Alliance. The proposed resolution stated:

“That, in the opinion of this House, the Government of Ontario should release a plan of action on accessibility in response to David Onley’s review of the Accessibility for Ontarians with Disabilities Act that includes, but is not limited to, a commitment to implement new standards for the built environment, stronger enforcement of the Act, accessibility training for design professionals, and an assurance that public money is never again used to create new accessibility barriers.”

Premier Ford had every good reason to support this proposed resolution, as we explained in the June 10, 2019 AODA Alliance Update. Yet, as described in detail in the June 11, 2019 AODA Alliance Update, the Doug Ford Government used its majority in the Legislature to defeat this resolution on May 30, 2019, right in the middle of National Access Abilities Week.

The speeches by Conservative MPPs in the Legislature on the Government’s behalf, in opposition to that motion, voiced false and harmful stereotypes about disability accessibility. Those statements in effect called into serious question the Ford Government’s commitment to the effective implementation and enforcement of the AODA. They denigrated the creation and enforcement of AODA accessibility standards as red tape that threatened to imperil businesses and hurt people with disabilities.

13. The Ford Government Has Failed to Effectively Address the Urgent Needs of Ontarians with Disabilities During the COVID-19 Pandemic

All of the foregoing would be enough in ordinary times to merit the “F” grade which the Ford Government is here awarded. However, its treatment of people with disabilities and their accessibility needs during the COVID-19 pandemic makes that grade all the more deserved.

In the earliest weeks, the Government deserved a great deal of leeway for responding to the pandemic, because it was understandably caught off guard, as was the world, by the enormity of this nightmare. However, even well after the initial shock period when the pandemic hit and for the year or more since then, the Ford Government has systemically failed to effectively address the distinctive and heightened urgent needs of people with disabilities in the pandemic.

People with disabilities were foreseeably exposed to disproportionately contract COVID-19, to suffer its worst hardships and to die from it. Yet too often the Government took a failed “one size fits all” approach to its emergency planning, that failed to address the urgent needs of people with disabilities. This issue has preoccupied the work of the AODA Alliance and many other disability organizations over the past 14 months.

Two of the areas where the Government most obviously failed were in health care and education. This is especially inexcusable since the Government had the benefit of a Health Care Standards Development Committee, a K-12 Education Standards Development Committee and a Post-Secondary Education Standards Development Committee to give the Government ideas and advice throughout the pandemic. The K-12 Education Standards Development Committee delivered a detailed package of recommendations for the pandemic response four months into the pandemic. Yet those recommendations have largely if not totally gone unimplemented.

The Government repeatedly left it to each school board, college, university, and health care provider to each separately figure out what disability barriers had arisen during the pandemic, and how to remove and prevent those barriers. This is a predictable formula for wasteful duplication of effort, for increased costs and workloads, all in the middle of a pandemic.

For example, the Ford Government largely left it to each frontline teacher and principal to figure out how to accommodate the recurring needs of students with different disabilities during distance learning. The Government relied on TVO as a major partner in delivering distance learning to school students, even though TVO’s distance learning offerings have accessibility barriers that are unforgivable at any time, and especially during a pandemic.

As another example, the Ford Government did not properly plan to ensure that the process for booking and arranging a COVID-19 vaccine was disability-accessible. There is no specific accessible booking hotline to help people with disabilities navigate the booking process from beginning to end.

There is no assurance that drug stores or others through whom vaccines can be booked have accessible websites. We have received complaints that the Government’s own online booking portal has accessibility problems. Arranging for a barrier-free vaccination for People with Disabilities is even harder than the public is finding for just booking a vaccination for those with no disabilities.

14. The Lives of Vulnerable People with Disabilities are Endangered by the Ford Government’s Secret Plans for Critical Care Triage During the COVID-19 Pandemic, If Hospitals Cannot Serve All Critical Care Patients

The AODA Alliance, working together with other disability organizations, has also had to devote a great deal of effort to try to combat the danger that vulnerable people with disabilities would face disability discrimination in access to life-saving critical care if the pandemic overloads hospitals, leading to critical care triage. The Ford Government has created new disability barriers by allowing clear disability discrimination to be entrenched in Ontario’s critical care triage protocol. Even though formal critical care triage has not yet been directed, there is a real danger that it has occurred on the front lines without proper public accountability e.g. by ambulance crews declining to offer critical care to some patients at roadside, when called via 911.

The Ford Government has allowed a concerted disinformation campaign to be led by those who designed the Ontario critical care triage protocol, and who are falsely claiming that there is no disability discrimination in that protocol.

Further Background

Further background on all of the issues addressed in this report card can be found on the AODA Alliance’s web site. It has separate pages, linked to its home page, addressing such topics as accessibility issues in transportation, health care, education, information and communication, the built environment, AODA enforcement, and disability issues arising during the COVID-19 pandemic, among others. Follow @aodaalliance



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Disability Rights Advocate Resorts to Freedom of Information Application to Unearth the Ford Government’s Secret Plans for Critical Care Triage if Overcrowded Hospitals Can’t Serve All Critically-Ill Patients


ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

NEWS RELEASE – FOR IMMEDIATE RELEASE

Disability Rights Advocate Resorts to Freedom of Information Application to Unearth the Ford Government’s Secret Plans for Critical Care Triage if Overcrowded Hospitals Can’t Serve All Critically-Ill Patients

May 20, 2021 Toronto: To Mark today, Global Accessibility Awareness Day, the AODA Alliance makes public a Freedom of Information application by its chair, David Lepofsky, filed to finally enable the public to see the Ford Government’s secret plans for critical care triage. Since the pandemic began over 14 months ago, the Ford Government has kept a tight lid on its critical care triage plans. This new Freedom of Information application tries to drag into public light The Government’s plans on this life-and-death issue. (Key excerpt from the Freedom of Information application set out below).

