There’s a renewed call today for greater protections for the many British Columbians with a hidden disability. As Kylie Stanton reports, those with learning disabilities say they’re being left out simply because their condition is not as obvious.
There’s a renewed call today for greater protections for the many British Columbians with a hidden disability. As Kylie Stanton reports, those with learning disabilities say they’re being left out simply because their condition is not as obvious.
ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE
NEWS RELEASE – FOR IMMEDIATE RELEASE
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:
“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.
May 31, 2021
Prepared by the AODA Alliance
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.
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.
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.
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:
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.”
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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
8 June 2020
Eleisha Foon, Journalist
More flexibility with hours and working from home will help people with physical and intellectual challenges to be a part of the workforce, disability advocates say.
New Zealanders with disabilities have been calling for more flexibility in working arrangements for years and Covid-19 has made that more of a possibility.
Disability Rights Commissioner Paula Tesoriero said one in four New Zealanders have a disability, so workplaces must stay flexible, and have improving the diversity of their workforce on their radar to fully utilise their skills.
“During Covid New Zealanders at large got real insight into the disabling world that many people with impairments or chronic health conditions have to deal with on a daily basis,” she said.
She said about 30 percent of public sector respondents in a 2019 survey on diversity reported disability as an important issue compared to 19 percent for those in the private sector.
Both numbers were low in her view and she encouraged employers to understand the benefits to having people with disability in the workforce.
Tanya Harrison is blind and has a sleeping disorder due to low melatonin, and has been looking for work since January.
She said her ideal job would be working from home for a company like Emerge Aotearoa providing support for people needing mental health services.
“I was telling people months ago, I really want to work from home because for me it is much more suitable.
“People used to say ‘oh, bet jobs like that would be scarce’ … now you don’t get that response. There is a fresh canvas where we can put new ideas out there and hear how things work for others.”
Disabled Persons Assembly New Zealand chief executive Prudence Walker said most of the staff she hired had a disability.
“Catering for the flexibility that people need, the access that people need is day-to-day heart of what we do. We have a really talented team and it they didn’t have the flexibility – people wouldn’t work for us.”
Before the coronavirus, 39 percent of young people with disabilities were not in any employment, training or education. There is hope the government’s free apprenticeship scheme could help change this.
Walker said employers needed to remove all barriers within the recruitment process to make things accessible and welcoming to all. Employers must understand what they need to perform best and not assume people’s needs.
“Employers really lose out when they undervalue what disabled people might be able to bring. That could be to do with people’s personal bias, discomfort or not knowing a lot around disability.”
Deaf Aotearoa chief executive Lachlan Keating said there had been increased awareness and interest in learning sign language thanks to the daily press conference on Covid-19 case updates.
More opportunities for interpreters had been opening up and sign classes had been hugely popular, with some selling out across the country, he said.
He said greater awareness of New Zealand Sign Language – one of three official languages in New Zealand – must continue.
“Sometimes the greatest hurdle disabled people can be up against is others’ low expectations and assumptions about abilities and that can start when disabled children are at school and it continues right throughout the recruitment process.”
Paula Tesoriero agreed a change in mindsets was a must and said a lot of that responsibility rested with employers and recruiters.
She said the greatest barrier to employment for disabled people seeking work was employers’ assumptions.
The commissioner pointed out there was generally little to no added cost to hiring someone with a disability.
Belong well-being and equity specialist Jody Brownlie works with businesses to help their staff and organisations thrive, and said well being and staff retention would be at the forefront of most employers’ minds.
Covid-19 had forced changes to how companies operated, and the ones continuing to embrace flexibility would hire and attract better people for the role.
Tesoriero said “now is the time to have the conversation around how we increase the participation rate of people with disabilities.”
By Tyrone Burke
Companies often assume that accommodating an employee with a disability will cost thousands of dollars. It’s a misperception that can create an additional barrier to finding employment, and it contributes to the job gap between students with disabilities and those without.
“In reality, accommodations often cost $500 or less” says Julie Caldwell, assistant director of program operations for the David C. Onley Initiative.
“Part of what this initiative has been doing is busting myths about disability and addressing the biases, fears and misperceptions that employers can have.”
Since launching in 2018, the David C. Onley Initiative has been developing knowledge, resources and tools to support the employment readiness and career aspirations of students with disabilities. The $5-million project is named for former Ontario lieutenant-governor David C. Onley, and funded by the Ministry of Training, Colleges and Universities.
It’s a Carleton-led partnership with the University of Ottawa, Algonquin College and CollÃ¨ge La CitÃ©. In order to better understand the factors contributing to the employability of students with disabilities, the initiative embedded researchers in career and disability offices on each of the four campuses.
David C. Onley Initiative Making Recommendations to Advance Employment for Post-Secondary Students with Disabilities David C. Onley
They spoke to those responsible for planning recruitment events about how they ensured that students with disabilities were included, and hosted a series of accessible showcases on each campus, parallel to typical career fairs.
“Because they were for students with disabilities only, it allowed employers and students to engage in meaningful conversations in a safe environment,” says Caldwell.
“Students didn’t have to fear disclosing they had a disability when being considered for meaningful career opportunities.”
“At the core of this initiative, we were looking at how we can enhance the collaboration amongst career and accessibility offices across each campus, to identify ways to better communicate, collaborate and support students with disabilities.”
The David C. Onley Initiative has also sought to inform and educate, both through public awareness campaigns like #ableto and through direct outreach to employers.
“We talked to employers about whether they had diversity and inclusion recruitment teams, and what resources, tools and/or services they had in place to support the hiring of students with disabilities,” says Caldwell.
“In many cases, we received feedback about how organizations are open to hiring a person with a disability, but that they are unsure of how to have a conversation about accessibility and accommodations in the workplace, if needed. They fear saying or doing the wrong thing. Some employers are operating under perceived fears, barriers and/or biases. We busted myths about some of these thoughts through our ableto.ca campaign.”
In September 2020, the initiative will deliver a final report to the Ministry of Training, Colleges and Universities. Based on its research, it will recommend a transferable model to help facilitate relevant supports for employability of students with disabilities.
“Ontario is facing a skilled labor shortage,” says Caldwell.
“Students with disabilities who are graduating from college and university programs have the training and knowledge to help address this shortage, but are often being overlooked because employers do not have access to tools, training and resources to help them create more accessible and inclusive work environments.”
Though the initiative’s work is winding down, its findings will be carried forward. Last December, Carleton launched a new pan-Canadian research initiative comprised of academic institutions, corporate partners and community service providers ” the Canadian Accessibility Network. One of its five main areas of interest is the advancement of employment opportunities for Canadians with disabilities.
And throughout the project, the initiative has aimed to affect a lasting culture shift in Ottawa’s educational and business communities.
“We wanted to build the capacity of everybody we came in touch with ” employers, campus career or disability offices, and community service providers,” says Caldwell.
By Laurie MonsebraatenSocial Justice Reporter
Toronto Star, May 22, 2020
Amanda Demerse lost her part-time job as a rink attendant with the City of North Bay in March when the municipality closed recreation facilities due to the COVID-19 pandemic.
What happened next, amid a global health emergency, is an example of what goes on every day for vulnerable people living on the fault lines of creaking federal and provincial income support systems, social policy experts say.
Since Demerse is on provincial social assistance, she is required to apply for Employment Insurance (EI), a federal benefit that Ontario and most other provinces claw back dollar for dollar.
But millions of other Canadians thrown out of work when the country went into lockdown applied for EI, too, quickly crashing the cumbersome system and prompting Ottawa to introduce a temporary emergency benefit to keep people financially afloat while ordered to stay at home to prevent spreading the virus.
Ottawa said those, such as Demerse, who applied for EI and lost their jobs on March 15 or later, would be transferred automatically to the Canada Emergency Response Benefit (CERB). The emergency federal benefit pays $2,000 a month for four months to those out of work or making less than $1,000 due to the pandemic and who have earned at least $5,000 in the past year.
To date, some 7.8 million Canadian workers have applied for the CERB, including as many as 75,000 Ontarians on social assistance who lost part-time jobs.
In April, Carla Qualtrough, Minister for Employment, Workforce Development and Disability Inclusion, urged provinces to exempt the emergency federal benefit from social assistance clawbacks “to ensure vulnerable Canadians do not fall behind.”
B.C., Yukon and the Northwest Territories obliged.
Ontario, Alberta, Manitoba and Quebec agreed to partial clawbacks.
The rest of the provinces ignored Qualtrough; they claw back the entire amount.
Under a temporary measure introduced by Doug Ford’s Ontario government last month, laid-off workers on social assistance are able to keep $1,100 of the CERB on top of their provincial welfare benefits.
But due to an EI reporting anomaly the last shift Demerse worked was March 8. Ottawa never transferred her application to the CERB.
And because Demerse is on social assistance and receiving EI, she is allowed to keep nothing.
Demerse, 31, who has an intellectual disability and is unable to work full-time, relies on Ontario Disability Support Program (ODSP) benefits to supplement her part-time wages.
Without those wages, she is struggling to make ends meet, said her father Johnny, who is his daughter’s financial guardian.
“She lost her job because of COVID,” he said in an interview. “She should be on CERB like everybody else. It’s craziness that they put her on EI where she can’t keep any of it.”
The North Bay woman’s circumstances form just one example of the many cracks in federal and provincial emergency support systems for vulnerable Canadians laid bare by the coronavirus crisis, experts say.
As governments turn their focus to reopening the economy, it will be important to deal with the “tectonic plates” of federal and provincial income support that too often collide with one another and cause “earthquakes” for vulnerable people, they say.
A spokesperson for Qualtrough, said Ottawa has expanded eligibility for the CERB to include workers who have exhausted their EI benefits since Dec. 29, 2019.
But, in an email exchange with the Star, Marielle Hossack was silent on whether laid-off workers such as Demerse would be allowed to transfer to CERB before their EI benefits run out.
Toronto social policy expert John Stapleton says Ottawa’s silence on cases such as that of Demerse is disappointing, but not surprising.
“The easiest thing would be for Minister Qualtrough to deem EI as CERB for anyone who has lost their job to the pandemic,” said Stapleton, a former provincial social services bureaucrat.
“Now that CERB is in place and is a replacement for EI, why would Ottawa not offer the same break to people receiving EI who were unlucky enough to have their jobs end earlier but who need to self-isolate in the same way?”
This begs the question why provinces, which treat social assistance as a program of last resort, continue to claw back federal supports from people who are clearly in need, Stapleton said.
Maximum monthly benefits for Demerse and others receiving ODSP are $1,169, and just $733 for people without disabilities, amounts that fall as much as 60 per cent below the poverty line.
“Why do we continue having a destitution-model social assistance system?” Stapleton asked.
“Why is it that as soon as you start to dig yourself out, the government takes everything away from you?
“It’s high time this was changed,” he said.
Demerse is among 884 people on social assistance who reported EI benefits in April, according to provincial officials. Treating these workers the same as those receiving CERB on a temporary basis ? would not be costly for the province, Stapleton said.
“But EI is only one of the tectonic plates of federal and provincial income support,” Stapleton said.
“If we exempt EI, why not CPP-Disability, veterans’ benefits, workers’ compensation and other income-replacement programs? Why would you not offer this same break to people receiving those benefits?” he asked.
The reason is likely cost and equity.
Taken together, as many as 52,000 people on social assistance receive federal and provincial benefits that are subject to complete clawbacks, Stapleton estimated.
Those clawbacks poured about $34 million into provincial coffers in April, said Palmer Lockridge, a spokesperson for Ontario’s ministry of children, community and social services.
Ontario isn’t ready to give any of that money back to people such as Demerse by treating EI the same as CERB during the pandemic.
