Download in MS Word format the AODA Alliance’s June 18, 2020 finalized brief to the Ontario Government on what needs to be done to meet the needs of students with disabilities during the transition to school re-opening



Download in MS Word format the AODA Alliance’s June 18, 2020 finalized brief to the Ontario Government on what needs to be done to meet the needs of students with disabilities during the transition to school re-opening



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Please Email the Ontario Government to Support the AODA Alliance’s Finalized Brief on Measures Needed to Meet the Needs of Students with Disabilities Now and During the Transition to Schools Re-Opening


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

Please Email the Ontario Government to Support the AODA Alliance’s Finalized Brief on Measures Needed to Meet the Needs of Students with Disabilities Now and During the Transition to Schools Re-Opening

June 18, 2020

          SUMMARY

Working at warp speed, the AODA Alliance has finalized and submitted its brief to the Ontario Government on what must be done to meet the needs of at least one third of a million students with disabilities in kindergarten to Grade 12 now and during the eventual transition to schools re-opening. We set out that 23-page brief below.

We invite and encourage you to email the Ontario Government right away to support our brief’s 19 recommendations. Those recommendations are set out and described throughout the brief. To make it easier for you, at the end of the brief is an appendix that lists all the recommendations together in one place.

You can support us by emailing the Government at this address: [email protected] If you are part of a disability community organization, please get your organization to write the Government to support our recommendations. Of course, we encourage you to add any thoughts, experiences or recommendations that you wish.

It is good if you can use your own words when you write the Government. If you don’t have time, you might just wish to say something like this:

“I support the recommendations made in the AODA Alliance’s June 18, 2020 brief to the Ontario Government on what needs to be done to meet the needs of students with disabilities now and during the transition to re-opened schools.”

We thank everyone who took the time to read over the draft of this brief that we circulated for comment on June 11, 2020. We got fantastic feedback. We drew heavily on that feedback as we finalized this brief.

This finalized brief makes all the 17 recommendations that were in our draft brief (with some minor improvements) with one exception. Based on feedback we received, we removed our draft recommendation 13(b) in the draft brief. It had recommended that schools re-open for vulnerable students first. Our finalized brief replaced that recommendation with this, in #13(b):

“The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.”

This finalized brief adds two new recommendations, 18 and 19. These propose that the Government and school boards across the board make more use during the COVID-19 pandemic of the Special Education Advisory Committee that each Ontario school board is required to have, if they are not doing so now.

In addition to writing the Government to support our recommendations, we encourage you to send this brief to your local school board and school trustees. Encourage them to take the actions we recommend in this brief.

For more background on these issues, please visit the AODA Alliances COVID-19 web page and our education web page.

Stay safe, and let us know what you do to help us press for these reforms. Email us at [email protected]

          MORE DETAILS

A Brief to the Ontario Government on Key Measures Needed to Address the Learning Needs of Students with Disabilities in Ontario During the COVID-19 Crisis Both During Distance Learning and During The Transition to the Eventual Re-Opening of Schools

Submitted by the Accessibility for Ontarians with Disabilities Act Alliance

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

To: The Hon. Stephen Lecce, Minister of Education

Via email [email protected]

June 18, 2020

 Introduction

The AODA Alliance submits this brief to the Minister of Education for Ontario, in response to the Ministry of Education’s public consultation on the transition to school re-opening during the COVID-19 pandemic.

The AODA Alliance is a voluntary non-partisan grassroots coalition of individuals and organizations. Our mission is:

“To contribute to the achievement of a barrier-free Ontario for all persons with disabilities, by promoting and supporting the timely, effective, and comprehensive implementation of the Accessibility for Ontarians with Disabilities Act.”

To learn about us, visit: https://www.aodaalliance.org.

Our coalition is the successor to the Ontarians with Disabilities Act Committee. The ODA Committee advocated more than ten years for the enactment of strong, effective disability accessibility legislation. Our coalition builds on the ODA Committee’s work. We draw our membership from the ODA Committee’s broad, grassroots base. To learn about the ODA Committee’s history, visit: http://www.odacommittee.net.

We have been widely recognized by the Ontario Government, by all political parties in the Ontario Legislature, within the disability community and by the media, as a key voice leading the non-partisan campaign for accessibility in Ontario. In every provincial election since 2005, parties that made election commitments on accessibility did so in letters to the AODA Alliance.

Among our many activities, we led a multi-year campaign to get the Ontario Government to agree to develop an Education Accessibility Standard under the AODA to tear down the many barriers that impede students with disabilities in Ontario’s education system. Our years of efforts to advocate for accessibility for students with disabilities are documented on our website’s education page.

Our efforts and expertise on accessibility for people with disabilities have been recognized in MPPs’ speeches in the Ontario Legislature, and beyond. Our website and Twitter feed are widely consulted as helpful sources of information on accessibility efforts in Ontario and elsewhere. We have achieved this as an unfunded volunteer community coalition.

The Government must pay special heed to the input it receives from the disability community including parents of students with disabilities . Input to the Government from other organizations can fail to effectively address the specific experience and needs of students with disabilities . The recommendations in this brief are gathered together in a list in the appendix appearing at the end of this brief. Our position in this brief is summarized as follows:

  1. a) The COVID-19 crisis has imposed disproportionate added hardships on people with disabilities. As part of this, it has led to disproportionate, serious hardships being inflicted on students with disabilities in Ontario schools. These hardships are exacerbated by no small part by serious pre-existing problems and disability barriers that have faced students with disabilities for years in Ontario’s education system, which have been made even worse for too many students with disabilities during the COVID-19 pandemic.
  1. b) In this brief we address the needs of all students with disabilities, using the inclusive definition of “disability” in the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act . We do not limit our recommendations to the narrower group of students whose disability falls in the narrower definitions of “special education “ or “exceptionality” that the Ministry of Education uses.
  1. c) To date, the provincial response to the problems facing students with disabilities during the COVID-19 pandemic has been substantially insufficient. The AODA Alliance offers 19 recommendations in this brief, to effectively address this, starting now and into the fall. Our fuller recommendations for comprehensive and long term reforms in the form of a strong and effective Education Accessibility Standard are set out in the AODA Alliance’s October 10, 20-19 Framework for the promised Education Accessibility Standard.
  1. d) While students are not able to go to school this spring due to the COVID-19 crisis, students with disabilities are experiencing wildly different learning experiences. Some are making good progress. Some are making much less progress. Some are making no progress or are losing ground. Some are getting extensive educational supports from their school board. Some are getting much less support. Some are getting little if any support. Conditions and supports can vary widely, even within the same school board and by students with the same disability.
  1. e) There is a pressing need for a comprehensive Ministry of Education plan of action to address the needs of students with disabilities during the COVID-19 crisis.
  1. f) There is a need for a provincial “Students with Disabilities Command Table” at the Ministry of Education.
  1. g) The Ministry must prevent a rash of principals refusing to admit some students with disabilities to school when schools re-open.
  1. h) There is a need for specific COVID-19 Individual Education Plans for individual students with disabilities before and during the transition to return to school.
  1. i) There is a need for Provincial and School Board Rapid Response Teams to be established to address recurring urgent needs of students with disabilities.
  1. j) A surge of specialized supports for students with disabilities is needed when schools re-open.
  1. k) School boards must plan for the needs of students with disabilities who cannot themselves ensure social distancing.
  1. l) The Ministry must ensure the full accessibility of digital platforms used for remote classes or “synchronous learning”.
  1. m) The Ontario Government must immediately ensure the digital accessibility of Ontario Government and TVO online learning resources.
  1. n) The Ministry of Education and school boards must stop making some learning resources available only in PDF format as this creates accessibility barriers.
  1. o) One size fits all does not fit for return to school.
  1. p) There is a need for a rapid method to spread the word to teachers and parents about effective teaching strategies for students with disabilities during COVID-19.
  1. q) Distance learning must be effectively provided for students who cannot return to school right away when schools re-open.
  1. r) The Ministry of Education should now create provincial resources for parents to prepare their students for the return to school.
  1. s) New protocols are needed for safe school bussing for students with disabilities.
  1. t) The Ministry should ensure the very active engagement of each school board’s Special Education Advisory Committee.

This brief builds on extensive involvement of the AODA Alliance during the COVID-19 crisis, advocating for the needs of people with disabilities across society. On June 11, 2020, we made public a draft of this brief, and solicited public input on it. We were very gratified by the supportive and helpful feedback we received. We have drawn heavily on that feedback to produce this finalized brief. We are urging one and all to share their own advice and recommendations with the Ontario Government during this important consultation.

 1. Pressing Need for A Comprehensive Ministry of Education Plan of Action to Address Needs of Students with Disabilities During the COVID-19 Crisis

Since the COVID-19 crisis began, the AODA Alliance has repeatedly urged the Ontario Government to develop and announce a comprehensive plan to meet the needs of students with disabilities during the COVID-19 crisis. This has been needed so over 70 school boards don’t have to each re-invent the wheel in deciding what the needs of students with disabilities are and how best to meet them. To date, the Ontario Government has not done what we have urged.

The need for this comprehensive provincial plan remains pressing during the period of distance learning due to school closures. It is also needed to ensure that students with disabilities’ needs are met across Ontario when schools eventually re-open. Ontario needs to also be prepared in the event of the realistic possibility that distance learning will have to continue in the fall, either because school re-opening is further delayed, or because a second wave of COVID-19 would require another round of school closures.

To date, the Ontario Government has primarily focused its education strategy during the COVID-19 pandemic on students without disabilities. Almost as an afterthought, it then reminded school boards that they should also accommodate students with special education needs.

The plan for students with disabilities should, to the extent possible, be included in the Ministry’s overall plan for school re-opening.

We therefore recommend that:

#1. The Ministry of Education should immediately develop, announce and implement a comprehensive plan for meeting the learning needs of students with disabilities during the COVID-19 crisis. This plan should include during this time of distance learning, during an eventual return to school, and in case of a future COVID-19 wave that requires another round of school closures. To the extent possible, this plan should be an integral part of the Ministry’s overall plan it is developing for school re-opening.

 2. Need for a Provincial “Students with Disabilities Command Table”

To deal with the need for rapid planning during the COVID-19 crisis, the Ontario Government has commendably set up its own “command tables” to deal with critical areas, like health care planning and planning for the safe operation of the economy during this crisis. This enables the Government to have critical expertise at the table to make rapid and key decisions.

There is a pressing need for a “students with disabilities command table” within the Government to plan for the learning needs of students with disabilities during the COVID-19 pandemic. No such table or concentrated expertise centre exists now within Ontario’s Ministry of Education. We have been pressing for this for three months. That table needs to be staffed by professionals with focused expertise on providing education to students with disabilities.

This is not meant to be an advisory or consultative table. It needs to be a planning and implementation table that can quickly and nimbly make decisions and effectively connect with the frontlines in the education system, where the action is.

This need is not fulfilled by the Minister of Education having had some consultative meetings with the Minister’s Advisory Committee on Special Education (MACSE), which still has vacancies, or with the AODA K-12 Education Standards Development Committee. Those bodies are only advisory. They do not have the capacity of a Ministry command table. Of course, it is good that they have been consulted.

We therefore recommend that:

#2. The Ministry of Education should immediately establish a “Students with Disabilities Education Command Table” to oversee the development and implementation of a Government action plan for meeting the urgent learning needs of students with disabilities during the COVID-19 crisis, and to swiftly react to issues for students with disabilities as they arise.

 3. Preventing a Rash of Refusals to Admit Students with Disabilities to School When Schools Re-Open

Ontario’s Education Act lets a school principal refuse to admit to school any “person whose presence in the school or classroom would in the principal’s judgment be detrimental to the physical or mental well-being of the pupils…”. Disability advocates have repeatedly criticized this as an excessive, arbitrary and unfair power. The Education Act and the Ministry of Education leave to school boards and individual principals an extremely wide discretion over when, how and why to exclude a student from school under this power. The Education Act does not even require principals to give a parent their reasons for excluding a student from school. It does not cap the duration of the student’s exclusion from school. It does not require a school board or the Ministry to keep track of how often or why students are excluded from school under this power.

Disproportionately, this excessive power has been used against students with disabilities, leading them too often to be excluded from school altogether or allowing them to attend school only for reduced hours. Long before the COVID-19 crisis, parents’ and students’ advocates have called for this power to be reduced and regulated. See for example the January 30, 2019 joint news release by the AODA Alliance and the Ontario Autism Coalition. To date, the Ontario Government has not made any significant reform of this power.

In September 2018, the Ontario Human Rights Commission released an updated policy on accessible education for students with disabilities. Its recommendations to the Ontario Government included, among other things:

“9. Identify and end the practice of exclusion wherein principals ask parents to keep primary and secondary students with disabilities home from school for part or all of the school day (and the role that an improper use of section 265(1)(m) of the Education Act may be playing in this practice).”

There is a serious risk that some principals will feel at liberty to use this power to exclude some students with disabilities from school during school re-openings in the midst of the COVID-19 pandemic, especially before any effective vaccine is invented and widely available. This is especially so if school boards do not now effectively plan for the inclusion and accommodation of students with disabilities at school during the transition to school re-opening. They may do so either because they don’t know how to accommodate some students with disabilities during social distancing, or because the Ontario Government and/or their school board has not given them the staffing, directions and resources they need to be able to effectively include and accommodate those students at school for part or all of the school day. Such exclusions from school raise serious human rights concerns and are contrary to the student’s right to an education.

With all the uncertainties and pressures anticipated during the transition back to school, a principal can be expected to feel a real temptation to use the power to refuse to admit such students to school during a COVID-19 school re-opening. This is so because it would seem to solve the problem of having to plan for those students’ needs at school.

The need to reform practices regarding a school principal’s power to refuse to admit a student to school for part or all of the school day has therefore become even more pressing in light of the COVID-19 pandemic. The AODA Alliance considers this a major priority. It is essential that school re-openings this fall do not lead to a rash of principals’ refusals to admit any number of students with disabilities to school. Such a rash of exclusions would thereby create two classes of students, those allowed to return to school and those who are excluded from school, especially if this disproportionately divides along disability lines.

The Ontario Government has commendably been willing to give directions to a school board about the use of its power to refuse to admit students to school in other contexts. It can and should do so here as well. The Ontario Ministry of Education has very recently given directions to the Peel District School Board to keep and report data on exclusions of students from school by race. In directive number 9, the Ministry stipulated that:

“The Board shall centrally track disaggregated race-based data on suspensions (in-school and out-of-school), expulsions and exclusions, and report publicly through the Annual Equity Accountability Report Card.”

We therefore recommend that:

#3. The Ministry of Education should immediately issue a policy direction to all school boards, imposing restrictions on when and how a principal may exclude a student from school, including directions that:

  1. a) During the re-opening at schools, students with disabilities have an equal right to attend schools for the entire school day as do students without disabilities. The power to refuse to admit a student to school for all or part of the school day should not be used in a way that disproportionately burdens students with disabilities or that creates a barrier to their right to attend school.
  1. b) A principal who refuses to admit a student to school during the school re-opening process should be required to immediately give the student and their family written notice of their decision to do so, including written reasons for the refusal to admit, the duration of the refusal to admit and notice of the family’s right to appeal this refusal to admit to the school board.
  1. c) A principal who refuses to admit a student to school for all or part of the school day should be required to immediately report this in writing to their school board’s senior management, including the reasons for the exclusion, its duration and whether the student has a disability. Each school board should be required to compile this information and to report it on a bi-monthly basis to the board of trustees, the public and the Ministry of Education (with individual information totally anonymized). The Ministry should promptly make public on a provincial basis and a school board by school board basis the information it receives on numbers, reasons and durations of refusals to admit during post- COVID-19 school re-opening.

 4. Need for Specific COVID-19 Individual Education Plans for Individual Students with Disabilities Before and During Transition to Return to School

For each student with disabilities, distance learning during COVID-19 will have created different deficits and challenges. The transition back to school will present challenges and needs that will vary from student to student.

Students’ IEPs were all written earlier this past school year while students were in school. They were written with no contemplation of the COVID-19 crisis or the challenges and hardships of distance learning and then of a later transition back to school. All students with disabilities will need their IEP modified to address these unforeseen needs.

As an immediate measure, students with disabilities each now need a customized COVID-19 –specific IEP to be created and implemented. This should not be limited to students whose disability fits within the narrow and incomplete definition of “exceptionality” in Ontario, which leaves out some disabilities. It should be provided to any student that has a disability within the meaning of the Ontario Human Rights Code. It should not be limited to students whose disability has been formally “identified” at an Identification and Placement Review Committee.

This COVID-19 IEP would not replace the student’s existing IEP. It would not replace the usual IEP development process when school is back in usual operation. This COVID-19 IEP is meant as an immediate, temporary or interim measure to address these hitherto-unanticipated events and related learning needs. IEPs are supported to deal, among other things, with transition needs. Both the transition to distance learning and the later transition to school re-opening fit well within that rubric.

The COVID-19 IEP should be developed now and over the summer, not in the fall when students are already back in school. This may well require new resources to enable this to be developed over the summer.

As noted earlier, there is a real possibility that distance learning will continue in September, or may have to later resume due to a resurgence or a second wave of COVID-19. These COVID-19 IEPs need to now anticipate and effectively address each of these possible eventualities.

The development of each student’s COVID-19 IEP should start with a direct phone conversation as soon as possible between the student’s teacher and the family. They should discuss where the gains and gaps have been, the concerns for the fall that are anticipated and how best to address them. The COVID-19 IEP should be developed in close consultation with the family and, where appropriate, the student.

We therefore recommend that:

#4. For each student with disabilities, each school board should now:

  1. a) Contact the family of each student with disabilities, preferably by phone rather than email, to discuss and identify the student’s progress during the school shutdown, the student’s specific and individualized disability-related deficits and needs arising from and during distance learning due to the COVID-19 crisis and the student’s needs and challenges related to eventual transition to school (including any vulnerabilities of other family members due to the COVID-19 pandemic), and;
  1. b) Create a COVID-19 IEP to set specific goals and activities to effectively address their disability-related needs during distance learning, and in connection with transition back to school.

 5. Need for Provincial and School Board Rapid Response Teams to Be Established to Address Recurring Urgent Needs of Students with Disabilities

During the COVID-19 crisis, Ontario’s education system continues to try to navigate uncharted territory. No matter how much planning for the needs of students with disabilities takes place as we here recommend, unexpected surprises will crop up. School boards and the Ministry of Education each need to be able to quickly detect these, and to nimbly respond to them. Traditionally, large organizations are not always the best at rapid and nimble adaptations in the midst of great uncertainty.

Parents, teachers and principals need a central point in the school board to report difficult challenges. Each school board needs to quickly feed this information to a single point at the Ministry that is staying on top of things, for rapid responses to recurring issues around the province.

We therefore recommend that:

#5. The Ministry of Education should assign staff to assist its Students with Disabilities Command Table by serving as a central rapid response team to receive feedback from school boards on recurring issues facing students with disabilities and to help find solutions to share with school boards.

#6. The Ministry should direct that each school board shall establish a similar central rapid response team within the board to receive and act on feedback from teachers, principals and families about problems they are encountering serving students with disabilities during the COVID-19 period, that will quickly network with other similar offices at other school boards, and that can report recurring issues to the Ministry.