“It’s great that daily infections are dropping and vaccines are reaching more people, but the risk remains that critical care may have to be triaged if this positive trend reverses, if there’s new variants or if there’s a fourth wave,” said David Lepofsky, who leads the non-partisan AODA Alliance, which campaigns for accessibility for people with disabilities, including in the health care system. “The public has a right to know exactly what instructions have been given to ICU hospital staff and ambulance crews on who lives and who dies, if critical care triage becomes necessary. The public also has a right to know who is making these life-and-death decisions for the Government, and that is what my Freedom of Information application aims to unearth.”

This Freedom of Information application is necessary because the Ford Government has refused to answer any of the nine detailed and well-researched letters that the AODA Alliance has sent over the past eight months to Health Minister Christine Elliott, including the AODA Alliance‘s September 25, 2020 letter, its November 2, 2020 letter, its November 9, 2020 letter, its December 7, 2020 letter, its December 15, 2020 letter, its December 17, 2020 letter, its January 18, 2021 letter, its February 25, 2021 letter and its April 27, 2021 letter. It has refused to directly consult with the AODA Alliance or other disability advocates on this issue, hiding behind its external Bioethics Table, an advisory body that makes no decisions on this issue.

“If you want to see the January 13, 2021 Critical Care Triage Protocol, you won’t find it on a Government website. You will only find a leaked copy on the AODA Alliance website. We have no idea whether it has been changed since we got a leaked copy back in January,” said Lepofsky. “While critical care triage has not been publicly launched, Ontario hospitals have been doing practice drills behind closed doors using the Government’s secret instructions.”

The AODA Alliance, other disability groups and the Ontario Human Rights Commission have raised serious objections to disability discrimination in those parts of Ontario’s critical care triage plans that have been leaked to the public. When the Government is confronted with these concerns, it deflects inquiries to doctors, rather than publicly owning up to the critical care triage plans that are being readied under the Ford Government’s auspices.

Contact: AODA Alliance Chair David Lepofsky, [email protected]

For more background on this issue, check out:

  1. The AODA Alliance’s February 25, 2021 independent report on Ontario’s plans for critical care triage if hospitals are overwhelmed by patients needing critical care,
  1. The AODA Alliance’s captioned new online video detailing the disability discrimination in Ontario’s critical care triage protocol.
  1. The May 7, 2021 guest column by AODA Alliance Chair David Lepofsky in the Toronto Star and
  1. The AODA Alliance website’s health care page, detailing its efforts to tear down barriers in the health care system facing patients with disabilities, and its COVID-19 page, detailing its efforts to address the needs of people with disabilities during the COVID pandemic

Excerpt from the May 18, 2021 Freedom of Information application by AODA Alliance Chair David Lepofsky

  1. A record or records from on or after January 1, 2021 (including draft instructions or directions that have not yet been approved or activated) that directs hospitals and/or physicians in hospitals on how and/or when to conduct triage or rationing of critical care including refusing critical care to a patient needing critical care, including but not limited to any document purporting to set out an “Emergency Standard of Care” in relation to critical care. This includes any protocols or directions, draft or final, in relation to patients age 18 or older as well as any such directions or instructions, draft or otherwise, that relate to patients under the age of 18.
  1. A record or records dated on or after March 28, 2020 to ambulance services, ambulance crews, emergency medical technicians or other emergency patient transportation services, that directs (or includes draft directions that have not yet been activated or approved) emergency transportation staff on how or when to conduct triage or rationing of critical care in which critical care may be refused to patients needing critical care, including but not limited to any document purporting to set out an “Emergency Standard of Care” in relation to critical care.
  1. Any document or documents that include any or all of the following:
  1. a) Membership of the Critical care COVID Command Centre
  1. b) the Mandate and or assigned responsibilities of the Critical Care COVID Command Centre
  1. c) Any instructions since January 1, 2021 from or on behalf of the Critical care COVID Command Centre, in addition to those documents requested in paragraphs 1 or 2 above, to hospitals/and/or doctors, and/or ambulance crews or emergency medical technicians or emergency patient transportation services and/or any other health care professionals, on how and/or when to conduct any form of critical care triage so as to decline to provide critical care to a patient who needs critical care (including draft directions or instructions that have not yet been activated or approved).
  1. Any correspondence between the Ministry of Health and/or Ontario health and/or the Critical Care COVID Command Centre on the one hand, and the College of Physicians and Surgeons of Ontario (CPSO) on the other, dated September 11, 2020 or afterwards, on the topic of critical care triage and how and/or when critical care triage is to be conducted.
  1. Any document from September 11, 2020 and afterwards setting out plans or options or draft plans (whether or not they have been activated, approved or implemented) for legalizing, permitting or directing hospitals and/or physicians to withdraw critical care from a patient who needs critical care and does not consent to the withdrawal of critical care.