Lockridge suggested it was up to Ottawa to transfer the North Bay woman’s EI onto the CERB.
“Given the intent of the (CERB), we encourage the federal government to show flexibility so the people who need it can access it,” he said in an email.
Reducing social assistance clawbacks for all federal and provincial income replacement programs was a key recommendation of a 2017 expert panel report on income security reform. The report also recommended boosting social assistance by up to 22 per cent within three years, with a goal of allowing people to reach the poverty line by 2027 through a combination of federal and provincial income supports.
But that report, commissioned by the previous Liberal government, was scrapped when Doug Ford’s Progressive Conservatives were elected in 2018.
May 19, 2020
Source: Injured Workers Community Legal Clinic
THUNDER BAY, Ontario, May 19, 2020 (GLOBE NEWSWIRE) — Michelle Bachelet, the UN High Commissioner on Human Rights recently gave a statement sounding the alarm that Canadians living with disabilities including permanently injured workers face disproportionate challenges during the pandemic.
“People with disabilities must often rely on others for help with daily tasks,” she reminded, something that is increasingly difficult during COVID-19 (9 April 2020).
“our efforts to combat this virus won’t work unless we approach it holistically, which means taking great care to protect the most vulnerable and neglected people in society, both medically and economically.”(6 March 2020)
Injured workers along with all Canadians living with disabilities face a bevy of unique changes to their day to day life during these difficult times, including: a closure of therapy services that had been relied upon for pain management; significant reductions in home care;
increased reliance on family members;
the heightened costs associated with essential goods delivery and safe transportation.
Here in Canada, financial supports available on disability benefits remain well below the levels offered to other Canadians receiving CERB packages, and significant concerns remain about triage policies for disabled Canadians in emergency situations during medical equipment shortages. At the same time, support for the employers is at an all-time high.
Within days of COVID-19 related business shutdowns, the Province of Ontario and the Workplace Safety and Insurance Board (WSIB) delivered a premium-deferral package for employers that offered 1.9 billion dollars in immediate relief. In the six weeks that have followed the bailout for employers, no measures have been adopted to assist injured workers themselves including those who have become sick with Coronavirus.
In fact, the WSIB has insisted on adjudicating the case of every worker who becomes ill with Coronavirus separately, an arrangement that has resulted in the approval of just 513 out of almost 3500 claims submitted claims, with more than 2807 sick workers stuck in a very slow moving lineup to get any decision at all.
“Workers who are putting their health on the line to provide critical care and maintain supply chains have to know that they will be cared for not fought against if they get the virus,” says Janet Paterson, President of the Ontario Network of Injured Workers’ Groups (ONIWG), an umbrella organization representing thousands of permanently injured workers in the province.
“Imagine coming home from work at a hospital, grocery store, or care home with Coronavirus and, on top of knowing you’re gravely ill and you’ve put your family in serious danger, you need to engage in a battle with the compensation board to prove where you got this illness?”
ONIWG is among countless groups in Ontario and across Canada calling on compensation boards to follow the lead of multiple American jurisdictions and institute a “presumption” that would allow those working during the pandemic to receive automatic coverage if they become ill with virus, in much the same way that police and paramedics receive automatic coverage for PTSD.
ONIWG delivered a submission under the United Nations Convention on the Rights of Persons with Disabilities in September of 2019 highlighting some of the most discriminatory practices of the WSIB and the lack of access to justice to resolve these practices.
For example, the WSIB engages in a process called “deeming,” in which they assign “phantom jobs” to injured workers and reduce their benefits by 100% of the wages the Board estimates the worker should be earning whether they are able to get that job or not. Bafflingly, despite a provincial labour market that has shed half a million jobs in the last month alone, the WSIB continues to pretend permanently disabled workers are out there during a global pandemic working 40 hours a week at jobs that don’t even exist for Canadians with no physical restrictions.
For questions, interview requests, or to connect with an injured worker affected by the COVID-19 crisis, please contact: Janet Paterson, President, ONIWG
The pandemic has caused confusion among disability recipients when it comes to properly reporting income by Aaron Broverman
May 16, 2020
Confusion around the Ontario Disability Support Program during the pandemic put writer Meagan Gillmore in a financial bind.
It’s no secret that Torontonians with disabilities are particularly vulnerable to contracting COVID-19, and there’s a fear among the disabled community that they would not receive adequate treatment while in hospital.
Recently, the Ontario government has made it even more difficult for them to self-isolate and afford basic needs, even if they qualify for the Canadian Emergency Response Benefit (CERB).
The CERB provides up to $2,000 a month for up to 16 weeks to people who have lost their jobs as a result of the pandemic.
Hundreds of thousands Ontarians with disabilities already receive income support through the Ontario Disability Support Program (ODSP), but the maximum any single individual can receive already puts people 30 to 40 per cent below the poverty line at $1,169 a month. People on ODSP can work, but any income they earn is clawed back at $0.50 on the dollar and deducted from the cheque after the first $200.
After a month of uncertainty, the province announced on April 21 that the CERB would be treated as income if you are among the estimated 75,000 Ontarians with disabilities who receive ODSP but also qualify for the federal benefit (having made $5,000 in 2019). ODSP would be clawed back at the usual rate and an individual could expect to lose $900 from their cheque despite the federal government recommending the CERB not be treated as income.
“ODSP benefits have been very low for a long time. They are not adequate for someone to be able to live on,” says Arash Ghiassi, lawyer and Yale Public Interest Fellow at the Income Security Advocacy Centre (ISAC), a non-profit legal clinic advancing the systemic interests and rights of low-income Ontarians. “When faced with a pandemic, we know that poverty and disability are going to make it more difficult for ODSP recipients to be able to keep themselves healthy and keep all of us healthy.
“This [CERB] benefit is meant to go to all Canadians who need it, including people with disabilities,” Ghiassi adds. “It should not go to provincial coffers.”
As a result of qualifying for both CERB and ODSP, depending what a recipient earned before, some will get more money in their pockets than they did pre-pandemic and some will receive less.
“Some may argue that it’s unfair for anyone with a disability to receive more because they have lower fixed expenses than the average person,” says Ron Malis, a Toronto-based financial advisor who specializes in financial advice for people with disabilities and their families.
He contends that people with disabilities are getting the short end of the financial stick. “I would argue people on ODSP may have lower fixed expenses, but their discretionary expenses are also little to nothing so they have no wiggle room.”
Meanwhile, the pandemic is also causing confusion among ODSP recipients as far as how to properly report income, causing many to receive money they’re not actually entitled to and putting them on the hook to pay it back in addition to managing their own survival.
Meagan Gilmore is a freelance journalist who covers disability legislation issues for TV channel Accessible Media Inc. Before the pandemic, her ODSP payments were suspended because over the last few months she made too much to qualify.
Then in March, as things were beginning to shut down, not only was it difficult to get a hold of social workers at the ODSP, but Gilmore says she received a letter stating she wouldn’t need to report and that her ODSP would continue to be distributed at previous income levels. (In her case, zero.)
However, when she didn’t report her income for March, she received the full ODSP amount in April, as it was assumed she didn’t make any income. She had two choices: either write a cheque or have a small amount deducted from each cheque over the next 20 months.
“Obviously, I’m going to write a cheque for the full amount, but it’s one of those things where you think, ‘Really, you’re going to penalize someone for close to two years because you were unclear in your communication?’” says Gillmore.
According to Ghiassi, the difficult position Gillmore was put in is emblematic of other errors arising from the pandemic and the way benefits are treated if you receive ODSP.
“The issue of overpayment is an issue we’re hearing more and more about,” he says. “People are being penalized for applying for the CERB and then it turns out they don’t qualify for it and have to pay it back,” he says, adding that people have to pay it back twice once to the federal government and once as a partial clawback from the province.
“It’s an issue we’re seeing again and again and an issue we will see more when time goes by, but it needs to stop. We’ve asked the provincial government to stop assessing overpayments and receiving overpayments for the duration of the pandemic.”
Accessibility for Ontarians with Disabilities Act Alliance Update
United for a Barrier-Free Society for All People with Disabilities
March 25, 2020
The current COVID crisis is especially threatening for people with disabilities. As a result, we today wrote Ontario Premier Doug Ford to call for strong action to protect the urgent needs of Ontarians with disabilities during this critical time. Our letter is set out below.
In our letter, we:
* Ask Premier Ford to direct his senior officials to act on the recommendations for action in the March 20, 2020 AODA Alliance Update, which lists vital action that Ontarians with disabilities need our governments at all levels to take.
* Ask Premier Ford not to totally freeze during this COVID crisis the work of Standards Development Committees appointed under the Accessibility for Ontarians with Disabilities Act, even if some of their work must briefly be delayed, and
* Urge Premier Ford to convene via virtual meetings the available members of the Standards Development Committees now in place to brainstorm options for The Government could take to address the urgent needs of Ontarians with disabilities during The Government’s emergency planning to deal with the COVID crisis.
We again offer The Government our assistance with any efforts to ensure that the needs of Ontarians with disabilities are safeguarded during this crisis.
We also set out below the March 23, 2020 letter to Ontario Accessibility Minister Raymond Cho from NDP MPP Joel Harden. Mr. Harden offers good ideas for Government action during this crisis.
A total of 419 days have passed since the Ford Government received the final report of the Independent Review of the AODA’s implementation that former Lieutenant Governor David Onley conducted. We are still waiting for The Government to announce a serious plan of action to implement its recommendations regarding the AODA’s implementation and enforcement.
We always welcome your feedback on these issues, and any others! Email us at [email protected]
ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE
1929 Bayview Avenue
Toronto, Ontario M4G 3E8
Email: [email protected]
March 25, 2020
Via Email: [email protected]
To: Hon. Doug Ford, Premier
Room 281, Legislative Building
Dear Premier Ford,
Re: Ensuring that the Urgent Needs of 2.6 Million Ontarians with Disabilities Are Fully Addressed in The Government’s emergency Planning for the COVID Crisis
We appreciate all the hard work that the Government has been shouldering in the face of the horrible COVID virus crisis that is engulfing our province and the entire world. We know that at all levels, The Government is working under very difficult circumstances to head off unprecedented health and economic crises that we all now face.
It is vital that The Government’s emergency planning include strong and effective measures to ensure that the emergency needs of 2.6 million people with disabilities are effectively met. Ontarians with disabilities are already a vulnerable and disadvantaged part of our society. They will disproportionately suffer this crisis’s hardships.
On March 20, 2020, the AODA Alliance made public a comprehensive call for strong government action on this front. We ask you to share it with your Government’s senior officials. Please direct them to take the emergency actions listed there to address this part of the crisis.
It is also essential that The Government not over-react to this crisis by taking action that works against the important needs of Ontarians with disabilities. For example, yesterday, in the wake of this crisis, the Accessibility Ministry announced that it has put on hold the ongoing work on developing new accessibility standards for the time being. Its March 24, 2020 email to members of the K-12 Education Standards Development Committee (of which AODA Alliance Chair David Lepofsky is a member) included the following:
Note: SDC stands for Standards Development Committee.
“Please be advised that due to the current circumstances, the Ministry for Seniors and Accessibility will be suspending all planned SDC meetings, whether in person or teleconference, as well as any technical sub-committee/small team meetings until further notice….
At the request of the Chair, please release your April dates but continue to hold the May and June dates until further notice. We will keep you updated over the coming weeks.
The Ministry will continue to work on developing a revised workplan, in conversation with yourself on the restart of the SDC meetings when it becomes possible to do so….”
It is understandable that The Government cancelled the April 1, 2020 meeting of the K-12 Standards Development Committee, even as a virtual meeting, given the immediacy of the crisis. However, there was no need for The Government to have made an announcement that suspends all work of Standards Development Committees, even the informal work of sub-committees. Those sub-committees use email and conference calls to informally brainstorm ideas to bring forward when the full Standards Development Committee next meets. They have important work now in progress. No Government staff take part in those meetings.
