Disability Groups Present 6 Steps for the Ford Government to Repair Disability-Discriminatory Critical Care Triage Protocol – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance

ARCH Disability Law Centre

 

NEWS RELEASE – FOR IMMEDIATE RELEASE

 

Six Bio-Ethicists on Ontario Government’s “Bioethics Table” Confirm Ongoing Concerns Raised by Disability Organizations regarding the Discriminatory and Secret Plans for the Triaging of Critical Care

 

April 19, 2021 – Serious objections that have been raised by disability groups for over one year regarding Ontario’s plans for triaging life-saving critical care have been validated and echoed by a number of the very individuals that were advising the Ontario Government on it. In a revealing article by six bio-ethicists that advised the Government on what should be included in Ontario’s directions for rationing life-saving critical care, alarm bells continue to be rung with serious concerns that they raise including: the lack of transparency and public engagement in developing the Triage Protocol, the failure to consider social determinants of health, the prioritization of utilitarianism over human rights, and the reliance on problematic clinical tools that compound health inequities.

Last year, in April 2020, a Triage Advisory Committee (TAC) was formed by ARCH Disability Law Centre to come together in order to consult with and bring forward concerns of disability communities in Ontario flowing from the then newly leaked March 28, 2020 version of Ontario’s critical care Triage Protocol. The TAC is made up of representatives from various disability organizations and academics which includes the Accessibility for Ontarians with Disabilities Act (AODA) Alliance; ARCH Disability Law Centre; Canadian Down Syndrome Society; Centre for Independent Living in Toronto; Citizens With Disabilities – Ontario (CWDO); Community Living Ontario; Disability Law Intensive Program – Osgoode Hall Law School, York University; Lupus Canada; Muscular Dystrophy Canada; and Scholl Chair in Health Law and Policy, Faculty of Law, University of Toronto.

Over the last 12 months, and through ARCH and the AODA Alliance, TAC has tried to express its concerns repeatedly to the Bioethics Table, to the Ontario Government, and to the public. Despite this, the Ontario Government has failed to meet with us or to ensure that Ontario’s critical care triage protocol and plans are free of unlawful discrimination contrary to the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms.

The Ontario Government’s continued assertion that it has not authorized any Triage Protocol is especially of concern when the latest version of the critical care Triage Protocol, dated January 13, 2021, has been sent to all Ontario hospitals and subsequent training has been offered to hospitals and doctors that urges doctors and hospitals to use it. This Triage Protocol includes several problematic clinical assessment tools that discriminate against persons with disabilities and risks physicians making guestimates on who should be refused life-saving critical care.

The Ontario Government has had 14 months to ensure that lawful and constitutional directions are in place to ensure that decisions on who is to be refused life-saving critical care are free of unlawful discrimination.

As the third wave of the COVID-19 pandemic continues to strain Ontario’s healthcare system in unprecedented ways, TAC urgently calls for the Ontario Government to:

  1. Now make public the current version of the critical care triage protocol, all reports and recommendations regarding critical care triage by its external Bioethics Table since September 11, 2020, the Government’s plan of action for rolling out critical care triage if needed, and the content and results of drills or simulations of critical care triage held at any Ontario hospitals.
  1. Remove unlawful discrimination, including disability discrimination, from the January 13, 2021 Critical Care Triage Protocol, and substantially reduce the one year likely survival threshold for assessing who gets priority for receiving critical care during a period of critical care triage.
  1. Uphold the current law and ensure that doctors will not be permitted to remove or withdraw life-saving critical care from a patient already receiving it, without that patient’s consent.
  1. Not give a financial blank cheque to doctors and hospitals in advance (indemnification), nor should the College of Physicians and Surgeons of Ontario give doctors a regulatory blank cheque, if they rely on disability-discriminatory directions.
  1. Immediately hold a public consultation on how critical care triage should be conducted.
  1. Ensure that Ontario’s critical care triage plan and protocol are properly prescribed by law, by introducing legislation on critical care triage for debate in the Legislature, rather than dealing with it by an internal memo to hospitals.

Contact:

AODA Alliance Chair David Lepofsky

Email: [email protected]

Twitter: @aodaalliance

Robert Lattanzio, Executive Director

ARCH Disability Law Centre

Toll-free: 1-866-482-2724 extension 2233

Email: [email protected]

For more background on this issue, check out:

  1. The AODA Alliance website’s health care page, detailing its efforts regarding critical care triage and generally, its to tear down barriers in the health care system facing patients with disabilities, and our COVID-19 page, detailing our efforts to address the needs of people with disabilities during the COVID-19 crisis.
  2. The ARCH Disability Law Centre website’s COVID-19 page offers more about ARCH’s work on the clinical triage protocol, including a September 15, 2020 published article, visitation ban policies, access to technology and other issues concerning the rights of persons with disabilities during the COVID-19 crisis.



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Ontario Human Rights Commission Again Commendably Raises Human Rights Concerns with Ontario’s Critical Care Triage Plans, While the Ontario College of Physicians And surgeons Appears to Wrongly — Green Light Those Plans The AODA Alliance Responds!


Accessibility for Ontarians with Disabilities Act Alliance Update United for a Barrier-Free Society for All People with Disabilities
Web: https://www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: https://www.facebook.com/aodaalliance/

April 23, 2021

^ SUMMARY

Things are moving fast on the terrifying critical care triage front. The AODA Alliance and the disability organizations with whom we are collaborating are trying to stay ahead of a potential tidal wave facing us all.

^What’s New?

1. We understand that within the past two days, the Ontario College of Physicians and Surgeons wrote all Ontario Physicians. If our information is correct,, the College gave doctors the green light, if the Ontario Government directs it, to refuse or withdraw critical care in accordance with the critical care triage protocol which we have repeatedly blasted as disability-discriminatory.

We have just written the College of Physicians to ask for confirmation of this. If it is accurate, then we strongly object to this action, and ask the College to rescind it. The College is the self-governing professional body that licenses and regulates physicians in Ontario. As our letter, set out below, explains, the College never got our input on our serious disability-related concerns about Ontario’s disability-discriminatory critical care triage protocol and plans.

2. On this same front, today the Chief Commissioner of the Ontario Human Rights Commission, Ena Chadha, has commendably issued another public statement on this critical care triage issue. We set it out below, as well. She reiterates the Ontario Human Rights Commission’s serious concerns with the Ontario Government’s critical care triage plans.

3. Yesterday our April 8, 2021 news release raised concerns about the possibility that the Ford Government might agree in advance to indemnify doctors if they deny critical care to a patient who needs it, should critical care triage be directed in Ontario. Beyond that news release, there are so many ramifications if the Government takes this step.

For one thing, it will implicate the Government directly in any patient’s death that results from critical care triage. We would argue that that is the case, even without any indemnification arrangement with doctors. However, an indemnification arrangement cements it even more.

Will the Government give doctors a blank check in advance, paying all their damages claims and paying for their defence lawyers, no matter how a doctor acts when deciding who lives and who dies? Why is the Government not removing the flagrant disability discrimination from the January 13, 2021 Critical Care Triage Protocol, both because it is wrong, and because the taxpayer should not be giving physicians a guaranteed advanced blank check for such human rights violations. It certainly seems that the public should have some say in this life and death issue.

For more background
1. The AODA Alliance’s new February 25, 2021 independent report on Ontario’s plans for critical care triage if hospitals are overwhelmed by patients needing critical care.

2. Ontario’s January 13, 2021 triage protocol.

3. The eight unanswered letters from the AODA Alliance to the Ford Government on its critical care triage plan, including the AODA Alliance’s September 25, 2020 letter, its November 2, 2020 letter, its November 9, 2020 letter, its December 7, 2020 letter, its December 15, 2020 letter, its December 17, 2020 letter, its January 18, 2021 letter and its February 25, 2021 letter to Health Minister Christine Elliott.

4. The Government’s earlier external advisory Bioethics Table’s September 11, 2020 draft critical care triage protocol, finally revealed in December 2020.

5. The AODA Alliance website’s health care page, detailing its efforts to tear down barriers in the health care system facing patients with disabilities, and our COVID-19 page, detailing our efforts to address the needs of people with disabilities during the COVID-19 crisis.

^ MORE DETAILS

^April 9, 2021 Letter from the AODA Alliance to the Registrar and CEO of the Ontario College of Physicians and Surgeons

Accessibility for Ontarians with Disabilities Act Alliance
United for a Barrier-Free Society for All People with Disabilities
Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

Dr. Nancy Whitmore, Registrar and CEO
Via email: [email protected]; [email protected]

College of Physicians and Surgeons of Ontario
80 College Street
Toronto, Ontario M5G 2E2

Dear Dr. Whitmore,

Re: Possibility of Rationing or Triage of Critical Care in Ontario

We write to ask about the position of the Ontario College of Physicians and Surgeons on Ontario’s plans for critical care triage if COVID-19 overwhelms hospitals, requiring rationing of critical care. We are especially concerned that those plans include flagrant disability discrimination, a lack of required due process for vulnerable patients whose lives are at stake, and a troubling failure to respect basic legal requirements.

We understand that the College of Physicians and Surgeons appears to have sent an email to all licensed physicians in Ontario within the past 48 hours on the topic of critical care triage. It is our understanding that this email states in material part as follows:

“Critical Care Triage

If we reach a point where Ontario’s critical care capacity can no longer meet the surge in demand, what are physicians’ obligations with respect to the withholding or withdrawal of potentially life-saving or life-sustaining care?

The College appreciates how challenging the pandemic has and continues to be for physicians working in critical care capacities. If the pandemic worsens and intensive care admissions increase, physicians may be faced with very difficult decisions regarding the allocation of scarce resources. It is essential that physicians be supported in making the extraordinary decisions they may be faced with and that the public trust how those decisions are being made.

The College notes that the provincial government has enabled a centralized authority, its command tables, to manage, oversee and co-ordinate the implementation of appropriate critical care triage tools should this become necessary. While only the provincial government can take the steps necessary to enable physicians to withdraw life-sustaining treatment without consent in order to re-allocate those resources to another patient, the College recognizes that issues concerning withholding potentially life-saving or life-sustaining treatments may also arise.

Given the imperative of allocating critical care resources in a manner that aims to save as many lives as possible, the College acknowledges that physicians may, in following direction and guidance from the command tables, need to withhold potentially life-saving or life-sustaining treatments in a manner that departs from the expectations set out in our Planning for and Providing_Quality_ End-of -Life Care policy. To the degree that compliance with triage frameworks, once initiated by the provincial command tables, results in departures from these expectations, the College is supportive of physicians acting in accordance with the command tables’ triage protocols. Transparent and sensitive communication with patients’ families will continue to be of paramount importance in these situations.”