 6. Surge Needed in Specialized Supports for Students with Disabilities

All students will have fallen behind to varying extents during the months when schools were closed. This hardship falls especially on students with disabilities who have additional specialized curriculum to learn, related to their disabilities, or who need specialized supports to learn which are unavailable during distance learning.

When students return to school, students with disabilities who need those supports will need a surge in the hours of support provided to them to help them catch up and adjust to the return to school. School boards cannot simply pull those resources out of the air. School boards will need added funding to hire those staff. They will need provincial help in finding them where there are shortages.

For example, students with vision loss are unable to get the full benefit of teachers of the visually impaired (TVIs) teaching hands-on braille reading when schools are closed. When schools re-open, school boards will need to engage additional TVIs to help ramp up the surge in TVI hours to be provided to students. There is now a shortage of TVIs in Ontario. The Ministry will need to lead a concerted effort to create a surge of TVIs to help school boards fill this gap during the return to school. Comparable needs can similarly be identified for students with other disabilities where such specialized educational support is needed.

We therefore recommend that:

#7. The Ministry of Education should plan for, fund and coordinate the provision by school boards of a surge in specialized disability supports to those students with disabilities who will need them when students return to school.

 7. Planning for Needs of Students with Disabilities Who Cannot Themselves Ensure Social Distancing

As an illustration of the last issue discussed, any return to school while COVID-19 continues to exist in our community will require students to engage in social distancing. If schools re-open, they will be doing so mindful of the fact that many students will not be able to consistently and reliably engage in social distancing, frequent hand washing and other important protective activities. Many are too young to ensure that they can fully understand the need to do so and comply. For some older children, it may seem cool to periodically break the rules. For many, it will be impossible to remain attentive to these precautions all the time.

For any number of students with disabilities, social distancing and related safe practices may pose additional challenges. For some, wearing a mask may not be possible due to such things as sensory integration or behavioural issues.

Some students with disabilities require an education assistant (EA) or special needs assistant (SNA) for all or part of the day to fully take part in school activities. For some of these students, it will not be possible to remain two meters away while providing the support or assistance that the student needs. Some will require close assistance for eating, hand-washing and other personal needs.

Pre-COVID-19 staffing levels for EAs and SNAs were too often inadequate. They did not account for these important additional requirements. EAs and SNAs were not experienced with or trained for this before COVID-19. It is not sufficient to now send them an email with instructions, or a link to a training video, and thereafter to assume that they will be fully equipped to consistently and reliably handle these duties. In addition to new in-person training, they will need to have constant access to good quality personal protective equipment (PPE), like masks.

It is also important to employ enough EAs and SNAs so that they don’t have to split their time among multiple schools or venues, lest they pose a greater risk of transmitting the COVID-19 virus from place to place among vulnerable students.

We therefore recommend that:

#8. The Ministry of Education’s plan for school re-openings must include detailed directions on required measures for ensuring that students with disabilities are safe from COVID-19 during any return to school. This requires additional planning in advance by school boards and additional funding to school boards to hire and train the additional SNAs and EAs they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that an EA or SNA does not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.

 8. Ensuring Full Accessibility of Digital Platforms Used for Remote Classes or “Synchronous Learning”

We do not here wade into the dispute between the Ford Government and some teachers’ unions about whether or when a teacher should conduct online classes for their students in real time over the internet, sometimes called “synchronous learning”. We insist, however, that whenever an online real time class or synchronous learning takes place, or any other online meeting involving students with disabilities or their parents in connection with their education, it must be conducted via a fully accessible digital meeting platform.

When the Ontario Government moved our education system from the physical classroom to the virtual classroom in late March, it should have ensured from the start that the choice of digital meeting platforms was fully accessible. The Ontario Government did not do so, nor did it monitor school boards to see what platforms they were using. The Ontario Government dropped the ball on this critical accessibility concern, to the detriment of students, teachers and parents with disabilities. The Ministry of Education took the erroneous position that it was up to each school board to decide which online virtual meeting platform to use, based on the board’s assessment of its local needs. Yet these disability accessibility needs do not vary from school board to school board. They are the same across Ontario. The Ministry wastefully leaves it to each school board to investigate the relative accessibility of different virtual meeting platforms.

As a belated partial attempt to address this problem, the Minister of Education wrote school boards on or around May 26, 2020 about several issues regarding distance learning. That memo stated, among other things:

“Boards must ensure that the platforms they use for connecting with students and families are fully accessible for persons with disabilities.”

However, that direction provides no assistance to school boards on which platforms to use or avoid, or how to figure this out. It still leaves it to each school board to investigate this as much or as little as they wish, and then to duplicate the same investigations of this issue over and over across Ontario. We have seen no indication that the Minister’s direction led any school boards to change what they were doing in this regard.

This issue remains a live one and will continue into the fall. It is not clear when schools will re-open. Our education system may still be running on 100% distance learning at the start of the fall school term. Even when schools re-open, there is a real likelihood that some distance learning will continue in some blended model of in-school and distance education. As noted earlier, if a second wave of COVID-19 hits, as has happened elsewhere, requiring another round of school closures, Ontario will have to return to 100% distance learning.

At least one school board has improperly prohibited the use of Zoom, even though it is at least as accessible as, or more accessible than, other platforms. The Ministry of the Attorney General did its own comparison of digital meeting platforms, for use by the courts. The Superior Court of Justice of Ontario has decided to use Zoom as its platform for virtual court proceedings. If Zoom is safe enough for the Superior Court of Justice, there is no reason why a school board should prohibit its use.

Canada’s largest school board, TDSB, has announced that it is using Webex for parent-teacher meetings. This is so even though Webex has real accessibility problems. Such a practice should not be allowed.

We have heard examples of quite inaccurate information on this topic from some in the school board sector. Parents should not have to fight about this, one school board at a time, especially in the middle of a pandemic.

This topic requires ongoing effort and leadership by the Ministry. By August, there could well have been changes to the relative accessibility of different virtual meeting platforms. School boards need to operate based on current information.

We therefore recommend that:

#9. The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital meeting platforms available for use in Ontario schools. This should involve end-user testing. The Ministry should immediately send the resulting report and comparison to all school boards and make it public. This should be revisited as the fall approaches, in case there have been changes to the relative accessibility of different virtual meeting platforms. The Ministry should direct which platforms may be used and which may not be used for virtual or synchronous classes or parent/school meetings, based on their accessibility.

 9. Ensuring Digital Accessibility of Ontario Government and TVO Online Learning Resources

Over three months into the COVID-19 crisis, the Ontario Government has still not ensured that the online content that it provides to school boards, teachers, parents and students meets accessibility requirements for computer-users with disabilities. The AODA Alliance has been raising concerns with the Government about this since early in the pandemic. We have seen no public commitment to the needed corrective action. We have raised our concerns at senior levels within TVO and the Ministry of Education. The Government and TVO were required to comply with these accessibility requirements well before the advent of the COVID-19 pandemic.

We therefore recommend that:

#10. The Ministry of Education should immediately direct TVO to make its online learning content accessible to people with disabilities, and to promptly make public a plan of action to achieve this goal, with specific milestones and timelines.

#11. The Ministry of Education should make public a plan of action to swiftly make its own online learning content accessible for people with disabilities, setting out milestones and timelines, and should report to the public on its progress.

 10. Stop Making Some Learning Resources Available Only in PDF Format

Throughout this pandemic, as well as beforehand, the Ministry of Education and too many school boards have continued to make important digital information available to the public, including to parents, teachers and students, only in pdf format. That format can present accessibility problems for people with disabilities. When a document is made public in PDF format, it should also be made public in an accessible format, such as MS Word. This is an important time to start this long-overdue practice.

We therefore recommend that:

#12. The Ministry of Education should direct all its staff and all school boards that whenever making digital information public in a PDF format, it must at the same time also be made available in an accessible format such as an accessible MS Word document.

 11. One Size Fits All Does Not Fit for Return to School

To avoid chaos, a return to school should not be done all at once using a one-size-fits-all approach. Because we are in uncharted waters, it makes sense to go about this gradually and to try different approaches at different locations to see what works. We must avoid students with disabilities being again treated as after-thoughts who have to try to fit into a chaotic situation that was not designed with their needs in mind.

One suggestion that some have raised is to enable students with disabilities to return to school first, and for teaching staff to ensure their needs are met, before trying to also cope with an onslaught of all other students. Some have raised with us a concern that this might turn out to be a form of segregation, and could be detrimental for some of those students.

We therefore recommend that:

#13. The provincial plans for return to school should include these features:

  1. a) Rather than having all students across Ontario return to school at once, in a one-size-fits-all strategy, the Ontario Government should lead a strategic return to school process, trying out different approaches to see what works most effectively. For example, opening a few schools first to detect recurring problems and plan to prevent them would assist with opening of other schools across Ontario.
  1. b) The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.

 12. Need for A Rapid Method to Spread the Word to Teachers and Parents About Effective Teaching Strategies for Students with Disabilities During COVID-19

Teachers and parents of students with disabilities are struggling around Ontario to cope with distance learning and the barriers it can create for many students with disabilities. Teachers and parents are creating novel work-arounds to address this.

Yet the Ontario Government has not been effectively canvassing the frontlines of teachers and parents to gather these up and share them around the province, so all can benefit without having to re-invent the wheel in the midst of a traumatic pandemic. We have called on the Ontario Government for the past three months to do this without success. We modelled one way of doing this by our successful May 4, 2020 online virtual town hall on teaching students with disabilities during the COVID-19 crisis (jointly organized with the Ontario Autism Coalition). As far as we have been able to learn, the Ontario Government has neither taken up that idea nor has it shared with school boards the link to our May 4, 2020 virtual town hall so that they can all benefit from it. We have repeatedly asked the Ministry of Education to share that link with school boards.

In the meantime, to fill this gap, several school boards have commendably been trying to address this need themselves. They have themselves been compiling good ideas and sharing them within their own board.

This is a huge and wasteful duplication of effort. The Ontario Government should be centrally accumulating and compiling all these resources, as well as researching what other jurisdictions have compiled from their own experience. These should be rapidly made available to frontline teachers and parents in a way that is easy to access, not by a blizzard of endless links that few if anyone will have the time to explore.

This effort should have been done weeks ago. Nevertheless, it is still not too late, since distance learning will remain part of our lives in whole or in part until a vaccine for COVID-19 is created and widely administered.

It is important that any such resources be themselves fully accessible to teacher, school staff, students and family members with disabilities. We regret that we have no assurance of this. On June 15, 2020, the Ontario Government announced in a news release that it was now making available new teaching materials during the COVID-19 crisis, under the headline: “Ontario Develops Additional Learning Materials for Students and Teachers”. The AODA Alliance promptly wrote senior officials at the Ministry of Education to ask what steps were taken to ensure that these new educational materials are accessible to people with disabilities, and asking what was done to include tips for teaching students with disabilities. The Ministry has not answered as of the time this brief was submitted.

We therefore recommend that:

#14. The Ministry of Education should immediately put in place an effective proactive team to gather teaching strategies for students with disabilities during distance learning from frontline teachers, parents and school boards and make these easily available to the frontlines on an ongoing basis, in formats that are accessible to people with disabilities. These should be supplemented by strategies that the Ministry researches from other jurisdictions that have innovated creative solutions.

 13. Distance Learning Must Be Effectively Provided for Students Who Cannot Return to School

When schools re-open, each school board will have a duty to accommodate its students with disabilities in school unless the school board can prove that it is impossible to do so without undue hardship. There may be some students who cannot return to school when others do. Their disability may make it impossible to accommodate them in school under the restrictions that apply during the COVID-19 pandemic. Some students may not be able to return to school because their parents or other family members with whom they live are so medically vulnerable or immuno-compromised that the family must take heightened precautions to avoid the risk of contracting COVID-19.

In those cases, even if other students are learning at school, the school board must provide effective and accessible distance learning for those students who must remain at home. This may include home visits from teaching staff. In this, students with disabilities must be more effectively and consistently served during distance learning than was the case in the spring.

We therefore recommend that:

#15 The plans for return to school must include measures for ensuring that those who cannot return to school at the same time can secure effective distance learning, including home visits (with social distancing) from teaching staff.

 14. Creating Provincial Resources for Parents to Prepare Their Students for Return to School

Some students with disabilities will need extensive preparation at home for their eventual return to school, including learning about social distancing and other new school practices due to COVID-19. Some parents will need a great deal of time to deal with this. Each school board or teacher and family should not have to duplicate these efforts by inventing their own curriculum, social stories or other resources.

We therefore recommend that:

#16. The Ministry of Education should prepare teaching materials for teachers and parents to use, addressing different disability-related learning needs, for preparing students with disabilities for the return to school, to address such changes as social distancing.

 15. New Protocols Needed for Safe School Bussing

There were ample problems with bussing of students with disabilities to school before the COVID-19 crisis. In any return to school, heightened safeguards will be needed, including frequent sanitization of busses, ensuring students are seated more than 2 meters from each other and ensuring that the driver has PPE and doesn’t risk spreading COVID-19. It is not realistic to expect that this will all simply happen with private sector bussing companies who employ casual and part time drivers working at low wages.

We therefore recommend that:

#17. The Ministry of Education should create, fund and effectively enforce new standards for safe bussing practices for students with disabilities during any return to school while COVID-19 remains a community threat.

 16. Ensure Very Active Engagement of Each School Board’s Special Education Advisory Committee

Each Ontario school board is required to have a Special Education Advisory Committee to advise it on special education issues. We understand that some have met regularly during the school closures, using conference calls or virtual online meeting platforms. Others have not met regularly, from what we have heard.

SEACs have a great deal to offer in this area. In making our recommendations about SEACs, we note that SEACs are not required to include representation regarding students with all kinds of disabilities. They are instead required only to have members that represent families whose students whose disability falls within the more limited definition of “exceptionality” that the Ministry of Education uses. Of course, it is open to a school board to have its SEAC have a more inclusive membership. It is also open to SEAC members to speak to any needs of any students with disabilities . School boards and the Ontario Government must ensure that they get input regarding students with any and all kinds of disabilities.

It is essential that each school board ensures that its Special Education Advisory Committee (SEAC) is meeting at least once per month, if not more, during the COVID-19pandemic, including during the transition to re-opening. While they usually don’t meet during the summer, they should meet if possible during the 2020 summer. They should be fully engaged in planning for the needs of students with disabilities during the COVID-19 period.

Their volunteer efforts would have more impact if the Ministry of Education took two easy steps. First, the Minister should create a virtual network or listserv to enable SEACs to share their work with each other. No such network now exists. As well, the Ministry should collect input from all Ontario’s SEACs on their concerns and advice given during the COVID-19 era, as this is a readily-available avenue to more front-line experience of students with disabilities.

We therefore recommend that:

#18. Each school board should ensure that its Special Education Advisory Committee (SEAC) meets at least once per month, and preferably more often, during the COVID-19 crisis, to give its board ongoing input into planning for students with disabilities during the COVID-19 crisis.

#19. To get the most from the volunteer work of SEACs around Ontario, the Ministry of Education should:

  1. a) Create and maintain a listserv or other virtual network of all Ontario SEACs, to enable them to share their efforts with all other SEACs around Ontario, and
  1. b) Frequently gather input from SEACs around Ontario about the experiences of students with disabilities during the COVID-19crisis.

Appendix – List of Recommendations

#1. The Ministry of Education should immediately develop, announce and implement a comprehensive plan for meeting the learning needs of students with disabilities during the COVID-19 crisis. This plan should include during this time of distance learning, during an eventual return to school, and in case of a future COVID-19 wave that requires another round of school closures. To the extent possible, this plan should be an integral part of the Ministry’s overall plan it is developing for school re-opening.

#2. The Ministry of Education should immediately establish a “Students with Disabilities Education Command Table” to oversee the development and implementation of a Government action plan for meeting the urgent learning needs of students with disabilities during the COVID-19 crisis, and to swiftly react to issues for students with disabilities as they arise.

#3. The Ministry of Education should immediately issue a policy direction to all school boards, imposing restrictions on when and how a principal may exclude a student from school. including directions that:

#4. For each student with disabilities, each school board should now:

  1. a) Contact the family of each student with disabilities, preferably by phone rather than email, to discuss and identify the student’s progress during the school shutdown, the student’s specific and individualized disability-related deficits and needs arising from and during distance learning due to the COVID-19crisis and the student’s needs and challenges related to eventual transition to school (including any vulnerabilities of other family members due to the COVID-19 pandemic), and;
  1. b) Create a COVID-19 IEP to set specific goals and activities to effectively address their disability-related needs during distance learning, and in connection with transition back to school.

#5. The Ministry of Education should assign staff to assist its Students with Disabilities Command Table by serving as a central rapid response team to receive feedback from school boards on recurring issues facing students with disabilities and to help find solutions to share with school boards.

#6. The Ministry should direct that each school board shall establish a similar central rapid response team within the board to receive and act on feedback from teachers, principals and families about problems they are encountering serving students with disabilities during the COVID-19 period, that will quickly network with other similar offices at other school boards, and that can report recurring issues to the Ministry.

#7. The Ministry of Education should plan for, fund and coordinate the provision by school boards of a surge in specialized disability supports to those students with disabilities who will need them when students return to school.

#8. The Ministry of Education’s plan for school re-openings must include detailed directions on required measures for ensuring that students with disabilities are safe from COVID-19 during any return to school. This requires additional planning in advance by school boards and additional funding to school boards to hire and train the additional SNAs and EAs they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that an EA or SNA does not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.

#9. The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital meeting platforms available for use in Ontario schools. This should involve end-user testing. The Ministry should immediately send the resulting report and comparison to all school boards and make it public. This should be revisited as the fall approaches, in case there have been changes to the relative accessibility of different virtual meeting platforms. The Ministry should direct which platforms may be used and which may not be used for virtual or synchronous classes or parent/school meetings, based on their accessibility.

#10. The Ministry of Education should immediately direct TVO to make its online learning content accessible to people with disabilities, and to promptly make public a plan of action to achieve this goal, with specific milestones and timelines.

#11. The Ministry of Education should make public a plan of action to swiftly make its own online learning content accessible for people with disabilities, setting out milestones and timelines, and should report to the public on its progress.

#12. The Ministry of Education should direct all its staff and all school boards that whenever making digital information public in a PDF format, it must at the same time also be made available in an accessible format such as an accessible MS Word document.

#13. The provincial plans for return to school should include these features:

  1. a) Rather than having all students across Ontario return to school at once, in a one-size-fits-all strategy, the Ontario Government should lead a strategic return to school process, trying out different approaches to see what works most effectively. For example, opening a few schools first to detect recurring problems and plan to prevent them would assist with opening of other schools across Ontario.
  1. b) The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.

#14. The Ministry of Education should immediately put in place an effective proactive team to gather teaching strategies for students with disabilities during distance learning from frontline teachers, parents and school boards and make these easily available to the frontlines on an ongoing basis, in formats that are accessible to people with disabilities. These should be supplemented by strategies that the Ministry researches from other jurisdictions that have innovated creative solutions.

#15 The plans for return to school must include measures for ensuring that those who cannot return to school at the same time can secure effective distance learning, including home visits (with social distancing) from teaching staff.

#16. The Ministry of Education should prepare teaching materials for teachers and parents to use, addressing different disability-related learning needs, for preparing students with disabilities for the return to school, to address such changes as social distancing.