Of course, some Standards Development Committee members may have limited time on hand due to the crisis, as well as work or family obligations. However, for any who are isolated at home, with time on their hands, The Government should encourage them to feel free to carry on with their work. The Government should not send out a message that will sound to some like everything is to be entirely frozen until further notice.
Far from now shutting down the work of Standards Development Committees for the time being, The Government should now hurry to draw on these expert committees for help with emergency planning for the COVID crisis. Their membership was hand-picked based on their expertise in important areas concerning accessibility for people with disabilities.
We call on The Government to quickly convene virtual meetings of these Standards Development Committees to brainstorm ideas for measures that The Government should implement as part of its emergency planning, to help reduce this crisis’s disproportionate hardships for Ontarians with disabilities. For example:
Some Standards Development Committee members may be unavailable to take part in this brainstorming. Let’s just get whomever is available around the virtual table as soon as possible to put their heads together in the public interest.
There is no need to comply with the full procedural strictures that the Accessibility for Ontarians with Disabilities Act spells out for formal Standards Development Committee proceedings. This is because the aim would not be for these committees to formulate and vote on formal collective recommendations for new accessibility standards to be enacted under the AODA. Rather, The Government should call on their members to simply brainstorm ideas which individual members could offer and which The Government could collect, share with the public, and infuse into its emergency planning where appropriate.
We don’t suggest for a moment that only Standards Development Committee members should be consulted on these important issues. However, with the crisis now upon us all, these Committees are an easily-reached and readily available source of expertise that is right at hand.
In conclusion, we repeat what our March 20, 2020 call for action had emphasized. In this crisis, we are all experiencing more than ever the harms caused by past Government failures to effectively act on accessibility for people with disabilities. As but one example, there are real harms now flowing from the Government’s having left the work of Standards Development Committees frozen from the day it took office in June 2018 up until months later. Had the work of the Health Care Standards Development Committee not been frozen for over a year after June 2018, The Government would now have the benefit of its final recommendations as it rushes to put in place emergency health care services to combat the COVID virus.
Let’s learn the lessons of the past, and not stop the work of Standards Development Committees any longer than necessary and any more than necessary. Let’s accelerate their work where it will help us combat the societal effects of the COVID virus.
We remain at your service to help in any way we can. We wish you and all those working for the Government, as well as all Ontarians, health and safety in the wake of this crisis.
David Lepofsky CM, O. Ont
Chair Accessibility for Ontarians with Disabilities Act Alliance
The Hon. Raymond Cho Minister for Accessibility and Seniors [email protected]
Christine Elliott, Minister of Health and Deputy Premier [email protected]
Hon. Raymond Cho
Ministry for Seniors and Accessibility
777 Bay St.
Toronto, ON, M5G 2C8
March 23, 2020
Dear Minister Cho,
At this extraordinary time, we must do everything we can to support those who need it most. That is why I am writing to share with you two ideas for your Ministry that will ease the impact of the COVID-19 pandemic for seniors and people with disabilities.
In our constituency of Ottawa Centre, the Good Companions Seniors’ Centre runs an innovative program called the “Seniors Centre Without Walls”. The initiative allows seniors and people with disabilities to call a toll-free number and connect with each other remotely, allowing them to participate in educational seminars, music, interactive games and more.
During this public health emergency where seniors and people with disabilities are asked to stay home for their own safety, there is a heightened risk of social isolation. As I write to you, thousands of seniors and people with disabilities are living alone, cut off the from the activities that previously provided them with human to human connection.
That is why I am asking the Ministry of Seniors & Accessibility to work with Seniors Active Living Centres to expand the “Seniors Centre Without Walls” so that every senior or adult with a disability in Ontario can access this service. In doing so, special consideration should be paid to ensuring that Francophone and minority language speaking seniors are able to participate.
On a related note, we must ensure that Ontarians who are deaf or hard of hearing are able to receive crucial information on the availability of government services, business closures, and public health updates in the midst of this crisis.
That’s why I am requesting ASL interpretation for all government press conferences related to COVID-19, and the publication of official announcements in accessible formats. We need to make sure that all 1.9 million Ontarians with disabilities have the information they need to protect themselves and their families.
Minister, thank you for your consideration of this letter and its requests. I look forward to working with you to support our vulnerable seniors and people with disabilities in the days ahead.
My very best,
Official Opposition Critic for Seniors, Accessibility and People with Disabilities
MPP for Ottawa Centre
CC: Monique Doolittle-Romas
Accessibility for Ontarians with Disabilities Act Alliance Update
United for a Barrier-Free Society for All People with Disabilities
March 20, 2020
The Covid-19 virus crisis has serious implications for people with disabilities in our community. This cries out for immediate and major action by all levels of government. We call on our federal, provincial and municipal governments and other major public institutions to ensure that planning for the most vulnerable in our society, including people with disabilities, is a key part of all emergency planning in this area. We urge one and all to do what they can to stay isolated and safe.
We here offer concrete ideas. We are ready to help in any way we can. In this Update, we:
* outline some of the serious additional hardships that this Covid crisis is inflicting on over 2.6 million Ontarians with disabilities.
* Offer concrete proposals for immediate action by all levels of government and
* Outline some important lessons that our government must learn after this crisis is behind us all.
We recognize that our governments at all levels are rushing to address an unbelievable crisis. They have many huge pressures on them. They are working around the clock.
We deeply appreciate all the efforts made to date to help protect the public. We here offer constructive suggestions on how to ensure that their efforts include the pressing needs of people with disabilities in this crisis. In offering these ideas, we don’t want to leave any impression whatsoever that no one is doing anything for people with disabilities. We just want to ensure that our public institutions are collectively doing all we and they can on this front. It may well be that more is going on than we have seen. Whatever be the case, we hope the following ideas will help.
Of the great many people whom the Covid virus will affect, the 2.6 million Ontarians who have a disability will disproportionately feel its harmful effects. We offer a few important reflections on the particular needs of people with disabilities as our society copes with the Covid-19 virus crisis that has so swiftly engulfed us all.
Specific Government Planning for the Needs of People with Disabilities Is especially vital, for several reasons. Here are the ones we’ve identified on short notice. There are, no doubt, many other similar impacts on people with disabilities beyond those listed here.
First, those who are most vulnerable to the dangers of the Covid virus are seniors and people with disabilities. Disproportionately, seniors have disabilities. Whether or not one is a senior, those with fragile or compromised medical conditions are especially at risk. While not all people with disabilities are medically fragile or compromised, there are a higher proportion of medically vulnerable people among our population of people with disabilities.
Second, the media has reported that the virus has had an especially serious impact on some living in care homes. Of course, those living in such facilities are typically (if not entirely) people with disabilities.
Third, self-imposed isolation at home is vital for everyone at this dangerous time, in order to contain this virus. This self-isolation at home can present additional hardships for some people with disabilities. For them, eliminating all close contact with other people may not be possible.
Fourth, the much-needed cancellation of school and day care programs is hard on all kids. For children with certain disabilities, this can be even harder.
For example, for children with disabilities like autism, the need for a structured and predictable day is important. That structured and predictable day has been blown away by the closure of schools and many programs for children with disabilities. Some children with disabilities get critically important services at school, beyond the school’s education program. Their families must now struggle to find those services elsewhere, and try to get them brought into the home, lest they have to venture out into the community. Some of those services will be closed now, due to the economic shutdown that is hitting so much of our economy.
Some of the important support workers and service providers will face serious economic peril as they are closed or laid off during these closures. Their economic survival may be in jeopardy.
Fifth, effective self-isolation requires a person or family to dig into their savings. A disproportionate number of people with disabilities live at or below the poverty line. They won’t have the savings one needs for this.
Sixth, the homeless too often include people with addiction and/or other mental health conditions. For them, self-isolation at home to avoid this virus is not even an option.
Seventh, we have all been told that frequent hand-washing is extremely important to protect ourselves from getting this virus. As one person with a disability pointed out on Twitter, this is hard to do in washrooms where the soap dispenser is not in an accessible location.
Eighth, for those who were away from home as this crisis escalated, and who have to travel to get home, the many disability barriers in our transportation sector will feel even more amplified now. It has at times been hard to get through on the phone to an airline. Now it is even worse. Long waits at airports are hard on everyone. On passengers with disabilities with frail medical conditions or fatiguing conditions, this is much harder.
Ninth, as the spread of this virus gets worse, we are going to need to rely more and more on our health care system. Our governments are expected to plan for a major surge in demand for hospital services.
Yet patients with disabilities now still face far too many barriers in the health care system. After years and years of our advocacy, the Ontario Government is belatedly working on developing a Health Care Accessibility Standard under the Accessibility for Ontarians with Disabilities Act.
However, at the rate at which the Ontario Government has been going on this issue, a new regulation to set standards for accessibility in the health care system is likely still years away from being enacted and implemented. Last month we made public our detailed Framework that lists what needs to be done to make our health care system truly and fully accessible to patients with disabilities.
Tenth, as schools are closed and post-secondary education organizations such as colleges and universities move their teaching to online platforms, the recurring barriers in education facing students with disabilities become all the more hurtful.
For example, if any colleges and universities have not ensured the full accessibility of their digital learning environment, the move to online learning risks becoming the move to a world of even more education barriers. In that regard, last week the AODA Alliance made public a draft Framework for the promised Post-Secondary Education Accessibility Standard. We seek your input on that draft before we finalize it. Given the crisis facing us all, it is all the more important for post-secondary education organizations to move very fast now to ensure that their digital learning environments are barrier-free for students with disabilities.
Eleventh, the additional burdens of this virus can be felt differently in different disability contexts. For example:
Today, the maxim “It takes a village” rings loud and clear. As individuals, we can each reach out to others to see what assistance we can rally. Many are doing so. The business sector can also do a great deal to help, by planning measures to ensure that people with disabilities are accommodated during this crisis.
We commend everyone who is trying to help others, on a one-to-one basis, or through more collective efforts. We applaud those retail stores like grocery stores and drug stores that have announced plans to allocate special shopping hours for customers who are seniors or people with disabilities. We encourage the entire business community, and especially those in the food, restaurant, banking, and other retail and service areas, to implement and announce similarly creative strategies to ensure that customers with disabilities are effectively served.
Such commendable localized and individualized volunteer measures are only one part of the picture. it is absolutely essential for our governments at all levels to take a strong lead and to show decisive leadership on these disability concerns. They need to quickly plan and implement specific strategies to ensure that people with disabilities are safe, are fully protected from the community spread of the Covid-19 virus and are able to live in the isolation to which we all must commit ourselves. Our governments at all levels need to proactively build strong and effective disability considerations into all aspects of their emergency planning.
This makes good policy sense. It is so obvious to Ontarians with disabilities. However, over the years, we have found over and over that our governments too often fail to effectively take into account the needs of people with disabilities in their policy planning. This is so even though government after government congratulates itself on supposedly leading by example on disability accessibility and inclusion.
Multiple reports have told the Ontario Government about this serious unmet need and the lack of effective provincial leadership. This has continued even years after enactment of the Accessibility for Ontarians with Disabilities Act.
What we seek is a sensible thing to do. It is also an obligation on the part of our government.