Can you please confirm whether this is what the College has written to all Ontario doctors? If it is not, please let us know what the College has directed physicians on this topic.

If this or words to like effect are what the College has directed, we ask that the College immediately and publicly rescind it. It fails to take into account or even acknowledge the clear disability discrimination and denials of due process in Ontario’s critical care triage plans, which are contrary to the Ontario Human Rights Code and the Charter of Rights. Numerous serious human rights concerns with Ontario’s critical care triage plans have been repeatedly and publicly voiced by respected disability organizations like the AODA Alliance, the ARCH Disability Law Centre and others, as well as by the Ontario Human Rights Commission. Our efforts on this issue are extensively documented on our website’s health care page.

Before the College gives the Ontario Government’s critical care triage plans an official regulatory stamp of approval, it should, at a minimum, speak with those of us who are raising such serious concerns, and effectively take our concerns into account. We most recently crystalized many of those concerns in the AODA Alliance’s February 25, 2021 report on Ontario’s critical care triage plans.

We regret that the Ontario Health Ministry and Minister has not met with us, or even responded to our detailed correspondence on point. We have been relegated to the Government’s external advisory Bioethics Table. That Table makes no decisions, and has wrongly rejected key concerns that disability advocates have raised, too often without any explanation. After August 31, 2020, we did not had any meetings with that Bioethics Table except one on December 17, 2020. Our input at that last meeting appears to have been largely if not totally rejected, again, without reasons.

From the content of the Colleges statement which we quote above, if correct, it would appear that the Government and those acting on its behalf must have had direct content with the College in this connection. Can you please let us know what specific input, if any, the College itself has received regarding our disability concerns, and what input, if any, the College gave the Ontario Government about disability concerns with the critical care triage plans.

Making this situation worse, frontline doctors and hospitals have been urged to rely on the triage protocol, in a seriously flawed and misleading January, 23 2021 on-line webinar. For example, that webinar told doctors that the Ontario Human Rights Commission was consulted on this protocol, but did not tell them that the Commission and community groups have serious human rights objections to it.

It is our position that physicians who act pursuant to Ontario’s critical care triage plan and protocol do so at their peril. We share the view that there must be public trust and transparency in this issue. It has to date been mired in protracted secrecy as well as questionable public statements by the Government and those who have publicly defended Ontario’s critical care triage plans.

The College of Physicians and Surgeons of Ontario is required to regulate physicians in the public interest, protecting patients. The College should take a position on this critical care triage issue that is fully respectful of the rights and needs of vulnerable patients whose very lives are at stake during critical care triage.

We would welcome the chance to meet to provide the College with the input and information it should consider to take an informed and appropriate position on this issue.

Please stay safe.

Sincerely,

David Lepofsky CM, O. Ont
Chair Accessibility for Ontarians with Disabilities Act Alliance Twitter: @davidlepofsky

cc:
Premier Doug Ford [email protected]
Christine Elliott, Minister of Health, [email protected] Helen Angus, Deputy Minister of Health [email protected] Raymond Cho, Minister of Seniors and Accessibility [email protected]
Denise Cole, Deputy Minister for Seniors and Accessibility [email protected]
Mary Bartolomucci, Assistant Deputy Minister for the Accessibility Directorate, [email protected]
Todd Smith, Minister of Children, Community and Social Services [email protected]
Janet Menard, Deputy Minister, Ministry of Children, Community and Social Services [email protected]
Ena Chadha, Chief Commissioner of the Ontario Human Rights Commission [email protected]

^April 9, 2021 Public Statement by Chief Commissioner of the Ontario Human Rights Commission

Hello,

Today, the Ontario Human Rights Commission issued the following statement by Chief Commissioner Ena Chadha on human rights concerns with COVID-19 critical care triage:

April 9, 2021

OHRC statement on urgent human rights concerns with critical care triage

Unfortunately, Ontario is in its third wave of COVID-19.During its April 7 press conference to announce a stay-at-home order, the Ontario government emphasized that ICU admissions are increasing faster than the “worst-case scenario” predicted by their experts. The government also said it has not sanctioned any triage protocol should doctors be forced to decide who gets access to critical care and who does not.And last night, Ontario Health ordered hospitals to postpone non-urgent surgeries because of the growing caseload of COVID-19 patients.

The Ontario Human Rights Commission (OHRC) urgently calls on the government to clarify the statusof the Adult Critical Care Clinical Emergency Standard of Care for Major Surge protocol (the Emergency Standard of Care) that was circulated to hospitals in January. The governmentmust also confirmthat theHealth Care Consent Actprevails to protect the rights of patients and families at this time. Further, government should require hospitals to promptly collect data on vulnerable groups most affected by the pandemic, including older people, people with disabilities, Indigenous peoples and Black and other racialized people admitted to ICUs and whenever critical care is withheld or withdrawn.

Over the past year, the OHRC has repeatedly raised concerns about various versions of the triage protocol and the Emergency Standard of Care, including writing to the government last November and December.

On March 1, the OHRC highlighted concerns that the Emergency Standard of Care document and supplementary materials (such as an online short-term mortality risk calculator) included potentially discriminatory content, and called on the government to not implement Emergency Standard of Care without sufficient public input or consultation. The OHRC alsocalledon the government to publicly release and consult human rights stakeholders, including the OHRC, on the latest versions of the proposed critical care triage framework to make sure that this document and the Emergency Standard of Care, were consistent with and uphold the OntarioHuman Rights Code. We asked the government to do this before a potential third wave overwhelmed Ontario’s health-care system. Regrettably, that did not happen.

As the pandemic continues, the need to reflect human rights principles and respect human rights obligations in every response is greater than ever before.

We must ensurethat vulnerable groups disproportionately affected by the pandemic are not further disadvantaged by measures taken to manage critical care services in the days and weeks to come.

Ena Chadha
Chief Commissioner




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Read the AODA Alliance’s February 25, 2021 Letter to Ontario Minister of Health Christine Elliott – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance

United for a Barrier-Free Society for All People with Disabilities   Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

February 25, 2021

To: The Hon. Christine Elliott, Minister of Health

Via email: [email protected]

Ministry of Health

5th Floor

777 Bay St.

Toronto, ON M7A 2J3

Dear Minister,

Re: Ontario’s Plan for Medical Triage of Life-Saving Critical Care in the Event Hospitals Cannot Handle All COVID-19 Cases

We write to alert you to yet more serious concerns about the Ontario plan for critical care triage in the event that Ontario hospitals get overloaded and start to ration or triage life-saving critical care. With this letter, we enclose a new report that the AODA Alliance has prepared which independently reviews those plans. It identifies several serious new problems with the Ontario critical care triage plan, beyond those which we have earlier alerted you to in our unanswered letters, those being our September 25, 2020 letter, our November 2, 2020 letter, our November 9, 2020 letter, our December 7, 2020 letter, our December 15, 2020 letter, our December 17, 2020 letter and our January 18, 2021 letter.

We urge the Ford Government to immediately act to eliminate from Ontario’s critical care triage plan the problems we have identified up to now, and in this new report. Minister, this is an issue of life-and-death for Ontario’s most vulnerable people. It deserves a response from you.

For example, this new report reveals that a seriously troubling and disability-discriminatory online “Short Term Mortality Risk Calculator” has been created for triage doctors to use to calculate whether a patient should be refused life-saving critical care they need and want, if critical care triage must take place. It is available at www.stmrcalculator.ca It should immediately be shut down.

This new report also reveals that instructions may have been given or may be given to Ontario emergency services and EMTs on the possibility of not starting critical care supports in some situations for an emergency patient who needs and wants them, before reaching the hospital, if critical care triage has been directed for Ontario. This would be done so that hospitals don’t feel obligated to continue giving that patient critical care. We ask you to let us know if any such instructions have been given or have been designed or contemplated, by whom and to whom, with and with what authority? If so, we ask you to give us a copy of those instructions, past or present, and any draft instructions being considered.

This new report also shows that the troubling legal defence strategy that has been crafted to defend Ontario’s critical care triage plan is fatally flawed. It shows as well that this plan goes even further to in effect make each critical care triage physician a law unto themselves, dressed up as precise and objective medical science. We ask you to rescind that plan, and to ensure that any critical care triage plan or protocol is free of constitutional and human rights violations.

There has been no public announcement that critical care triage is already occurring in Ontario. To the contrary, The Government has said that it has not been occurring. Yet this report reveals that such triage in some form may already in effect be taking place in Ontario, according to a January 23, 2021 statement by one of the senior physicians involved in Ontario’s critical care triage planning. We ask you to immediately look into this, make all the relevant information public, and take steps to ensure that critical care triage does not occur until and unless it is free of these serious problems.

Please end your Government’s protracted secrecy in the area of critical care triage. This report reveals that senior physicians whom The Government has entrusted in this area have emphasized the importance of openness and transparency. For example, please make public now and provide us with the Bioethics Table’s secret January 12, 2021 report on critical care triage to The Government.

Minister, please now meet with us. Have your Ministry officials, responsible in this area, meet with us. Do not simply slough us off on the Bioethics Table. It is not the body making the decisions here. Moreover, the Bioethics Table has unwisely rejected some key parts of our input without explanation, without justification and without passing along the advice on this topic that it evidently opted to reject or disregard.

Please stay safe.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

CC:

Premier Doug Ford [email protected]

Helen Angus, Deputy Minister of Health [email protected]

Raymond Cho, Minister of Seniors and Accessibility [email protected]

Denise Cole, Deputy Minister for Seniors and Accessibility [email protected]

Mary Bartolomucci, Assistant Deputy Minister for the Accessibility Directorate, [email protected]

Todd Smith, Minister of Children, Community and Social Services [email protected]

Janet Menard, Deputy Minister, Ministry of Children, Community and Social Services [email protected]

Ena Chadha, Chief Commissioner of the Ontario Human Rights Commission [email protected]



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AODA Alliance to Present Tomorrow at Virtual Meeting of the City of Toronto’s Accessibility Advisory Committee to Oppose Allowing Electric Scooters


Submits Brief Showing City Staff Reports Prove E-Scooters Endanger Public Safety and Accessibility for People with Disabilities, Seniors, Children and Others

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE
NEWS RELEASE – FOR IMMEDIATE RELEASE

February 24, 2021 Toronto: Tomorrow, starting at 9:30 am, the City of Toronto’s Accessibility Advisory Committee will consider if the City should take steps to allow electric scooters (e-scooters) in Toronto. The AODA Alliance is scheduled to make a deputation to the Committee. The meeting will be live-streamed at: https://www.youtube.com/channel/UCfe2rzOnQzgEDvNzRRPUJsA

The AODA Alliance filed a detailed brief with the Committee. It explains that e-scooters would endanger public safety, lead to injuries and even deaths, create barriers to accessibility for people with disabilities, and force the taxpayer to shoulder new financial burdens. A City Staff Report last summer showed that the supposed social benefits of e-scooters reducing road traffic and pollution are illusory and unproven.