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Ontario is Not Out of the Woods When It Comes to the Danger of Disability Discrimination in Critical Care Triage – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance Update

United for a Barrier-Free Society for All People with Disabilities

Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

Ontario is Not Out of the Woods When It Comes to the Danger of Disability Discrimination in Critical Care Triage

May 19, 2021

            SUMMARY

It is very good that new daily COVID-19 infection rates are dropping and that more and more people are getting vaccinated. This makes it less likely that Ontario must resort to critical care triage in the immediate future.

However, disability discrimination in critical care triage remains a critical issue (pun intended). We have learned that things can take a turn for the worse very rapidly. With new COVID-19 variants, there is a risk of a later fourth surge. As well, emergency and ambulance crews may well be engaging in critical care triage right now, with no public accountability for it.

We know that behind closed doors, Ontario hospitals have been training their staffs to make critical care triage decisions. They are using the disability-discriminatory January 13, 2021 Critical Care Triage Protocol in that training. As such, disability discrimination is getting more and more embedded in our health care system, all publicly financed.

We will continue bringing these issues to the public’s and media’s attention. Here is the latest news on this issue.

 1. Urge Doctors, Nurses, Ambulance Crews and Hospital Administrators You Know to Watch the AODA Alliance’s Informative New Captioned Video on Disability Discrimination Problems with Ontario’s Critical care Triage Protocol

Do you know any doctors, nurses or others who work in hospital emergency rooms or intensive care units (ICUs)? Do you know any hospital administrators or people who work as part of ambulance crews?

Please encourage them all to watch the AODA Alliance’s new captioned video that explains the serious disability discrimination problems with Ontario’s critical care triage protocol. Those health care staff may have gotten some training on that protocol. We fear they are getting no training on the disability discrimination that permeates it.

We also recommend that you ask your family doctor to watch this video. If you end up in hospital, and if critical care triage is going on, you will want your doctor to help advocate for you in the face of the critical care triage protocol’s disability discrimination.

If you have not seen it, we invite you to also watch this video. This video is available for one and all at https://youtu.be/Ju8cyH7TbQo Hundreds have watched it in the two weeks since it was publicly posted. We’ve gotten very positive feedback about it. Please help us reach those on the front lines of Ontario’s health care system.. We believe that they won’t want to be engaging in any disability discrimination, and will wanted to be forewarned about it.

 2. Media Shines Much-Needed Spotlight on the Ford Government’s Relentless Secrecy over Its Critical Care Triage Plans

The Ford Government’s relentless secrecy still persists when it comes to its critical care triage protocol and plans. No doubt, senior Government officials think that the recent drop in new daily COVID infections and ICU occupancy means this whole issue may go away without them having to face public scrutiny for their disability discriminatory critical care triage plans. If so, we beg to differ.

Below we set out an excellent report in the May 6, 2021 edition of the online publication Press Progress. It reports on this protracted Government secrecy, and on criticism of it from the disability community and the Ontario Human Rights Commission.

This article reports on the fact that we and some others from the disability community have had a chance, months ago, to speak to the Ontario Government-appointed advisory Bioethics Table. We emphasize that that Table does not make any decisions in this area. It only gives advice. We don’t know what happens with that advice once the Bioethics Table gives it.

We don’t know what the Bioethics Table has advised the Government at any time after September 11, 2020. We don’t have any proof that the Bioethics Table ever reviewed and advised on the January 13, 2021 Critical Care Triage Protocol itself, or if it did, whether the Government accepted and implemented that advice. It is all shielded behind the Government-created fog of secrecy.

In this article, the argument is made that among other things, we need clarity on the Government’s critical care triage plans. We add that people with disabilities need much, much more than clarity about those plans. We have utter clarity that these plans are replete with disability discrimination. We need that disability discrimination removed.

In sharp contrast to Ontario’s paternalistic secrecy over its critical care triage protocol and plans, the media has reported that Alberta has made public its critical care triage protocol. We set out below an Edmonton Journal news report on this. We have not had an opportunity to review the Alberta critical care triage protocol and cannot comment on its contents.

 3. A Unique Chance to Read the Ford Government’s Talking Points For Defending Its Disability Discriminatory Critical Care Triage Protocol

The Ford Government’s strategy for several months has been to avoid saying anything about Ontario’s critical care triage protocol and plans wherever possible. When the media asks the Ford Government questions in this area, and if the Government responds at all, it typically deflects media questions to doctors. The doctor who seems to be very often the person to whom the Ford Government points, and who is in effect serving as the Government’s spokesperson, is Dr. James Downar. Dr. Downar has often been identified as the author or co-author of the January 13, 2021 Critical Care Triage Protocol. He is also a member of the Government-appointed advisory Bioethics Table.

Below we set out a statement which Dr. Downar has sent to a media outlet in response to a media inquiry. We offer these reflections on it:

  1. a) Dr. Downar’s response is similar to or the same as other quotations attributed to him that we have seen in other media reports. It reads like it is a set response.
  1. b) This statement reads like it could have been carefully written or vetted by someone within Ford Government. It has the flavour of a Government-drafted or Government-approved communications document.
  1. c) Dr. Downar’s statement is demonstrably inaccurate and misleading on important points. It is misleading where it talks about consultations being ongoing. We have repeatedly sought chances to get the Government to consult us on this issue. We have been very public about the fact that the Government has refused to do so.