#17. The Ministry of Education should create, fund and effectively enforce new standards for safe bussing practices for students with disabilities during any return to school while COVID-19 remains a community threat.

#18. Each school board should ensure that its Special Education Advisory Committee(SEAC) meets at least once per month, and preferably more often, during the COVID-19 crisis, to give its board ongoing input into planning for students with disabilities during the COVID-19 crisis.

#19. To get the most from the volunteer work of SEACs around Ontario, the Ministry of Education should:

  1. a) Create and maintain a listserv or other virtual network of all Ontario SEACs, to enable them to share their efforts with all other SEACs around Ontario, and
  1. b) Frequently gather input from SEACs around Ontario about the experiences of students with disabilities during the COVID-19crisis.



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Please Email the Ontario Government to Support the AODA Alliance’s Finalized Brief on Measures Needed to Meet the Needs of Students with Disabilities Now and During the Transition to Schools Re-Opening


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/

June 18, 2020

SUMMARY

Working at warp speed, the AODA Alliance has finalized and submitted its brief to the Ontario Government on what must be done to meet the needs of at least one third of a million students with disabilities in kindergarten to Grade 12 now and during the eventual transition to schools re-opening. We set out that 23-page brief below.

We invite and encourage you to email the Ontario Government right away to support our briefs 19 recommendations. Those recommendations are set out and described throughout the brief. To make it easier for you, at the end of the brief is an appendix that lists all the recommendations together in one place.

You can support us by emailing the Government at this address: [email protected] If you are part of a disability community organization, please get your organization to write the Government to support our recommendations. Of course, we encourage you to add any thoughts, experiences or recommendations that you wish.

It is good if you can use your own words when you write the Government. If you dont have time, you might just wish to say something like this:

I support the recommendations made in the AODA Alliances June 18, 2020 brief to the Ontario Government on what needs to be done to meet the needs of students with disabilities now and during the transition to re-opened schools.

We thank everyone who took the time to read over the draft of this brief that we circulated for comment on June 11, 2020. We got fantastic feedback. We drew heavily on that feedback as we finalized this brief.

This finalized brief makes all the 17 recommendations that were in our draft brief (with some minor improvements) with one exception. Based on feedback we received, we removed our draft recommendation 13(b) in the draft brief. It had recommended that schools re-open for vulnerable students first. Our finalized brief replaced that recommendation with this, in #13(b):

The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.

This finalized brief adds two new recommendations, 18 and 19. These propose that the Government and school boards across the board make more use during the COVID-19 pandemic of the Special Education Advisory Committee that each Ontario school board is required to have, if they are not doing so now.

In addition to writing the Government to support our recommendations, we encourage you to send this brief to your local school board and school trustees. Encourage them to take the actions we recommend in this brief.

For more background on these issues, please visit the AODA Alliances COVID-19 web page and our education web page.

Stay safe, and let us know what you do to help us press for these reforms. Email us at [email protected]

MORE DETAILS
A Brief to the Ontario Government on Key Measures Needed to Address the Learning Needs of Students with Disabilities in Ontario During the COVID-19 Crisis Both During Distance Learning and During The Transition to the Eventual Re-Opening of Schools

Submitted by the Accessibility for Ontarians with Disabilities Act Alliance
www.aodaalliance.org [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

To: The Hon. Stephen Lecce, Minister of Education
Via email [email protected]
June 18, 2020

Introduction

The AODA Alliance submits this brief to the Minister of Education for Ontario, in response to the Ministry of Educations public consultation on the transition to school re-opening during the COVID-19 pandemic.

The AODA Alliance is a voluntary non-partisan grassroots coalition of individuals and organizations. Our mission is:

To contribute to the achievement of a barrier-free Ontario for all persons with disabilities, by promoting and supporting the timely, effective, and comprehensive implementation of the Accessibility for Ontarians with Disabilities Act. To learn about us, visit: http://www.aodaalliance.org.

Our coalition is the successor to the Ontarians with Disabilities Act Committee. The ODA Committee advocated more than ten years for the enactment of strong, effective disability accessibility legislation. Our coalition builds on the ODA Committees work. We draw our membership from the ODA Committee’s broad, grassroots base. To learn about the ODA Committees history, visit: http://www.odacommittee.net.

We have been widely recognized by the Ontario Government, by all political parties in the Ontario Legislature, within the disability community and by the media, as a key voice leading the non-partisan campaign for accessibility in Ontario. In every provincial election since 2005, parties that made election commitments on accessibility did so in letters to the AODA Alliance.

Among our many activities, we led a multi-year campaign to get the Ontario Government to agree to develop an Education Accessibility Standard under the AODA to tear down the many barriers that impede students with disabilities in Ontario’s education system. Our years of efforts to advocate for accessibility for students with disabilities are documented on our websites education page.

Our efforts and expertise on accessibility for people with disabilities have been recognized in MPPs speeches in the Ontario Legislature, and beyond. Our website and Twitter feed are widely consulted as helpful sources of information on accessibility efforts in Ontario and elsewhere. We have achieved this as an unfunded volunteer community coalition.

The Government must pay special heed to the input it receives from the disability community including parents of students with disabilities . Input to the Government from other organizations can fail to effectively address the specific experience and needs of students with disabilities . The recommendations in this brief are gathered together in a list in the appendix appearing at the end of this brief. Our position in this brief is summarized as follows:

a) The COVID-19 crisis has imposed disproportionate added hardships on people with disabilities. As part of this, it has led to disproportionate, serious hardships being inflicted on students with disabilities in Ontario schools. These hardships are exacerbated by no small part by serious pre-existing problems and disability barriers that have faced students with disabilities for years in Ontario’s education system, which have been made even worse for too many students with disabilities during the COVID-19 pandemic.

b) In this brief we address the needs of all students with disabilities, using the inclusive definition of disability in the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act . We do not limit our recommendations to the narrower group of students whose disability falls in the narrower definitions of special education or exceptionality that the Ministry of Education uses.

c) To date, the provincial response to the problems facing students with disabilities during the COVID-19 pandemic has been substantially insufficient. The AODA Alliance offers 19 recommendations in this brief, to effectively address this, starting now and into the fall. Our fuller recommendations for comprehensive and long term reforms in the form of a strong and effective Education Accessibility Standard are set out in the AODA Alliances October 10, 20-19 Framework for the promised Education Accessibility Standard.

d) While students are not able to go to school this spring due to the COVID-19 crisis, students with disabilities are experiencing wildly different learning experiences. Some are making good progress. Some are making much less progress. Some are making no progress or are losing ground. Some are getting extensive educational supports from their school board. Some are getting much less support. Some are getting little if any support. Conditions and supports can vary widely, even within the same school board and by students with the same disability.

e) There is a pressing need for a comprehensive Ministry of Education plan of action to address the needs of students with disabilities during the COVID-19 crisis.

f) There is a need for a provincial Students with Disabilities Command Table at the Ministry of Education.

g) The Ministry must prevent a rash of principals refusing to admit some students with disabilities to school when schools re-open.

h) There is a need for specific COVID-19 Individual Education Plans for individual students with disabilities before and during the transition to return to school.

i) There is a need for Provincial and School Board Rapid Response Teams to be established to address recurring urgent needs of students with disabilities.

j) A surge of specialized supports for students with disabilities is needed when schools re-open.

k) School boards must plan for the needs of students with disabilities who cannot themselves ensure social distancing.

l) The Ministry must ensure the full accessibility of digital platforms used for remote classes or synchronous learning.

m) The Ontario Government must immediately ensure the digital accessibility of Ontario Government and TVO online learning resources.

n) The Ministry of Education and school boards must stop making some learning resources available only in PDF format as this creates accessibility barriers.

o) One size fits all does not fit for return to school.

p) There is a need for a rapid method to spread the word to teachers and parents about effective teaching strategies for students with disabilities during COVID-19.

q) Distance learning must be effectively provided for students who cannot return to school right away when schools re-open.

r) The Ministry of Education should now create provincial resources for parents to prepare their students for the return to school.

s) New protocols are needed for safe school bussing for students with disabilities.

t) The Ministry should ensure the very active engagement of each school boards Special Education Advisory Committee.

This brief builds on extensive involvement of the AODA Alliance during the COVID-19 crisis, advocating for the needs of people with disabilities across society. On June 11, 2020, we made public a draft of this brief, and solicited public input on it. We were very gratified by the supportive and helpful feedback we received. We have drawn heavily on that feedback to produce this finalized brief. We are urging one and all to share their own advice and recommendations with the Ontario Government during this important consultation.

1. Pressing Need for A Comprehensive Ministry of Education Plan of Action to Address Needs of Students with Disabilities During the COVID-19 Crisis

Since the COVID-19 crisis began, the AODA Alliance has repeatedly urged the Ontario Government to develop and announce a comprehensive plan to meet the needs of students with disabilities during the COVID-19 crisis. This has been needed so over 70 school boards dont have to each re-invent the wheel in deciding what the needs of students with disabilities are and how best to meet them. To date, the Ontario Government has not done what we have urged.

The need for this comprehensive provincial plan remains pressing during the period of distance learning due to school closures. It is also needed to ensure that students with disabilities needs are met across Ontario when schools eventually re-open. Ontario needs to also be prepared in the event of the realistic possibility that distance learning will have to continue in the fall, either because school re-opening is further delayed, or because a second wave of COVID-19 would require another round of school closures.

To date, the Ontario Government has primarily focused its education strategy during the COVID-19 pandemic on students without disabilities. Almost as an afterthought, it then reminded school boards that they should also accommodate students with special education needs.

The plan for students with disabilities should, to the extent possible, be included in the Ministrys overall plan for school re-opening.

We therefore recommend that:

#1. The Ministry of Education should immediately develop, announce and implement a comprehensive plan for meeting the learning needs of students with disabilities during the COVID-19 crisis. This plan should include during this time of distance learning, during an eventual return to school, and in case of a future COVID-19 wave that requires another round of school closures. To the extent possible, this plan should be an integral part of the Ministrys overall plan it is developing for school re-opening.

2. Need for a Provincial Students with Disabilities Command Table

To deal with the need for rapid planning during the COVID-19 crisis, the Ontario Government has commendably set up its own command tables to deal with critical areas, like health care planning and planning for the safe operation of the economy during this crisis. This enables the Government to have critical expertise at the table to make rapid and key decisions.

There is a pressing need for a students with disabilities command table within the Government to plan for the learning needs of students with disabilities during the COVID-19 pandemic. No such table or concentrated expertise centre exists now within Ontarios Ministry of Education. We have been pressing for this for three months. That table needs to be staffed by professionals with focused expertise on providing education to students with disabilities.

This is not meant to be an advisory or consultative table. It needs to be a planning and implementation table that can quickly and nimbly make decisions and effectively connect with the frontlines in the education system, where the action is.

This need is not fulfilled by the Minister of Education having had some consultative meetings with the Ministers Advisory Committee on Special Education (MACSE), which still has vacancies, or with the AODA K-12 Education Standards Development Committee. Those bodies are only advisory. They do not have the capacity of a Ministry command table. Of course, it is good that they have been consulted.

We therefore recommend that:

#2. The Ministry of Education should immediately establish a Students with Disabilities Education Command Table to oversee the development and implementation of a Government action plan for meeting the urgent learning needs of students with disabilities during the COVID-19 crisis, and to swiftly react to issues for students with disabilities as they arise.

3. Preventing a Rash of Refusals to Admit Students with Disabilities to School When Schools Re-Open

Ontarios Education Act lets a school principal refuse to admit to school any person whose presence in the school or classroom would in the principals judgment be detrimental to the physical or mental well-being of the pupils”. Disability advocates have repeatedly criticized this as an excessive, arbitrary and unfair power. The Education Act and the Ministry of Education leave to school boards and individual principals an extremely wide discretion over when, how and why to exclude a student from school under this power. The Education Act does not even require principals to give a parent their reasons for excluding a student from school. It does not cap the duration of the students exclusion from school. It does not require a school board or the Ministry to keep track of how often or why students are excluded from school under this power.

Disproportionately, this excessive power has been used against students with disabilities, leading them too often to be excluded from school altogether or allowing them to attend school only for reduced hours. Long before the COVID-19 crisis, parents and students advocates have called for this power to be reduced and regulated. See for example the January 30, 2019 joint news release by the AODA Alliance and the Ontario Autism Coalition. To date, the Ontario Government has not made any significant reform of this power.

In September 2018, the Ontario Human Rights Commission released an updated policy on accessible education for students with disabilities. Its recommendations to the Ontario Government included, among other things:

“9. Identify and end the practice of exclusion wherein principals ask parents to keep primary and secondary students with disabilities home from school for part or all of the school day (and the role that an improper use of section 265(1)(m) of the Education Act may be playing in this practice).”

There is a serious risk that some principals will feel at liberty to use this power to exclude some students with disabilities from school during school re-openings in the midst of the COVID-19 pandemic, especially before any effective vaccine is invented and widely available. This is especially so if school boards do not now effectively plan for the inclusion and accommodation of students with disabilities at school during the transition to school re-opening. They may do so either because they dont know how to accommodate some students with disabilities during social distancing, or because the Ontario Government and/or their school board has not given them the staffing, directions and resources they need to be able to effectively include and accommodate those students at school for part or all of the school day. Such exclusions from school raise serious human rights concerns and are contrary to the students right to an education.

With all the uncertainties and pressures anticipated during the transition back to school, a principal can be expected to feel a real temptation to use the power to refuse to admit such students to school during a COVID-19 school re-opening. This is so because it would seem to solve the problem of having to plan for those students needs at school.

The need to reform practices regarding a school principals power to refuse to admit a student to school for part or all of the school day has therefore become even more pressing in light of the COVID-19 pandemic. The AODA Alliance considers this a major priority. It is essential that school re-openings this fall do not lead to a rash of principals refusals to admit any number of students with disabilities to school. Such a rash of exclusions would thereby create two classes of students, those allowed to return to school and those who are excluded from school, especially if this disproportionately divides along disability lines.

The Ontario Government has commendably been willing to give directions to a school board about the use of its power to refuse to admit students to school in other contexts. It can and should do so here as well. The Ontario Ministry of Education has very recently given directions to the Peel District School Board to keep and report data on exclusions of students from school by race. In directive number 9, the Ministry stipulated that:

The Board shall centrally track disaggregated race-based data on suspensions (in-school and out-of-school), expulsions and exclusions, and report publicly through the Annual Equity Accountability Report Card.

We therefore recommend that:

#3. The Ministry of Education should immediately issue a policy direction to all school boards, imposing restrictions on when and how a principal may exclude a student from school, including directions that:

a) During the re-opening at schools, students with disabilities have an equal right to attend schools for the entire school day as do students without disabilities. The power to refuse to admit a student to school for all or part of the school day should not be used in a way that disproportionately burdens students with disabilities or that creates a barrier to their right to attend school.

b) A principal who refuses to admit a student to school during the school re-opening process should be required to immediately give the student and their family written notice of their decision to do so, including written reasons for the refusal to admit, the duration of the refusal to admit and notice of the familys right to appeal this refusal to admit to the school board.

c) A principal who refuses to admit a student to school for all or part of the school day should be required to immediately report this in writing to their school boards senior management, including the reasons for the exclusion, its duration and whether the student has a disability. Each school board should be required to compile this information and to report it on a bi-monthly basis to the board of trustees, the public and the Ministry of Education (with individual information totally anonymized). The Ministry should promptly make public on a provincial basis and a school board by school board basis the information it receives on numbers, reasons and durations of refusals to admit during post- COVID-19 school re-opening.

4. Need for Specific COVID-19 Individual Education Plans for Individual Students with Disabilities Before and During Transition to Return to School

For each student with disabilities, distance learning during COVID-19 will have created different deficits and challenges. The transition back to school will present challenges and needs that will vary from student to student.

Students IEPs were all written earlier this past school year while students were in school. They were written with no contemplation of the COVID-19 crisis or the challenges and hardships of distance learning and then of a later transition back to school. All students with disabilities will need their IEP modified to address these unforeseen needs.

As an immediate measure, students with disabilities each now need a customized COVID-19 specific IEP to be created and implemented. This should not be limited to students whose disability fits within the narrow and incomplete definition of exceptionality in Ontario, which leaves out some disabilities. It should be provided to any student that has a disability within the meaning of the Ontario Human Rights Code. It should not be limited to students whose disability has been formally identified at an Identification and Placement Review Committee.

This COVID-19 IEP would not replace the students existing IEP. It would not replace the usual IEP development process when school is back in usual operation. This COVID-19 IEP is meant as an immediate, temporary or interim measure to address these hitherto-unanticipated events and related learning needs. IEPs are supported to deal, among other things, with transition needs. Both the transition to distance learning and the later transition to school re-opening fit well within that rubric.

The COVID-19 IEP should be developed now and over the summer, not in the fall when students are already back in school. This may well require new resources to enable this to be developed over the summer.

As noted earlier, there is a real possibility that distance learning will continue in September, or may have to later resume due to a resurgence or a second wave of COVID-19. These COVID-19 IEPs need to now anticipate and effectively address each of these possible eventualities.

The development of each students COVID-19 IEP should start with a direct phone conversation as soon as possible between the students teacher and the family. They should discuss where the gains and gaps have been, the concerns for the fall that are anticipated and how best to address them. The COVID-19 IEP should be developed in close consultation with the family and, where appropriate, the student.

We therefore recommend that:

#4. For each student with disabilities, each school board should now:

a) Contact the family of each student with disabilities, preferably by phone rather than email, to discuss and identify the students progress during the school shutdown, the students specific and individualized disability-related deficits and needs arising from and during distance learning due to the COVID-19 crisis and the students needs and challenges related to eventual transition to school (including any vulnerabilities of other family members due to the COVID-19 pandemic), and;

b) Create a COVID-19 IEP to set specific goals and activities to effectively address their disability-related needs during distance learning, and in connection with transition back to school.

5. Need for Provincial and School Board Rapid Response Teams to Be Established to Address Recurring Urgent Needs of Students with Disabilities

During the COVID-19 crisis, Ontario’s education system continues to try to navigate uncharted territory. No matter how much planning for the needs of students with disabilities takes place as we here recommend, unexpected surprises will crop up. School boards and the Ministry of Education each need to be able to quickly detect these, and to nimbly respond to them. Traditionally, large organizations are not always the best at rapid and nimble adaptations in the midst of great uncertainty.

Parents, teachers and principals need a central point in the school board to report difficult challenges. Each school board needs to quickly feed this information to a single point at the Ministry that is staying on top of things, for rapid responses to recurring issues around the province.

We therefore recommend that:

#5. The Ministry of Education should assign staff to assist its Students with Disabilities Command Table by serving as a central rapid response team to receive feedback from school boards on recurring issues facing students with disabilities and to help find solutions to share with school boards.

#6. The Ministry should direct that each school board shall establish a similar central rapid response team within the board to receive and act on feedback from teachers, principals and families about problems they are encountering serving students with disabilities during the COVID-19 period, that will quickly network with other similar offices at other school boards, and that can report recurring issues to the Ministry.

6. Surge Needed in Specialized Supports for Students with Disabilities

All students will have fallen behind to varying extents during the months when schools were closed. This hardship falls especially on students with disabilities who have additional specialized curriculum to learn, related to their disabilities, or who need specialized supports to learn which are unavailable during distance learning.