“If e-scooters in Toronto get approved, Torontonians will suffer the personal injuries and get stuck paying the expenses while e-scooter rental companies, who are pushing for their product to get into Toronto, will earn the profits and try to dodge liability for injuries they cause,” said David Lepofsky, Chair of the non-partisan AODA Alliance that has spearheaded advocacy to protect people with disabilities from the dangers that e-scooters pose. “Those e-scooter corporate lobbyists will be laughing all the way to the bank while we are sobbing all the way to hospital emergency rooms.”

The AODA Alliance will applaud the Toronto Accessibility Advisory Committee for unanimously advising Toronto City Council back on February 3, 2020 that e-scooters should remain banned in Toronto. It will call on Mayor John Tory and City Council members to stand up for people with disabilities, seniors, children and others whom e-scooters endanger. They should stand up to the e-scooter corporate lobbyists that are inundating City Hall with a high-price feeding frenzy of backroom lobbying.

On October 30, 2020, a new report pulled back the curtain to reveal the stunning behind-the-scenes high-price feeding frenzy of back-room pressure that e-scooter corporate lobbyists have flooded City Hall with for months, relentlessly pressuring City Hall to pass a by-law to lift the much-needed ban on e-scooters. That report gave insight into why in the midst of the COVID-19 pandemic when other pressing issues should be a priority, Toronto’s municipal politicians are so seriously considering unleashing e-scooters in Toronto, despite their amply-documented dangers to people with disabilities, seniors and others. Key disability organizations vigourously oppose e-scooters, because of these proven dangers.

That report showed that entries in Toronto’s official Lobbyist Registry filling fully 73 pages, reveal that in just the two years from June 2018 to October 2020, eight e-scooter rental companies and three lobbying firms have documented fully 1,384 contacts with City Hall in person, by phone, by virtual meeting or by email. Amidst this onslaught of corporate lobbyists’ approaches are a dizzying 94 contacts with the Mayor’s Office, including 10 with Mayor Tory himself, 58 with the Mayor’s Senior Advisor, Legislative Affairs Daniela Magisano, 15 with Mayor Tory’s Director of Legislative Affairs Edward Birnbaum, 10 with his Chief of Staff Luke Robertson, and 1 with Mayor Tory’s Deputy Chief of Staff Courtney Glen.

Taking on the well-connected and well-funded corporate lobbyists at City Hall is quite a lopsided battle, but disability advocates are experienced with uphill battles. Corporate lobbyists are pressing for a pilot project in Toronto with e-scooters. This would be nothing less than a human experiment on the public and would endanger the public, including people with disabilities, without their consent. Human experimentation on non-consenting people is universally condemned.

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

For more background, read the AODA Alliance ‘s February 22, 2021 brief to the Toronto Accessibility Advisory Committee. Visit the AODA Alliance e-scooters web page. Check out the AODA Alliance’s short captioned video that shows why Toronto should not allow e-scooters.




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AODA Alliance Submits a Short, Punchy Brief to the Toronto Accessibility Advisory Committee, Calling for Toronto Not to Lift the Much-Needed Ban on Electric Scooters


Accessibility for Ontarians with Disabilities Act Alliance Update United for a Barrier-Free Society for All People with Disabilities
Web: https://www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: https://www.facebook.com/aodaalliance/

February 22, 2021

SUMMARY

Today, the AODA Alliance submitted a short, strong brief to the Toronto Accessibility Advisory Committee, set out below. It calls for Toronto to leave in place the ban on electric scooters (e-scooters).

The Toronto Accessibility Advisory Committee will be holding a special virtual meeting on the issue of e-scooters, and the danger they pose for people with disabilities, seniors, children and others, on Thursday, February 25, 2021. The AODA Alliance will be making a deputation at that meeting, in support of our brief.

Please spread the word about this issue. If you have not already done so, please write or phone Toronto Mayor John Tory. Tell him not to allow e-scooters in Toronto. His email is [email protected] You can call his office at 416 397-2489.

Send this new brief to your member of Toronto City Council, if you live in Toronto. If you are going to make a presentation to the February 25, 2021 meeting of the Toronto Accessibility Advisory Committee, please endorse this brief.

Learn more about this issue by watching the AODA Alliance’s new short, captioned video on why we must not allow e-scooters in Toronto. Also, check out the AODA Alliance’s action kit on this issue. Share these resources with your family members, friends and social media contacts.

Visit the AODA Alliance’s e-scooters web page. As always, we welcome your feedback. Write to us at [email protected]

Riding Electric Scooters in Toronto is Dangerous and Must Remain Banned
AODA Alliance brief to the Toronto Accessibility Advisory Committee on Electric Scooters February 22, 2021
Via email: [email protected]

Mayor Tory and Toronto City Council must not unleash dangerous electric scooters in Toronto. Riding e-scooters in public places in Toronto is now banned and remains banned unless Council legalizes them.

The AODA Alliance strongly commends the Toronto Accessibility Advisory Committee for holding a special meeting on February 25, 2021, to obtain input from the disability community on the dangers that e-scooters present to people with disabilities, seniors, children and others. We congratulate the Toronto Accessibility Advisory Committee for unanimously recommending to Toronto City Council a year ago, on February 3, 2020, that e-scooters should not be allowed in Toronto.

It was wrong for the City of Toronto’s Infrastructure and Environment Committee to pay only token lip service to that wise recommendation, at its July 9, 2020 meeting. It was also wrong for fully 11 out of 23 members of City council to vote on July 28, 2020, against the City staff further investigating the dangers that e-scooters pose to people with disabilities, including Councilors Ainslie, Bailao, Colle, Crawford, Filion, Ford, Grimes, Holyday, Lai, Layton and McKelvie. The fact that 11 members of Toronto City Council openly voted against the needs of Torontonians with disabilities is very troubling. None of those Council members reached out to the AODA Alliance to learn of our concerns before voting against the City further investigating them.

A City Staff Report last July, supplemented by the new February 2021 City Staff report prepared for the Toronto Accessibility Advisory Committee (key excerpts are below), amply shows that e-scooters endanger public safety in communities that have permitted them. Riders and innocent pedestrians get seriously injured or killed. They especially endanger seniors and people with disabilities. Blind people like myself cannot detect silent e-scooters accelerate at us at over 20 KPH, driven by unlicensed, untrained, uninsured, unhelmeted fun-seeking riders. Left strewn on sidewalks, e-scooters are tripping hazards for people with vision loss and an accessibility nightmare for wheelchair users.

It is no solution to just ban e-scooters from sidewalks. Last summer’s City Staff Report and the new City Staff report prepared for the Toronto Accessibility Advisory Committee (the latter excerpted below), document the silent menace of e-scooters continuing to be ridden on sidewalks in cities that just ban them from sidewalks. Toronto would need cops on every block. Toronto law enforcement told City Councilors on July 9, 2020, that they have no capacity to enforce new e-scooter rules. City Staff reported last summer that no city that allows e-scooters has gotten enforcement right.

E-scooters would cost taxpayers lots. This would include new law enforcement, OHIP for treating those injured by e-scooters, and lawsuits by the injured. Toronto has far more pressing budget priorities.

With COVID raging, why is City Council even considering the legalization of dangerous e-scooters? The October 30, 2020 report, released by the AODA Alliance, revealed the stunning well-funded behind-the-scenes feeding frenzy of back-room pressure that corporate lobbyists for e-scooter rental companies have inundated City Hall with for months. The corporate lobbyists want to make money on e-scooter rentals, laughing all the way to the bank, while injured pedestrians sob all the way to hospital emergency rooms. 73 pages of entries in Toronto’s Lobbyist Registry, quoted verbatim in that report, reveal that in just over two years, a stunning 1,384 contacts by corporate lobbyists have taken place with City Hall from top to bottom in person, by phone, virtual meeting or email. Of those, as of last fall, there had been 94 such contacts with Mayor Tory or his office. There may be a couple of janitors the e-scooter corporate lobbyists have not reached yet.

City Council should not conduct an e-scooter pilot. A pilot to study what? How many of us will be injured? We already know they will, from cities that allowed them. It is immoral to subject Torontonians to a City-wide human experiment, especially without our consent, where we can get injured. The call for a pilot project with e-scooters is just the corporate lobbyists’ strategy to try to get their foot firmly planted in the door, so it will be harder to later get rid of e-scooters.

Since we allow bikes, why not e-scooters? An e-scooter, unlike a bike, is a motor vehicle. They should not be exempt from public safety regulations that apply to motor vehicles. A person who has never ridden an e-scooter can hop on one and instantly throttle up to race over 20 KPH. A person cannot instantly pedal a bike that fast, especially if they have never ridden a bike. In any event, Toronto already has bikes and BikeShare. We do not need the dangers of e-scooters.

The July 2020 City Staff Report shows that e-scooters do not bring the great benefits for reduced car traffic and pollution that the corporate lobbyists for e-scooter rental companies claim.

Please make Toronto easier and not harder for those of us with disabilities to get around. Protect those who need safe, accessible streets and sidewalks, not the interests of corporate lobbyists.

Mayor Tory’s decision on this issue will strongly influence or decide how City Council votes. He should attend the February 25, 2021 special meeting of the Toronto Accessibility Advisory Committee, to hear directly from Torontonians with disabilities.

We need the Toronto Accessibility Advisory Committee to speak out again now, in as strong a voice as possible. On this issue, it is quite an uphill battle to get City Council to listen to us, over the call of the well-funded e-scooter corporate lobbyists. We need Toronto Mayor John Tory and all City Council members to stand up to those well-resourced and well-connected e-scooter corporate lobbyists, and to stand up for Torontonians with disabilities.

The e-scooter corporate lobbyists have proposed utterly inadequate solutions to the dangers that e-scooters pose. Those solutions are incapable of solving the problem. Only a ban on riding e-scooters in Toronto will provide us with the protections Torontonians deserve. The fact that the e-scooter corporate lobbyists have no effective solutions to offer, after operating e-scooters in several other cities around the world, proves that e-scooters should simply remain banned.