The Canadian Charter of Rights and Freedoms guarantees to people with disabilities the constitutional right to equality before and under to the law, and to the equal protection and equal benefit of the law without discrimination based on disability. The Supreme Court of Canada made this obligation clear almost a quarter century ago in the landmark case of Eldridge v. British Columbia. It held that governments have a strong duty to take into account and accommodate the needs of people with disabilities when they design and implement public programs, including, most notably, health care. The AODA itself is a law which the grassroots disability community fought for over a decade, to turn Eldridge’s powerful language into a reality in the lives of people with disabilities. However, since the AODA was enacted in 2005, Government after Government has achieved progress on accessibility and inclusion for people with disabilities at a glacial pace, according to the 2019 report of the Third Independent Review of the AODA’s implementation conducted by former Lieutenant Governor David Onley.
The accessibility standards enacted to date under the AODA include some requirements regarding emergency planning for people with disabilities. We set these out at the end of this Update. They only cover a small part of what people with disabilities now need in Ontario from their governments and leading public sector organizations like hospitals and public transit providers.
The AODA Alliance has repeatedly revealed that successive governments have done a poor job of enforcing the AODA. In this crisis, the harm to people with disabilities from that failure is even more harmful.
We offer a list of actions that governments should immediately take. This is not the last word on this issue. This list is only the first word. Proper planning and feedback from people with disabilities will reveal other important actions to add to this list.
For example, announcements by the Prime Minister of Canada or Ontario’s Premier should be simultaneously available with captioning and Sign Language interpretation. Public websites where emergency information is posted should be fully barrier-free. Plain language options should be available for persons with intellectual or cognitive disabilities.
This could include emergency supplements to social assistance like ODSP, the Disability Tax Credit and other financial supports. Emergency expedited procedures to process those claims should be implemented. There should be a moratorium on Government efforts to cut off such social assistance supports as ODSP. Protections against credit card penalties during this crisis should also be on the agenda. Those who lead the advocacy efforts for income security for people with disabilities should be at the forefront of discussions on this issue.
As but one example, the Covid testing centres that governments are rushing to open should be designed to be fully barrier-free for patients with disabilities. The AODA Alliance’s Framework for barrier-free health care services is a good starting point for this.
However, these safety masks and gloves must also be made available widely to people with disabilities who need them to be used by care-givers, attendant care providers, group home staff, and other like people with whom they must closely deal.
Governments are scrambling to deal quickly with this Covid crisis. It is vital to ensure that the needs of people with disabilities are not again left out of the policy planning process, where the stakes for everyone are so high.
When we get this crisis behind us, there will be much-needed efforts to figure out what went wrong, and how we can learn from the events that are now unfolding. Our governments, public institutions and private sector organizations must learn some key lessons from the experience of people with disabilities.
One big lesson to be learned is that we are now all suffering the consequences of grossly-inadequate past government efforts at making our society fully accessible to people with disabilities. As one example, for years, the disability community has faced far too much resistance when seeking to get requirements enacted to install such helpful accessibility features as automatic water faucets, soap dispensers and paper towel dispensers in public bathrooms. The same goes for requiring automatic power doors, so that one does not have to either physically open the door or press a button to get the door to open. Yet in the face of the Covid crisis, these basic accessibility features are now vital to protect everyone from the dangerous spread of the Covid virus when we use a public washroom.
Similarly, in the past, some employees with disabilities have encountered resistance when they have asked some employers to let them work from home. Other employers were supportive. With this virus, employers have rapidly made this accommodation widely available to many of their employees, as a good public health measure to prevent the spread of the virus. ` We need to more effectively ensure that no employees with disabilities ever have to face such resistance to such workplace accommodations in the future.
One can imagine many more such illustrations of this broader lesson to be learned. These examples help show that the failure of government after government in Ontario to effectively implement and enforce the AODA must dramatically change in the future. Three successive Government-appointed Independent Reviews of the AODA’s implementation and enforcement have called for major reforms and strong new provincial leadership. The current Ontario Government has had 414 days since it received the most recent of these reports, and still has no effective plan to implement it.
March 19, 2020
)Note: The AODA Alliance encourages all governments to consider the following recommendations which one of our supporters brought to our attention.)
In the light of the COVID19 pandemic and its disproportionate impact on persons with disabilities, the International Disability Alliance (IDA) has compiled the following list of the main barriers that persons with disabilities face in this emergency situation along with some practical solutions and recommendations. This document is based on inputs received from our members around the world aiming to assist global, regional, national and local advocacy to more efficiently address the range of risks persons with disabilities face.
If you have any updates on how COVID 19 is affecting persons with disabilities in your area of work, or want to share any good practices or lessons learnt, please contact IDA Inclusive Humanitarian Adviser Ms Elham Youssefian via emailing [email protected]
Recommendation 1: Persons with disabilities must receive information about infection mitigating tips, public restriction plans, and the services offered, in a diversity of accessible formats
Recommendation 2: Additional protective measures must be taken for people with certain types of impairment.
Recommendation 3: Rapid awareness raising and training of personnel involved in the response are essential
Recommendation 4: All preparedness and response plans must be inclusive of and accessible to women with disabilities
Recommendation 5: No disability-based institutionalization and abandonment is acceptable
Recommendation 6: During quarantine, support services, personal assistance, physical and communication accessibility must be ensured
Recommendation 7: Measures of public restrictions must consider persons with disabilities on an equal basis with others
Recommendation 8: Persons with disabilities in need of health services due to COVID19 cannot be deprioritized on the ground of their disability
Recommendation 9: OPDs can and should play a key role in raising awareness of persons with disabilities and their families.
Recommendation 10: OPDs can and should play a key role in advocating for disability-inclusive response to the COVID19 crisis
*For updated resources on inclusion of persons with disabilities in Covid19 prevention and response, please regularly check the webpage dedicated by the International Disability Alliance at http://www.internationaldisabilityalliance.org/covid-19
The Integrated Accessibility Standards Regulation, enacted in 2011 under the Accessibility for Ontarians with Disabilities Act, includes the following emergency-related provisions.
Emergency procedure, plans or public safety information
(2) Obligated organizations that prepare emergency procedures, plans or public safety information and make the information available to the public shall meet the requirements of this section by January 1, 2012.
Workplace emergency response information
(2) If an employee who receives individualized workplace emergency response information requires assistance and with the employee’s consent, the employer shall provide the workplace emergency response information to the person designated by the employer to provide assistance to the employee. O. Reg. 191/11, s. 27 (2).
(3) Employers shall provide the information required under this section as soon as practicable after the employer becomes aware of the need for accommodation due to the employee’s disability.
(4) Every employer shall review the individualized workplace emergency response information,
(a) when the employee moves to a different location in the organization;
(b) when the employee’s overall accommodations needs or plans are reviewed; and
(c) when the employer reviews its general emergency response policies.
(5) Every employer shall meet the requirements of this section by January 1, 2012.
(2) The process for the development of documented individual accommodation plans shall include the following elements:
(3) Individual accommodation plans shall,
(a) if requested, include any information regarding accessible formats and communications supports provided, as described in section 26;
(b) if required, include individualized workplace emergency response information, as described in section 27; and
(c) identify any other accommodation that is to be provided.
Emergency preparedness and response policies
(a) shall establish, implement, maintain and document emergency preparedness and response policies that provide for the safety of persons with disabilities; and
(b) shall make those policies available to the public. O. Reg. 191/11, s. 37 (1).
(2) Conventional transportation service providers and specialized transportation service providers shall, upon request, provide the policies described in subsection (1) in an accessible format. O. Reg. 191/11, s. 37 (2).
(3) Conventional transportation service providers and specialized transportation service providers shall meet the requirements of this section by January 1, 2012.
Regarding para-transit services, the Integrated Accessibility Standards Regulation requires:
Emergency or compassionate grounds
(a) where the services are required because of an emergency or on compassionate grounds; and
(b) where there are no other accessible transportation services to meet the person’s needs. O. Reg. 191/11, s. 65 (1).
(2) A person shall apply for the services described in subsection (1) in the manner determined by the specialized transportation service provider. O. Reg. 191/11, s. 65 (2).
(3) Specialized transportation service providers shall meet the requirements of this section by January 1, 2014.
Accessibility for Ontarians with Disabilities Act Alliance Update
United for a Barrier-Free Society for All People with Disabilities
February 25, 2020
What must be done to make Ontario’s health care system accessible to patients with disabilities and to any patients’ support people with disabilities? What should be included in the Health Care Accessibility Standard that the Ontario Government is now developing under the Accessibility for Ontarians with Disabilities Act?
Here we unveil our most thorough and comprehensive brief on this topic. Below please find the AODA Alliance’s finalized Framework on what the Health Care Accessibility Standard should include.
We have submitted this new Framework to the Ford Government. We have also submitted it to the Health Care Standards Development Committee. The Government appointed that Committee under the AODA. That Standards Development Committee has the job of developing recommendations on what the Government should include in the promised Health Care Accessibility Standard to make Ontario’s health care system disability-accessible. This Framework sets out what we urge that Standards Development Committee to recommend to the Ford Government.
Last December we made public a draft of this Framework and invited your feedback. We thank all those who sent us feedback. We’ve done our best to use that feedback as we finalized this Framework. This final brief includes everything that was in our December draft. It has added recommendations, drawing on the excellent feedback we received from our supporters.
So what’s next? The Health Care Standards Development Committee is now writing a set of draft recommendations for the Government on what the Health Care Accessibility Standard should include. Later this year, that Committee is expected to make its draft recommendations public, and to invite public feedback on it. After that, the Health Care Standards Development Committee is required to consider that public feedback as it finalizes its recommendations to the Government.
The Health Care Standards Development Committee certainly knows about our efforts on this issue. Last December, we sent our earlier draft of this Framework to that Committee. On January 16, 2020, AODA Alliance Chair David Lepofsky made a 15 minute presentation to the Health Care Standards Development Committee on our recommendations. As noted above, we have now provided this finalized Framework to the Standards Development Committee.
We have asked the Health Care Standards Development Committee to adopt all of our recommendations. At the very least, we have asked that Committee to append this framework to its draft recommendations and to invite public feedback on it.
Once the Health Care Standards Development Committee makes its draft recommendations public for our feedback, we will circulate it to you. We will prepare a submission to the Standards Development Committee, using this Framework as our foundation.
Please share this Framework with people you know who work in the health care system. It would be great if Ontario’s health care system starts taking action on our recommendations now, because they are good ideas!
In addition to this Framework, you may wish to check out the captioned 1-hour talk on barriers in the health care system by AODA Alliance Chair David Lepofsky. For all our efforts in recent years, leading the campaign to get Ontario to enact a much-needed Health Care Accessibility Standard to make the health care system accessible to patients with disabilities, check out the AODA Alliance’s health care page on our website.
A grand total of 390 days have now gone by since the Ford Government received the final report on the AODA’s implementation and enforcement that was prepared by former Lieutenant Governor David Onley. We are still waiting for the Ford Government to come up with an effective plan to implement the Onley Report’s recommendations to strengthen the AODA’s implementation and enforcement.
February 25, 2020
Proposed by the Accessibility for Ontarians with Disabilities Act Alliance
The Ontario Government has committed to develop a Health Care Accessibility Standard under the Accessibility for Ontarians with Disabilities Act (AODA). In 2017, the Ontario Government appointed a Health Care Standards Development Committee to make recommendations on what the Health Care Accessibility Standard should include. On March 7, 2019, the Doug Ford Government committed to resume this Committee’s work.
The AODA requires the Ontario Government to lead Ontario to become accessible to people with disabilities by 2025. The Government is required to do so by enacting and effectively enforcing accessibility standards, which are enforceable regulations. Under the AODA, an accessibility standard is required to specifically spell out the barriers that are to be removed or prevented, what specifically must be done to remove or prevent them, and the timelines required for these actions.
In this Framework, the AODA Alliance proposes key ingredients and aims that should be included in the Health Care Accessibility Standard. We hope this will assist the Health Care Standards Development Committee.