When students return to school, students with disabilities who need those supports will need a surge in the hours of support provided to them to help them catch up and adjust to the return to school. School boards cannot simply pull those resources out of the air. School boards will need added funding to hire those staff. They will need provincial help in finding them where there are shortages.

For example, students with vision loss are unable to get the full benefit of teachers of the visually impaired (TVIs) teaching hands-on braille reading when schools are closed. When schools re-open, school boards will need to engage additional TVIs to help ramp up the surge in TVI hours to be provided to students. There is now a shortage of TVIs in Ontario. The Ministry will need to lead a concerted effort to create a surge of TVIs to help school boards fill this gap during the return to school. Comparable needs can similarly be identified for students with other disabilities where such specialized educational support is needed.

We therefore recommend that:

#7. The Ministry of Education should plan for, fund and coordinate the provision by school boards of a surge in specialized disability supports to those students with disabilities who will need them when students return to school.

7. Planning for Needs of Students with Disabilities Who Cannot Themselves Ensure Social Distancing

As an illustration of the last issue discussed, any return to school while COVID-19 continues to exist in our community will require students to engage in social distancing. If schools re-open, they will be doing so mindful of the fact that many students will not be able to consistently and reliably engage in social distancing, frequent hand washing and other important protective activities. Many are too young to ensure that they can fully understand the need to do so and comply. For some older children, it may seem cool to periodically break the rules. For many, it will be impossible to remain attentive to these precautions all the time.

For any number of students with disabilities, social distancing and related safe practices may pose additional challenges. For some, wearing a mask may not be possible due to such things as sensory integration or behavioural issues.

Some students with disabilities require an education assistant (EA) or special needs assistant (SNA) for all or part of the day to fully take part in school activities. For some of these students, it will not be possible to remain two meters away while providing the support or assistance that the student needs. Some will require close assistance for eating, hand-washing and other personal needs.

Pre-COVID-19 staffing levels for EAs and SNAs were too often inadequate. They did not account for these important additional requirements. EAs and SNAs were not experienced with or trained for this before COVID-19. It is not sufficient to now send them an email with instructions, or a link to a training video, and thereafter to assume that they will be fully equipped to consistently and reliably handle these duties. In addition to new in-person training, they will need to have constant access to good quality personal protective equipment (PPE), like masks.

It is also important to employ enough EAs and SNAs so that they dont have to split their time among multiple schools or venues, lest they pose a greater risk of transmitting the COVID-19 virus from place to place among vulnerable students.

We therefore recommend that:

#8. The Ministry of Educations plan for school re-openings must include detailed directions on required measures for ensuring that students with disabilities are safe from COVID-19 during any return to school. This requires additional planning in advance by school boards and additional funding to school boards to hire and train the additional SNAs and EAs they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that an EA or SNA does not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.

8. Ensuring Full Accessibility of Digital Platforms Used for Remote Classes or Synchronous Learning

We do not here wade into the dispute between the Ford Government and some teachers unions about whether or when a teacher should conduct online classes for their students in real time over the internet, sometimes called synchronous learning. We insist, however, that whenever an online real time class or synchronous learning takes place, or any other online meeting involving students with disabilities or their parents in connection with their education, it must be conducted via a fully accessible digital meeting platform.

When the Ontario Government moved our education system from the physical classroom to the virtual classroom in late March, it should have ensured from the start that the choice of digital meeting platforms was fully accessible. The Ontario Government did not do so, nor did it monitor school boards to see what platforms they were using. The Ontario Government dropped the ball on this critical accessibility concern, to the detriment of students, teachers and parents with disabilities. The Ministry of Education took the erroneous position that it was up to each school board to decide which online virtual meeting platform to use, based on the boards assessment of its local needs. Yet these disability accessibility needs do not vary from school board to school board. They are the same across Ontario. The Ministry wastefully leaves it to each school board to investigate the relative accessibility of different virtual meeting platforms.

As a belated partial attempt to address this problem, the Minister of Education wrote school boards on or around May 26, 2020 about several issues regarding distance learning. That memo stated, among other things:

Boards must ensure that the platforms they use for connecting with students and families are fully accessible for persons with disabilities.

However, that direction provides no assistance to school boards on which platforms to use or avoid, or how to figure this out. It still leaves it to each school board to investigate this as much or as little as they wish, and then to duplicate the same investigations of this issue over and over across Ontario. We have seen no indication that the Ministers direction led any school boards to change what they were doing in this regard.

This issue remains a live one and will continue into the fall. It is not clear when schools will re-open. Our education system may still be running on 100% distance learning at the start of the fall school term. Even when schools re-open, there is a real likelihood that some distance learning will continue in some blended model of in-school and distance education. As noted earlier, if a second wave of COVID-19 hits, as has happened elsewhere, requiring another round of school closures, Ontario will have to return to 100% distance learning.

At least one school board has improperly prohibited the use of Zoom, even though it is at least as accessible as, or more accessible than, other platforms. The Ministry of the Attorney General did its own comparison of digital meeting platforms, for use by the courts. The Superior Court of Justice of Ontario has decided to use Zoom as its platform for virtual court proceedings. If Zoom is safe enough for the Superior Court of Justice, there is no reason why a school board should prohibit its use.

Canadas largest school board, TDSB, has announced that it is using Webex for parent-teacher meetings. This is so even though Webex has real accessibility problems. Such a practice should not be allowed.

We have heard examples of quite inaccurate information on this topic from some in the school board sector. Parents should not have to fight about this, one school board at a time, especially in the middle of a pandemic.

This topic requires ongoing effort and leadership by the Ministry. By August, there could well have been changes to the relative accessibility of different virtual meeting platforms. School boards need to operate based on current information.

We therefore recommend that:

#9. The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital meeting platforms available for use in Ontario schools. This should involve end-user testing. The Ministry should immediately send the resulting report and comparison to all school boards and make it public. This should be revisited as the fall approaches, in case there have been changes to the relative accessibility of different virtual meeting platforms. The Ministry should direct which platforms may be used and which may not be used for virtual or synchronous classes or parent/school meetings, based on their accessibility.

9. Ensuring Digital Accessibility of Ontario Government and TVO Online Learning Resources

Over three months into the COVID-19 crisis, the Ontario Government has still not ensured that the online content that it provides to school boards, teachers, parents and students meets accessibility requirements for computer-users with disabilities. The AODA Alliance has been raising concerns with the Government about this since early in the pandemic. We have seen no public commitment to the needed corrective action. We have raised our concerns at senior levels within TVO and the Ministry of Education. The Government and TVO were required to comply with these accessibility requirements well before the advent of the COVID-19 pandemic.

We therefore recommend that:

#10. The Ministry of Education should immediately direct TVO to make its online learning content accessible to people with disabilities, and to promptly make public a plan of action to achieve this goal, with specific milestones and timelines.

#11. The Ministry of Education should make public a plan of action to swiftly make its own online learning content accessible for people with disabilities, setting out milestones and timelines, and should report to the public on its progress.

10. Stop Making Some Learning Resources Available Only in PDF Format

Throughout this pandemic, as well as beforehand, the Ministry of Education and too many school boards have continued to make important digital information available to the public, including to parents, teachers and students, only in pdf format. That format can present accessibility problems for people with disabilities. When a document is made public in PDF format, it should also be made public in an accessible format, such as MS Word. This is an important time to start this long-overdue practice.

We therefore recommend that:

#12. The Ministry of Education should direct all its staff and all school boards that whenever making digital information public in a PDF format, it must at the same time also be made available in an accessible format such as an accessible MS Word document.

11. One Size Fits All Does Not Fit for Return to School

To avoid chaos, a return to school should not be done all at once using a one-size-fits-all approach. Because we are in uncharted waters, it makes sense to go about this gradually and to try different approaches at different locations to see what works. We must avoid students with disabilities being again treated as after-thoughts who have to try to fit into a chaotic situation that was not designed with their needs in mind.

One suggestion that some have raised is to enable students with disabilities to return to school first, and for teaching staff to ensure their needs are met, before trying to also cope with an onslaught of all other students. Some have raised with us a concern that this might turn out to be a form of segregation, and could be detrimental for some of those students.

We therefore recommend that:

#13. The provincial plans for return to school should include these features:

a) Rather than having all students across Ontario return to school at once, in a one-size-fits-all strategy, the Ontario Government should lead a strategic return to school process, trying out different approaches to see what works most effectively. For example, opening a few schools first to detect recurring problems and plan to prevent them would assist with opening of other schools across Ontario.

b) The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.

12. Need for A Rapid Method to Spread the Word to Teachers and Parents About Effective Teaching Strategies for Students with Disabilities During COVID-19

Teachers and parents of students with disabilities are struggling around Ontario to cope with distance learning and the barriers it can create for many students with disabilities. Teachers and parents are creating novel work-arounds to address this.

Yet the Ontario Government has not been effectively canvassing the frontlines of teachers and parents to gather these up and share them around the province, so all can benefit without having to re-invent the wheel in the midst of a traumatic pandemic. We have called on the Ontario Government for the past three months to do this without success. We modelled one way of doing this by our successful May 4, 2020 online virtual town hall on teaching students with disabilities during the COVID-19 crisis (jointly organized with the Ontario Autism Coalition). As far as we have been able to learn, the Ontario Government has neither taken up that idea nor has it shared with school boards the link to our May 4, 2020 virtual town hall so that they can all benefit from it. We have repeatedly asked the Ministry of Education to share that link with school boards.

In the meantime, to fill this gap, several school boards have commendably been trying to address this need themselves. They have themselves been compiling good ideas and sharing them within their own board.

This is a huge and wasteful duplication of effort. The Ontario Government should be centrally accumulating and compiling all these resources, as well as researching what other jurisdictions have compiled from their own experience. These should be rapidly made available to frontline teachers and parents in a way that is easy to access, not by a blizzard of endless links that few if anyone will have the time to explore.

This effort should have been done weeks ago. Nevertheless, it is still not too late, since distance learning will remain part of our lives in whole or in part until a vaccine for COVID-19 is created and widely administered.

It is important that any such resources be themselves fully accessible to teacher, school staff, students and family members with disabilities. We regret that we have no assurance of this. On June 15, 2020, the Ontario Government announced in a news release that it was now making available new teaching materials during the COVID-19 crisis, under the headline: Ontario Develops Additional Learning Materials for Students and Teachers. The AODA Alliance promptly wrote senior officials at the Ministry of Education to ask what steps were taken to ensure that these new educational materials are accessible to people with disabilities, and asking what was done to include tips for teaching students with disabilities. The Ministry has not answered as of the time this brief was submitted.

We therefore recommend that:

#14. The Ministry of Education should immediately put in place an effective proactive team to gather teaching strategies for students with disabilities during distance learning from frontline teachers, parents and school boards and make these easily available to the frontlines on an ongoing basis, in formats that are accessible to people with disabilities. These should be supplemented by strategies that the Ministry researches from other jurisdictions that have innovated creative solutions.

13. Distance Learning Must Be Effectively Provided for Students Who Cannot Return to School

When schools re-open, each school board will have a duty to accommodate its students with disabilities in school unless the school board can prove that it is impossible to do so without undue hardship. There may be some students who cannot return to school when others do. Their disability may make it impossible to accommodate them in school under the restrictions that apply during the COVID-19 pandemic. Some students may not be able to return to school because their parents or other family members with whom they live are so medically vulnerable or immuno-compromised that the family must take heightened precautions to avoid the risk of contracting COVID-19.

In those cases, even if other students are learning at school, the school board must provide effective and accessible distance learning for those students who must remain at home. This may include home visits from teaching staff. In this, students with disabilities must be more effectively and consistently served during distance learning than was the case in the spring.

We therefore recommend that:

#15 The plans for return to school must include measures for ensuring that those who cannot return to school at the same time can secure effective distance learning, including home visits (with social distancing) from teaching staff.

14. Creating Provincial Resources for Parents to Prepare Their Students for Return to School

Some students with disabilities will need extensive preparation at home for their eventual return to school, including learning about social distancing and other new school practices due to COVID-19. Some parents will need a great deal of time to deal with this. Each school board or teacher and family should not have to duplicate these efforts by inventing their own curriculum, social stories or other resources.

We therefore recommend that:

#16. The Ministry of Education should prepare teaching materials for teachers and parents to use, addressing different disability-related learning needs, for preparing students with disabilities for the return to school, to address such changes as social distancing.

15. New Protocols Needed for Safe School Bussing

There were ample problems with bussing of students with disabilities to school before the COVID-19 crisis. In any return to school, heightened safeguards will be needed, including frequent sanitization of busses, ensuring students are seated more than 2 meters from each other and ensuring that the driver has PPE and doesnt risk spreading COVID-19. It is not realistic to expect that this will all simply happen with private sector bussing companies who employ casual and part time drivers working at low wages.

We therefore recommend that:

#17. The Ministry of Education should create, fund and effectively enforce new standards for safe bussing practices for students with disabilities during any return to school while COVID-19 remains a community threat.

16. Ensure Very Active Engagement of Each School Boards Special Education Advisory Committee

Each Ontario school board is required to have a Special Education Advisory Committee to advise it on special education issues. We understand that some have met regularly during the school closures, using conference calls or virtual online meeting platforms. Others have not met regularly, from what we have heard.

SEACs have a great deal to offer in this area. In making our recommendations about SEACs, we note that SEACs are not required to include representation regarding students with all kinds of disabilities. They are instead required only to have members that represent families whose students whose disability falls within the more limited definition of exceptionality that the Ministry of Education uses. Of course, it is open to a school board to have its SEAC have a more inclusive membership. It is also open to SEAC members to speak to any needs of any students with disabilities . School boards and the Ontario Government must ensure that they get input regarding students with any and all kinds of disabilities.

It is essential that each school board ensures that its Special Education Advisory Committee (SEAC) is meeting at least once per month, if not more, during the COVID-19pandemic, including during the transition to re-opening. While they usually dont meet during the summer, they should meet if possible during the 2020 summer. They should be fully engaged in planning for the needs of students with disabilities during the COVID-19 period.

Their volunteer efforts would have more impact if the Ministry of Education took two easy steps. First, the Minister should create a virtual network or listserv to enable SEACs to share their work with each other. No such network now exists. As well, the Ministry should collect input from all Ontarios SEACs on their concerns and advice given during the COVID-19 era, as this is a readily-available avenue to more front-line experience of students with disabilities.

We therefore recommend that:

#18. Each school board should ensure that its Special Education Advisory Committee (SEAC) meets at least once per month, and preferably more often, during the COVID-19 crisis, to give its board ongoing input into planning for students with disabilities during the COVID-19 crisis.

#19. To get the most from the volunteer work of SEACs around Ontario, the Ministry of Education should:

a) Create and maintain a listserv or other virtual network of all Ontario SEACs, to enable them to share their efforts with all other SEACs around Ontario, and

b) Frequently gather input from SEACs around Ontario about the experiences of students with disabilities during the COVID-19crisis.

Appendix List of Recommendations

#1. The Ministry of Education should immediately develop, announce and implement a comprehensive plan for meeting the learning needs of students with disabilities during the COVID-19 crisis. This plan should include during this time of distance learning, during an eventual return to school, and in case of a future COVID-19 wave that requires another round of school closures. To the extent possible, this plan should be an integral part of the Ministrys overall plan it is developing for school re-opening.

#2. The Ministry of Education should immediately establish a Students with Disabilities Education Command Table to oversee the development and implementation of a Government action plan for meeting the urgent learning needs of students with disabilities during the COVID-19 crisis, and to swiftly react to issues for students with disabilities as they arise.

#3. The Ministry of Education should immediately issue a policy direction to all school boards, imposing restrictions on when and how a principal may exclude a student from school. including directions that:

#4. For each student with disabilities, each school board should now:

a) Contact the family of each student with disabilities, preferably by phone rather than email, to discuss and identify the students progress during the school shutdown, the students specific and individualized disability-related deficits and needs arising from and during distance learning due to the COVID-19crisis and the students needs and challenges related to eventual transition to school (including any vulnerabilities of other family members due to the COVID-19 pandemic), and;

b) Create a COVID-19 IEP to set specific goals and activities to effectively address their disability-related needs during distance learning, and in connection with transition back to school.

#5. The Ministry of Education should assign staff to assist its Students with Disabilities Command Table by serving as a central rapid response team to receive feedback from school boards on recurring issues facing students with disabilities and to help find solutions to share with school boards.

#6. The Ministry should direct that each school board shall establish a similar central rapid response team within the board to receive and act on feedback from teachers, principals and families about problems they are encountering serving students with disabilities during the COVID-19 period, that will quickly network with other similar offices at other school boards, and that can report recurring issues to the Ministry.

#7. The Ministry of Education should plan for, fund and coordinate the provision by school boards of a surge in specialized disability supports to those students with disabilities who will need them when students return to school.

#8. The Ministry of Educations plan for school re-openings must include detailed directions on required measures for ensuring that students with disabilities are safe from COVID-19 during any return to school. This requires additional planning in advance by school boards and additional funding to school boards to hire and train the additional SNAs and EAs they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that an EA or SNA does not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.

#9. The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital meeting platforms available for use in Ontario schools. This should involve end-user testing. The Ministry should immediately send the resulting report and comparison to all school boards and make it public. This should be revisited as the fall approaches, in case there have been changes to the relative accessibility of different virtual meeting platforms. The Ministry should direct which platforms may be used and which may not be used for virtual or synchronous classes or parent/school meetings, based on their accessibility.

#10. The Ministry of Education should immediately direct TVO to make its online learning content accessible to people with disabilities, and to promptly make public a plan of action to achieve this goal, with specific milestones and timelines.

#11. The Ministry of Education should make public a plan of action to swiftly make its own online learning content accessible for people with disabilities, setting out milestones and timelines, and should report to the public on its progress.

#12. The Ministry of Education should direct all its staff and all school boards that whenever making digital information public in a PDF format, it must at the same time also be made available in an accessible format such as an accessible MS Word document.

#13. The provincial plans for return to school should include these features:

a) Rather than having all students across Ontario return to school at once, in a one-size-fits-all strategy, the Ontario Government should lead a strategic return to school process, trying out different approaches to see what works most effectively. For example, opening a few schools first to detect recurring problems and plan to prevent them would assist with opening of other schools across Ontario.

b) The COVID-19 IEP of each student with disabilities should tailor their plans for the return to school to meet their individual needs. Students with disabilities who need this accommodation should be afforded a chance to return to the school facility early so they can be oriented to any changes to which they need to adjust in the COVID-19 era.

#14. The Ministry of Education should immediately put in place an effective proactive team to gather teaching strategies for students with disabilities during distance learning from frontline teachers, parents and school boards and make these easily available to the frontlines on an ongoing basis, in formats that are accessible to people with disabilities. These should be supplemented by strategies that the Ministry researches from other jurisdictions that have innovated creative solutions.

#15 The plans for return to school must include measures for ensuring that those who cannot return to school at the same time can secure effective distance learning, including home visits (with social distancing) from teaching staff.

#16. The Ministry of Education should prepare teaching materials for teachers and parents to use, addressing different disability-related learning needs, for preparing students with disabilities for the return to school, to address such changes as social distancing.

#17. The Ministry of Education should create, fund and effectively enforce new standards for safe bussing practices for students with disabilities during any return to school while COVID-19 remains a community threat.