For example, geofencing cannot work. GPS technology is not precise enough to know when an e-scooter is ridden on a sidewalk, as opposed to on a road. Moreover, geofencing does not prevent any of the dangers that the silent menace of e-scooters present when ridden on the road, e.g. on roads where there is no sidewalk.

As another example, placing e-scooters in docking stations does not ensure that e-scooters are kept there. It does not prevent the dangers that e-scooters present when being ridden on roads, sidewalks or other public places.

We therefore call on the Toronto Accessibility Advisory Committee to pass a resolution along the following lines:

The Toronto Accessibility Advisory Committee recommends to Toronto City Council that:

1. The use of electric scooters in any public place should remain banned in Toronto, including riding an e-scooter that the rider rents, owns or borrows.

2. No pilot project with electric scooters should be conducted in Toronto. City Council should not conduct an experiment that endangers Torontonians.

3. City law enforcement officers should now enforce the ban on riding e-scooters in Toronto, in the case of anyone who now rides one.

We want to make it clear that these references to banning e-scooters do not refer to the very different scooters that some people with disabilities use for mobility devices. Those mobility devices are now permitted and of course, should remain permitted.

Learn more about the dangers that e-scooters pose to people with disabilities, seniors, children and others, by visiting the AODA Alliance e-scooter web page and by watching the AODA Alliance’s new short, captioned video on this issue.

Learn more about the AODA Alliance by visiting www.aodaalliance.org, by following @aodaalliance on Twitter, by visiting our Facebook page at www.facebook.com or by emailing us at [email protected]

Excerpts from the City of Toronto Staff Report to February 25, 2021, Special Meeting of the Toronto Accessibility Advisory Committee

Excerpt 1

According to the UDV (German Insurers Accident Research) in January 2021, e-scooter riders are 4 times more (or 400% more) likely than bicyclists to injure others, due to e-scooters being illegally ridden on sidewalks.
In 21% of e-scooter incidents with personal injury, the victim is not the rider, but another road user. This is due in part to e-scooters being ridden on sidewalks 60% of the time when they should be on the road or bike lane.
According to Austria’s Kuratorium für Verkehrssicherheit (KFV) in October 2020, 34% of 573 e-scooter riders observed at several Vienna locations illegally rode on the sidewalk.
Even if there was a bike path, 23 percent preferred the sidewalk. If there was only one cycle or multi-purpose lane, 46 percent rode on the sidewalk. If there was no cycling infrastructure, 49 percent rolled illegally on the sidewalk. Excerpt 2

Accessibility Feedback on Proposed Solutions
Technologies are still emerging and not adequate yet:
Geofencing and other technologies to prevent sidewalk riding are not sophisticated enough and would only apply to rental e-scooters.
Docking stations for e-scooters has potential but is still in development.
Lock-to cables on e-scooters mean they could be locked anywhere (e.g., café fence/railing) including in spots blocking entrance access and paths of travel.
There is already a lack of bike parking so this would worsen the number of sidewalk obstructions on narrow and cluttered sidewalks.
If Bike Share Toronto were dockless, there would not be enough bike rings to lock the rental fleet same for dockless rental e-scooter fleets. Accessibility Feedback on Proposed Solutions
Not enough city resources for enforcement and infrastructure priorities
Oversight is very labour- and resource-intensive and depends on enforcement, which is already stretched or non-existent in parts of the City.
o Licence plates on rental e-scooter fleets could help, but this is a reactive tool and would be a drain on city resources to monitor and enforce. Bigger priorities for limited city resources.
Inadequate infrastructure is a bigger priority not enough sidewalk space or accessible infrastructure; not enough bike lanes/bike lane space; and not enough public transit.
Importance of other city priorities before allowing something which poses a hazard and a nuisance for pedestrians and persons with disabilities.

Accessibility Feedback on Proposed Solutions
Impacts on seniors and persons with disabilities on sidewalks
COVID-19 has resulted in challenges for persons with disabilities, their caregivers and pedestrians who use sidewalks as a necessity and not for recreation.
Allowing e-scooters will pose hazards that affect persons with disabilities, seniors, their caregivers and pedestrians.
Risk of severe injury for seniors or persons with disabilities if tripping and falling or struck by an e-scooter.
Inability to identify e-scooter rider because of their speed, and that the person’s credit card on the app may not be the person riding the e-scooter.

Excerpt 3
Canadian context City of Calgary
No bike share. Only rental e-scooters allowed in Alberta.
Allows e-scooter riding on sidewalks.
43% of 311 requests about bad behaviour or conflicts with pedestrians; 42% parking concerns. (total of 769 requests over the pilot period)
Now allowing e-scooter use on some roads to reduce sidewalk riding issues. Added slow speed zones and 30 parking zones (2.5% of riders ended trips in parking zones; 10% of the e-scooter fleet was deployed to the parking zones).
E-scooters to return via the procurement process. Lowered fleet cap from 2,800 (2020) to 1,500 (2021). Will require licence plates for enforcement.
Likely that e-scooters have the highest rate of injury per transportation mode but less severe. 43% of EMS e-scooter injuries required surgery (double that of EMS bicycles at 21%). 37% of severe e-scooter injuries had suspected intoxication.
1,300 e-Scooter-related ER visits during the pilot period but may be over-inclusive of other devices referred to as scooters. 75 required ambulance transport, 5% were pedestrians injured.

Canadian context City of Ottawa
No bike share. Personal use and rental e-scooters allowed on roads with max 50km/h limit, bike lanes, and trails/paths that are not National Capital Commission multi-use paths.
Lowered max. speed to 20km/hr for e-scooters from the permitted 24km/hr under the provincial pilot. 8km/hr for slow zones, e.g., transit malls/stations.
Piloted a fleet of 600 e-scooters with 3 vendors in 2020. Will increase the fleet cap to between 1,200 and 1,500 for 2021 and expand outside the Greenbelt (suburban area).
76% of e-scooter riders surveyed used e-scooters for recreation; 2% to connect to transit (COVID-19 context)
Will pilot in 2021 via procurement process. Staff labour costs not included in cost-recovery. Considering designated parking areas. 69% of all survey respondents reported encountering improperly parked e-scooters.
No injury data collection with hospitals and not likely for 2021 given the pandemic.
Accessibility stakeholders were consulted and raised concerns about sidewalk riding and improper parking, especially barriers for persons with low vision or no vision.

Large Urban Peer Cities
Peer cities have banned rental/shared e-scooters from downtowns in Chicago and New York City. No rental/shared e-scooters yet in places such as:
Montréal (not for 2021) or Vancouver
Massachusetts (e.g., City of Boston)
Pennsylvania (e.g., City of Philadelphia)
New South Wales (e.g., City of Sydney, Australia)
Scotland (e.g., City of Edinburgh), The Netherlands (e.g., Amsterdam), and
Others have banned or since banned them, e.g., Copenhagen (city centre), Houston, San Diego (boardwalk ban), etc.
NYC (outside of Manhattan only) and Transport for London (UK) pilots not yet underway.




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Yesterday’s Roundtable on Critical Care Triage during the COVID-19 Pandemic, Hosted by the Ontario Human Rights Commission, Leads the AODA Alliance to Again Write Health Minister Christine Elliott to Raise Important New Issues


Accessibility for Ontarians with Disabilities Act Alliance Update United for a Barrier-Free Society for All People with Disabilities
Web: http://www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: http://www.facebook.com/aodaalliance/

December 18, 2020
SUMMARY

Yesterday, the AODA Alliance joined the ARCH Disability Law Centre and a number of other advocates from Ontario’s disability, racialized and Indigenous communities, all invited by the Ontario Human Rights Commission to a virtual roundtable discussion. It focused on the September 11, 2020 draft critical medical care triage protocol that was finally made public a week earlier. We have campaigned for three months to get that document made public.

Given the number of participants, we could only scratch the surface on this life-and-death issue during this two-hour roundtable. The painful fact that that day, Ontario had another record-breaking number of new COVID-19 infections made this discussion especially urgent and long-overdue.

A number of new important issues were identified at this roundtable by a spectrum of participants. All were in strong agreement on a range of concerns. The AODA Alliance’s concerns were echoed or endorsed by a number of participants.

Some of the key points which the AODA Alliance raised are spelled out in the newest letter to Ontario Health Minister Christine Elliot from the AODA Alliance, dated December 17, 2020 and set out below. We hope that the Minister will this time respond to our letter. The Ford Government has not answered any of our earlier letters to her on this topic.

Present to receive feedback at the roundtable were representatives from the Ontario Human Rights Commission and the Ontario-Government’s external Bioethics Table. As well, there were some representatives from the Ford Government, including from the Health Minister’s office, from Ontario Health, and from the Government’s internal Critical Care Command Centre. We asked to be sent the names and contact information for these provincial officials and are waiting to hear back. We also asked to be sent all the information on the Bioethics Table’s September 11, 2020 draft critical care triage protocol that the Government has sent to hospitals. No one spoke up to agree to send this to us.

This entire triage issue remains in flux. We will keep you posted. With COVID-19 infections rising and hospitals getting filled to capacity, we fear that triage may be taking place right now.

Send your feedback to us at [email protected]

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

MORE DETAILS

December 17, 2020 Letter from the AODA Alliance to Ontario Health Minister Christine Elliott Accessibility for Ontarians with Disabilities Act Alliance
United for a Barrier-Free Society for All People with Disabilities
Web: www.aodaalliance.org Email: [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

December 17, 2020

To: The Hon. Christine Elliott, Minister of Health
Via email: [email protected]
Ministry of Health
5th Floor
777 Bay St.
Toronto, ON M7A 2J3

Dear Minister,

Re: Ontario Government’s Protocol for Medical Triage of Life-Saving Critical Care in the Event Hospitals Cannot Handle All COVID-19 Cases

We urgently write to follow up on our five unanswered letters to you dated September 25, November 2, November 9, December 7 and December 15, 2020. These ask about the Ford Government’s plans for deciding which patients would be refused life-saving critical medical care that they need, if the record-breaking surge in COVID-19 cases overloads Ontario hospitals and requires rationing or “triage” of critical care beds and services.

This morning, we took part in a two-hour virtual roundtable, convened by the Ontario Human Rights Commission and the Government-appointed COVID-19 Bioethics Table. It was convened on very short notice to gather feedback on the Bioethics Table’s recently-released September 11, 2020 proposed critical care triage protocol.