This statement is also inaccurate and misleading where it seeks to claim that disability discrimination plays no part in the Ontario critical care triage protocol. Contrary to what this statement claims, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports.

For example, if a cancer patient needs critical care, they will be deprioritized if a patient is “Completely disabled and cannot carry out any self-care; totally confined to bed or chair”. As another example, if a patient needing critical care is over 65 and has a progressive disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. In both examples, this is disability discrimination, pure and simple.

This statement tries to defend Ontario’s critical care triage protocol by arguing that it does not make the Clinical Frailty Scale (which we have shown to be disability-discriminatory) because, among other things it does not apply that tool to assessing patients with a stable disability. As we have publicly emphasized, this is no defence. You cannot justify discriminating against some people with disabilities, e.g. those with progressive disabilities, by pleading that you don’t also discriminate against those with stable non-progressive disabilities. In the same way, you cannot defend discrimination against Muslims by pleading that you don’t also discriminate against Catholics.

It is deeply troubling that the Government’s defender keeps repeating these bogus arguments long after we have shown them to be so obviously incorrect. The Government has certainly not disavowed these statements that are made in its defence.

 4. The Call for the Ontario Government to Remove the Disability Discrimination from Its Critical Care Triage Protocol Has Come From the Trade Union Sector

Below we set out a recent public statement by the Canadian Union of Public Employees CUPE Ontario echoing our concerns about Ontario’s critical care triage protocol and plans. We welcome support from any and all parts of our society.

 5. Delay and Delay and Delay

There have now been 839 days, or over 2 and a third years, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no effective plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis. The Ontario Government only has 1,323 days left until 2025, the deadline by which the Government must have led Ontario to become fully accessible to people with disabilities.

            MORE DETAILS

 Press Progress May 6, 2021

Originally posted at https://pressprogress.ca/disability-groups-say-ontario-government-did-not-consult-them-on-life-and-death-covid-19-triage-decisions/

Disability Groups Say Ontario Government Did Not Consult Them on Life and Death COVID-19 ‘Triage’ Decisions

Ontario Human Rights Commission Chief Commissioner says vulnerable groups deserve certainty on ’life and death triage decisions’

by PressProgress

May 6, 2021

Ontario Health Minister Christine Elliott promised to involve disability advocates in the drafting of possible “triage protocols” to decide who may be health denied care should hospitals be overwhelmed.

But the province’s major disability advocacy groups say they haven’t been consulted by the Ministry on the current drafts. They worry those drafts could be discriminatory and that they could be implemented on short notice.

According to The Globe and Mail, hospitals across Toronto were practicing triage protocols to reserve Intensive Care Unit (ICU) beds for those most likely to survive, through last week.

Draft triage protocols, which were sent to hospitals on January 13, have not been finalized according to Ontario’s Health Minister. But the drafts’ emphasis on testing patients’ abilities to live “without assistance” — to weigh whether care should be allocated — has many advocates for people with disabilities worried.

On April 21, Ontario Health Minister Christine Elliott told the legislative assembly:

“I asked that this issue be dealt with—with the people with disabilities groups as well as with the Ontario Human Rights Commission. There have been numerous discussions, but nothing has been activated yet, and I can assure you that nothing has been approved at this point.”

Lawyer and AODA alliance chair David Lepofsky says the January 13 draft protocols discriminate against certain disabled people by ranking patients based on their ability to conduct Instrumental Activities Of Daily Living.

“For a person with cancer they look explicitly at whether a person is disabled and can’t get out of bed or less,” Lepofsky told PressProgress. “If it’s a person over 65 with a progressive disease it asks if they can do 11 Activities of Daily Living — getting up, shopping, eating, using the phone, doing your finances — without assistance. If not, you rank lower.”

“That’s disability.”

Yet, Lepofsky said he hasn’t been able to discuss the organization’s concerns with the minister or ministry representatives. “The only consulting that’s gone on at all is a body external to the government called the Bioethics Table. Our consultations with them were last summer — ending August 31 — and then one meeting virtually on December 17. Many of us said we needed more time and needed to prepare.”

Since the draft was leaked, on January 13, Lepofsky said the group has received no further contact.

Ontario Human Rights Commission Chief Commissioner Ena Chadha told PressProgress the OHRC has been telling the government for over a year it needs to consult with concerned advocates for people with disabilities on any triage protocol. Chadha said that wasn’t done.

While an advisory body, the Bioethics Table, consulted some affected groups ahead of the January 13 drafts, since December 2020, Chadha said no other notable consultations appear to have followed. “Since then human rights experts, and vulnerable groups disproportionately impacted by the COVID-19 pandemic, including people with disabilities, older persons, Indigenous peoples and racialized communities, have not been consulted on these latest protocols.”

“They have a right to clarity and certainty on how life and death triage decisions would affect them. Health care practitioners who would be compelled to make these difficult decisions deserve the same clarity and certainty,” Chadha said.

“Human rights groups are concerned that, despite the Minister’s expressed comments, the reality on the ground will be that the Emergency Standard of Care document circulated to hospitals in January will be used anyway out of necessity.”