#18. Each school board should ensure that its Special Education Advisory Committee(SEAC) meets at least once per month, and preferably more often, during the COVID-19 crisis, to give its board ongoing input into planning for students with disabilities during the COVID-19 crisis.

#19. To get the most from the volunteer work of SEACs around Ontario, the Ministry of Education should:

a) Create and maintain a listserv or other virtual network of all Ontario SEACs, to enable them to share their efforts with all other SEACs around Ontario, and

b) Frequently gather input from SEACs around Ontario about the experiences of students with disabilities during the COVID-19crisis.




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What Must Be Done to Make Ontario’s Health Care System Fully Accessible to Patients with Disabilities? Check Out the AODA Alliance’s Finalized Framework for the Promised Health Care Accessibility Standard


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/

February 25, 2020

SUMMARY

What must be done to make Ontario’s health care system accessible to patients with disabilities and to any patients’ support people with disabilities? What should be included in the Health Care Accessibility Standard that the Ontario Government is now developing under the Accessibility for Ontarians with Disabilities Act?

Here we unveil our most thorough and comprehensive brief on this topic. Below please find the AODA Alliance’s finalized Framework on what the Health Care Accessibility Standard should include.

We have submitted this new Framework to the Ford Government. We have also submitted it to the Health Care Standards Development Committee. The Government appointed that Committee under the AODA. That Standards Development Committee has the job of developing recommendations on what the Government should include in the promised Health Care Accessibility Standard to make Ontario’s health care system disability-accessible. This Framework sets out what we urge that Standards Development Committee to recommend to the Ford Government.

Last December we made public a draft of this Framework and invited your feedback. We thank all those who sent us feedback. We’ve done our best to use that feedback as we finalized this Framework. This final brief includes everything that was in our December draft. It has added recommendations, drawing on the excellent feedback we received from our supporters.

So what’s next? The Health Care Standards Development Committee is now writing a set of draft recommendations for the Government on what the Health Care Accessibility Standard should include. Later this year, that Committee is expected to make its draft recommendations public, and to invite public feedback on it. After that, the Health Care Standards Development Committee is required to consider that public feedback as it finalizes its recommendations to the Government.

The Health Care Standards Development Committee certainly knows about our efforts on this issue. Last December, we sent our earlier draft of this Framework to that Committee. On January 16, 2020, AODA Alliance Chair David Lepofsky made a 15 minute presentation to the Health Care Standards Development Committee on our recommendations. As noted above, we have now provided this finalized Framework to the Standards Development Committee.

We have asked the Health Care Standards Development Committee to adopt all of our recommendations. At the very least, we have asked that Committee to append this framework to its draft recommendations and to invite public feedback on it.

Once the Health Care Standards Development Committee makes its draft recommendations public for our feedback, we will circulate it to you. We will prepare a submission to the Standards Development Committee, using this Framework as our foundation.

Please share this Framework with people you know who work in the health care system. It would be great if Ontario’s health care system starts taking action on our recommendations now, because they are good ideas!

In addition to this Framework, you may wish to check out the captioned 1-hour talk on barriers in the health care system by AODA Alliance Chair David Lepofsky. For all our efforts in recent years, leading the campaign to get Ontario to enact a much-needed Health Care Accessibility Standard to make the health care system accessible to patients with disabilities, check out the AODA Alliance’s health care page on our website.

A grand total of 390 days have now gone by since the Ford Government received the final report on the AODA’s implementation and enforcement that was prepared by former Lieutenant Governor David Onley. We are still waiting for the Ford Government to come up with an effective plan to implement the Onley Report’s recommendations to strengthen the AODA’s implementation and enforcement.

A Framework for the Health Care Accessibility Standard

February 25, 2020

Proposed by the Accessibility for Ontarians with Disabilities Act Alliance
www.aodaalliance.org [email protected] Twitter: @aodaalliance Facebook: www.facebook.com/aodaalliance/

Introduction — What is This Framework?

The Ontario Government has committed to develop a Health Care Accessibility Standard under the Accessibility for Ontarians with Disabilities Act (AODA). In 2017, the Ontario Government appointed a Health Care Standards Development Committee to make recommendations on what the Health Care Accessibility Standard should include. On March 7, 2019, the Doug Ford Government committed to resume this Committee’s work.

The AODA requires the Ontario Government to lead Ontario to become accessible to people with disabilities by 2025. The Government is required to do so by enacting and effectively enforcing accessibility standards, which are enforceable regulations. Under the AODA, an accessibility standard is required to specifically spell out the barriers that are to be removed or prevented, what specifically must be done to remove or prevent them, and the timelines required for these actions.

In this Framework, the AODA Alliance proposes key ingredients and aims that should be included in the Health Care Accessibility Standard. We hope this will assist the Health Care Standards Development Committee.

The Health Care Accessibility Standard should set detailed requirements for specific actions that health care providers and organizations shall take. It is not sufficient for this accessibility standard to vaguely require health care facilities or providers to simply make plans and policies on accessibility, or to vaguely require obligated organizations to consider or include accessibility features in their health care facilities or services. The details of what this accessibility standard will require are vital to its success.

Some needed actions will have to be taken by each health care facility and/or health care provider. Some will need to be taken by the self-governing bodies that regulate each of the health professions in Ontario. Some of the needed actions will have to be taken by the Ontario Government. The Government funds, centrally plans and oversees Ontario’s health care system.

It is especially pressing to now effectively address disability barriers in Ontario’s health care system. In 2020, Ontario’s health care system is still replete with serious accessibility barriers, even fully 15 years after the AODA was enacted. Too often, it has been designed and operated on the unspoken or unarticulated premise that it is largely if not totally meant for patients without disabilities. Yet disproportionately, those who use and need the health care system are people with disabilities.

We each make the greatest use of health care services towards the end of our lives. Disabilities are far more prevalent among seniors. Disability most often is caused by aging.

Twenty-three years ago, in Eldridge v. British Columbia [1997] 3 SCR 624, the Supreme Court of Canada established the broad principle that patients with disabilities have a constitutional right to accessible health care services in Canada. Yet since then, the Ontario Government has not undertaken a comprehensive effort or strategy to identify the recurring disability barriers in the health care system. It has not implemented a comprehensive plan to remove and prevent those barriers. In the meantime, old barriers remain while new ones keep being created.

Even the very barrier that the Supreme Court ordered provincial governments to fix almost a quarter century ago too often remains in place. In the Eldridge case, the Supreme Court ruled that the Charter of Rights makes provincial governments responsible to ensure the provision of Sign Language interpreter services for deaf patients in hospitals that need them to effectively communicate with health care providers. This is a constitutional right of those patients. Yet in its December 26, 2019 edition, the Hamilton Spectator reported on recent incidents where this vital service was not assured in a Hamilton, Ontario hospital.

Ontario needs a strong, comprehensive and enforceable Health Care Accessibility Standard enacted under the AODA so that patients with disabilities don’t have to fight an endless number of legal cases under the Canadian Charter of Rights and Freedoms and the Ontario Human Rights Code to tear down these many barriers, one at a time. Health care facilities and providers should not have to each separately re-invent the accessibility wheel, trying to figure out how to address the known and recurring disability barriers in Ontario’s health care system.

In her case, it took Ms. Eldridge up to seven years to win the right to a sign language interpreter in a hospital’s emergency room where she gave birth to twins. A pregnant woman about to give birth in a hospital emergency room cannot be expected to wait seven years for such a needed accessibility service.

Achieving accessibility in Ontario’s health care system should be doable for several compelling reasons. The system receives enormous public funding. Health funding is always a high priority for government after government. There is substantial centralized government planning of the health care system. This issue bears on the lives and health of everyone in Ontario. This is because everyone is bound to eventually get a disability as they age.

Moreover, Ontario’s health care system is undergoing ongoing and substantial reforms and innovation. Every year, new health care facilities are established or built. Change is always in the wind. That makes changes in favour of accessibility easier to implement.

We hope the Health Care Standards Development Committee finds this Framework helpful. We ask the Health Care Standards Development Committee to vote separately on each of these recommendations. In any event, we encourage the Standards Development Committee to attach this Framework to its forthcoming package draft recommendations that it will be required to circulate and post for public comment. That would enable the Health Care Standards Development Committee to get public input on this Framework to guide its development of its final recommendations.

This Framework reflects our years of efforts at gathering input from the grassroots of Ontario’s disability community and consulting experts here and abroad. Last December, we made public a draft of this Framework for public comment. We are indebted to those who read it so carefully and offered suggested improvements. We’ve done our best to incorporate the excellent feedback that we received.

It has taken our substantial multi-year grassroots effort to reach the point of having a Health Care Standards Development Committee appointed and now working on developing recommendations on what the promised Health Care Accessibility Standard should include. Since 2009, the AODA Alliance has led the campaign to get the Ontario Government to develop a Health Care Accessibility Standard. This is documented on our website’s Health Care page. It took the previous Ontario Government up to six years just to decide in 2015 to develop a Health Care Accessibility Standard. It took another two years to get the previous Government to take the first step of appointing this Health Care Standards Development Committee. We then had to fight for up to a year to get the current Government to lift the freeze on the work of the Health Care Standards Development Committee.

The AODA Alliance spearheaded all of these grassroots efforts. At the same time, we have had to campaign against the Ontario Government’s efforts to substantially narrow the range of disability accessibility barriers that the Health Care Standards Development Committee would be free to consider.

In this Framework, the term “health care facility” means any organization that provides any kind of health care service, from a major hospital to a local physician’s office. It includes an organization whose primary purpose is not provision of health care, but which includes a health care service within it. For example, a university may include a health clinic, which, for the purpose of this Framework, is treated as a health care facility. The term “major health care facility” refers to larger health care facilities and centres, not smaller operations like an office for a single physician, dentist or other health care professional.

In this Framework, “health care provider” means anyone who helps provide any kind of health care service, including any health care professional (whether or not their profession is regulated), any support staff or volunteers that assist them and any drug store staff that assist a patient with getting and using medications.

In this Framework, we address barriers in the health care system that can impede patients with disabilities, and/or any patients’ support people (whether family members, friends or others) where the support person or care giver has a disability. Whether or not a patient has a disability, some of their care givers or support people (such as family members) may have disabilities. The disability barriers in the health care system that impede patients with disabilities can also often impede a care giver or support person who has disabilities.

This framework sets out recommendations for actions that the Health Care Accessibility Standard should require. In this Framework, when we state that a health care provider or facility or other organization “should” do something, we mean that the Health Care Accessibility Standard should require this action. We do not propose these actions as guidelines or best practices. “Best practices” or guidelines are not mandatory or enforceable. This Framework proposes actions which need to be mandatory and enforceable.

We acknowledge with thanks the tremendous help provided to us by the ARCH Disability Law Centre and by an amazing team of volunteer law students at the Osgoode Hall Law School who made a huge difference in the preparation of this Framework.

The following are the headings in this Framework:

1. What Should the Long-Term Objectives of the Health Care Accessibility Standard Be?

2. A Vision of An Accessible Health Care System

3. General Provisions that the Health Care Accessibility Standard Should Include

4. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Know About Available Health Care Services, about Available Disability-Related Supports and Accommodations, about Important Information Regarding Their Diagnosis and Treatment and about How to Access Them

5. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Physically Get to Health Care Services

6. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Get into and Around Facilities Where Health Care Services are Provided

7. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Furniture and Floor Plans in Health Care Facilities

8. The Right of Patients with Disabilities to Identify their Disability-Related Accessibility Needs in Advance and to Request Accessibility/Accommodation from a Health Care Provider or Facility

9. The Right of Patients with Disabilities to Accessible Diagnostic and Treatment Equipment

10. The Right of Patients with Disabilities to the Privacy of Their Health Care Information

11. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Information and Communication in Connection with Health Care Services and Products

12. The Right of Patients with Disabilities to the Support Services They Need to Access Health Care Services

13. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Health Care Providers Free from Knowledge and Attitude Barriers Regarding Disabilities

14. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Complaint Processes at Health Care Providers’ Self-Governing Colleges and to Have Those Colleges Ensure that the Profession They Regulate Are Trained to Meet the Needs of Patients with Disabilities

15. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Systemic Action and Safeguards to Remove and Prevent Barriers in Ontario’s Health Care System

16. The Need to Harness the Experience and Expertise of People with Disabilities Working in the Health Care System to Expedite the Removal and Prevention of Barriers Facing Patients with Disabilities and Any Patients’ Support People with Disabilities

1. What Should the Long-term Objectives of the Health Care Accessibility Standard Be?

#1-1. The objective of the Health Care Accessibility Standard should be to ensure that Ontario’s health care system and the services, facilities and products offered in it, become fully accessible to all patients with any kind of disabilities and to any support people with disabilities for any patient, by 2025, the AODA’s deadline, by requiring the removal and prevention of accessibility barriers that impede people with disabilities, and by providing a prompt, accessible, fair, effective and user-friendly process to learn about and seek disability-related accommodations tailored to a person’s individual disability-related needs. It should aim to ensure that patients with disabilities can fully benefit from and be fully included in the health care services and products offered in Ontario’s health care system on a footing of equality. It should aim to eliminate the need for patients with disabilities and any support people with disabilities to have to contend with and fight against health care accessibility barriers, one at a time, and the need for health care providers to have to re-invent the accessibility wheel one health care facility or one health care provider at a time. It should aim for health care services, facilities and products in Ontario to be designed and operated based on accessibility principles of universal design.

This is what the AODA requires this accessibility standard to achieve. This goal also lives up to the Charter of Rights’ and Ontario Human Rights Code’s accessibility requirements. Some incorrectly think that the AODA imposes new requirements for accessibility. In fact, it seeks to get obligated organizations to do what the Ontario Human Rights Code and the Charter of Rights have required them to do for well over three decades.

It would be grossly inadequate for the Health Care Accessibility Standard to set a weaker and less specific goal, e.g. merely to “improve accessibility” in the health care system. It would fulfil that weaker goal to simply remove only one barrier somewhere in Ontario’s huge health care system. It would leave our health care system with far too many accessibility barriers.

2. A Vision of An Accessible Health Care System

To begin, the Health Care Accessibility Standard should set out a vision of what an accessible health care system should include. An accessible health care system should include the following:

#2-1. The health care system will be designed and operated from top to bottom for all its patients, including patients with all kinds of disabilities, as disability is defined in the Ontario Human Rights Code and/or the Canadian Charter of Rights and Freedoms. The health care system will no longer be designed and operated from an implicit starting point of aiming predominantly to serve the fictional “average” patient, who is too often imagined as having no disabilities.

#2-2. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to easily find out what health care services are available and how and where to get them.

#2-3. Places where health care services are offered will be reachable by accessible public transit routes and will have sufficient accessible parking immediately adjacent to them.

#2-4. The built environment in the health care system, such as hospitals and any other places where health care services are provided, including the furniture there, will all be fully accessible to people with disabilities, and will be designed based on the principle of universal design.

#2-5. Patients with disabilities will be able to seek, receive and fully benefit from the health care services and products that are available in the health care system and which they require.

#2-6. Health care providers will consistently and reliably know how to meet the needs of patients with disabilities and where needed, any patients’ support people with disabilities, to ensure that patients with disabilities fully benefit from their health care services.

#2-7. Patients with disabilities, and where needed, any patients’ support people with disabilities, will be able to effectively communicate with health care providers and health care staff in connection with requesting or receiving health care services and products throughout each stage of the healthcare process. This will include face-to-face interactions, telephone or alternates to telephone use, accessible information and forms as well as alternate arrangements for providing one’s signature. For example, health care facilities and ambulances will be equipped with needed equipment to ensure effective communication with people with communication-related disabilities.

#2-8. Patients with disabilities, and where needed, any patients’ support persons with disabilities, will have prompt, effective and easy access to user-friendly information in accessible formats and in multiple languages on the health care options, programs, services, supports and accommodations available for their disability, and on the process for seeking these. As well, printed, online and other written information about available health care services, diagnoses, prognosis, treatments, exercises, medications, and other information provided to or available to patients with disabilities and, where needed, any patients’ support people with disabilities in connection with health care services and products, will be readily and easily available in an accessible format. This includes, for example, a patient’s health care records and labels/instructions for prescription drugs.

#2-9. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to get and receive information relevant to their health care needs in private, e.g. when giving information at a health care provider’s office or when seeking or receiving information about their medication at a pharmacy, rather than in a public place where others can overhear. Effective procedures will protect the confidentiality of private information relating to patients with disabilities who rely on others to assist them with communication.

#2-10. Information technology and applications which patients can use at home, or at a health care facility in connection with seeking and receiving health care services, will be designed based on principals of universal design and will be accessible to and usable by patients with disabilities, and where needed, to any patients’ support people with disabilities. Where needed for effective communication, health care facilities will also provide alternatives to telephone use including email, text, video and authorized human assistance.

#2-11. Health care products, and any instructions for their use, will be designed and available based on principles of universal design so that people with disabilities and not just people with no disability can use and benefit from them.

#2-12. Diagnostic and treatment equipment and furniture will be designed based on principles of universal design and will be fully accessible to patients with disabilities.

#2-13. Support services such as sighted guides for visually impaired patients and attendant care will be available to patients with disabilities who need them while going to or at a facility to receive health care services.

#2-14. Publicly funded appointments for receiving health care services will be sufficiently long to enable a patient with a disability, who needs more time, to be able to receive the health care services they need. If a patient with disabilities cannot attend a health care provider’s premises due to their disability, there will be in place measure whenever possible for remote appointments or home visits.

#2-15. Where patients with disabilities or any patients’ support people with disabilities need a disability-related accommodation in connection with health care services, there will be a prompt, user-friendly process for requesting and obtaining the needed accommodations.

#2-16. Patients will be free to use their own accommodation supports, such as service animals, when seeking or obtaining health care services and products.

#2-17. Where patients with disabilities or where needed, any patients’ support people with disabilities, believe that a health care provider is not effectively meeting the patient’s disability-related needs, they will have access to a prompt, fair, open and arms-length review process, including an offer of a voluntary Alternative Resolution Process if needed, conducted by someone who was not involved in the original decision or activity and who does not oversee the work of those involved in the patient’s health care services.

#2-18. There will be no bureaucratic, procedural or policy barriers that impede the effective accommodation of individual patients with disabilities or, where needed, any patients’ support people with disabilities, at any levels of Ontario’s health care system.

#2-19. New Government strategies, services and facilities in Ontario’s health care system will be proactively designed from the start and operated to fully include the needs of patients with disabilities. Those responsible at the provincial and local levels for leading, overseeing and operating Ontario’s health care system will have strong and specific requirements to address disability accessibility and inclusion in their mandates and will be accountable for their work on this issue. Ontario’s disability community will have ongoing and effective input into public decisions on the design and operation of Ontario’s health care system to ensure that existing disability accessibility barriers are removed and no new ones are created.

#2-20. An accessible health care system is one where people with disabilities can work in a barrier-free workplace. The barriers which impede people with disabilities as patients and their family members and caregivers often also impede health care providers and workers with disabilities.

3. General Provisions that the Health Care Accessibility Standard Should Include

The intent or rationale of the following recommendations is for the Health Care Accessibility Standard to include general requirements across the health care system that will ensure that its specific accessibility requirements are effective.