These are among the many urgent points that arose at or from the discussion at that roundtable:

1. None of us invited to that roundtable from the disability, racialized or Indigenous communities had had anywhere near the time we needed to properly review the detailed 36-page September 11, 2020 draft critical care triage protocol. Such virtual face-to-face consultations are vital but must be preceded by enough time to prepare. Sending in written submissions is no substitute. Don’t now consider that the consultation check box can be ticked.

2. No one has shown us that anything in the proposed triage protocol is authorized by law. We have raised this concern time and again. The most interesting and thorough discussion with the Bioethics Table on how triage should be carried out is utterly irrelevant if the protocol, whatever it says, is not properly mandated by law a law that passes constitutional muster.

For example, it will be shocking and deeply disturbing to many if not most to learn the draft triage protocol would have doctors under certain triage circumstances actually withdraw critical care services from a critical care patient who needs those services and who is in the middle of receiving those insured medical services. How can a mere memo from some bureaucrat in the Ministry of Health or from Ontario Health purport to authorize that, if there is no legislative authority for it? Couldn’t that give rise to possible criminal responsibility, for those taking such action? We don’t believe that a provincial memo overrides the Criminal Code of Canada.

3. It appeared that none of us, from whom input was being sought, could understand from this 36-page document exactly how a doctor is to specifically decide who will be refused critical care under the September 11, 2020 draft triage protocol. We cannot give the kind of detailed input that is needed without that being clarified. We wrote the Bioethics Table co-chairs about this in advance of this meeting. No such clarification was provided.

4. An extremely worrisome revelation was made in the only statement we have heard from anyone within the Government’s internal critical care triage infrastructure. Dr. Andrew Baker identified himself as a member of the Ministry of Health’s Critical Care Command Centre. Right near the end of the roundtable, responding to feedback at the roundtable, Dr. Baker stated that doctors value life inherently, and that at present, doctors “default to life years, when we have finite resources. One principle, life years.”

What we take from this is that at present, such triage decisions would be made based on “life years saved.” He went on to say that a new approach to triage, embodying the concerns raised at the roundtable (with which he seemed to find real merit), would in effect have to wait for a future time. That would have to be after this pandemic is over.

That statement in effect summarily and categorically dismissed all the serious human rights and constitutional concerns we had raised for two hours as not ready to be implemented during this pandemic, even if critical care triage becomes necessary.

We strongly disagree. The Government cannot give up on this now. The thought that we might not have time to put these principles into action now is especially cruel, since our community has been pleading with your Government since early April to directly consult us on this issue.

Dr. Baker’s endorsement of using “life years saved” points to an approach riddled with discrimination because of age, disability, or both. Minister, Dr. Baker’s single statement crystalizes so many of our concerns. It reveals that whatever is written in this or other triage protocols won’t matter at the front lines, and that vulnerable seniors and people with disabilities, among others, now have a great deal to worry about.

This requires you to immediately take over personal leadership on this issue, and to let our vulnerable communities speak directly to you and your senior officials.

5. From what we can determine, the September 11, 2020 draft triage protocol would have a doctor or doctors assess, based on an individual clinical assessment, if a patient, needing critical care, has less than 12 months to live. As I pointed out at the roundtable, Dr. James Downar, of the Bioethics Table, has previously told us that when doctors assess whether a patient has less than 3 months to live in order to decide if that patient should be allowed to go into palliative care, doctors “lie”. By this, we understand him to mean that they try to make a result-oriented assessment to get palliative resources for their patient.

If doctors routinely lie for assessing a patient’s likely mortality within three months, we have every reason to fear that they could do the same when the figure is changed from three months to twelve months, in connection with critical care triage decisions. We realize that there is a difference between admission to palliative care on the one hand, and admission to critical care on the other. However, for current purposes, that difference does not make a difference.

6. The September 11, 2020 draft critical care triage protocol, like the two earlier versions that the Bioethics Table produced this year, give these life-and-death decisions over to doctors. As addressed in our next point, we think this needs reconsideration. It provides no appeal from those doctors to an outside independent body, such as a court or the Consent and Capacity Board. Such an appeal is needed. Moreover, it proposes to immunize doctors and other health care professionals making these life-and-death decisions from any accountability. It states that the protocol should:

“4. Ensure liability protection for all those who would be involved in implementing the Proposed Framework (e.g., physicians, clinical teams, Triage Team members, Appeals Committee members, implementation planners, etc.), including an Emergency Order related to any aspect requiring a deviation from the Health Care Consent Act.”

It is certainly questionable whether that can be done. We believe it is beyond question that it should not be done.

7. As we also emphasized at the roundtable, it is not clear to us that these purely medical triage criteria are the way for Ontario to go. Other non-medical triage criteria outside the preserve of doctors are worth considering.

Minister, please talk to us. Have your Ministry officials talk to us. Don’t wait until it is too late.

Stay safe.

Sincerely,

David Lepofsky, CM, O. Ont
Chair, Accessibility for Ontarians with Disabilities Act Alliance

Enclosure: December 11, 2020 email from AODA Alliance Chair David Lepofsky to Jennifer Gibson, Bioethics Table co-chair

cc:
Premier Doug Ford [email protected]
Helen Angus, Deputy Minister of Health [email protected] Raymond Cho, Minister of Seniors and Accessibility [email protected]
Denise Cole, Deputy Minister for Seniors and Accessibility [email protected]
Mary Bartolomucci, Assistant Deputy Minister for the Accessibility Directorate, [email protected]
Todd Smith, Minister of Children, Community and Social Services [email protected]
Janet Menard, Deputy Minister, Ministry of Children, Community and Social Services [email protected]
Ena Chadha, Chief Commissioner of the Ontario Human Rights Commission [email protected] Jennifer Gibson, Co-Chair, Bioethics Table [email protected] Dianne Godkin, Co-Chair, Bioethics Table [email protected]




Source link

Yesterday’s Roundtable on Critical Care Triage during the COVID-19 Pandemic, Hosted by the Ontario Human Rights Commission, Leads the AODA Alliance to Again Write Health Minister Christine Elliott to Raise Important New Issues


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

Yesterday’s Roundtable on Critical Care Triage during the COVID-19 Pandemic, Hosted by the Ontario Human Rights Commission, Leads the AODA Alliance to Again Write Health Minister Christine Elliott to Raise Important New Issues

December 18, 2020

SUMMARY

Yesterday, the AODA Alliance joined the ARCH Disability Law Centre and a number of other advocates from Ontario’s disability, racialized and Indigenous communities, all invited by the Ontario Human Rights Commission to a virtual roundtable discussion. It focused on the September 11, 2020 draft critical medical care triage protocol that was finally made public a week earlier. We have campaigned for three months to get that document made public.

Given the number of participants, we could only scratch the surface on this life-and-death issue during this two-hour roundtable. The painful fact that that day, Ontario had another record-breaking number of new COVID-19 infections made this discussion especially urgent and long-overdue.

A number of new important issues were identified at this roundtable by a spectrum of participants. All were in strong agreement on a range of concerns. The AODA Alliance’s concerns were echoed or endorsed by a number of participants.

Some of the key points which the AODA Alliance raised are spelled out in the newest letter to Ontario Health Minister Christine Elliot from the AODA Alliance, dated December 17, 2020 and set out below. We hope that the Minister will this time respond to our letter. The Ford Government has not answered any of our earlier letters to her on this topic.

Present to receive feedback at the roundtable were representatives from the Ontario Human Rights Commission and the Ontario-Government’s external Bioethics Table. As well, there were some representatives from the Ford Government, including from the Health Minister’s office, from Ontario Health, and from the Government’s internal Critical Care Command Centre. We asked to be sent the names and contact information for these provincial officials and are waiting to hear back. We also asked to be sent all the information on the Bioethics Table’s September 11, 2020 draft critical care triage protocol that the Government has sent to hospitals. No one spoke up to agree to send this to us.

This entire triage issue remains in flux. We will keep you posted. With COVID-19 infections rising and hospitals getting filled to capacity, we fear that triage may be taking place right now.

Send your feedback to us at [email protected].

For more background on this issue, check out:

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

MORE DETAILS

December 17, 2020 Letter from the AODA Alliance to Ontario Health Minister Christine Elliott

Accessibility for Ontarians with Disabilities Act Alliance

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

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

December 17, 2020

To: The Hon. Christine Elliott, Minister of Health

Via email: [email protected]

Ministry of Health

5th Floor

777 Bay St.

Toronto, ON M7A 2J3

Dear Minister,

Re: Ontario Government’s Protocol for Medical Triage of Life-Saving Critical Care in the Event Hospitals Cannot Handle All COVID-19 Cases

We urgently write to follow up on our five unanswered letters to you dated September 25, November 2, November 9, December 7 and December 15, 2020. These ask about the Ford Government’s plans for deciding which patients would be refused life-saving critical medical care that they need, if the record-breaking surge in COVID-19 cases overloads Ontario hospitals and requires rationing or “triage” of critical care beds and services.

This morning, we took part in a two-hour virtual roundtable, convened by the Ontario Human Rights Commission and the Government-appointed COVID-19 Bioethics Table. It was convened on very short notice to gather feedback on the Bioethics Table’s recently-released September 11, 2020 proposed critical care triage protocol.

These are among the many urgent points that arose at or from the discussion at that roundtable:

  1. None of us invited to that roundtable from the disability, racialized or Indigenous communities had had anywhere near the time we needed to properly review the detailed 36-page September 11, 2020 draft critical care triage protocol. Such virtual face-to-face consultations are vital but must be preceded by enough time to prepare. Sending in written submissions is no substitute. Don’t now consider that the consultation check box can be ticked.
  1. No one has shown us that anything in the proposed triage protocol is authorized by law. We have raised this concern time and again. The most interesting and thorough discussion with the Bioethics Table on how triage should be carried out is utterly irrelevant if the protocol, whatever it says, is not properly mandated by law – a law that passes constitutional muster.

For example, it will be shocking and deeply disturbing to many if not most to learn the draft triage protocol would have doctors under certain triage circumstances actually withdraw critical care services from a critical care patient who needs those services and who is in the middle of receiving those insured medical services. How can a mere memo from some bureaucrat in the Ministry of Health or from Ontario Health purport to authorize that, if there is no legislative authority for it? Couldn’t that give rise to possible criminal responsibility, for those taking such action? We don’t believe that a provincial memo overrides the Criminal Code of Canada.