The Health Care Accessibility Standard should set detailed requirements for specific actions that health care providers and organizations shall take. It is not sufficient for this accessibility standard to vaguely require health care facilities or providers to simply make plans and policies on accessibility, or to vaguely require obligated organizations to consider or include accessibility features in their health care facilities or services. The details of what this accessibility standard will require are vital to its success.
Some needed actions will have to be taken by each health care facility and/or health care provider. Some will need to be taken by the self-governing bodies that regulate each of the health professions in Ontario. Some of the needed actions will have to be taken by the Ontario Government. The Government funds, centrally plans and oversees Ontario’s health care system.
It is especially pressing to now effectively address disability barriers in Ontario’s health care system. In 2020, Ontario’s health care system is still replete with serious accessibility barriers, even fully 15 years after the AODA was enacted. Too often, it has been designed and operated on the unspoken or unarticulated premise that it is largely if not totally meant for patients without disabilities. Yet disproportionately, those who use and need the health care system are people with disabilities.
We each make the greatest use of health care services towards the end of our lives. Disabilities are far more prevalent among seniors. Disability most often is caused by aging.
Twenty-three years ago, in Eldridge v. British Columbia  3 SCR 624, the Supreme Court of Canada established the broad principle that patients with disabilities have a constitutional right to accessible health care services in Canada. Yet since then, the Ontario Government has not undertaken a comprehensive effort or strategy to identify the recurring disability barriers in the health care system. It has not implemented a comprehensive plan to remove and prevent those barriers. In the meantime, old barriers remain while new ones keep being created.
Even the very barrier that the Supreme Court ordered provincial governments to fix almost a quarter century ago too often remains in place. In the Eldridge case, the Supreme Court ruled that the Charter of Rights makes provincial governments responsible to ensure the provision of Sign Language interpreter services for deaf patients in hospitals that need them to effectively communicate with health care providers. This is a constitutional right of those patients. Yet in its December 26, 2019 edition, the Hamilton Spectator reported on recent incidents where this vital service was not assured in a Hamilton, Ontario hospital.
Ontario needs a strong, comprehensive and enforceable Health Care Accessibility Standard enacted under the AODA so that patients with disabilities don’t have to fight an endless number of legal cases under the Canadian Charter of Rights and Freedoms and the Ontario Human Rights Code to tear down these many barriers, one at a time. Health care facilities and providers should not have to each separately re-invent the accessibility wheel, trying to figure out how to address the known and recurring disability barriers in Ontario’s health care system.
In her case, it took Ms. Eldridge up to seven years to win the right to a sign language interpreter in a hospital’s emergency room where she gave birth to twins. A pregnant woman about to give birth in a hospital emergency room cannot be expected to wait seven years for such a needed accessibility service.
Achieving accessibility in Ontario’s health care system should be doable for several compelling reasons. The system receives enormous public funding. Health funding is always a high priority for government after government. There is substantial centralized government planning of the health care system. This issue bears on the lives and health of everyone in Ontario. This is because everyone is bound to eventually get a disability as they age.
Moreover, Ontario’s health care system is undergoing ongoing and substantial reforms and innovation. Every year, new health care facilities are established or built. Change is always in the wind. That makes changes in favour of accessibility easier to implement.
We hope the Health Care Standards Development Committee finds this Framework helpful. We ask the Health Care Standards Development Committee to vote separately on each of these recommendations. In any event, we encourage the Standards Development Committee to attach this Framework to its forthcoming package draft recommendations that it will be required to circulate and post for public comment. That would enable the Health Care Standards Development Committee to get public input on this Framework to guide its development of its final recommendations.
This Framework reflects our years of efforts at gathering input from the grassroots of Ontario’s disability community and consulting experts here and abroad. Last December, we made public a draft of this Framework for public comment. We are indebted to those who read it so carefully and offered suggested improvements. We’ve done our best to incorporate the excellent feedback that we received.
It has taken our substantial multi-year grassroots effort to reach the point of having a Health Care Standards Development Committee appointed and now working on developing recommendations on what the promised Health Care Accessibility Standard should include. Since 2009, the AODA Alliance has led the campaign to get the Ontario Government to develop a Health Care Accessibility Standard. This is documented on our website’s Health Care page. It took the previous Ontario Government up to six years just to decide in 2015 to develop a Health Care Accessibility Standard. It took another two years to get the previous Government to take the first step of appointing this Health Care Standards Development Committee. We then had to fight for up to a year to get the current Government to lift the freeze on the work of the Health Care Standards Development Committee.
The AODA Alliance spearheaded all of these grassroots efforts. At the same time, we have had to campaign against the Ontario Government’s efforts to substantially narrow the range of disability accessibility barriers that the Health Care Standards Development Committee would be free to consider.
In this Framework, the term “health care facility” means any organization that provides any kind of health care service, from a major hospital to a local physician’s office. It includes an organization whose primary purpose is not provision of health care, but which includes a health care service within it. For example, a university may include a health clinic, which, for the purpose of this Framework, is treated as a health care facility. The term “major health care facility” refers to larger health care facilities and centres, not smaller operations like an office for a single physician, dentist or other health care professional.
In this Framework, “health care provider” means anyone who helps provide any kind of health care service, including any health care professional (whether or not their profession is regulated), any support staff or volunteers that assist them and any drug store staff that assist a patient with getting and using medications.
In this Framework, we address barriers in the health care system that can impede patients with disabilities, and/or any patients’ support people (whether family members, friends or others) where the support person or care giver has a disability. Whether or not a patient has a disability, some of their care givers or support people (such as family members) may have disabilities. The disability barriers in the health care system that impede patients with disabilities can also often impede a care giver or support person who has disabilities.
This framework sets out recommendations for actions that the Health Care Accessibility Standard should require. In this Framework, when we state that a health care provider or facility or other organization “should” do something, we mean that the Health Care Accessibility Standard should require this action. We do not propose these actions as guidelines or best practices. “Best practices” or guidelines are not mandatory or enforceable. This Framework proposes actions which need to be mandatory and enforceable.
We acknowledge with thanks the tremendous help provided to us by the ARCH Disability Law Centre and by an amazing team of volunteer law students at the Osgoode Hall Law School who made a huge difference in the preparation of this Framework.
The following are the headings in this Framework:
#1-1. The objective of the Health Care Accessibility Standard should be to ensure that Ontario’s health care system and the services, facilities and products offered in it, become fully accessible to all patients with any kind of disabilities and to any support people with disabilities for any patient, by 2025, the AODA’s deadline, by requiring the removal and prevention of accessibility barriers that impede people with disabilities, and by providing a prompt, accessible, fair, effective and user-friendly process to learn about and seek disability-related accommodations tailored to a person’s individual disability-related needs. It should aim to ensure that patients with disabilities can fully benefit from and be fully included in the health care services and products offered in Ontario’s health care system on a footing of equality. It should aim to eliminate the need for patients with disabilities and any support people with disabilities to have to contend with and fight against health care accessibility barriers, one at a time, and the need for health care providers to have to re-invent the accessibility wheel one health care facility or one health care provider at a time. It should aim for health care services, facilities and products in Ontario to be designed and operated based on accessibility principles of universal design.
This is what the AODA requires this accessibility standard to achieve. This goal also lives up to the Charter of Rights’ and Ontario Human Rights Code’s accessibility requirements. Some incorrectly think that the AODA imposes new requirements for accessibility. In fact, it seeks to get obligated organizations to do what the Ontario Human Rights Code and the Charter of Rights have required them to do for well over three decades.
It would be grossly inadequate for the Health Care Accessibility Standard to set a weaker and less specific goal, e.g. merely to “improve accessibility” in the health care system. It would fulfil that weaker goal to simply remove only one barrier somewhere in Ontario’s huge health care system. It would leave our health care system with far too many accessibility barriers.
To begin, the Health Care Accessibility Standard should set out a vision of what an accessible health care system should include. An accessible health care system should include the following:
#2-1. The health care system will be designed and operated from top to bottom for all its patients, including patients with all kinds of disabilities, as disability is defined in the Ontario Human Rights Code and/or the Canadian Charter of Rights and Freedoms. The health care system will no longer be designed and operated from an implicit starting point of aiming predominantly to serve the fictional “average” patient, who is too often imagined as having no disabilities.
#2-2. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to easily find out what health care services are available and how and where to get them.
#2-3. Places where health care services are offered will be reachable by accessible public transit routes and will have sufficient accessible parking immediately adjacent to them.
#2-4. The built environment in the health care system, such as hospitals and any other places where health care services are provided, including the furniture there, will all be fully accessible to people with disabilities, and will be designed based on the principle of universal design.
#2-5. Patients with disabilities will be able to seek, receive and fully benefit from the health care services and products that are available in the health care system and which they require.
#2-6. Health care providers will consistently and reliably know how to meet the needs of patients with disabilities and where needed, any patients’ support people with disabilities, to ensure that patients with disabilities fully benefit from their health care services.
#2-7. Patients with disabilities, and where needed, any patients’ support people with disabilities, will be able to effectively communicate with health care providers and health care staff in connection with requesting or receiving health care services and products throughout each stage of the healthcare process. This will include face-to-face interactions, telephone or alternates to telephone use, accessible information and forms as well as alternate arrangements for providing one’s signature. For example, health care facilities and ambulances will be equipped with needed equipment to ensure effective communication with people with communication-related disabilities.
#2-8. Patients with disabilities, and where needed, any patients’ support persons with disabilities, will have prompt, effective and easy access to user-friendly information in accessible formats and in multiple languages on the health care options, programs, services, supports and accommodations available for their disability, and on the process for seeking these. As well, printed, online and other written information about available health care services, diagnoses, prognosis, treatments, exercises, medications, and other information provided to or available to patients with disabilities and, where needed, any patients’ support people with disabilities in connection with health care services and products, will be readily and easily available in an accessible format. This includes, for example, a patient’s health care records and labels/instructions for prescription drugs.
#2-9. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to get and receive information relevant to their health care needs in private, e.g. when giving information at a health care provider’s office or when seeking or receiving information about their medication at a pharmacy, rather than in a public place where others can overhear. Effective procedures will protect the confidentiality of private information relating to patients with disabilities who rely on others to assist them with communication.
#2-10. Information technology and applications which patients can use at home, or at a health care facility in connection with seeking and receiving health care services, will be designed based on principals of universal design and will be accessible to and usable by patients with disabilities, and where needed, to any patients’ support people with disabilities. Where needed for effective communication, health care facilities will also provide alternatives to telephone use including email, text, video and authorized human assistance.
#2-11. Health care products, and any instructions for their use, will be designed and available based on principles of universal design so that people with disabilities and not just people with no disability can use and benefit from them.
#2-12. Diagnostic and treatment equipment and furniture will be designed based on principles of universal design and will be fully accessible to patients with disabilities.
#2-13. Support services such as sighted guides for visually impaired patients and attendant care will be available to patients with disabilities who need them while going to or at a facility to receive health care services.
#2-14. Publicly funded appointments for receiving health care services will be sufficiently long to enable a patient with a disability, who needs more time, to be able to receive the health care services they need. If a patient with disabilities cannot attend a health care provider’s premises due to their disability, there will be in place measure whenever possible for remote appointments or home visits.
#2-15. Where patients with disabilities or any patients’ support people with disabilities need a disability-related accommodation in connection with health care services, there will be a prompt, user-friendly process for requesting and obtaining the needed accommodations.
#2-16. Patients will be free to use their own accommodation supports, such as service animals, when seeking or obtaining health care services and products.
#2-17. Where patients with disabilities or where needed, any patients’ support people with disabilities, believe that a health care provider is not effectively meeting the patient’s disability-related needs, they will have access to a prompt, fair, open and arms-length review process, including an offer of a voluntary Alternative Resolution Process if needed, conducted by someone who was not involved in the original decision or activity and who does not oversee the work of those involved in the patient’s health care services.