On April 28, the Ontario Medical Association hosted a panel featuring Peel Region Medical Officer Lawrence Loh and OMA head Samantha Hill titled Making Difficult Decisions During the Pandemic. Included on the agenda was “Who should be ventilated if resources are limited?”

A spokesperson for the OMA confirmed the discussion was “focusing on existing guidelines” as per the January 13 proposals from Critical Care Services.

“We were sent notice that the triage protocol could be initiated within days,” a doctor at Markham Stouffville hospital told PressProgress. “They’ve been talking about this for sometime. I can’t believe I and my colleagues will be asked to make life and death decisions for people.”

Further, an early May memo obtained by the Globe from Ontario’s “critical care command centre”signalled the health system had plans to utilize the existing drafts. The memo noted, cautiously, that recent increases in capacity may mean “we will not need to activate the Emergency Standard of Care or recommend the use of the triage protocol.”

Community Living CEO Chris Beesley said his organization has been frustrated by a lack of communication from Ontario’s Ministry of Health.

“Since last Spring, we’ve been working with a coalition of disability focused organizations, to try and get some transparency on the triage protocol,” Beesley told PressProgress.

However, Beesley said, “Neither Minister Elliott nor anyone from her staff had communicated with us since last July.”

Arch Disability Law Centre lawyer Mariam Shanouda also told PressProgress “We have never been consulted by the Ministry of Health.”

“We have met several times now with the Bioethics Table which is a Table that was struck by the Ministry to advise them on the Triage Protocol. The last time we were invited to meet with the Bioethics Table was in December 2020, which is especially concerning since the latest version of the Triage Protocol is dated January 13, 2021,” Shanouda said. The organization said it has not been consulted since.

Six members of Ontario’s Bioethics Table additionally warned April 15 that “without public discussion, the vulnerability of already marginalized groups is intensified and trust eroded.”

PressProgress contacted Critical Care Services to respond to concerns advocates had that the consultations were insufficient and the draft it sent out could be discriminatory. CCSO referred PressProgress to Bioethics table member Dr. James Downar, who, CBC News reports, wrote the January 13 drafts.

Dr. Downar told PressProgress:

“The Emergency Standard of Care is a contingency plan to be used as an option of last resort. It was based on recommendations that were developed by the Ontario COVID-19 Bioethics table, which conducted extensive consultations with multiple stakeholders including disability advocates and the Ontario Human Rights Commission. The consultations are continuing, and the process of generating, reviewing and updating any triage plan should always be an ongoing process, responding to changing conditions, emerging evidence and an evolving understanding of the ethical, social and legal implications.”

Ontario’s Ministry of Health did not respond to requests for comment from PressProgress.

On April 27, the Ministry called for special medical assistance from Canada’s armed forces as hospitals face a surge in COVID-19 ICU patients.”

PressProgress

PressProgress is an award-winning non-profit news organization focused on uncovering and unpacking the news through original investigative and explanatory journalism.

@pressprogress

PressProgress is a news division of the Broadbent Institute

 Written Statement in April 2021 to News Outlet by Dr. James Downar in Response to Media Inquiry Regarding Critical Care Triage Protocol

  1. Critical care triage has not yet been initiated anywhere in Ontario. The focus of the critical care community is on building capacity to see us through this surge.
  2. The Emergency Standard of Care is a contingency plan to be used as an option of last resort. It was based on recommendations that were developed by the Ontario COVID-19 Bioethics table, which conducted extensive consultations with multiple stakeholders including disability advocates and the Ontario Human Rights Commission. The consultations are continuing, and the process of generating, reviewing and updating any triage plan should always be an ongoing process, responding to changing conditions, emerging evidence and an evolving understanding of the ethical, social and legal implications.
  3. The only criterion used to prioritize critical care would be short-term mortality risk. This is always based on an individualized assessment, and clinical guidance is provided to help assess risk in people depending on their medical condition. But assessment tools should only be used in situations where they help indicate mortality risk, and with respect to disabilities, there are clear and explicit instructions not to use the Clinical Frailty Scale for people under the age of 65, or for anyone with chronic, stable disabilities or other conditions where it would not indicate mortality risk. For other conditions, mortality risk can be determined without any assessment of function. In other words, people with identical disabilities would be prioritized very differently if their mortality risks were different, and people with no disabilities at all receive a lower priority if their mortality risk is high. The focus is squarely on mortality risk, not ability or function. This is very important.”

 Edmonton Journal April 30, 2021

Originally posted at https://edmontonjournal.com/news/local-news/ahs-releases-triage-protocol-outlining-which-patients-would-receive-care-if-icus-become-overwhelmed-by-covid-19

AHS releases triage protocol outlining which patients would receive care if ICUs become overwhelmed by COVID-19

Author of the article: Anna Junker

The Royal Alexandra Hospital is pictured in Edmonton. The hospital’s ICU unit has seen COVID-19 surges during the pandemic. PHOTO BY SHAUGHN BUTTS /Postmedia, file

Alberta Health Services has released a triage plan for determining who will receive critical care in the event that COVID-19 patients outnumber available ICU beds in the province.