  1. It appeared that none of us, from whom input was being sought, could understand from this 36-page document exactly how a doctor is to specifically decide who will be refused critical care under the September 11, 2020 draft triage protocol. We cannot give the kind of detailed input that is needed without that being clarified. We wrote the Bioethics Table co-chairs about this in advance of this meeting. No such clarification was provided.
  1. An extremely worrisome revelation was made in the only statement we have heard from anyone within the Government’s internal critical care triage infrastructure. Dr. Andrew Baker identified himself as a member of the Ministry of Health’s Critical Care Command Centre. Right near the end of the roundtable, responding to feedback at the roundtable, Dr. Baker stated that doctors value life inherently, and that at present, doctors “default to life years, when we have finite resources. One principle, life years.”

What we take from this is that at present, such triage decisions would be made based on “life years saved.” He went on to say that a new approach to triage, embodying the concerns raised at the roundtable (with which he seemed to find real merit), would in effect have to wait for a future time. That would have to be after this pandemic is over.

That statement in effect summarily and categorically dismissed all the serious human rights and constitutional concerns we had raised for two hours as not ready to be implemented during this pandemic, even if critical care triage becomes necessary.

We strongly disagree. The Government cannot give up on this now. The thought that we might not have time to put these principles into action now is especially cruel, since our community has been pleading with your Government since early April to directly consult us on this issue.

Dr. Baker’s endorsement of using “life years saved” points to an approach riddled with discrimination because of age, disability, or both. Minister, Dr. Baker’s single statement crystalizes so many of our concerns. It reveals that whatever is written in this or other triage protocols won’t matter at the front lines, and that vulnerable seniors and people with disabilities, among others, now have a great deal to worry about.

This requires you to immediately take over personal leadership on this issue, and to let our vulnerable communities speak directly to you and your senior officials.

  1. From what we can determine, the September 11, 2020 draft triage protocol would have a doctor or doctors assess, based on an individual clinical assessment, if a patient, needing critical care, has less than 12 months to live. As I pointed out at the roundtable, Dr. James Downar, of the Bioethics Table, has previously told us that when doctors assess whether a patient has less than 3 months to live in order to decide if that patient should be allowed to go into palliative care, doctors “lie”. By this, we understand him to mean that they try to make a result-oriented assessment to get palliative resources for their patient.

If doctors routinely lie for assessing a patient’s likely mortality within three months, we have every reason to fear that they could do the same when the figure is changed from three months to twelve months, in connection with critical care triage decisions. We realize that there is a difference between admission to palliative care on the one hand, and admission to critical care on the other. However, for current purposes, that difference does not make a difference.

  1. The September 11, 2020 draft critical care triage protocol, like the two earlier versions that the Bioethics Table produced this year, give these life-and-death decisions over to doctors. As addressed in our next point, we think this needs reconsideration. It provides no appeal from those doctors to an outside independent body, such as a court or the Consent and Capacity Board. Such an appeal is needed. Moreover, it proposes to immunize doctors and other health care professionals making these life-and-death decisions from any accountability. It states that the protocol should:

“4.       Ensure liability protection for all those who would be involved in implementing the Proposed Framework (e.g., physicians, clinical teams, Triage Team members, Appeals Committee members, implementation planners, etc.), including an Emergency Order related to any aspect requiring a deviation from the Health Care Consent Act.”

It is certainly questionable whether that can be done. We believe it is beyond question that it should not be done.

  1. As we also emphasized at the roundtable, it is not clear to us that these purely medical triage criteria are the way for Ontario to go. Other non-medical triage criteria outside the preserve of doctors are worth considering.

Minister, please talk to us. Have your Ministry officials talk to us. Don’t wait until it is too late.

Stay safe.

Sincerely,

David Lepofsky, CM, O. Ont

Chair, Accessibility for Ontarians with Disabilities Act Alliance

Enclosure: December 11, 2020 email from AODA Alliance Chair David Lepofsky to Jennifer Gibson, Bioethics Table co-chair

cc:

Premier Doug Ford [email protected]

Helen Angus, Deputy Minister of Health [email protected]

Raymond Cho, Minister of Seniors and Accessibility [email protected]

Denise Cole, Deputy Minister for Seniors and Accessibility [email protected]

Mary Bartolomucci, Assistant Deputy Minister for the Accessibility Directorate, [email protected]

Todd Smith, Minister of Children, Community and Social Services [email protected]

Janet Menard, Deputy Minister, Ministry of Children, Community and Social Services [email protected]

Ena Chadha, Chief Commissioner of the Ontario Human Rights Commission [email protected]a

Jennifer Gibson, Co-Chair, Bioethics Table [email protected]

Dianne Godkin, Co-Chair, Bioethics Table [email protected]



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Tell Us What Successes or Barriers Students with Disabilities Are Experiencing This Fall at School or During Distance Education – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

Tell Us What Successes or Barriers Students with Disabilities Are Experiencing This Fall at School or During Distance Education

December 1, 2020

Please take a minute to send us your feedback! We want to hear from parents and guardians of students with disabilities in Ontario Schools, from students with disabilities themselves, and from anyone working or volunteering in our schools. How has it been going for students with disabilities this fall, either during distance learning or when attending at school? Please email us your answers, even if you only have a minute or two. Write us at [email protected]

Here are the questions that are especially important. Feel free to answer all or just some of them:

  1. Is your child attending school in person or taking part in distance learning? Why did you choose one over the other?
  1. If your child is taking part in distance learning, how is it going? Are they learning as much as when they are at school?
  1. If your child is taking part in distance education, are they encountering any disability barriers or disability-related problems? If so, how effective has the school board been at overcoming those barriers or problems?
  1. If your child is attending school in person, have they encountered any additional disability barriers or problems due to the COVID-19 pandemic and measures taken to address it? If so, how effective has the school board been at removing or fixing those barriers or problems?

We appreciate any time you can take to send us your feedback. Please respond, if at all possible, by the end of Monday, December 7, 2020.

We will read every response we get. It will help us formulate our ongoing advocacy efforts. We will not reveal any names or specific identifying information you share with us.

As a volunteer coalition, we won’t be able to give advice on specific cases. However, if you want some practical tips on how to advocate for a child with disabilities in the school system, check out the AODA Alliance’s new online video on this topic.

For more background on these issues, visit

  1. The AODA Alliance’s COVID-19 web page and our education accessibility web page.
  1. The July 24, 2020 report on meeting the needs of students with disabilities during school re-opening by the COVID-19 subcommittee of the K-12 Education Standards Development Committee.
  1. The AODA Alliance‘s July 23, 2020 report on the need to rein in the power of school principals to refuse to admit a student to school.
  1. The AODA Alliance’s June 18, 2020 brief to the Ford Government on how to meet the needs of students with disabilities during school re-opening.
  1. The widely viewed online video of the May 4, 2020 virtual Town Hall on meeting the needs of students with disabilities during the COVID-19 crisis, co-organized by the Ontario Autism Coalition and the AODA Alliance.



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It’s Time for the Ford Government to Agree to Create a Built Environment Accessibility Standard under Ontario’s Disabilities Act – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

It’s Time for the Ford Government to Agree to Create a Built Environment Accessibility Standard under Ontario’s Disabilities Act

November 30, 2020

            SUMMARY

Today is the first day of our non-partisan grassroots disability accessibility movement’s 27th year in action!!

We call on the Ford Government to immediately take effective action to tackle the many barriers that Ontarians with disabilities continue to face in the built environment. More specifically, we call on the Ford Government to announce that it will develop and enact a comprehensive, strong and effective Built Environment Accessibility Standard under the Accessibility for Ontarians with Disabilities Act. The Government should now post an announcement recruiting people to serve on a Built Environment Standards Development Committee under the AODA. That Committee is needed to consult the public and to make recommendations on what the Built Environment Accessibility Standard should include.

That AODA Standards Development Committee should be free to make whatever recommendations it deems helpful to address any aspect of the built environment. Part of its mandate should be to conduct the long-overdue mandatory review of Ontario’s weak and limited “Design of Public Spaces AODA Accessibility Standard”. The AODA required that review to begin three years ago. A review of the Design of Public Spaces Accessibility Standard is only a small part of what is now needed.

The Ontario Government typically and wrongly treats the Ontario Building Code and existing AODA accessibility standards as the only legally required benchmark that it must meet in new or significantly renovated buildings. Yet those legal requirements fall far short of what people with disabilities need. A building that is built in full compliance with the Ontario Building Code and with existing AODA accessibility standards need not be fully accessible, and likely will not be fully accessible to people with disabilities. It will not meet the higher accessibility requirements guaranteed to people with disabilities by the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms.

Below we give more background on this issue. To learn even more about the AODA Alliance’s multi-year campaign to get a strong and effective Built Environment Accessibility Standard enacted in Ontario under the AODA, check out the AODA Alliance website’s built environment page.

There have now been 669 days, or 22 months, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has still announced no comprehensive plan of new action to implement that blistering report, including its strong recommendations regarding disability barriers in the built environment. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis, addressed in the new online video we unveiled last week.

            MORE DETAILS

 1. A Province Still Full of Disability Barriers in the Built Environment

The Accessibility for Ontarians with Disabilities Act requires Ontario to become accessible to people with disabilities by January 1, 2025. This includes ensuring the accessibility of “buildings”, as well as employment, goods, services and facilities in Ontario. The AODA requires the Ontario Government to enact all the regulations (called accessibility standards) that are needed to ensure that Ontario becomes accessible by 2025.

Only a little over four years is left for Ontario to achieve this legally mandatory goal. Ontario remains far behind schedule for reaching it. One of the areas where Ontario remains far behind is in making the built environment accessible to people with disabilities. Although this AODA Alliance Update focuses on barriers in the built environment, we emphasize that Ontario remains full of many other kinds of disability barriers as well that need to be removed, beyond those in the built environment.

No one could credibly deny that the built environment in Ontario remains replete with too many accessibility barriers. Under the AODA, the Ontario Government must appoint an Independent Review of the AODA’s implementation every three years or so. The two most recent AODA Independent Reviews each found that barriers in the built environment remain a serious problem. This includes the 2014 report of Mayo Moran’s second AODA Independent Review and David Onley’s 2019 third Independent Review of the AODA.

Both Independent Reviews called for new Government action under the AODA to address the many persisting disability barriers in the built environment. The Onley Report described Ontario as full of “soul-crushing barriers”, with progress on accessibility taking place at a “glacial” pace.

 2. Ontario Has No Comprehensive Accessibility Standard Ensuring that the Built Environment Becomes Accessible

Many are shocked to learn that even though it is now over 15 years since the AODA was passed, there is still no Built Environment Accessibility Standard enacted under the AODA to ensure that the built environment in Ontario becomes accessible by 2025.