#2-18. There will be no bureaucratic, procedural or policy barriers that impede the effective accommodation of individual patients with disabilities or, where needed, any patients’ support people with disabilities, at any levels of Ontario’s health care system.
#2-19. New Government strategies, services and facilities in Ontario’s health care system will be proactively designed from the start and operated to fully include the needs of patients with disabilities. Those responsible at the provincial and local levels for leading, overseeing and operating Ontario’s health care system will have strong and specific requirements to address disability accessibility and inclusion in their mandates and will be accountable for their work on this issue. Ontario’s disability community will have ongoing and effective input into public decisions on the design and operation of Ontario’s health care system to ensure that existing disability accessibility barriers are removed and no new ones are created.
#2-20. An accessible health care system is one where people with disabilities can work in a barrier-free workplace. The barriers which impede people with disabilities as patients and their family members and caregivers often also impede health care providers and workers with disabilities.
The intent or rationale of the following recommendations is for the Health Care Accessibility Standard to include general requirements across the health care system that will ensure that its specific accessibility requirements are effective.
#3-1. The Health Care Accessibility Standard should address the accessibility needs of patients with any kind of disability, and the accessibility needs of any patients’ support people with any kind of disability. The term “disability” should be defined broadly to include any disability within the meaning of the AODA or the Ontario Human Rights Code.
#3-2. The Health Care Accessibility Standard should cover and apply to all public and private health care programs, services and products available in Ontario, whether or not they are offered in a hospital and whether or not OHIP covers them. It should cover all health care providers and professions, whether or not Ontario recognizes, regulates or licenses them. It should cover every location or facility where health care services can be delivered in Ontario, including e.g. hospitals, long term care facilities, offices and clinics for physicians, dentists, physiotherapists, psychologists, occupational therapists, speech language pathologists, and all other health care professions and providers. It should cover ambulances and other vehicles which can transport patients in connection with health care services. It should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic or other communities within Ontario.
#3-3. The Health Care Accessibility Standard should not be limited to hospitals and the hospital sector. Most people get most health care services outside of hospitals. If the Health Care Accessibility Standard were limited to barriers in hospitals, it would leave out most of the health care system and most of the barriers in the health care system. It would force people with disabilities to go to overcrowded hospitals to get their health care services, since hospitals would be the only place where accessible services would be assured to them.
The fact that the Government’s terms of reference for the Health Care Standards Development Committee focus on the hospital sector does not prevent this Standards Development Committee from making recommendations that go beyond the hospital sector. A number of earlier AODA Standards Development Committees have made recommendations beyond their terms of reference. We ask the Health Care Standards Development Committee to do the same.
Most if not all of the barriers identified in this Framework occur both in hospitals and in other places where health care services and products are provided. At the very least, the Health Care Standards Development Committee should make recommendations about all of these barriers proposed in this Framework as they relate to hospitals, and then should recommend that the Health Care Accessibility Standard require the same action on the same barriers where they occur anywhere else in the health care system where health care services or products are provided to patients.
#3-4. The Health Care Accessibility Standard should cover ambulances and other vehicles that transport patients in connection with the receipt of health care services.
#3-5. The Health Care Accessibility Standard should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic, indigenized or other communities within Ontario.
#3-6. The Health Care Accessibility Standard should require the removal of existing barriers, and not only the prevention of new barriers.
#3-7. If the Health Care Standards Development Committee identifies a recurring accessibility barrier in Ontario’s health care system, it should make recommendations on how to remove or prevent that barrier, even if there is a less effective or comprehensive existing health care regulation or statute that may already apply to it in whole or in part.
The Health Care Accessibility Standard will take precedence and prevail over any other laws, if those other laws either create or permit health care accessibility barriers, or if they do not effectively remedy those barriers, or if they provide less accessibility than the Health Care Accessibility Standard. If an existing law, such as a statute or regulation governing the health care system, creates an accessibility barrier or impedes the removal or prevention of a health care barrier, the Health Care Standards Development Committee should recommend measures to be included in the Health Care Accessibility Standard that would remove or prevent those barriers. It should recommend the modification or repeal of any law that itself creates or permits health care barriers. Any provincial legislation or regulations that create accessibility barriers against patients with disabilities are contrary to the guarantees of equality to people with disabilities in the Ontario Human Rights Code and the Charter of Rights.
#3-8. The Health Care Accessibility Standard should require each health care facility and health care provider to create a welcoming environment for patients with disabilities and any patients’ support people with disabilities to seek accommodations for their disabilities when receiving health care services.
#3-9. Each major health care facility such as each hospital should be required to establish a permanent committee of its board to be called the “Accessibility Committee.” This Accessibility Committee should have responsibility for overseeing the facility’s compliance with the AODA, and with the requirements of the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms in so far as they guarantee the right of people with disabilities to fully participate in and fully benefit from the health care services that the facility provides. It should endeavour to reflect the spectrum of disability needs.
#3-10. Each major health care facility such as each hospital should be required to establish or designate the position of Chief Accessibility/Accommodation Officer, reporting to the Chief Executive Officer. Their mandate, responsibility and authority should be to ensure proper leadership on the facility’s accessibility and accommodation obligations under the Ontario Human Rights Code, the Canadian Charter of Rights and Freedoms and the AODA, including the requirements of this accessibility standard. This responsibility may be assigned to an existing senior management official.
#3-11. Beyond the specific measures to remove and prevent barriers set out in the Health Care Accessibility Standard and in other accessibility standards enacted under the AODA, each health care facility and health care provider should be required to periodically and systematically review its health care services, facilities, equipment and products to identify recurring accessibility barriers that can impede the provision of health care services to patients with disabilities. A comprehensive plan for removing and preventing these accessibility barriers should be developed, implemented and made public with clear timelines, with clear assignment of responsibilities for action, monitoring for progress, and reporting to the facility’s accessibility committee. This plan should aim at all accessibility barriers that can impede patients with disabilities from fully benefiting from the facility’s health care services, whether or not they are specifically identified in the Health Care Accessibility Standard or in any other AODA accessibility standards.
Barriers: Patients with disabilities and support people with disabilities too often find it difficult to get accessible information to find out from their health care facility from their health care provider, from the health care system at large and/or from the Ontario Government about the health care services that are available, or about where and how to get them.
The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support people with disabilities can find out what health care services are available to them and where to obtain them.
#4-1. Each health care provider or facility should be required to make readily available, in an accessible format, information about the health care services or products they offer and about where and how to arrange to get them. If the health care provider or facility has a website, this information should be accessibly posted prominently on that facility or provider’s website in plain language. Where communication supports or assistance is needed to access this information, those supports should be made available (See below regarding communication supports).
#4-2. The Ontario Government or any provincial organization mandated to oversee or deliver health care services should be required to make readily available to the public in accessible formats, including on the internet, detailed information on the menu of health care services available in Ontario, and on how and where to arrange to get those services.
Barriers: Obstacles that impede people with disabilities from physically getting to places where they need to go to receive health care services and products, include, such things as:
The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support persons with disabilities can get to the places where health care services and products are provided.
We ask the Health Care Standards Development Committee to make the following recommendations. These could be incorporated either or both into the promised Health Care Accessibility Standard or into the Transportation Accessibility Standard, to address those transportation barriers in the health care context. In 2011, the Ontario Government enacted the Transportation Accessibility Standard, as part of the 2011 Integrated Accessibility Standards Regulation.
In 2016, the Ontario Government appointed the Transportation Standards Development Committee to review the 2011 Transportation Accessibility Standard and to make recommendations where needed, to strengthen it. In 2018, the Transportation Standards Development Committee made very weak recommendations for revisions to the 2011 Transportation Accessibility Standard. The Transportation Standards Development Committee did not recommend many if not most of the improvements that the AODA Alliance and the ARCH Disability Law Centre called for, in their joint July 31, 2017 brief to the Transportation Standards Development Committee. In over two years since then, the Ontario Government has announced no plans to implement any improvements to strengthen the 2011 Transportation Accessibility Standard.
The Transportation Standards Development Committee’s 2018 recommendations to revise the 2011 Transportation Accessibility Standard, if adopted, would not fix any of the deficiencies in the 2011 Transportation Accessibility Standard. Since receiving the final recommendation of the Transportation Standards Development Committee over one and a half years ago, the Ontario Government has not announced any revisions to the 2011 AODA Transportation Accessibility Standard. It is therefore still open to the Ontario Government to make improvements under the AODA to the 2011 Transportation Accessibility Standard beyond the weak ones that the Transportation Standards Development Committee recommended in 2018.
#5-1. Wherever possible, any new health care facility or provider receiving public funds that is setting up a new location should be required to locate at or near an accessible public transit stop on an accessible public transit route, with an accessible path of travel from the public transit stop to the health care facility or provider. Similarly, where an existing health care facility or provider is going to move to another location, it should be required to attempt to relocate to a location that is on an accessible public transit route.
#5-2. Where it is medically possible for a patient to take part in a health care service without physically attending at the health care facility or provider, an option should be provided for taking part remotely, e.g. via Facetime or other remote video conferencing. The Health Care Accessibility Standard should also require the removal of the OHIP barrier to funded physicians house calls.
#5-3. Where OHIP or a health care facility or provider has a policy or practice of permitting only one health issue per visit, an exception should be created for patients with disabilities for whom transportation to the health care facility is impeded by accessibility barriers.
#5-4. A health care facility or provider should not be permitted to charge a late fee or a missed appointment fee where a patient with a disability has in good faith attempted to attend on time but was made late or precluded from attending by transportation barriers (such as being made late for the appointment by the community’s para-transit service).
#5-5. When the Ontario Government is undertaking planning for new health care services, or for improvements to health care services, it should be required to include in those plans, and to make public, requirements to ensure that wherever possible, health care services and facilities are provided in locations on accessible public transit routes, with an accessible path of travel from the accessible public transit stop to the facility or provider.
#5-6. The 2011 Transportation Accessibility Standard should be amended to set accessibility requirements for public transit stations and stops, as the joint July 31, 2017 AODA Alliance/ARCH brief to the Transportation Standards Development Committee recommended.
#5-7. The Health Care Accessibility Standard should set technical specifications to ensure the full accessibility of ambulances and other vehicles that transport patients, including patients with disabilities, to or from health care services. See also below re: the need to include in those vehicles equipment for communication with patients with communication-related disabilities.
Barriers: Barriers in the built environment where health care services are provided that impede people with disabilities from getting into places where health care services and products are offered, or from safely and independently getting around these places, such as:
The Ontario Building Code and current AODA accessibility standards are substantially inadequate to meet the need for fully accessible facilities where health care services are provided. A new building in which health care services are provided, that is fully compliant with the Ontario Building Code and current AODA accessibility standards, can still have serious accessibility barriers. See generally https://www.aodaalliance.org/category/built-environment/
As such, the promised Health Care Standards Development Committee needs to set built environment accessibility standard requirements to address existing barriers, and to prevent the creation of new barriers, in places where health care services and products are provided to patients. As far as we can tell, the Ontario Government has in place no mandatory accessibility standard, required for the design of a new health care facility such as a hospital or long-term care facility, beyond the inadequate Ontario Building Code, to ensure that it is fully accessible. Similarly, the Government has no such accessibility standard, beyond the inadequate Ontario Building Code, for retrofitting an existing health care facility which is undergoing a major renovation. As well, the Government has in place no detailed accessibility standard whatsoever for a health facility to be retrofitted for accessibility, if that facility has no major renovation underway.