#3-1. The Health Care Accessibility Standard should address the accessibility needs of patients with any kind of disability, and the accessibility needs of any patients’ support people with any kind of disability. The term “disability” should be defined broadly to include any disability within the meaning of the AODA or the Ontario Human Rights Code.

#3-2. The Health Care Accessibility Standard should cover and apply to all public and private health care programs, services and products available in Ontario, whether or not they are offered in a hospital and whether or not OHIP covers them. It should cover all health care providers and professions, whether or not Ontario recognizes, regulates or licenses them. It should cover every location or facility where health care services can be delivered in Ontario, including e.g. hospitals, long term care facilities, offices and clinics for physicians, dentists, physiotherapists, psychologists, occupational therapists, speech language pathologists, and all other health care professions and providers. It should cover ambulances and other vehicles which can transport patients in connection with health care services. It should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic or other communities within Ontario.

#3-3. The Health Care Accessibility Standard should not be limited to hospitals and the hospital sector. Most people get most health care services outside of hospitals. If the Health Care Accessibility Standard were limited to barriers in hospitals, it would leave out most of the health care system and most of the barriers in the health care system. It would force people with disabilities to go to overcrowded hospitals to get their health care services, since hospitals would be the only place where accessible services would be assured to them.

The fact that the Government’s terms of reference for the Health Care Standards Development Committee focus on the hospital sector does not prevent this Standards Development Committee from making recommendations that go beyond the hospital sector. A number of earlier AODA Standards Development Committees have made recommendations beyond their terms of reference. We ask the Health Care Standards Development Committee to do the same.

Most if not all of the barriers identified in this Framework occur both in hospitals and in other places where health care services and products are provided. At the very least, the Health Care Standards Development Committee should make recommendations about all of these barriers proposed in this Framework as they relate to hospitals, and then should recommend that the Health Care Accessibility Standard require the same action on the same barriers where they occur anywhere else in the health care system where health care services or products are provided to patients.

#3-4. The Health Care Accessibility Standard should cover ambulances and other vehicles that transport patients in connection with the receipt of health care services.

#3-5. The Health Care Accessibility Standard should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic, indigenized or other communities within Ontario.

#3-6. The Health Care Accessibility Standard should require the removal of existing barriers, and not only the prevention of new barriers.

#3-7. If the Health Care Standards Development Committee identifies a recurring accessibility barrier in Ontario’s health care system, it should make recommendations on how to remove or prevent that barrier, even if there is a less effective or comprehensive existing health care regulation or statute that may already apply to it in whole or in part.

The Health Care Accessibility Standard will take precedence and prevail over any other laws, if those other laws either create or permit health care accessibility barriers, or if they do not effectively remedy those barriers, or if they provide less accessibility than the Health Care Accessibility Standard. If an existing law, such as a statute or regulation governing the health care system, creates an accessibility barrier or impedes the removal or prevention of a health care barrier, the Health Care Standards Development Committee should recommend measures to be included in the Health Care Accessibility Standard that would remove or prevent those barriers. It should recommend the modification or repeal of any law that itself creates or permits health care barriers. Any provincial legislation or regulations that create accessibility barriers against patients with disabilities are contrary to the guarantees of equality to people with disabilities in the Ontario Human Rights Code and the Charter of Rights.

#3-8. The Health Care Accessibility Standard should require each health care facility and health care provider to create a welcoming environment for patients with disabilities and any patients’ support people with disabilities to seek accommodations for their disabilities when receiving health care services.

#3-9. Each major health care facility such as each hospital should be required to establish a permanent committee of its board to be called the “Accessibility Committee.” This Accessibility Committee should have responsibility for overseeing the facility’s compliance with the AODA, and with the requirements of the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms in so far as they guarantee the right of people with disabilities to fully participate in and fully benefit from the health care services that the facility provides. It should endeavour to reflect the spectrum of disability needs.

#3-10. Each major health care facility such as each hospital should be required to establish or designate the position of Chief Accessibility/Accommodation Officer, reporting to the Chief Executive Officer. Their mandate, responsibility and authority should be to ensure proper leadership on the facility’s accessibility and accommodation obligations under the Ontario Human Rights Code, the Canadian Charter of Rights and Freedoms and the AODA, including the requirements of this accessibility standard. This responsibility may be assigned to an existing senior management official.

#3-11. Beyond the specific measures to remove and prevent barriers set out in the Health Care Accessibility Standard and in other accessibility standards enacted under the AODA, each health care facility and health care provider should be required to periodically and systematically review its health care services, facilities, equipment and products to identify recurring accessibility barriers that can impede the provision of health care services to patients with disabilities. A comprehensive plan for removing and preventing these accessibility barriers should be developed, implemented and made public with clear timelines, with clear assignment of responsibilities for action, monitoring for progress, and reporting to the facility’s accessibility committee. This plan should aim at all accessibility barriers that can impede patients with disabilities from fully benefiting from the facility’s health care services, whether or not they are specifically identified in the Health Care Accessibility Standard or in any other AODA accessibility standards.

4. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Know About the Health Care Services Available to Them, About Available Disability-Related Supports and Accommodations, About Important Information Regarding Their Diagnosis and Treatment and About How to Access Them

Barriers: Patients with disabilities and support people with disabilities too often find it difficult to get accessible information to find out from their health care facility from their health care provider, from the health care system at large and/or from the Ontario Government about the health care services that are available, or about where and how to get them.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support people with disabilities can find out what health care services are available to them and where to obtain them.

#4-1. Each health care provider or facility should be required to make readily available, in an accessible format, information about the health care services or products they offer and about where and how to arrange to get them. If the health care provider or facility has a website, this information should be accessibly posted prominently on that facility or provider’s website in plain language. Where communication supports or assistance is needed to access this information, those supports should be made available (See below regarding communication supports).

#4-2. The Ontario Government or any provincial organization mandated to oversee or deliver health care services should be required to make readily available to the public in accessible formats, including on the internet, detailed information on the menu of health care services available in Ontario, and on how and where to arrange to get those services.

5. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Physically Get to Health Care Services

Barriers: Obstacles that impede people with disabilities from physically getting to places where they need to go to receive health care services and products, include, such things as:

a) The many public transit barriers that the Transportation Accessibility Standard has not removed or prevented. This results in such things as health care facilities and providers that are not on an accessible public transit route, and restrictions on para-transit services being able to cross over municipal boundaries to get to them. The Transportation Standards Development Committee’s spring 2018 final report to the Ontario Government left out many important revisions needed to the 2011 Transportation Accessibility Standard (part of the 2011 Integrated Accessibility Standards Regulation), that were identified in the July 31, 2017 joint brief by the AODA Alliance and the ARCH Disability Law Centre.

b) Health care funding conditions that require that a patient must attend a physician’s office to receive health care services can impede access to health care services for whose disability prevents them from travelling to that office.

c) “One issue per visit” policies in physicians’ offices can prevent those with multiple disabilities, or disabilities plus illness/ailment from receiving adequate treatment. This discourages them from seeking treatment.

d) The new ‘mega hospitals’ that replace smaller, older hospitals create transportation barriers for those who live in rural areas. They also create access barriers for people with lung disease or fatiguing conditions who must walk long distances from the parking lot to the entrance and through the building to get to elevators.

e) Limited accessible parking lots and spaces near hospitals i.e. which cannot accommodate modified vans with raised roof or side lift for wheelchair.

f) When a para-transit service fails to show up on time, a patient can arrive late to a doctor’s office, and have the doctor’s office impose a financial penalty for supposedly missing the appointment.

g) Reductions or elimination of funding for house visits by a health care provider preclude the possibility of home visits for patients who are physically incapable of going to the health care provider’s office or facility to get treatment. For 2019 provincial cuts to OHIP coverage for a physician’s house visit to a patient, see http://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/11000/bul11214.aspx

The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support persons with disabilities can get to the places where health care services and products are provided.

We ask the Health Care Standards Development Committee to make the following recommendations. These could be incorporated either or both into the promised Health Care Accessibility Standard or into the Transportation Accessibility Standard, to address those transportation barriers in the health care context. In 2011, the Ontario Government enacted the Transportation Accessibility Standard, as part of the 2011 Integrated Accessibility Standards Regulation.

In 2016, the Ontario Government appointed the Transportation Standards Development Committee to review the 2011 Transportation Accessibility Standard and to make recommendations where needed, to strengthen it. In 2018, the Transportation Standards Development Committee made very weak recommendations for revisions to the 2011 Transportation Accessibility Standard. The Transportation Standards Development Committee did not recommend many if not most of the improvements that the AODA Alliance and the ARCH Disability Law Centre called for, in their joint July 31, 2017 brief to the Transportation Standards Development Committee. In over two years since then, the Ontario Government has announced no plans to implement any improvements to strengthen the 2011 Transportation Accessibility Standard.

The Transportation Standards Development Committee’s 2018 recommendations to revise the 2011 Transportation Accessibility Standard, if adopted, would not fix any of the deficiencies in the 2011 Transportation Accessibility Standard. Since receiving the final recommendation of the Transportation Standards Development Committee over one and a half years ago, the Ontario Government has not announced any revisions to the 2011 AODA Transportation Accessibility Standard. It is therefore still open to the Ontario Government to make improvements under the AODA to the 2011 Transportation Accessibility Standard beyond the weak ones that the Transportation Standards Development Committee recommended in 2018.

#5-1. Wherever possible, any new health care facility or provider receiving public funds that is setting up a new location should be required to locate at or near an accessible public transit stop on an accessible public transit route, with an accessible path of travel from the public transit stop to the health care facility or provider. Similarly, where an existing health care facility or provider is going to move to another location, it should be required to attempt to relocate to a location that is on an accessible public transit route.

#5-2. Where it is medically possible for a patient to take part in a health care service without physically attending at the health care facility or provider, an option should be provided for taking part remotely, e.g. via Facetime or other remote video conferencing. The Health Care Accessibility Standard should also require the removal of the OHIP barrier to funded physicians house calls.

#5-3. Where OHIP or a health care facility or provider has a policy or practice of permitting only one health issue per visit, an exception should be created for patients with disabilities for whom transportation to the health care facility is impeded by accessibility barriers.

#5-4. A health care facility or provider should not be permitted to charge a late fee or a missed appointment fee where a patient with a disability has in good faith attempted to attend on time but was made late or precluded from attending by transportation barriers (such as being made late for the appointment by the community’s para-transit service).

#5-5. When the Ontario Government is undertaking planning for new health care services, or for improvements to health care services, it should be required to include in those plans, and to make public, requirements to ensure that wherever possible, health care services and facilities are provided in locations on accessible public transit routes, with an accessible path of travel from the accessible public transit stop to the facility or provider.

#5-6. The 2011 Transportation Accessibility Standard should be amended to set accessibility requirements for public transit stations and stops, as the joint July 31, 2017 AODA Alliance/ARCH brief to the Transportation Standards Development Committee recommended.

#5-7. The Health Care Accessibility Standard should set technical specifications to ensure the full accessibility of ambulances and other vehicles that transport patients, including patients with disabilities, to or from health care services. See also below re: the need to include in those vehicles equipment for communication with patients with communication-related disabilities.

6. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Get into and Around Facilities Where Health Care Services are Provided

Barriers: Barriers in the built environment where health care services are provided that impede people with disabilities from getting into places where health care services and products are offered, or from safely and independently getting around these places, such as:

a) Older hospitals and other facilities where health care services are provided that lack obvious and basic accessibility features like ramps, accessibility features in washrooms like transfer spaces at toilets, grab bars, accessible signage to departments or elevators, etc.

b) New hospitals, such as Toronto’s Women’s College Hospital, that have obvious accessibility problems despite being opened eleven years after the AODA was passed.

c) Parking facilities with automated parking payment kiosks that are inaccessible to wheelchair users.

d) Health care facilities with inaccessible doors to the check-in/waiting areas.

e) Health care facilities including reception areas that use print signs to communicate important information or directions to patients and which offer no accessible means for people with vision loss or dyslexia to obtain this information, e.g. dim signage lighting making it hard to read the sign for people with low vision, signage that does not use plain language for those with intellectual or cognitive disabilities.

f) Facilities where health care services are provided that are obstacle courses, e.g. with chairs, tables, signs or other obstacles blocking parts of hallways or other paths of travel.

g) Diagnostic, isolation, consultation, waiting and/or treatment rooms that are too small to accommodate wheelchairs or other mobility devices or support people or service animals.

h) Reception desks behind windows with “speakers”, making it hard to communicate for those with hearing loss, and which are placed too high for those in wheelchairs or those having smaller stature. These also can cause privacy issues.

i) Reception desks, where access to them is blocked, or where knee space is blocked, preventing face to face access.

j) Doorways within a health care facility that are too tight to allow a wheelchair or other mobility device to pass through.

k) Elevators lacking audio floor announcements and elevator buttons that lack braille and colour-contrasted large print for use by persons with vision loss.

l) The absence of way-finding guidance such as tactile floor strips or signage to direct people with vision loss or cognitive or intellectual disabilities through a health care facility, e.g. through large open areas like hospital lobbies.

m) Health care facilities that have fragrances or other substances affecting those with environmental sensitivities.

n) Equipment e.g. commode, alternating mattresses, nurse call switches, etc., that are not accessible for use by a person with a motor disability.

o) Children’s play areas in a health care facility that lack furniture that accommodates children using a mobility device like a wheelchair.

The Ontario Building Code and current AODA accessibility standards are substantially inadequate to meet the need for fully accessible facilities where health care services are provided. A new building in which health care services are provided, that is fully compliant with the Ontario Building Code and current AODA accessibility standards, can still have serious accessibility barriers. See generally https://www.aodaalliance.org/category/built-environment/

As such, the promised Health Care Standards Development Committee needs to set built environment accessibility standard requirements to address existing barriers, and to prevent the creation of new barriers, in places where health care services and products are provided to patients. As far as we can tell, the Ontario Government has in place no mandatory accessibility standard, required for the design of a new health care facility such as a hospital or long-term care facility, beyond the inadequate Ontario Building Code, to ensure that it is fully accessible. Similarly, the Government has no such accessibility standard, beyond the inadequate Ontario Building Code, for retrofitting an existing health care facility which is undergoing a major renovation. As well, the Government has in place no detailed accessibility standard whatsoever for a health facility to be retrofitted for accessibility, if that facility has no major renovation underway.

The Ontario Government has announced no plan to develop a comprehensive Built Environment Accessibility Standard under the AODA. Yet the Ontario Human Rights Code, and in some cases, the Charter of Rights, require these facilities to become disability-accessible.

As a result, each time a new hospital or other health care facility is built, or a renovation to one is undertaken, the organization needs to individually hire consultants to reinvent the accessibility wheel. Their advice need not be followed, or even disclosed to the public. This wastes public money. It leads to patchworks of varying levels of accessibility from organization to organization.

The 2019 final report of David Onley’s Independent Review of the AODA concluded that Ontario’s laws on the accessibility of the built environment are inadequate and that design professionals such as architects are not trained to ensure that they design buildings that everyone can access. However, the Ontario Government has announced no plans to upgrade the Ontario Building Code ‘s accessibility provisions, or to enact an AODA Built Environment Accessibility Standard, despite our repeated requests.

The Health Care Standards Development Committee should get direct input for technical requirements on these issues from qualified accessibility consultants, preferably ones who have experience giving advice regarding the accessibility of health care facilities.

The intent/rationale of the following recommendations is to ensure that patients and their support people with disabilities can get into and around facilities or other built environment where health care services and products are provided. The following lists examples of needed requirements but is not exhaustive.

#6-1. The Health Care Accessibility Standard should set specific and detailed accessibility requirements to ensure the accessibility of the built environment where health care services and products are provided, beyond the weak Ontario Building Code and the existing AODA accessibility standards. These should include accessibility requirements in new construction and major renovations. These should also include readily achievable retrofit requirements for existing facilities that are not undergoing a major renovation. Here is a sample of requirements for which detailed standards should be set:

#6-2. The front area or drop-off areas for a hospital or other health care facility should be accessible, with automatic power doors that do not require a button to be found and pressed, and with tactile walking surface indicators both to warn when a person is walking into a driving area and to guide a person to the facility’s entrance. All other entrances and exits should be fully accessible, with automatic power door operators and an accessible path of travel to the door. This includes entrances from indoor or underground parking to the health care facility.

#6-3. Inside the health care facility, major public areas such as emergency room doors should always be fully accessible and have automatic power door openers.

#6-4. For the benefit of patients and others with learning and cognitive disabilities, vision loss or other disabilities that can affect mobility or way-finding, hospitals and other health care facilities should have way-finding markings in important areas such as the main lobby from the front door to the help desk and other major routes such as to main elevators, including colour contrasted markings such as a carpeted path or tactile walking surface indicators.

#6-5. Hospitals and other health care facilities with elevators should have accessible elevators that can accommodate people using mobility devices. They should also have accessible elevator buttons (with braille and large print on or beside each button), braille and large print floor numbers just outside elevator doors, and audible floor announcements on elevators. Elevator button panels should be consistent in layout from one elevator to the next.

#6-6. Health care facilities, including hospitals, should never install “destination elevators” which require a person to pre-select the floor to which they are going before entering the elevators. These present unfixable accessibility problems.

#6-7. Hospitals and other health care facilities should have accessible signage throughout, including braille and large print, for key locations. For example, public bathrooms should have accessible braille and large print signs on them. These signs should be placed in consistent and predictable locations.

#6-8. Where a health care facility has power doors that require a button to be pushed (i.e. they don’t open automatically), the button should always be located throughout the health care facility in a consistent place to make it easier to find. The button should be located near the door, so that a slow-moving individual can make it through the open door after pressing the button before the door closes. The button should always be located on the wall, and not on a free-standing post or bollard.

#6-9. Despite weaker requirements in other AODA accessibility standards, the Health Care Accessibility Standard should set out specific and strong requirements for the accessibility of any electronic kiosks in hospitals and other health care facilities, such as:

a) specifying their required end-user functionality that effectively address recurring known needs arising from specific disabilities, and,

b) ensuring that they are at an accessible height e.g. for those using a wheelchair or other mobility device.

As a starting point, see the US Access Board’s standard for accessible electronic kiosks.

#6-10. Patient consultation or treatment rooms should have enough space to enable people using mobility devices to navigate in them and reach any treatment or consultation area. They should have enough space to enable a Sign Language interpreter to be positioned in the room to interpret for a deaf patient or support person.

#6-11. Movable furniture such as desks, tables or chairs should not obstruct accessible paths of travel around a facility where health care services are delivered, such as a doctor’s office, e.g. in their hallways or treatment rooms.

#6-12. Major health care facilities should provide accessible waiting areas for accessible transit pickup and drop-off, close to the pickup/drop-off point, with clear sight lines.

#6-13. Major health care facilities such as hospitals should be designed to avoid major sensory overstimulation or acoustic overloads, such as bright lights, loud music, large atrium areas, or frequent loud announcements. This is especially important in treatment areas or hospital rooms.

#6-14. Throughout a health care facility, proper colour contrasting should be required to assist people with low vision and cognitive disabilities, such as around elevator opening, doorways, and on the edge of stairs and handrails.

#6-15. Health care facilities should be required to have accessible bathrooms so that all patients can use the facilities, including adult change tables, sufficient transfer space and maneuvering room for mobility devices.

#6-16. Major health care facilities should include sensory rooms for people with sensory overload issues, such as in hospital emergency rooms.