Over 14 years ago, the Liberal Ontario Government under Premier Dalton McGuinty commendably committed to enact a Built Environment Accessibility Standard under the AODA. Back then, the Government appointed a Built Environment Standards Development Committee under the AODA to make recommendations on what the promised Built Environment Accessibility Standard should include. That Standards Development Committee submitted its final recommendations to the Government by 2010.

In the 2011 Ontario election, Premier McGuinty promised to enact the Built Environment Accessibility Standard “promptly.” However, to this day, Ontario still does not have an AODA Built Environment Accessibility Standard.

In December 2012, the previous McGuinty Government passed a very weak and limited “Design of Public Spaces” Accessibility Standard under the AODA. That regulation only addresses a very limited range of disability barriers in the built environment, mainly some that are outside buildings. As for the vital area of disability barriers inside buildings, that Accessibility Standard only addresses some in public service areas, such as counter heights. Further limiting its effectiveness, the Design of Public Spaces Accessibility Standard only deals with preventing the creation of some new barriers. It does not require removal of any existing barriers anywhere in the built environment inside or outside buildings.

As for the many other disability barriers inside buildings, in December 2013, the McGuinty Government passed very limited changes to the weak accessibility provisions in the Ontario Building Code. Even after those changes, the Ontario Building Code still fails to effectively ensure that a building, even a new building, will be barrier-free for people with disabilities. It requires no retrofits of existing buildings that are not undergoing a major renovation, even if accessibility would be readily achievable.

As a result, even if a new building fully complies with the Ontario Building Code and the Design of Public Spaces Accessibility Standard, it can and usually does end up having accessibility barriers designed into it. The AODA Alliance has documented this cruel reality in three widely-viewed captioned online videos. Serious accessibility problems are revealed in the AODA Alliance‘s 2018 vid HYPERLINK “https://youtu.be/za1UptZq82o”eo about new and recently-renovated Toronto area transit stations, its 2017 video about the new Ryerson University Student Learning Centre and its 2016 video about Centennial College’s new Culinary Arts Centre. Each of those videos secured great media coverage.

Yet such barriers in the built environment can expose providers of goods, services, facilities or employment to human rights complaints, alleging disability discrimination. Those organizations that must comply with the Canadian Charter of Rights and Freedoms are also exposed to the possibility of claims that such barriers violate the guarantee of equality without discrimination because of disability in section 15 of the Charter of Rights.

 3. The Ontario Government is in Breach of Its AODA Obligations

Within five years after an AODA accessibility standard is enacted, section 9(9) of the AODA requires the Government to appoint a new Standards Development Committee to review that standard. This review is done to see if that accessibility standard is strong enough to ensure accessibility is achieved by 2025.

As explained earlier, the Government enacted the Design of Public Spaces Accessibility Standard in December 2012. The Government was therefore required to appoint a Standards Development Committee to review it by December 2017. Yet no Standards Development Committee has ever been appointed to conduct that mandatory review.

That mandatory deadline was reached and missed three years ago. The previous Liberal Government of Premier Kathleen Wynne is responsible for the first six months of that 3-year violation of the AODA. The Conservative Government is responsible for the other two and a half years of that AODA violation.

We have diligently and repeatedly alerted each successive Government and each accessibility minister well in advance of this obligation. They should not need a volunteer community coalition like the AODA Alliance to tell them of such basic obligations under the AODA. This is especially so since each successive Ontario Government has claimed to be leading the rest of Ontario by its example on accessibility. Such an overt breach of the law is hardly the example by which Ontarians should be led.

 4. Meanwhile, The Ford Government Uses Public Money to Create New Disability Barriers

It is bad enough that the Government leaves existing disability barriers in place. It makes this problem worse when the Government allows public money to be used to build new buildings and infrastructure without ensuring that these will be barrier-free for people with disabilities. It will cost much more to later remove those barriers. To use public money to create new disability barriers is a serious misuse of public money.

The Ford Government has not committed to never use public money to create new disability barriers. For example, last summer, amidst the COVID-19 pandemic, the Ford Government announced that it is spending half a billion dollars to build new schools and do major renovations to existing schools. The Government has no measures in place to ensure that those publicly-funded building projects will be barrier-free.

As well, the Government is in the process of building a new major court building in downtown Toronto. The AODA Alliance has raised serious accessibility concerns about that building’s design. The Government has also announced plans to move ahead with a range of other public infrastructure projects, with no assurance that those projects will be fully accessible. The Ontario Government has a disturbing track-record in this context.

 5. Promises Made – Promises Not Kept

The Government’s failure to effectively address this issue flies in the face of Premier Doug Ford’s written commitments to the AODA Alliance during the 2018 Ontario general election. In his May 15, 2018 letter to the AODA Alliance setting out his party’s election pledges on disability accessibility, Doug Ford wrote, among other things:

“Your issues are close to the hearts of our Ontario PC Caucus and Candidates, which is why they will play an outstanding role in shaping policy for the Ontario PC Party to assist Ontarians in need.

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.

Whether addressing standards for public housing, health care, employment or education, our goal when passing the AODA in 2005 was to help remove the barriers that prevent people with disabilities from participating more fully in their communities.

For the Ontario PCs, this remains our goal. Making Ontario fully accessible by 2025 is an important goal under the AODA and it’s one that would be taken seriously by an Ontario PC government…

…This is why we’re disappointed the current government has not kept its promise with respect to accessibility standards. An Ontario PC government is committed to working with the AODA Alliance to address implementation and enforcement issues when it comes to these standards.

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

We have written Premier Ford more than once to raise serious concerns about his Government’s failure to act effectively on accessibility issues such as this. He has never agreed to meet with us or to speak on the phone. He deflects all our issues and requests to the Government’s Accessibility Minister Raymond Cho. Minister Cho has never agreed to create a Built Environment Accessibility Standard under the AODA.

 6. Ford Government’s Only New Initiative on Accessibility of the Built Environment is a Wasteful Failure

Since taking office in June 2018, the only new initiative to which the Ford Government repeatedly points for disability barriers in the built environment was its controversial spring 2019 announcement that it is diverting 1.3 million dollars over two years to the Rick Hansen Foundation (RHF) to have its so called “private accessibility certification program” to look at some buildings in Ontario to decide if it would “certify” them as accessible. The AODA Alliance was never consulted on that decision.

We have strongly opposed this as a very poor use of public money. It will not help the accessibility cause.

The AODA Alliance has made public numerous concerns with the RHF “certification” process. Neither the Ford Government nor the RHF have publicly disputed the accuracy of our concerns.

For example, an RHF “certification” does not in fact certify anything. If the RHF gives a building a rating of “accessible”, it does not mean that that building is in fact accessible.

Those whom the RHF authorizes to conduct these inspections need not have the required expertise to assess a building’s accessibility. The RHF only requires an assessor to take an 8-day course. That course is far too short. Its training contents are quite deficient and problematic.

One and a half years after this Ford Government strategy was launched, there is no evidence that a single building has been thereby made accessible, or that a single barrier in the built environment was rectified. All that the Government may have accomplished is to give an inappropriate public subsidy to the RHF in its effort to break into the Ontario market, in competition with local Ontario-based accessibility consultants having far more expertise in this field.

For example, earlier this year, one could hear RHF advertisements on Toronto radio stations, promoting the RHF “certification” program. We asked the Ontario Government if these advertisements were directly or indirectly subsidized by the Ontario Government. The Government did not answer this inquiry.

It is not clear to us that the Government and RHF have found enough organizations to take up the offer of a Government-subsidized RHF appraisal. That would make sense, since the RHF assessment of their building’s accessibility is not reliable.

It would have been much more appropriate for the Government to have invested those public funds into the development and enactment of a Built Environment Accessibility Standard under the AODA, and on effectively enforcing the inadequate accessibility requirements that are already on the books.

 7. What Have the Opposition Parties Said On Point?

The Ontario NDP committed as follows on November 9, 2020 as part of its housing plan:

“We’ll mandate Universal Design building codes, which are standards that reflect the needs of people of all ages, sizes, abilities and disabilities.”

The Ontario Liberal Party has not announced a platform on this issue since the 2018 election. In her May 14, 2018 letter to the AODA Alliance setting out the Liberal Party’s disability accessibility commitments in the 2018 election, Kathleen Wynne committed to the following:

  1. “exploring and determining next steps for preventing and removing accessibility barriers in the built environment”
  1. “New and Existing Accessibility Standards

The creation of new standards is a critical element of the Ontario Liberal commitment to an accessible Ontario by 2025. We intend to continue the reviews already underway and continue the work of developing standards in the areas of health care and education. We would welcome advice from these committees on built environment issues and look forward to making the process more open and transparent to ensure all voices are heard without compromising necessary privacy and accountability measures.

Beyond ongoing work, we know that there are barriers in the province that need to be addressed through standards. Earlier this year, former Minister Tracy Machala publicly stated that the standards governing the built environment need to be strengthened to achieve our goal. That’s why she convened a summit on the subject attended by many impacted stakeholders, including the AODA Alliance. We will use the feedback gleaned from this summit and further consultation with stakeholders to determine the best path forward as we track toward the mandated review of the standard. Given the complexity of housing construction, building modification, and renovation, we will also work with builders, developers, architects, and other experts before committing to a path forward on residential housing and retrofits.

Getting to an accessible Ontario requires that we also ensure that the professionals most connected to design and construction know about accessibility. To this end, we will work with regulatory bodies, colleges, universities, and professional organizations to ensure that accessibility is included throughout the process.

Standards for AFPs differ project to project, but all Project Companies are required to comply with all legislation on AFP projects, including the AODA and accessibility requirements in the Ontario Building Code. This is the de facto minimum standard. Issues related to accessibility in AFP projects are therefore related to the content of the standards. On built environment issues specifically, that’s why we have committed to working with stakeholders toward the next review of the standard.”

“Accessibility in Education”

In its May 4, 2018 letter to the AODA Alliance setting out its election pledges on disability accessibility in the 2018 election, the Green Party of Ontario committed:

“e) Take Overdue Steps to Ensure the Accessibility of the Built Environment, Including Residential Housing

We support accessibility as an essential component of any new building project or retrofit. Training in accessible design should be a requirement across all licensing and educational institutions in Ontario, and all new building projects should meet standard accessibility requirements before approval. A strategy must be developed both to increase the supply of accessible housing within Ontario and to undertake the retrofitting of existing buildings in order for them to meet accessibility standards.”