The 50-page Critical Care Triage plan, unveiled Friday, would not be activated until the health authority has exhausted all other options, such as transferring patients, health-care staff, equipment and medication between different hospitals in the same health zone or across the province. It would be implemented based on direction from the AHS CEO, in consultation with the executive leadership team.

“When activated the triage protocol will be utilized in all health-care facilities and critical care units in Alberta to prioritize patients who have the greatest likelihood of overall survival,” the report states.

The plan lays out four “pandemic or disaster” stages, which would determine whether triaging is necessary.

In a “minor surge,” the number of patients requiring critical care would exceed resources. As a result, staff may be pulled from other critical care units to help with care and patients may be moved into recovery rooms.

A “moderate surge” would see staff brought in from other areas of hospitals and patients moved to recovery rooms or subspecialty ICUs. Transfers for patients in emergency departments would be delayed.

Triaging may be required in a “major surge,” which would occur when 90 per cent or more of available ICU beds in the province are occupied. The first phase of triaging would only allow patients who are predicted to have more than 20 per cent likelihood of surviving one year to enter the ICU.

A “large-scale surge” would see 95 per cent or more of available ICUs in the province occupied and could see the second phase of triaging activated. Under that scenario, those with a 50 per cent chance of surviving one year would be admitted to the ICU. Pediatric triaging will be considered.

“Information about a patient’s underlying illness, disease, or disability will not be taken into consideration unless they directly impact a patient’s likelihood of surviving the next year,” the report states.

Decisions for critical care eligibility will not include a person’s age, sex, socioeconomic status, race, disability, employment status, or the cost of future care. Once a decision has been made on who gets care, it cannot be appealed by the patient or family.

Alberta has the capacity to fully staff 425 ICU beds for COVID-19 and non-COVID-19 patients. As of Friday, there are 152 COVID-19 patients in the ICU – the highest since the beginning of the pandemic.

Kerry Williamson, spokesman for AHS, said in a statement the Edmonton Zone currently has 102 ICU beds open — a base of 72 general adult beds and an additional 30 spaces.

This week, the Edmonton Zone was between 86 and 88 per cent capacity for all ICU beds.

‘I just can’t imagine’

Dr. Noel Gibney, co-chair of the Strategic COVID-19 Pandemic Committee for the Edmonton Zone, said the triage plan is well-developed, but it is not a situation to ever want to be in.

“I just can’t imagine, explaining to the patients or their families why these individuals are not going to get the care that they need,” Gibney said. “I can’t imagine doing that day after day after day, or multiple times in the day. I mean that the moral distress associated with that would be extreme.”

He said the postponement of surgeries and release of the triage protocol suggests AHS is extremely worried about a “disaster-type situation.”

Gibney said the public health restrictions that are currently in place are “absolutely not” enough, and warned that the protocol could need to be activated this month.

“I get the sense that the government has some notion that they may be able to just vaccinate the province out of trouble this time. But we’re not going to do that,” Gibney said.

“We’re in a situation where modelling shows that in about three weeks, so that by May 22, we will be at a point where we may reach Phase 1 of the pandemic triage protocol.”

He said the province needs to implement a strict lockdown and use the same health measures that were in place last April – moving all schooling online, limiting retail to essential-only, closing non health-related personal services like hair and nail salons, severely limiting or close places of worship, and closing patios.

Adequate sick pay also needs to be implemented, he said.

“Some of the components of what the government has been doing with targeted vaccinations, I think that’s great, but it simply isn’t going to be enough in time to get us out of that danger that we’re in,” Gibney said.

[email protected]

Twitter.com/JunkerAnna

 Financial Post May 12, 2021

f

Originally posted at https://financialpost.com/pmn/press-releases-pmn/business-wire-news-releases-pmn/theres-no-room-for-discrimination-against-people-with-disabilities-cupe-ontario-and-joel-harden-call-for-consultation-and-revision-of-triage-protocol

Press Releases Business Wire News Releases

“There’s No Room for Discrimination Against People With Disabilities”: CUPE Ontario and Joel Harden Call for Consultation and Revision of Triage Protocol

Author of the article: Business Wire

Business Wire

Publishing date: May 12, 2021 • 23 hours ago • 2 minute read • Join the conversation

TORONTO — The Ontario Government’s draft plan to ration access to at-capacity critical-care is discriminatory and must be revised immediately, said the Canadian Union of Public Employees (CUPE) Ontario and Joel Harden, NDP MPP for Ottawa Centre and the Critic for Accessibility & Persons with Disabilities.

“The fact that the draft plan says that doctors will look at your short-term mortality risk or your capacity for self-care to decide if you get access to limited intensive care units is nothing more than blatant discrimination against people with disabilities,” said Fred Hahn, President of CUPE Ontario. “This dangerously violates the foundational rights of Ontarians our members care for and the rights of many of our members themselves.”

While Health Minister Christine Elliott recently said that Ontario may not need to resort to rationing, due to reduced demand for ICUs, concerns raised by CUPE Ontario, the Ontario Human Rights Commission (OHRC), disability organizations, and the six bioethicists on the government’s advisory Bioethics Table remain.

“I’m not reassured by that at all,” said Michele Gardner, member of CUPE Ontario’s Workers with Disabilities Committee. “This discriminatory triage protocol can still be used at any time. It makes it clear that people with disabilities are at risk of not getting the critical-care they need because of explicitly biased criteria.”