The Ontario Government has announced no plan to develop a comprehensive Built Environment Accessibility Standard under the AODA. Yet the Ontario Human Rights Code, and in some cases, the Charter of Rights, require these facilities to become disability-accessible.
As a result, each time a new hospital or other health care facility is built, or a renovation to one is undertaken, the organization needs to individually hire consultants to reinvent the accessibility wheel. Their advice need not be followed, or even disclosed to the public. This wastes public money. It leads to patchworks of varying levels of accessibility from organization to organization.
The 2019 final report of David Onley’s Independent Review of the AODA concluded that Ontario’s laws on the accessibility of the built environment are inadequate and that design professionals such as architects are not trained to ensure that they design buildings that everyone can access. However, the Ontario Government has announced no plans to upgrade the Ontario Building Code ‘s accessibility provisions, or to enact an AODA Built Environment Accessibility Standard, despite our repeated requests.
The Health Care Standards Development Committee should get direct input for technical requirements on these issues from qualified accessibility consultants, preferably ones who have experience giving advice regarding the accessibility of health care facilities.
The intent/rationale of the following recommendations is to ensure that patients and their support people with disabilities can get into and around facilities or other built environment where health care services and products are provided. The following lists examples of needed requirements but is not exhaustive.
#6-1. The Health Care Accessibility Standard should set specific and detailed accessibility requirements to ensure the accessibility of the built environment where health care services and products are provided, beyond the weak Ontario Building Code and the existing AODA accessibility standards. These should include accessibility requirements in new construction and major renovations. These should also include readily achievable retrofit requirements for existing facilities that are not undergoing a major renovation. Here is a sample of requirements for which detailed standards should be set:
#6-2. The front area or drop-off areas for a hospital or other health care facility should be accessible, with automatic power doors that do not require a button to be found and pressed, and with tactile walking surface indicators both to warn when a person is walking into a driving area and to guide a person to the facility’s entrance. All other entrances and exits should be fully accessible, with automatic power door operators and an accessible path of travel to the door. This includes entrances from indoor or underground parking to the health care facility.
#6-3. Inside the health care facility, major public areas such as emergency room doors should always be fully accessible and have automatic power door openers.
#6-4. For the benefit of patients and others with learning and cognitive disabilities, vision loss or other disabilities that can affect mobility or way-finding, hospitals and other health care facilities should have way-finding markings in important areas such as the main lobby from the front door to the help desk and other major routes such as to main elevators, including colour contrasted markings such as a carpeted path or tactile walking surface indicators.
#6-5. Hospitals and other health care facilities with elevators should have accessible elevators that can accommodate people using mobility devices. They should also have accessible elevator buttons (with braille and large print on or beside each button), braille and large print floor numbers just outside elevator doors, and audible floor announcements on elevators. Elevator button panels should be consistent in layout from one elevator to the next.
#6-6. Health care facilities, including hospitals, should never install “destination elevators” which require a person to pre-select the floor to which they are going before entering the elevators. These present unfixable accessibility problems.
#6-7. Hospitals and other health care facilities should have accessible signage throughout, including braille and large print, for key locations. For example, public bathrooms should have accessible braille and large print signs on them. These signs should be placed in consistent and predictable locations.
#6-8. Where a health care facility has power doors that require a button to be pushed (i.e. they don’t open automatically), the button should always be located throughout the health care facility in a consistent place to make it easier to find. The button should be located near the door, so that a slow-moving individual can make it through the open door after pressing the button before the door closes. The button should always be located on the wall, and not on a free-standing post or bollard.
#6-9. Despite weaker requirements in other AODA accessibility standards, the Health Care Accessibility Standard should set out specific and strong requirements for the accessibility of any electronic kiosks in hospitals and other health care facilities, such as:
As a starting point, see the US Access Board’s standard for accessible electronic kiosks.
#6-10. Patient consultation or treatment rooms should have enough space to enable people using mobility devices to navigate in them and reach any treatment or consultation area. They should have enough space to enable a Sign Language interpreter to be positioned in the room to interpret for a deaf patient or support person.
#6-11. Movable furniture such as desks, tables or chairs should not obstruct accessible paths of travel around a facility where health care services are delivered, such as a doctor’s office, e.g. in their hallways or treatment rooms.
#6-12. Major health care facilities should provide accessible waiting areas for accessible transit pickup and drop-off, close to the pickup/drop-off point, with clear sight lines.
#6-13. Major health care facilities such as hospitals should be designed to avoid major sensory overstimulation or acoustic overloads, such as bright lights, loud music, large atrium areas, or frequent loud announcements. This is especially important in treatment areas or hospital rooms.
#6-14. Throughout a health care facility, proper colour contrasting should be required to assist people with low vision and cognitive disabilities, such as around elevator opening, doorways, and on the edge of stairs and handrails.
#6-15. Health care facilities should be required to have accessible bathrooms so that all patients can use the facilities, including adult change tables, sufficient transfer space and maneuvering room for mobility devices.
#6-16. Major health care facilities should include sensory rooms for people with sensory overload issues, such as in hospital emergency rooms.
#6-17. In a health care facility, all stairs and staircases, including “feature staircases” (included as aesthetic design enhancements) should be accessible, e.g. with tactile warnings at the top and bottom of each set of stairs, no open risers and with proper colour contrast on railings and step edges. There should never be curving staircases.
#6-18. Health care facilities should provide charging areas for electric mobility devices.
#6-19. Hospital rooms should be able to accommodate a patient’s mobility device so they can keep theirs with them and readily available when admitted to hospital.
#6-20. In a health care facility, waiting areas, isolation areas, breastfeeding rooms, staff areas and volunteer areas should be designed to be accessible.
#6-21. Accessible and bariatric paths of travel should be provided in health care facilities.
#6-22. Despite the more limited provisions regarding the provision of accessible parking spaces in other AODA accessibility standards, the Health Care Accessibility Standard should set higher and more specific requirements for accessible parking spaces for health care facilities, such as:
#6-23. Health Care facilities should have designated snow-piling areas outside, to prevent snow from being shoveled onto accessible paths of travel.
#6-24. Major health care facilities such as hospitals should provide service animal relief areas close to the facility’s door, covered wherever possible, with an accessible path of travel to them.
#6-25. When a major new health care facility like a hospital is being designed, or a major new wing or renovation is being planned, especially if public money is helping fund it, a properly trained and qualified accessibility consultant should be required to be engaged on the project from the very beginning. Their accessible design advice should be transmitted unedited to the Government or other organization for whom the project is being built and should be made public. Direct consultation with end-users with disabilities should be part of the design process from the beginning.
Barrier: Furniture, related equipment and floor plan layouts in health care facilities too often were chosen or designed without taking into account the accessibility needs of patients with disabilities and any patients’ support people with disabilities.
The intent/rationale of the following recommendations is to ensure that health care facilities create barrier-free spaces for patients and support people with disabilities. The following list of examples of needed requirements is not exhaustive.
#7-1. Each hospital patient’s bed should have an accessible means for a patient with disabilities to notify the nursing station of a health care need, not just a button or pull-string that they may not be able to reach and operate.
#7-2. Furniture such as seating in health care facilities should be designed with accessibility features and positioned in a manner that does not block accessible paths of travel.
#7-3. A Help Desk should be positioned immediately inside the main entrance of any major health care facility, including hospitals, to assist patients, including patients with disabilities, to get directions or help to their destination within the facility, or to request other accommodation supports.
#7-4. In any discrete department or area where health care services are provided, (such as an area for day surgery), the check-in desk should be located immediately adjacent to the entrance to that area, so that patients and support people with disabilities can easily reach it after entering the room or area.
#7-5. Accessible public service counters should be installed, even in existing health care facilities, with a specified height requirement, no glass barrier creating barriers for people with hearing loss and knee space for people using a mobility device.
#7-6. A large health care facility like a hospital should have rest areas along routes through the building so that people with fatiguing conditions can stop and rest along their route to get health care services.
#7-7. Health care facilities such as hospitals should have emergency areas of refuge with separate ventilation in case of fire, so that people with disabilities who cannot escape the building have safe areas to wait, while being protected from life-threatening smoke.
#7-8. The Ontario Government should make available to health care facilities and providers:
#7-9. The Ontario Government should provide a hub for procuring accessible furniture to help health care facilities and providers reduce the cost of their acquisition.
Barrier: Health care providers, and especially large facilities, too often do not provide an easy-to-access way for a patient with disabilities or for any patients’ support people to notify the health care provider of their need for a disability accommodation or accessibility, so that these can be provided in a timely fashion.
The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people can easily alert a health care facility or provider, in advance, of any disability-related accessibility or accommodation needs, and can arrange to have these met in connection with their receiving health care services and products.
#8-1. Each health care provider and facility should be required to put in place a system and designate a person to solicit and receive requests from patients or their support people for disability accommodations in connection with health care services or products.
#8-2. Each health care provider or facility should be required to make readily-available to the public, including to their patients, in an accessible format, information about how to identify themselves in advance to the health care provider as having disability-related accessibility or accommodation needs, and to ask to arrange for these needs to be met.
#8-3. Each hospital and larger health care facility should be required to collect anonymized information on disability-related accessibility and accommodation requests received from or on behalf of patients with disabilities, to assist that health care provider or facility in planning for future disability accessibility and accommodation. This anonymized information should be available for study by the Government or other health policy planners.
#8-4. The Chief Executive Officer of any hospital or large health care facility should annually review the information that the facility has collected on the requests for disability accessibility and accommodation that the facility has received and report to the board of directors on measures that could improve the facility’s capacity to meet these needs.
Barrier: Too often, diagnostic and treatment equipment used by health care facilities or health care providers are not designed based on principles of universal design. Too often they are instead designed without sufficient regard to the needs of patients with disabilities.
The intent/rationale of the following recommendations is to systematically replace inaccessible diagnostic and treatment equipment over time with accessible equipment, while maximizing patient access to accessible equipment in the meantime.
#9-1. The Health Care Accessibility Standard should set specific technical requirements for the accessibility of diagnostic and treatment equipment. As a starting point, the Health Care Standards Development Committee should consider the accessible medical diagnostic equipment standards that the US Access Board has formulated. The needs of patients with all kinds of disabilities, and not only those with mobility disabilities, should be met by the technical requirements that the Health Care Accessibility Standard sets.
#9-2. The Ontario Government should impose a strict funding condition on the purchase or rental of any new health care diagnostic or treatment equipment anywhere in the health care system requiring that it must be accessible to patients with disabilities and designed based on principles of universal design, in compliance with the technical standards to be included in the Health Care Accessibility Standard.
#9-3. The Ontario Government should be required to make readily available to health care providers and facilities, and to the public, an up-to-date list of accessible health care diagnostic and treatment equipment and venders, so that each health care provider and facility does not have to re-invent the wheel by re-investigating these same issues.
#9-4. To save money, the Ontario Government should be required to attempt to negotiate bulk purchasing of accessible diagnostic and treatment equipment so that health care facilities and providers can obtain them at lower prices.
#9-5. When health care facilities and providers purchase, rent or otherwise acquire new or replacement diagnostic or treatment equipment, these should be required to be accessible to patients with disabilities and to be designed based on principles of universal design.
#9-6. Health care facilities and providers should survey their existing diagnostic or treatment equipment, and take the following steps to address any accessibility problems they have, if that equipment is not now being replaced:
#9-7. These accessibility/universal design requirements should also apply to consumer health care products, such as for example, pill bottles.
Barrier: Too often, patients with disabilities are not assured a chance to give and receive information regarding their health care needs in private, when dealing with health care providers or facilities. This can include e.g. having a health professional’s assistant assist a patient with disabilities to fill out a printed medical history form in the office’s open reception area rather than in private. Another common example is a pharmacy giving private information about medications to a patient over the counter in a pharmacy, where others can easily overhear this.