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AODA Alliance Asks Toronto Mayor John Tory to Stand up for People with Disabilities and to Stand up to Corporate Lobbyists for Electric Scooter Rental Companies who are Inundating City Hall


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

AODA Alliance Asks Toronto Mayor John Tory to Stand up for People with Disabilities and to Stand up to Corporate Lobbyists for Electric Scooter Rental Companies who are Inundating City Hall

November 4, 2020

          SUMMARY

The AODA Alliance today wrote an important letter to Toronto Mayor John Tory (See below). We asked him not to allow electric scooters (e-scooters) in Toronto. They endanger the safety of the public and especially people with disabilities and seniors. We’ve been told over and over that he will make the ultimate decision.

If he won’t just stop this now, we urge Mayor Tory to himself hold an open, accessible series of virtual town halls with people with disabilities in Toronto to hear our concerns about e-scooters. Our October 30, 2020 news release revealed how City Hall has been the target of a well-funded feeding frenzy by corporate lobbyists for e-scooter rental companies. In today’s letter, we ask Mayor Tory to stand up for Torontonians with disabilities and to stand up to the e-scooter corporate lobbyists.

You can help us with this important issue. Please email Mayor Tory. Tell him not to allow e-scooters in Toronto. Tell him to listen to people with disabilities, and not to the e-scooter corporate lobbyists. You can write him at:

[email protected]

For more tips on how you can help people with disabilities, seniors and others, press the City of Toronto not to unleash the dangers of e-scooters upon us, check out the AODA Alliance’s Toronto e-scooters Action Kit.

We’ve gotten word that some of the e-scooter rental companies are trying to hold some sort of meeting or consultation to hear from people with disabilities about their concerns with e-scooters. We take a dim view of this. Those companies are well aware of our well-documented concerns. They showed no such interest until it became clear that our concerns were impeding their allied members of City Council from railroading this issue through the City in a hurry. We anticipate that those corporate lobbyists are trying to position themselves on the disability issue so they look like they are genuinely concerned.

It is the City of Toronto, and particularly Mayor Tory, that should be holding a major, open and accessible public consultation with people with disabilities on their concerns regarding the dangers that e-scooters create. The e-scooter companies have an unalterable financial goal, which is to spread e-scooter rentals as far as they can.

We always welcome your feedback. Write us at [email protected]

For more background:

  1. The AODA Alliance’s July 8, 2020 brief to the City of Toronto Infrastructure and Environment Committee, already endorsed by Spinal Cord Injury Ontario and the March of Dimes of Canada
  1. The open letter to all Ontario municipal councils from 11 major disability organizations, opposing e-scooters in Ontario, and
  1. A sampling of news reports on the serious injuries that e-scooters have caused in communities that permit them.
  1. The AODA Alliance e-scooters web page.

          MORE DETAILS

November 4, 2020 Letter to Toronto Mayor John Tory from the AODA Alliance

Accessibility for Ontarians with Disabilities Act Alliance

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

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

November 4, 2020

To: Mayor John Tory

Via Email: [email protected]

Office of the Mayor

City Hall, 2nd Floor

100 Queen St. W.

Toronto, ON M5H 2N2

Twitter: @JohnTory

Dear Mayor Tory,

Re: Protecting Torontonians from the Dangers of Electric Scooters

We seek your leadership to protect all Torontonians, and especially people with disabilities and seniors, whose safety is endangered if Toronto permits electric scooters (e-scooters). By all accounts, the practical decision will be yours, as our mayor, on whether to allow e-scooters. If you say no, enough members of City Council will follow your lead to stop this danger.

We seek your leadership in standing up to e-scooter corporate lobbyists and to stand up for the many Torontonians who don’t want to be injured by e-scooters. To that end, we ask that you:

  1. Please stop the City’s consideration of e-scooters before it goes any further.
  1. If not, then at the very least, put any consideration of e-scooters on hold until the COVID-19 pandemic is well behind us. No doubt, City Council and staff now have much higher priorities.
  1. If not, then if any steps at all are to happen on this issue over the next months, you, as mayor, should personally lead an open, accessible and extensive City consultation with people with disabilities and seniors on the dangers that e-scooters pose. That would be the best way to act upon the City Council’s July 28, 2020 motion, addressed below. As Toronto’s mayor, we ask that you hold public virtual face-to-face town hall meetings with these Torontonians so you hear directly from them.

The Issue

An e-scooter is a silent motor vehicle. If allowed, a joy-rider with no license or training could rocket around on an e-scooter at 20 kph or faster. E-scooter riders and innocent pedestrians would get seriously injured or killed. See a recent CBC report on e-scooter injuries suffered in Calgary.

The silent menace of e-scooters especially endangers seniors and people with disabilities, such as people who are blind or have low vision or balance issues, or whose disability makes them slower to scramble out of the way. A blind pedestrian can’t know when a silent e-scooter races toward them at over 20 kph, driven by a fun-seeking unlicensed, untrained, uninsured, unhelmetted rider.

The Dangers to People with Disabilities, Seniors and Others

In cities where e-scooters are allowed, rental e-scooters, left strewn around public places, create new mobility barriers to accessibility for people using a wheelchair, walker or other mobility device. For people who are blind, deafblind or have low vision, they are a serious unexpected tripping hazard.

When you spoke with me back on December 9, 2019, you were awaiting a City Staff report on e-scooters. Since then, a detailed June 24, 2020 City of Toronto Staff Report showed that to allow e-scooters in Toronto will endanger public safety, send e-scooter riders and innocent pedestrians to hospital emergency rooms, require significant new law enforcement efforts and impose new financial burdens on the taxpayer to cover added costs that e-scooters trigger. The Staff Report also shows that e-scooters do not bring the great benefits for reduced car traffic and pollution that corporate lobbyists for e-scooter rental companies claim.

E-scooters would especially endanger public safety and accessibility for people with disabilities and others on sidewalks. The City Staff Report shows that in cities where e-scooters are allowed but banned on sidewalks, they are nevertheless ridden on sidewalks. At the July 9, 2020 Toronto Infrastructure and Environment Committee meeting, law enforcement officials told Councilors that overburdened officers have no capacity to handle added burdens of enforcing new e-scooter regulations, if enacted. One Councilor remarked that City law enforcement officials don’t now even enforce restrictions on riding bikes on sidewalks.

This shows that Toronto should reject e-scooters. Why then is the City and City Council still considering this at all, much less during the current devastating COVID-19 pandemic?

Feeding Frenzy at City Hall by E-scooter Rental Companies’ Corporate Lobbyists

A recent AODA Alliance report provides insight. It documents that City Hall has been flooded by a well-funded feeding frenzy by corporate lobbyists for the e-scooter rental companies. Entries in Toronto’s Lobbyist Registry, filling fully 73 pages, reveal that from June 2018 to the present, eight e-scooter rental companies and three lobbying firms had 1,384 contacts with City Hall in person, by phone, by virtual meeting, or by email. Among these are at least 112 meetings and 1,153 emails with City officials.

Among many other City officials, this includes contacts with the Mayor’s Office, including 10 with you; 58 with your Senior Advisor, Legislative Affairs; 15 with your Director of Legislative Affairs; 10 with your Chief of Staff; and 1 with your Deputy Chief of Staff.

It is a long-standing, time-tested requirement that motor vehicles are only permitted when the motor vehicle and the driver are properly licensed, when the driver has had to undergo mandatory training, where the vehicle is subjected to safety technical standards, and where both the driver and vehicle are insured. These important safeguards are needed to protect public safety.

The e-scooter corporate lobbyists are trying to get you to let them duck all these safeguards. Those corporate lobbyists want to make money on e-scooter rentals, laughing all the way to the bank as seriously injured pedestrians sob all the way to hospital emergency rooms. They falsely claim that the City can approve e-scooters at no cost to the City or the public.

The June 24, 2020 City Staff report overwhelmingly supports the conclusion that the City of Toronto should not lift the ban on e-scooters. Why then did the Staff Report reach an irrational and unexplained suggestion that Toronto should run a pilot with e-scooters? The report does not say. It makes no sense, given the report’s conclusions about e-scooters’ known dangers and unrealized benefits.

Moreover, to run a pilot would be to expose Torontonians to serious injuries if not deaths, just to see if e-scooters are a good idea. Experimenting on the public, when the risks are so serious, would be demonstrably immoral. The corporate lobbyists seek a “pilot” as a pretext to establish a market in Toronto for their product, as a fait accompli.

The only explanation is the e-scooter corporate lobbyists’ feeding frenzy at City Hall. Our report reveals that they have not only been vigourously lobbying your office and your colleagues on City Council, but a stunning spectrum of City employees as well, such as the Project Lead, Big Data Innovation Team, Transportation Services (62 contacts), the Manager, Street Furniture Management, Transportation Services (41 contacts), the Project Officer, Pedestrian Projects, Transportation Services (37 contacts), the Manager, Operational Policy & Innovation Transportation Services (36 contacts), the Manager, Data & Analytics Transportation Services (26 contacts), the Manager, Transportation Policy & Innovation, Transportation Services (25 contacts), the Director, Policy & Innovation, Transportation Services (22 contacts), the Coordinator Bicycle Safety Education, Transportation Services (18 contacts), the General Manager, Transportation Services (18 contacts), the Manager Transportation Services (18 contacts), the Project Lead Environment, Policy & Research, Environment and Energy (13 contacts), the Director, Transportation Infrastructure Management, Transportation Services (12 contacts), the Manager, Policy and Research Environment & Energy (10 contacts), the Manager, Strategic Policy and Innovation, Transportation Services (7 contacts) and the Manager, Cycling Infrastructure & Programs Transportation Services (7 contacts).

Earlier this year, on February 3, 2020, the municipally appointed Toronto Accessibility Advisory Committee unanimously recommended to City Council that Toronto should not allow e-scooters because they endanger people with disabilities. On July 28, 2020, City Council voted to direct City Staff to report back on the disability accessibility concerns regarding e-scooters. We thank you for voting in support of that motion.

It was deeply disturbing that fully 11 City Council members voted on July 28, 2020 to oppose getting more information on the dangers that e-scooters create for people with disabilities. That appears explicable by the e-scooter corporate lobbyists’ relentless pressure.

That the e-scooter corporate lobbyists argue that the COVID-19 pandemic would be a great time to start allowing e-scooters in Toronto would only pile hardship upon hardship for society’s most vulnerable People with disabilities are now suffering disproportionate hardships due to the COVID-19 crisis.

Let’s Talk

Can I speak with you by phone about these issues? It has been almost a year since we had our earlier discussion. Please make your legacy one which made this city safer and more accessible for people with disabilities. Do not leave a legacy of a Toronto where it becomes harder and more dangerous for us to get around.

Sincerely,

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance



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