“The protocol must be revised to remove any discrimination and we must be consulted moving forward,” added Gardner. “The OHRC has raised the problem of lack of consultation, and so have the six members of the bioethics table, who rightly said that without it this government is only intensifying the vulnerability of people with disabilities.”

“More than a year has passed since over 200 community organizations wrote to the Ford government urging it to remove disability discrimination from its triage protocol. The response so far has been silence,” said Harden. “It’s time to stop the secrecy surrounding critical care triage and for the Ford government to remove disability discrimination from its protocol.”

Contacts

Daniel Tseghay

Communications Representative, CUPE

[email protected]





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Changes at Parlee Beach means improved access for people with disabilities


New Brunswick’s largest beach will once again be open to the public starting Friday and visitors to Parlee Beach Provincial Park will notice some changes that include improved access for those with disabilities.

“We have been lobbying for years now to make the entire province accessible,” said Mathieu Stever, the manager of the ParaNB program with Ability New Brunswick

The provincial park is getting a $2-million facelift in advance of its second season in operation amid the pandemic. According to the province, funding for the upgrades is being applied from the capital improvement budgets from 2020 to 2022.

Read more:
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The work includes upgrades to roads, entrances, the canteen, restaurant bar and patio area as well as improved access to the beach, according to the park’s manager, Michel Mallet, who said they partnered with Ability NB on the project starting in 2019.

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“We call it a comfort station, which is basically an accessible washroom and accessible charging room and shower outside,” said Mallet.

Improved sidewalks and beach-friendly wheelchairs will also be available for visitors, said Mallet.

He said an accessible playground is also being installed in the coming weeks. The hope is to have the upgrades ready by the end of the school year, he said.


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Program helping Moncton youth with disabilities find work


Program helping Moncton youth with disabilities find work – Mar 18, 2021

“I think it is great having Parlee Beach set the example of how you can renovate the beach and make it accessible for everyone because our motto is that everyone plays,” said Stever.

Stever said he hopes the initiative will encourage other provincial parks in the province to do similar upgrades.

“It is everyone’s right to be able to access all recreation activities in the province”, he said.

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Parlee Beach opens on Friday with COVID-19 protocols similar to last year, said Mallet.

All washrooms and changing rooms, even the accessible ones, will remain closed for now, he said.

Access to the provincial beach for vacationers from outside of the province will also depend on the loosening of COVID-19 restrictions.





© 2021 Global News, a division of Corus Entertainment Inc.





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Send Us Your Feedback on the Initial or Draft Recommendations for What the Promised Health Care Accessibility Standard Should Include that Were Prepared by the Government-Appointed Health Care Standards Development Committee


Accessibility for Ontarians with Disabilities Act Alliance Update

United for a Barrier-Free Society for All People with Disabilities

Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

Send Us Your Feedback on the Initial or Draft Recommendations for What the Promised Health Care Accessibility Standard Should Include that Were Prepared by the Government-Appointed Health Care Standards Development Committee

May 10, 2021

            SUMMARY

It is more important than ever for the Ontario Government to remove and prevent the many disability barriers that impede patients with disabilities in Ontario’s health care system. If anything, the COVID-19 pandemic and the Government’s response to it have made those barriers worse. That flies in the face of the Accessibility for Ontarians with Disabilities Act (AODA), which requires the Ontario Government to lead our health care system and our entire society to become accessible to over 2.6 million Ontarians with disabilities by 2025.

We now seek your feedback once again on the barriers that people with disabilities face in Ontario’s health care system. Last week, on Friday, May 7, 2021, the Ford Government belatedly and at last posted online for public comment the initial or draft recommendations in this area that were prepared by the Government—appointed advisory Health Care Standards Development Committee. We are going to write a brief to that Committee, giving it our feedback on their recommendations. We aim for that Committee’s final recommendations to be as strong and effective as possible. We need your input.

We have posted the Health Care Standards Development Committee’s initial or draft recommendations on the AODA Alliance website at https://www.aodaalliance.org/wp-content/uploads/2021/05/Health-Care-SDC-Initial-Report-As-Submitted.doc. The Government also has them posted, at least for now, on its website, with the link set out below.

Please give The Committee’s recommendations a read, and send us your thoughts. What do you like about them? Are they missing anything that should be added? Are they strong and comprehensive enough?

We welcome and invite your feedback to help us as we work on our brief. Send your thoughts to us at [email protected]

Of course, you are also strongly encouraged to send your feedback and recommendations directly to the Health Care Standards Development Committee. You have up until August 11, 2021 to do that. The contact information for the Health Care Standards Development Committee is set out below, in the Government’s announcement.

If you want helpful background on the barriers people with disabilities face in the health care system,, including what the AODA Alliance has recommended in the past to the Health Care Standards Development Committee (based on feedback from our supporters), take a look at these resources:

  1. The AODA Alliance’s February 25, 2020 Framework that it submitted to the Health Care Standards Development Committee on what the promised Health Care Accessibility Standard should include. We developed that Framework in consultation with our supporters, after getting input from multiple sources.
  1. The captioned November 26, 2019 online video by AODA Alliance Chair David Lepofsky where he describes many of the disability barriers in the health care system that the Health Care Accessibility Standard needs to remove and prevent. This video has been viewed over 1,000 times.
  1. The more recent April 27, 2021 captioned video by AODA Alliance Chair David Lepofsky on one specific and frightening barrier that people with disabilities, face, namely Ontario’s disability-discriminatory critical care triage protocol, which was created in case hospitals must ration life-saving critical care due to COVID-19 overloads.
  1. The saga of the AODA Alliance’s non-partisan campaign that it has waged for over a decade to get the Ontario Government to enact a strong and effective health Care Accessibility Standard under the AODA, documented on the AODA Alliance’s health care web page.