#6-17. In a health care facility, all stairs and staircases, including “feature staircases” (included as aesthetic design enhancements) should be accessible, e.g. with tactile warnings at the top and bottom of each set of stairs, no open risers and with proper colour contrast on railings and step edges. There should never be curving staircases.

#6-18. Health care facilities should provide charging areas for electric mobility devices.

#6-19. Hospital rooms should be able to accommodate a patient’s mobility device so they can keep theirs with them and readily available when admitted to hospital.

#6-20. In a health care facility, waiting areas, isolation areas, breastfeeding rooms, staff areas and volunteer areas should be designed to be accessible.

#6-21. Accessible and bariatric paths of travel should be provided in health care facilities.

#6-22. Despite the more limited provisions regarding the provision of accessible parking spaces in other AODA accessibility standards, the Health Care Accessibility Standard should set higher and more specific requirements for accessible parking spaces for health care facilities, such as:

a) requiring a greater number of accessible parking spots for the facility, where possible.

b) requiring that the accessible parking spots be located as close as possible to the doors of the health care facility.

c) requiring that at least some of the accessible parking spots have larger dimensions to accommodate larger accessible vans, so that a passenger with a disability can park in that spot and have sufficient room to exit the vehicle, and

d) requiring that there be accessible curb cuts and an accessible path of travel from the accessible parking spots to the health care facilities’ entrances.

#6-23. Health Care facilities should have designated snow-piling areas outside, to prevent snow from being shoveled onto accessible paths of travel.

#6-24. Major health care facilities such as hospitals should provide service animal relief areas close to the facility’s door, covered wherever possible, with an accessible path of travel to them.

#6-25. When a major new health care facility like a hospital is being designed, or a major new wing or renovation is being planned, especially if public money is helping fund it, a properly trained and qualified accessibility consultant should be required to be engaged on the project from the very beginning. Their accessible design advice should be transmitted unedited to the Government or other organization for whom the project is being built and should be made public. Direct consultation with end-users with disabilities should be part of the design process from the beginning.

7. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Accessible Furniture and Floor Plans in Health Care Facilities

Barrier: Furniture, related equipment and floor plan layouts in health care facilities too often were chosen or designed without taking into account the accessibility needs of patients with disabilities and any patients’ support people with disabilities.

The intent/rationale of the following recommendations is to ensure that health care facilities create barrier-free spaces for patients and support people with disabilities. The following list of examples of needed requirements is not exhaustive.

#7-1. Each hospital patient’s bed should have an accessible means for a patient with disabilities to notify the nursing station of a health care need, not just a button or pull-string that they may not be able to reach and operate.

#7-2. Furniture such as seating in health care facilities should be designed with accessibility features and positioned in a manner that does not block accessible paths of travel.

#7-3. A Help Desk should be positioned immediately inside the main entrance of any major health care facility, including hospitals, to assist patients, including patients with disabilities, to get directions or help to their destination within the facility, or to request other accommodation supports.

#7-4. In any discrete department or area where health care services are provided, (such as an area for day surgery), the check-in desk should be located immediately adjacent to the entrance to that area, so that patients and support people with disabilities can easily reach it after entering the room or area.

#7-5. Accessible public service counters should be installed, even in existing health care facilities, with a specified height requirement, no glass barrier creating barriers for people with hearing loss and knee space for people using a mobility device.

#7-6. A large health care facility like a hospital should have rest areas along routes through the building so that people with fatiguing conditions can stop and rest along their route to get health care services.

#7-7. Health care facilities such as hospitals should have emergency areas of refuge with separate ventilation in case of fire, so that people with disabilities who cannot escape the building have safe areas to wait, while being protected from life-threatening smoke.

#7-8. The Ontario Government should make available to health care facilities and providers:

a) guides on accessible procurement including procurement of accessible furniture

b) lists of venders of accessible furniture

#7-9. The Ontario Government should provide a hub for procuring accessible furniture to help health care facilities and providers reduce the cost of their acquisition.

8. The Right of Patients with Disabilities to Identify their Disability-Related Accessibility Needs in Advance and to Request Accessibility/Accommodation from a Health Care Provider or Facility

Barrier: Health care providers, and especially large facilities, too often do not provide an easy-to-access way for a patient with disabilities or for any patients’ support people to notify the health care provider of their need for a disability accommodation or accessibility, so that these can be provided in a timely fashion.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people can easily alert a health care facility or provider, in advance, of any disability-related accessibility or accommodation needs, and can arrange to have these met in connection with their receiving health care services and products.

#8-1. Each health care provider and facility should be required to put in place a system and designate a person to solicit and receive requests from patients or their support people for disability accommodations in connection with health care services or products.

#8-2. Each health care provider or facility should be required to make readily-available to the public, including to their patients, in an accessible format, information about how to identify themselves in advance to the health care provider as having disability-related accessibility or accommodation needs, and to ask to arrange for these needs to be met.

#8-3. Each hospital and larger health care facility should be required to collect anonymized information on disability-related accessibility and accommodation requests received from or on behalf of patients with disabilities, to assist that health care provider or facility in planning for future disability accessibility and accommodation. This anonymized information should be available for study by the Government or other health policy planners.

#8-4. The Chief Executive Officer of any hospital or large health care facility should annually review the information that the facility has collected on the requests for disability accessibility and accommodation that the facility has received and report to the board of directors on measures that could improve the facility’s capacity to meet these needs.

9. The Right of Patients with Disabilities to Accessible Diagnostic and Treatment Equipment

Barrier: Too often, diagnostic and treatment equipment used by health care facilities or health care providers are not designed based on principles of universal design. Too often they are instead designed without sufficient regard to the needs of patients with disabilities.

The intent/rationale of the following recommendations is to systematically replace inaccessible diagnostic and treatment equipment over time with accessible equipment, while maximizing patient access to accessible equipment in the meantime.

#9-1. The Health Care Accessibility Standard should set specific technical requirements for the accessibility of diagnostic and treatment equipment. As a starting point, the Health Care Standards Development Committee should consider the accessible medical diagnostic equipment standards that the US Access Board has formulated. The needs of patients with all kinds of disabilities, and not only those with mobility disabilities, should be met by the technical requirements that the Health Care Accessibility Standard sets.

#9-2. The Ontario Government should impose a strict funding condition on the purchase or rental of any new health care diagnostic or treatment equipment anywhere in the health care system requiring that it must be accessible to patients with disabilities and designed based on principles of universal design, in compliance with the technical standards to be included in the Health Care Accessibility Standard.

#9-3. The Ontario Government should be required to make readily available to health care providers and facilities, and to the public, an up-to-date list of accessible health care diagnostic and treatment equipment and venders, so that each health care provider and facility does not have to re-invent the wheel by re-investigating these same issues.

#9-4. To save money, the Ontario Government should be required to attempt to negotiate bulk purchasing of accessible diagnostic and treatment equipment so that health care facilities and providers can obtain them at lower prices.

#9-5. When health care facilities and providers purchase, rent or otherwise acquire new or replacement diagnostic or treatment equipment, these should be required to be accessible to patients with disabilities and to be designed based on principles of universal design.

#9-6. Health care facilities and providers should survey their existing diagnostic or treatment equipment, and take the following steps to address any accessibility problems they have, if that equipment is not now being replaced:

a) Identify where the nearest place is where a patient can get diagnosis or treatment services where there is accessible diagnostic and treatment equipment, and to help facilitate the access of the patient with disabilities to health care services from that provider or facility.

b) Adopt and implement an interim plan to make any readily achievable accessibility improvements to the health care facility’s or provider’s existing diagnostic or treatment equipment.

c) Develop plans to purchase, rent or otherwise acquire accessible diagnostic or treatment equipment over a period of up to five years.

#9-7. These accessibility/universal design requirements should also apply to consumer health care products, such as for example, pill bottles.

10. The Right of Patients with Disabilities to the Privacy of Their Health Care Information

Barrier: Too often, patients with disabilities are not assured a chance to give and receive information regarding their health care needs in private, when dealing with health care providers or facilities. This can include e.g. having a health professional’s assistant assist a patient with disabilities to fill out a printed medical history form in the office’s open reception area rather than in private. Another common example is a pharmacy giving private information about medications to a patient over the counter in a pharmacy, where others can easily overhear this.

The intent/rationale of the following recommendations is to ensure that the privacy of patients with disabilities is fully respected in connection with health care services.

#10-1. Any health care facility or provider, including such places as doctors’ offices and pharmacies, should be required to designate an accessible private area where patients with disabilities can give and receive private information in connection with their health care services or products without others being able to overhear this.

#10-2. Health care facilities and providers should be required to notify all patients, including patients with disabilities, of their right to have their health care needs and issues discussed and information exchanged in a private location, and should instruct their staff, including any who deal with patients or the public, of their duty to fully respect this right.

11. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Information and Communication in Connection with Health Care

Barrier: Too often, critical health care information in the health care system is provided in inaccessible formats, or via inaccessible websites or other technology, or without the communication supports that people with communication-related disabilities need.

The 2011 Information and Communication Accessibility Standard, enacted as part of the 2011 Integrated Accessibility Standards Regulation, has not ensured that these barriers to health care-related information are removed and prevented. The July 24, 2019 draft recommendations of the Information and Communication Standards Development Committee, while helpful, would not fully address all the concerns identified here. See further the AODA Alliance’s November 26, 2019 brief to the Information and Communication Standards Development Committee.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people with disabilities can effectively communicate with health care providers in connection with receiving health care services and products and will get accessible information needed for that purpose.

Beyond the following recommendations, we strongly encourage the Health Care Standards Development Committee to get input on detailed requirements to include regarding accessible information and communication in connection with health care from Communication Disabilities Access Canada. CDAC is a widely respected and leading national expert in this area.

#11-1. Without limiting the information and communications to which this part of the Health Care Accessibility Standard should apply, it should address:

a) Information or communications needed to provide a health care provider with the patient’s history, needs, symptoms or other health problems.

b) Information and communications regarding the patient’s diagnosis, prognosis or treatment, including any risks, follow-up or other health care services to secure.

c) A health care facility’s discharge instructions.

#11-2. Health Care facilities should be equipped with assistive listening devices to enable patients with hearing loss and support people with hearing loss to be able to effectively communicate e.g. at nursing stations, help desks, and when dealing directly with health care providers.

#11-3. Health care-related products such as prescription and non-prescription medications should be provided when needed with accessible labels, instructions or users’ manuals, available in accessible formats. Those who sell or rent these to the public should be required to regularly notify the public, including their customers, that accessible labels, instructions, and users’ manuals are available on request. See e.g. work on developing standards and practices for accessible prescription drug container labels by the US Access Board. See also the February 6, 2020 news release announcing that the Empire chain of stores, including all Sobeys Stores, will provide accessible prescription labels to customers with disabilities free of charge on request. If they can, so can all other drug stores.

#11-4. Where a health care facility or health care provider provides information about their services or facilities in print or via the internet, they should be required to ensure that their website meets current international accessibility requirements along prompt time lines, even if the Information and Communication Accessibility Standard does not now require this. Currently, the Information and Communication Accessibility Information and Communication Accessibility Standard has too many exemptions, leaves out too many providers of goods and services, and has timelines that are too long. Whether or not those exemptions, exclusions and long timelines are justified for other sectors, they are unjustified for a sector as important as the health care sector.

#11-5. Ambulances and other vehicles that transport patients should include equipment to facilitate communication with patients with communication disabilities, such as remotely-accessed sign language interpretation and other communication supports.

#11-6. The Health Care Accessibility Standard should set more specific and detailed requirements than the Information and Communication Accessibility Standard, to require hospitals, other health care facilities and other health care providers to ensure that patients with communication-related disabilities get the communication supports they need in a timely fashion to ensure that they can effectively communicate with their health care provider in connection with their health care services and products.

#11-7. The Ontario Government should be required to set up hubs or centralized services to enable health care facilities and providers, including small providers, to quickly and easily access communication supports needed for patients with communication-related disabilities (for example Sign Language interpreters and real time captioning). The Ontario Government should fund these services as part of its funding of the health care system, in furtherance of the Supreme Court of Canada’s Eldridge decision.

#11-8. Any prepared information on health care conditions, treatment instructions, prognoses, risks, laboratory or other test results and the like which a health care facility or provider makes available to patients, whether in print or electronic form, should be made available at the same time on request in an accessible format. The standard should direct that PDF format is not sufficient to be accessible, and that if information is available in a PDF document, it should also be posted in an accessible format such as HTML or MS Word. Health care facilities and providers should be required to notify patients, including patients and their support people with disabilities, that any hard copy or electronic documents provided to them can be requested and obtained in an accessible format on request.

#11-9. Where a health care facility or provider asks patients or their support people to use information technology hardware or software in connection with the delivery of health care services (such as asking them to fill out their medical history on a portable computer or tablet device), the facility or provider shall:

a) In the case of new or updated information technology or equipment to be acquired, ensure that it is accessible to people with disabilities and is designed based on principles of universal design;

b) In the case of existing information technology now being used, retrofit to be accessible except where this would pose an undue hardship and,

c) As an alternative, ensure that patients with disabilities or their support people with disabilities are assisted to use that technology, in private, at the same time as others would use it, where this would not reduce their access to the health care services to which it pertains.

#11-10. Because Ontario’s system for electronic health care records has been centrally created, the Health Care Accessibility Standard should require the Ontario Government and any provincial agency that is responsible for overseeing the design, procurement or operation of the system for electronic health care records in Ontario to ensure that these records will be kept and available in accessible formats for patients and support people with disabilities, and, as a related benefit, to health care providers and their staff with disabilities. The same requirement as above should apply regarding the use of PDF format.

#11-11. Individual health care organizations or facilities, including laboratories, that create their own health care records in electronic form should also be required to ensure that they are readily available in accessible formats for patients with disabilities and any patients’ support people with disabilities, and, as a side benefit, for health care providers and their staff with disabilities.

#11-12. The Ontario Government should be required to develop and make public a strategy for ensuring that health care promotion initiatives in Ontario are accessible to people with disabilities. For example, it should require that:

a) All advertisements for health care promotion should have captioning and audio description.

b) All mail-out, printed and online materials focusing on health promotion should be required to be in accessible formats, regardless of any exemptions in the Information and Communication Accessibility Standard.

Barrier: Healthcare providers:

a) may not recognize a patient who has an invisible communication disability;

b) may not know how to communicate with a patient if the patient uses ways other than speech to communicate;

c) may overestimate or underestimate a patient’s comprehension and ability to give informed consent;

d) may erroneously assume the patient’s incapacity based on their communication disability;

e) may not know how and/or when to provide communication accommodations and supports for effective communication.

The intent/rationale of the following recommendations is to ensure that patients who have disabilities that affect their communication have timely accommodations and supports for their effective two-way communication at all times with healthcare providers and throughout the healthcare process.

#11-13. The Healthcare Accessibility Standards should require:
a) Intake procedures that identify, document and share a patient’s communication profile with their healthcare team. For example, the patient’s preferred communication method, home language and authorized communication assistant.

b) Procedures to ensure privacy and confidentiality of information if third parties are present to assist with communication.

c) Provision of required communication accommodations and supports. Accommodations include items that patients need to communicate, such as pen, paper, boogie board, picture, letter board and communication devices. Supports include strategies that healthcare providers can use to facilitate communication with a patient as well as assistance from people who know the patient well, a sign language interpreter, a language translator, a speech language pathologist.

d) Engagement when needed of Speech-Language Pathology services to provide appropriate accommodations and supports, in situations where a patient has no means to communicate or to ensure authenticity of communication in high stake consent situations.

e) Access to generic, commercial picture/word displays for emergency, ICU and inpatient use.

#11-14. To facilitate the provision of these communication supports and accommodations to patients with communication disabilities and to reduce or eliminate wasteful duplication of efforts, the Ontario Government should be required to:

a) Ensure in any education program for health care providers or professionals (including first responders and emergency care staff), training on core competencies on communicating with patients who may have unclear speech, reduced comprehension of spoken language or who may use sign language, writing, picture, letter boards, communication devices and/or someone else to assist a patient with communication.

b) Establish and fund a central hub for rapid provision of communication supports referred to here, which health care facilities and providers can use.

c) Create, widely distribute and publicize readily available and easy-to-use kits and guides for health care facilities and providers, including first responders, on how to arrange for effective communication with a patient with communication disabilities.

12. The Right of Patients with Disabilities to the Support Services They Need to Access Health Care Services

Barrier: Too often, health care facilities can lack the essential support services that patients with disabilities need to be able to access the health care services that the facility offers. Examples include hospital patients with disabilities who need help with eating, patients who need attendant care, or patients with vision loss who need to be guided to and from their destinations within a health care facility.

The intent/rationale of the following recommendations is to ensure that patients with disabilities get the support services they need to be able to make use of and fully benefit from the health care services and facilities that are offered to the public in Ontario’s health care system.

#12-1. Hospitals and other major health care facilities should be required to provide support services for patients with disabilities when needed to ensure that those patients can fully access and benefit from the health care services that the facility offers, such as:

a) Attendant care.

b) Assistance with meals.

c) Assistance being guided to and getting around the health care facility e.g. for patients with vision loss or cognitive disabilities.

#12-2. In a hospital or other major health care facility, there should be one nurse at each nursing station designated to receive training and to be responsible for addressing the needs of patients with complex needs due to their disability.

#12-3. No health care facility or provider will refuse to allow a patient with disabilities or any patients’ support people with disabilities to use their own needed accommodations, such as a service animal, when seeking or obtaining health care services or products.

13. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Health Care Providers Free from Knowledge and Attitude Barriers Regarding Disabilities

Barrier: Too often, front-line workers in Ontario’s health care system including professional health care providers and their staff and volunteers have knowledge and attitude gaps regarding patients with disabilities that create barriers to equal services, due to the lack of sufficient training on this.

The intent/rationale of the following recommendations is to ensure that those who work directly with patients with disabilities and with any patients’ support people with disabilities have proper training on how to meet the needs of people with disabilities so that people with disabilities are freed from stereotypes, patronization and paternalism.

#13-1. Each of the self-governing colleges that regulates a health care profession in Ontario should set detailed requirements for specific and sufficient training that must be obtained before a person can qualify to get a license to practice in Ontario in that profession, such as for physicians, nurses, dentists, etc. For those who already have a license to practice, those colleges should be required to set mandatory specific training to be obtained in this area, with time lines for doing so, as part of their licensees’ continuing professional development requirements. This training should include requirements for the health care professional to train their staff who interact with patients and the public.

#13-2. The Ontario Government should be required to impose a condition of its funding for post-secondary education programs to train anyone in a health care discipline, profession or field that the college or university must include a sufficient designated and mandatory curriculum on meeting the needs of patients with disabilities.

#13-3. The training requirements under the 2011 Integrated Accessibility Standards Regulation should be revised to provide that the training for any employees or volunteers in an organization of any size that provides any health care services or products must include training specific to the barriers facing patients with disabilities and any patients’ support people with disabilities in the health care system.

14. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Complaint Processes at Health Care Providers’ Self-Governing Colleges, and to Have Those Colleges Ensure that the Profession They Regulate Are Trained to Meet the Needs of Patients with Disabilities

Barrier: The self-governing colleges that govern some 26 kinds of health care professionals in Ontario are not assured to have in place sufficient ways to ensure that their members are providing accessible health care services to patients with disabilities.