The intent/rationale of the following recommendations is to ensure that the privacy of patients with disabilities is fully respected in connection with health care services.
#10-1. Any health care facility or provider, including such places as doctors’ offices and pharmacies, should be required to designate an accessible private area where patients with disabilities can give and receive private information in connection with their health care services or products without others being able to overhear this.
#10-2. Health care facilities and providers should be required to notify all patients, including patients with disabilities, of their right to have their health care needs and issues discussed and information exchanged in a private location, and should instruct their staff, including any who deal with patients or the public, of their duty to fully respect this right.
Barrier: Too often, critical health care information in the health care system is provided in inaccessible formats, or via inaccessible websites or other technology, or without the communication supports that people with communication-related disabilities need.
The 2011 Information and Communication Accessibility Standard, enacted as part of the 2011 Integrated Accessibility Standards Regulation, has not ensured that these barriers to health care-related information are removed and prevented. The July 24, 2019 draft recommendations of the Information and Communication Standards Development Committee, while helpful, would not fully address all the concerns identified here. See further the AODA Alliance’s November 26, 2019 brief to the Information and Communication Standards Development Committee.
The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people with disabilities can effectively communicate with health care providers in connection with receiving health care services and products and will get accessible information needed for that purpose.
Beyond the following recommendations, we strongly encourage the Health Care Standards Development Committee to get input on detailed requirements to include regarding accessible information and communication in connection with health care from Communication Disabilities Access Canada. CDAC is a widely respected and leading national expert in this area.
#11-1. Without limiting the information and communications to which this part of the Health Care Accessibility Standard should apply, it should address:
#11-2. Health Care facilities should be equipped with assistive listening devices to enable patients with hearing loss and support people with hearing loss to be able to effectively communicate e.g. at nursing stations, help desks, and when dealing directly with health care providers.
#11-3. Health care-related products such as prescription and non-prescription medications should be provided when needed with accessible labels, instructions or users’ manuals, available in accessible formats. Those who sell or rent these to the public should be required to regularly notify the public, including their customers, that accessible labels, instructions, and users’ manuals are available on request. See e.g. work on developing standards and practices for accessible prescription drug container labels by the US Access Board. See also the February 6, 2020 news release announcing that the Empire chain of stores, including all Sobeys Stores, will provide accessible prescription labels to customers with disabilities free of charge on request. If they can, so can all other drug stores.
#11-4. Where a health care facility or health care provider provides information about their services or facilities in print or via the internet, they should be required to ensure that their website meets current international accessibility requirements along prompt time lines, even if the Information and Communication Accessibility Standard does not now require this. Currently, the Information and Communication Accessibility Information and Communication Accessibility Standard has too many exemptions, leaves out too many providers of goods and services, and has timelines that are too long. Whether or not those exemptions, exclusions and long timelines are justified for other sectors, they are unjustified for a sector as important as the health care sector.
#11-5. Ambulances and other vehicles that transport patients should include equipment to facilitate communication with patients with communication disabilities, such as remotely-accessed sign language interpretation and other communication supports.
#11-6. The Health Care Accessibility Standard should set more specific and detailed requirements than the Information and Communication Accessibility Standard, to require hospitals, other health care facilities and other health care providers to ensure that patients with communication-related disabilities get the communication supports they need in a timely fashion to ensure that they can effectively communicate with their health care provider in connection with their health care services and products.
#11-7. The Ontario Government should be required to set up hubs or centralized services to enable health care facilities and providers, including small providers, to quickly and easily access communication supports needed for patients with communication-related disabilities (for example Sign Language interpreters and real time captioning). The Ontario Government should fund these services as part of its funding of the health care system, in furtherance of the Supreme Court of Canada’s Eldridge decision.
#11-8. Any prepared information on health care conditions, treatment instructions, prognoses, risks, laboratory or other test results and the like which a health care facility or provider makes available to patients, whether in print or electronic form, should be made available at the same time on request in an accessible format. The standard should direct that PDF format is not sufficient to be accessible, and that if information is available in a PDF document, it should also be posted in an accessible format such as HTML or MS Word. Health care facilities and providers should be required to notify patients, including patients and their support people with disabilities, that any hard copy or electronic documents provided to them can be requested and obtained in an accessible format on request.
#11-9. Where a health care facility or provider asks patients or their support people to use information technology hardware or software in connection with the delivery of health care services (such as asking them to fill out their medical history on a portable computer or tablet device), the facility or provider shall:
#11-10. Because Ontario’s system for electronic health care records has been centrally created, the Health Care Accessibility Standard should require the Ontario Government and any provincial agency that is responsible for overseeing the design, procurement or operation of the system for electronic health care records in Ontario to ensure that these records will be kept and available in accessible formats for patients and support people with disabilities, and, as a related benefit, to health care providers and their staff with disabilities. The same requirement as above should apply regarding the use of PDF format.
#11-11. Individual health care organizations or facilities, including laboratories, that create their own health care records in electronic form should also be required to ensure that they are readily available in accessible formats for patients with disabilities and any patients’ support people with disabilities, and, as a side benefit, for health care providers and their staff with disabilities.
#11-12. The Ontario Government should be required to develop and make public a strategy for ensuring that health care promotion initiatives in Ontario are accessible to people with disabilities. For example, it should require that:
Barrier: Healthcare providers:
The intent/rationale of the following recommendations is to ensure that patients who have disabilities that affect their communication have timely accommodations and supports for their effective two-way communication at all times with healthcare providers and throughout the healthcare process.
#11-13. The Healthcare Accessibility Standards should require:
#11-14. To facilitate the provision of these communication supports and accommodations to patients with communication disabilities and to reduce or eliminate wasteful duplication of efforts, the Ontario Government should be required to:
Barrier: Too often, health care facilities can lack the essential support services that patients with disabilities need to be able to access the health care services that the facility offers. Examples include hospital patients with disabilities who need help with eating, patients who need attendant care, or patients with vision loss who need to be guided to and from their destinations within a health care facility.
The intent/rationale of the following recommendations is to ensure that patients with disabilities get the support services they need to be able to make use of and fully benefit from the health care services and facilities that are offered to the public in Ontario’s health care system.
#12-1. Hospitals and other major health care facilities should be required to provide support services for patients with disabilities when needed to ensure that those patients can fully access and benefit from the health care services that the facility offers, such as:
#12-2. In a hospital or other major health care facility, there should be one nurse at each nursing station designated to receive training and to be responsible for addressing the needs of patients with complex needs due to their disability.
#12-3. No health care facility or provider will refuse to allow a patient with disabilities or any patients’ support people with disabilities to use their own needed accommodations, such as a service animal, when seeking or obtaining health care services or products.
Barrier: Too often, front-line workers in Ontario’s health care system including professional health care providers and their staff and volunteers have knowledge and attitude gaps regarding patients with disabilities that create barriers to equal services, due to the lack of sufficient training on this.
The intent/rationale of the following recommendations is to ensure that those who work directly with patients with disabilities and with any patients’ support people with disabilities have proper training on how to meet the needs of people with disabilities so that people with disabilities are freed from stereotypes, patronization and paternalism.
#13-1. Each of the self-governing colleges that regulates a health care profession in Ontario should set detailed requirements for specific and sufficient training that must be obtained before a person can qualify to get a license to practice in Ontario in that profession, such as for physicians, nurses, dentists, etc. For those who already have a license to practice, those colleges should be required to set mandatory specific training to be obtained in this area, with time lines for doing so, as part of their licensees’ continuing professional development requirements. This training should include requirements for the health care professional to train their staff who interact with patients and the public.
#13-2. The Ontario Government should be required to impose a condition of its funding for post-secondary education programs to train anyone in a health care discipline, profession or field that the college or university must include a sufficient designated and mandatory curriculum on meeting the needs of patients with disabilities.
#13-3. The training requirements under the 2011 Integrated Accessibility Standards Regulation should be revised to provide that the training for any employees or volunteers in an organization of any size that provides any health care services or products must include training specific to the barriers facing patients with disabilities and any patients’ support people with disabilities in the health care system.
Barrier: The self-governing colleges that govern some 26 kinds of health care professionals in Ontario are not assured to have in place sufficient ways to ensure that their members are providing accessible health care services to patients with disabilities.
The intent/rationale of the following recommendations is to ensure that health care professionals’ self-governing colleges effectively oversee the profession that they govern to ensure that they are providing accessible services to patients with disabilities, and have a fully accessible complaint process for the public to use.
#14-1. Each health care profession’s self-governing college should be required to:
Barrier: Too often, the Ontario Government and individual health care facilities go about their business planning for and operating Ontario’s health care system without taking into account the needs of patients with disabilities. This results in systemic barriers being left in place and new ones being created.
The intent/rationale of the following recommendations is to ensure that each health care facility and the Ontario Government effectively take into account the needs of patients with disabilities when designing and planning for Ontario’s health care system and when operating it on a day-to-day basis, and have safeguards in place to catch recurring accessibility gaps. The Supreme Court’s Eldridge decision requires the Government to do this.
#15-1. The Ministry of Health should be required to designate a senior official at the “Assistant Deputy Minister” level as the leading public official who is responsible for ensuring accessibility, accommodation and inclusion for patients with disabilities in Ontario’s health care system. They should be responsible for ensuring that any policies, plans or proposals regarding the health care system are screened to ensure that they will not create any new barriers for patients with disabilities, and will instead remove barriers.
#15-2. The Ministry of Health should be required to conduct a system-wide review of the health care system for any systemic barriers, in consultation with the public including people with disabilities. It should identify and make public a plan to remove and prevent systemic or system-wide barriers that impede patients with disabilities from receiving accessible health care, along time lines that the Health Care Accessibility Standard will set.
#15-3. Each hospital and other major health care facility should be required to establish and regularly publicize a dedicated disability accessibility/accommodation complaints hotline, to trigger prompt action when problems are raised.
#15-4. The Ministry of Health should be required to establish and regularly publicize a hotline to receive complaints about accessibility problems facing patients and support people with disabilities in Ontario’s health care system. The Ministry should be required to annually publish a report with an anonymized summary of the substance of complaints received and action taken to prevent their recurrence.
Barrier: OHIP fee schedules for medical services that assume a patient has no disability and requires no additional time for the health appointment. For example, some patients with disabilities need more time to undress, get on the assessment table, and then get dressed again. Communication disabilities may lead to needing more time to discuss a patient’s condition with them, including such things as their medical history, diagnosis, and treatment options. Patients with complex disabilities can require more time for their condition to be medically assessed and treatment to be provided or discussed. The individual physician should not be required to personally finance all of this. The current OHIP funding model creates a harmful economic incentive for physicians to avoid taking on patients with significant or complex disabilities as their patient.
#15-5. The OHIP fee schedule should be revised provide for added time to serve the needs of patients with disabilities who need more time for assessment, diagnosis and treatment, to eliminate the harmful financial incentive that the Ontario Government now creates for physicians to avoid treating taking on those patients.
Barrier: People with disabilities working or volunteering in the health care system too often face accessibility barriers in the workplace that also hurt people with disabilities who seek health care services.
The intent/rationale of the following recommendations is to ensure that the experience and expertise of people with disabilities working for pay or as volunteers in the health care system is effectively harnessed to help root out the accessibility barriers that impede patients with disabilities and any patients’ support people with disabilities. This is because workplace disability barriers and health care service disability barriers often are the same or substantially overlap.
#16-1. Each hospital and major health care facility should be required to establish a committee of those employees and volunteers with disabilities who wish to voluntarily join it, to give the facility’s senior management feedback on the barriers in the health care facility that could impede patients with disabilities or any patients’ support people with disabilities, and/or employees/volunteers with disabilities.