There has been a series of inexcusable Government delays in getting to this important interim stage on the road to the enactment of a strong and effective Health Care Accessibility Standard in Ontario. As a result of our five or more years of advocacy up to that point, on February 13, 2015, the Ontario cabinet minister then responsible for the AODA, Eric Hoskins, announced that the Government of Ontario would develop and enact a Health Care Accessibility Standard under the AODA. That was six years ago.

Under the AODA, the first step required for the government to develop an accessibility standard is for the Minister responsible for the AODA to appoint an advisory committee (a “Standards Development Committee”) to make recommendations on what the specific accessibility standard should include. That Standards Development Committee is required to include representatives from the disability community as well as representatives from the obligated sector, such as health or education.

Some two years later, in or around 2017, the government appointed the advisory Health Care Standards Development Committee to develop recommendations on what should be included in the promised Health Care Accessibility Standard. It should not have taken the previous Kathleen Wynne Government some two years just to appoint an advisory committee.

Under the AODA, a Standards Development Committee is first required to develop initial or draft recommendations for the government. These initial or draft recommendations on what the accessibility standard in issue should include are to be submitted to the Minister. Under s. 10(1) of the AODA, upon receiving initial or draft recommendations from a Standards Development Committee, the minister is required to make those initial or draft recommendations public for at least 45 days, including posting them on the internet. The public is to be invited to give feedback on those initial or draft recommendations. That is the interim stage we have now reached.

That public feedback is to then be given to the Standards Development Committee. After that public feedback is received, the Standards Development Committee meets to review the feedback and to finalize its recommendations for the government on what the accessibility standard in issue should include.

Once finalized, the Standards Development Committee then is required to submit its final recommendations to the Minister. Section 10(1) of the AODA requires the Minister to make those final recommendations public upon receiving them. Thereafter, the government can enact some, all, or none of what the Standards Development Committee recommended.

Here we are, some four years after the Health Care Standards Development Committee was appointed, and we are now just getting to the stage of being able to review their initial or draft recommendations. This illustrates why progress towards an accessible Ontario has been so painfully slow.

The delays in the health care context are certainly not the sole fault of the previous Wynne Government. The Ford Government left the Health Care Standards Development Committee frozen and unable to work for over a year after it took office. Precious time was lost.

After it finally got back to work, the Health Care Standards Development Committee submitted its initial or draft recommendations to the Ford Government by the end of last December, over five months ago. Yet the Ford Government only made them public last Friday. Section 10 of the AODA required the Government to make them public upon receiving them.

Had the Government made these initial or draft recommendations public upon receiving them, the public consultation could have wrapped up by now. The Health Care Standards Development Committee could have now been going back to work, drawing on that public input to finalize its recommendations. Instead, that Committee won’t be able to resume its work until some time this fall, depending on the extent of further Government delays. More time is wasted due to the Government.

Will the Ford Government’s delays on disability accessibility ever stop? There have now been 830 days, or over 2 and a quarter years, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no effective plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis. The Ontario Government only has 1,332 days left until 2025, the deadline by which the Government must have led Ontario to become fully accessible to people with disabilities.

More Details

The Ford Government’s May 7, 2021 Announcement on the Health Care Standards Development Committee’s Initial or Draft Recommendations

In Ontario, the Accessibility for Ontarians with Disabilities Act, 2005 outlines the legislated process for the development of new accessibility standards through Standards Development Committees.

Standards Development Committees are responsible for developing and reviewing accessibility standards in Ontario. These accessibility standards help move Ontario forward on its journey to create a more accessible and inclusive province.

The Health Care Standards Development Committee was tasked with developing recommendations for proposed accessibility health care standards for hospitals. The Committee is a group of representatives comprised of people with disabilities, disability organizations and health sector experts.

The Initial Recommendations Report of the Health Care Standards Development Committee is now available for public comment.

https://www.ontario.ca/page/consultation-initial-recommendations-development-health-care-accessibility-standards

The Report will be posted online for a period of 65 business days. Members of the public can submit feedback until August 11, 2021.

The initial report contains 22 recommendations that the committee developed and on which it voted.

As these recommendations may impact you or your community, we would encourage you to participate in this process. We would also encourage you to share this information broadly with your networks.

A survey has been developed to seek public feedback and is linked from the consultation page together with the report itself.

Written submissions can also be sent in by email to

[email protected].

Members of the public or interested organizations can also reach out to the Accessibility for Ontarians with Disabilities Division by email at

[email protected]

for any questions.

All feedback received will be considered by the Committee before finalizing their recommendations to the Minister. Identifying information will remain confidential as per the Government of Ontario’s Privacy Policy, and all survey responses will remain anonymous.

Sincerely,

Mary Bartolomucci

Assistant Deputy Minister (A)



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