The intent/rationale of the following recommendations is to ensure that health care professionals’ self-governing colleges effectively oversee the profession that they govern to ensure that they are providing accessible services to patients with disabilities, and have a fully accessible complaint process for the public to use.

#14-1. Each health care profession’s self-governing college should be required to:

a) Review its public complaints process to identify any barriers at any stage in that process that could adversely affect people with disabilities filing a complaint, or about whom a complaint is filed.

b) Develop a plan for removing and preventing any accessibility barriers identified whether or not those barriers are specified in any current AODA accessibility standards.

c) Publicly report to its governing board of directors and the public on these barriers and the college’s plans to remove and prevent such barriers, in order to achieve a barrier-free complaints process.

d) Establish and maintain a standing committee of its governing board of directors responsible for the accessibility of the services that the college offers the public, including, but not limited to its public complaints process.

e) Regularly consult with the public, including people with disabilities, on barriers that people with disabilities experience when seeking the services of the health care professionals that that profession regulates, to be shared with the board’s Accessibility Committee.

f) As provided in Recommendation #13-1 above, set specific curriculum requirements that a person must complete on providing accessible services to patients with disabilities, in order to qualify to get a license to practice in the profession they regulate.

g) As required by Recommendation #13-1 above, for those already licensed to practice in the profession they regulate, set continuing professional development training requirements on providing accessible services to patients with disabilities that a licensed professional must complete.

15. The Right of Patients with Disabilities to Systemic Action and Safeguards to Remove and Prevent Barriers in Ontario’s Health Care System, and to the Removal of Existing Systemic Barriers to Accessible Health Care

Barrier: Too often, the Ontario Government and individual health care facilities go about their business planning for and operating Ontario’s health care system without taking into account the needs of patients with disabilities. This results in systemic barriers being left in place and new ones being created.

The intent/rationale of the following recommendations is to ensure that each health care facility and the Ontario Government effectively take into account the needs of patients with disabilities when designing and planning for Ontario’s health care system and when operating it on a day-to-day basis, and have safeguards in place to catch recurring accessibility gaps. The Supreme Court’s Eldridge decision requires the Government to do this.

#15-1. The Ministry of Health should be required to designate a senior official at the “Assistant Deputy Minister” level as the leading public official who is responsible for ensuring accessibility, accommodation and inclusion for patients with disabilities in Ontario’s health care system. They should be responsible for ensuring that any policies, plans or proposals regarding the health care system are screened to ensure that they will not create any new barriers for patients with disabilities, and will instead remove barriers.

#15-2. The Ministry of Health should be required to conduct a system-wide review of the health care system for any systemic barriers, in consultation with the public including people with disabilities. It should identify and make public a plan to remove and prevent systemic or system-wide barriers that impede patients with disabilities from receiving accessible health care, along time lines that the Health Care Accessibility Standard will set.

#15-3. Each hospital and other major health care facility should be required to establish and regularly publicize a dedicated disability accessibility/accommodation complaints hotline, to trigger prompt action when problems are raised.

#15-4. The Ministry of Health should be required to establish and regularly publicize a hotline to receive complaints about accessibility problems facing patients and support people with disabilities in Ontario’s health care system. The Ministry should be required to annually publish a report with an anonymized summary of the substance of complaints received and action taken to prevent their recurrence.

Barrier: OHIP fee schedules for medical services that assume a patient has no disability and requires no additional time for the health appointment. For example, some patients with disabilities need more time to undress, get on the assessment table, and then get dressed again. Communication disabilities may lead to needing more time to discuss a patient’s condition with them, including such things as their medical history, diagnosis, and treatment options. Patients with complex disabilities can require more time for their condition to be medically assessed and treatment to be provided or discussed. The individual physician should not be required to personally finance all of this. The current OHIP funding model creates a harmful economic incentive for physicians to avoid taking on patients with significant or complex disabilities as their patient.

#15-5. The OHIP fee schedule should be revised provide for added time to serve the needs of patients with disabilities who need more time for assessment, diagnosis and treatment, to eliminate the harmful financial incentive that the Ontario Government now creates for physicians to avoid treating taking on those patients.

16. The Need to Harness the Experience and Expertise of People with Disabilities Working in the Health Care System to Expedite the Removal and Prevention of Barriers Facing Patients and Their Support People with Disabilities

Barrier: People with disabilities working or volunteering in the health care system too often face accessibility barriers in the workplace that also hurt people with disabilities who seek health care services.

The intent/rationale of the following recommendations is to ensure that the experience and expertise of people with disabilities working for pay or as volunteers in the health care system is effectively harnessed to help root out the accessibility barriers that impede patients with disabilities and any patients’ support people with disabilities. This is because workplace disability barriers and health care service disability barriers often are the same or substantially overlap.

#16-1. Each hospital and major health care facility should be required to establish a committee of those employees and volunteers with disabilities who wish to voluntarily join it, to give the facility’s senior management feedback on the barriers in the health care facility that could impede patients with disabilities or any patients’ support people with disabilities, and/or employees/volunteers with disabilities.




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What Must Be Done to Make Ontario’s Health Care System Fully Accessible to Patients with Disabilities? Check Out the AODA Alliance’s Finalized Framework for the Promised Health Care Accessibility Standard


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/

What Must Be Done to Make Ontario’s Health Care System Fully Accessible to Patients with Disabilities? Check Out the AODA Alliance’s Finalized Framework for the Promised Health Care Accessibility Standard

February 25, 2020

          SUMMARY

What must be done to make Ontario’s health care system accessible to patients with disabilities and to any patients’ support people with disabilities? What should be included in the Health Care Accessibility Standard that the Ontario Government is now developing under the Accessibility for Ontarians with Disabilities Act?

Here we unveil our most thorough and comprehensive brief on this topic. Below please find the AODA Alliance’s finalized Framework on what the Health Care Accessibility Standard should include.

We have submitted this new Framework to the Ford Government. We have also submitted it to the Health Care Standards Development Committee. The Government appointed that Committee under the AODA. That Standards Development Committee has the job of developing recommendations on what the Government should include in the promised Health Care Accessibility Standard to make Ontario’s health care system disability-accessible. This Framework sets out what we urge that Standards Development Committee to recommend to the Ford Government.

Last December we made public a draft of this Framework and invited your feedback. We thank all those who sent us feedback. We’ve done our best to use that feedback as we finalized this Framework. This final brief includes everything that was in our December draft. It has added recommendations, drawing on the excellent feedback we received from our supporters.

So what’s next? The Health Care Standards Development Committee is now writing a set of draft recommendations for the Government on what the Health Care Accessibility Standard should include. Later this year, that Committee is expected to make its draft recommendations public, and to invite public feedback on it. After that, the Health Care Standards Development Committee is required to consider that public feedback as it finalizes its recommendations to the Government.

The Health Care Standards Development Committee certainly knows about our efforts on this issue. Last December, we sent our earlier draft of this Framework to that Committee. On January 16, 2020, AODA Alliance Chair David Lepofsky made a 15 minute presentation to the Health Care Standards Development Committee on our recommendations. As noted above, we have now provided this finalized Framework to the Standards Development Committee.

We have asked the Health Care Standards Development Committee to adopt all of our recommendations. At the very least, we have asked that Committee to append this framework to its draft recommendations and to invite public feedback on it.

Once the Health Care Standards Development Committee makes its draft recommendations public for our feedback, we will circulate it to you. We will prepare a submission to the Standards Development Committee, using this Framework as our foundation.

Please share this Framework with people you know who work in the health care system. It would be great if Ontario’s health care system starts taking action on our recommendations now, because they are good ideas!

In addition to this Framework, you may wish to check out the captioned 1-hour talk on barriers in the health care system by AODA Alliance Chair David Lepofsky. For all our efforts in recent years, leading the campaign to get Ontario to enact a much-needed Health Care Accessibility Standard to make the health care system accessible to patients with disabilities, check out the AODA Alliance’s health care page on our website.

A grand total of 390 days have now gone by since the Ford Government received the final report on the AODA’s implementation and enforcement that was prepared by former Lieutenant Governor David Onley. We are still waiting for the Ford Government to come up with an effective plan to implement the Onley Report’s recommendations to strengthen the AODA’s implementation and enforcement.

          A Framework for the Health Care Accessibility Standard

February 25, 2020

Proposed by the Accessibility for Ontarians with Disabilities Act Alliance

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

Introduction — What is This Framework?

The Ontario Government has committed to develop a Health Care Accessibility Standard under the Accessibility for Ontarians with Disabilities Act (AODA). In 2017, the Ontario Government appointed a Health Care Standards Development Committee to make recommendations on what the Health Care Accessibility Standard should include. On March 7, 2019, the Doug Ford Government committed to resume this Committee’s work.

The AODA requires the Ontario Government to lead Ontario to become accessible to people with disabilities by 2025. The Government is required to do so by enacting and effectively enforcing accessibility standards, which are enforceable regulations. Under the AODA, an accessibility standard is required to specifically spell out the barriers that are to be removed or prevented, what specifically must be done to remove or prevent them, and the timelines required for these actions.

In this Framework, the AODA Alliance proposes key ingredients and aims that should be included in the Health Care Accessibility Standard. We hope this will assist the Health Care Standards Development Committee.

The Health Care Accessibility Standard should set detailed requirements for specific actions that health care providers and organizations shall take. It is not sufficient for this accessibility standard to vaguely require health care facilities or providers to simply make plans and policies on accessibility, or to vaguely require obligated organizations to consider or include accessibility features in their health care facilities or services. The details of what this accessibility standard will require are vital to its success.

Some needed actions will have to be taken by each health care facility and/or health care provider. Some will need to be taken by the self-governing bodies that regulate each of the health professions in Ontario. Some of the needed actions will have to be taken by the Ontario Government. The Government funds, centrally plans and oversees Ontario’s health care system.

It is especially pressing to now effectively address disability barriers in Ontario’s health care system. In 2020, Ontario’s health care system is still replete with serious accessibility barriers, even fully 15 years after the AODA was enacted. Too often, it has been designed and operated on the unspoken or unarticulated premise that it is largely if not totally meant for patients without disabilities. Yet disproportionately, those who use and need the health care system are people with disabilities.

We each make the greatest use of health care services towards the end of our lives. Disabilities are far more prevalent among seniors. Disability most often is caused by aging.

Twenty-three years ago, in Eldridge v. British Columbia [1997] 3 SCR 624, the Supreme Court of Canada established the broad principle that patients with disabilities have a constitutional right to accessible health care services in Canada. Yet since then, the Ontario Government has not undertaken a comprehensive effort or strategy to identify the recurring disability barriers in the health care system. It has not implemented a comprehensive plan to remove and prevent those barriers. In the meantime, old barriers remain while new ones keep being created.

Even the very barrier that the Supreme Court ordered provincial governments to fix almost a quarter century ago too often remains in place. In the Eldridge case, the Supreme Court ruled that the Charter of Rights makes provincial governments responsible to ensure the provision of Sign Language interpreter services for deaf patients in hospitals that need them to effectively communicate with health care providers. This is a constitutional right of those patients. Yet in its December 26, 2019 edition, the Hamilton Spectator reported on recent incidents where this vital service was not assured in a Hamilton, Ontario hospital.

Ontario needs a strong, comprehensive and enforceable Health Care Accessibility Standard enacted under the AODA so that patients with disabilities don’t have to fight an endless number of legal cases under the Canadian Charter of Rights and Freedoms and the Ontario Human Rights Code to tear down these many barriers, one at a time. Health care facilities and providers should not have to each separately re-invent the accessibility wheel, trying to figure out how to address the known and recurring disability barriers in Ontario’s health care system.

In her case, it took Ms. Eldridge up to seven years to win the right to a sign language interpreter in a hospital’s emergency room where she gave birth to twins. A pregnant woman about to give birth in a hospital emergency room cannot be expected to wait seven years for such a needed accessibility service.

Achieving accessibility in Ontario’s health care system should be doable for several compelling reasons. The system receives enormous public funding. Health funding is always a high priority for government after government. There is substantial centralized government planning of the health care system. This issue bears on the lives and health of everyone in Ontario. This is because everyone is bound to eventually get a disability as they age.

Moreover, Ontario’s health care system is undergoing ongoing and substantial reforms and innovation. Every year, new health care facilities are established or built. Change is always in the wind. That makes changes in favour of accessibility easier to implement.

We hope the Health Care Standards Development Committee finds this Framework helpful. We ask the Health Care Standards Development Committee to vote separately on each of these recommendations. In any event, we encourage the Standards Development Committee to attach this Framework to its forthcoming package draft recommendations that it will be required to circulate and post for public comment. That would enable the Health Care Standards Development Committee to get public input on this Framework to guide its development of its final recommendations.

This Framework reflects our years of efforts at gathering input from the grassroots of Ontario’s disability community and consulting experts here and abroad. Last December, we made public a draft of this Framework for public comment. We are indebted to those who read it so carefully and offered suggested improvements. We’ve done our best to incorporate the excellent feedback that we received.

It has taken our substantial multi-year grassroots effort to reach the point of having a Health Care Standards Development Committee appointed and now working on developing recommendations on what the promised Health Care Accessibility Standard should include. Since 2009, the AODA Alliance has led the campaign to get the Ontario Government to develop a Health Care Accessibility Standard. This is documented on our website’s Health Care page. It took the previous Ontario Government up to six years just to decide in 2015 to develop a Health Care Accessibility Standard. It took another two years to get the previous Government to take the first step of appointing this Health Care Standards Development Committee. We then had to fight for up to a year to get the current Government to lift the freeze on the work of the Health Care Standards Development Committee.

The AODA Alliance spearheaded all of these grassroots efforts. At the same time, we have had to campaign against the Ontario Government’s efforts to substantially narrow the range of disability accessibility barriers that the Health Care Standards Development Committee would be free to consider.

In this Framework, the term “health care facility” means any organization that provides any kind of health care service, from a major hospital to a local physician’s office. It includes an organization whose primary purpose is not provision of health care, but which includes a health care service within it. For example, a university may include a health clinic, which, for the purpose of this Framework, is treated as a health care facility. The term “major health care facility” refers to larger health care facilities and centres, not smaller operations like an office for a single physician, dentist or other health care professional.

In this Framework, “health care provider” means anyone who helps provide any kind of health care service, including any health care professional (whether or not their profession is regulated), any support staff or volunteers that assist them and any drug store staff that assist a patient with getting and using medications.

In this Framework, we address barriers in the health care system that can impede patients with disabilities, and/or any patients’ support people (whether family members, friends or others) where the support person or care giver has a disability. Whether or not a patient has a disability, some of their care givers or support people (such as family members) may have disabilities. The disability barriers in the health care system that impede patients with disabilities can also often impede a care giver or support person who has disabilities.

This framework sets out recommendations for actions that the Health Care Accessibility Standard should require. In this Framework, when we state that a health care provider or facility or other organization “should” do something, we mean that the Health Care Accessibility Standard should require this action. We do not propose these actions as guidelines or best practices. “Best practices” or guidelines are not mandatory or enforceable. This Framework proposes actions which need to be mandatory and enforceable.

We acknowledge with thanks the tremendous help provided to us by the ARCH Disability Law Centre and by an amazing team of volunteer law students at the Osgoode Hall Law School who made a huge difference in the preparation of this Framework.

The following are the headings in this Framework:

  1. What Should the Long-Term Objectives of the Health Care Accessibility Standard Be?
  1. A Vision of An Accessible Health Care System
  1. General Provisions that the Health Care Accessibility Standard Should Include
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Know About Available Health Care Services, about Available Disability-Related Supports and Accommodations, about Important Information Regarding Their Diagnosis and Treatment and about How to Access Them
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Physically Get to Health Care Services
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Get into and Around Facilities Where Health Care Services are Provided
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Furniture and Floor Plans in Health Care Facilities
  1. The Right of Patients with Disabilities to Identify their Disability-Related Accessibility Needs in Advance and to Request Accessibility/Accommodation from a Health Care Provider or Facility
  1. The Right of Patients with Disabilities to Accessible Diagnostic and Treatment Equipment
  1. The Right of Patients with Disabilities to the Privacy of Their Health Care Information
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Information and Communication in Connection with Health Care Services and Products
  1. The Right of Patients with Disabilities to the Support Services They Need to Access Health Care Services
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Health Care Providers Free from Knowledge and Attitude Barriers Regarding Disabilities
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Complaint Processes at Health Care Providers’ Self-Governing Colleges and to Have Those Colleges Ensure that the Profession They Regulate Are Trained to Meet the Needs of Patients with Disabilities
  1. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Systemic Action and Safeguards to Remove and Prevent Barriers in Ontario’s Health Care System
  1. The Need to Harness the Experience and Expertise of People with Disabilities Working in the Health Care System to Expedite the Removal and Prevention of Barriers Facing Patients with Disabilities and Any Patients’ Support People with Disabilities

1. What Should the Long-term Objectives of the Health Care Accessibility Standard Be?

#1-1. The objective of the Health Care Accessibility Standard should be to ensure that Ontario’s health care system and the services, facilities and products offered in it, become fully accessible to all patients with any kind of disabilities and to any support people with disabilities for any patient, by 2025, the AODA’s deadline, by requiring the removal and prevention of accessibility barriers that impede people with disabilities, and by providing a prompt, accessible, fair, effective and user-friendly process to learn about and seek disability-related accommodations tailored to a person’s individual disability-related needs. It should aim to ensure that patients with disabilities can fully benefit from and be fully included in the health care services and products offered in Ontario’s health care system on a footing of equality. It should aim to eliminate the need for patients with disabilities and any support people with disabilities to have to contend with and fight against health care accessibility barriers, one at a time, and the need for health care providers to have to re-invent the accessibility wheel one health care facility or one health care provider at a time. It should aim for health care services, facilities and products in Ontario to be designed and operated based on accessibility principles of universal design.

This is what the AODA requires this accessibility standard to achieve. This goal also lives up to the Charter of Rights’ and Ontario Human Rights Code’s accessibility requirements. Some incorrectly think that the AODA imposes new requirements for accessibility. In fact, it seeks to get obligated organizations to do what the Ontario Human Rights Code and the Charter of Rights have required them to do for well over three decades.

It would be grossly inadequate for the Health Care Accessibility Standard to set a weaker and less specific goal, e.g. merely to “improve accessibility” in the health care system. It would fulfil that weaker goal to simply remove only one barrier somewhere in Ontario’s huge health care system. It would leave our health care system with far too many accessibility barriers.

2. A Vision of An Accessible Health Care System

To begin, the Health Care Accessibility Standard should set out a vision of what an accessible health care system should include. An accessible health care system should include the following:

#2-1. The health care system will be designed and operated from top to bottom for all its patients, including patients with all kinds of disabilities, as disability is defined in the Ontario Human Rights Code and/or the Canadian Charter of Rights and Freedoms. The health care system will no longer be designed and operated from an implicit starting point of aiming predominantly to serve the fictional “average” patient, who is too often imagined as having no disabilities.

#2-2. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to easily find out what health care services are available and how and where to get them.

#2-3. Places where health care services are offered will be reachable by accessible public transit routes and will have sufficient accessible parking immediately adjacent to them.

#2-4. The built environment in the health care system, such as hospitals and any other places where health care services are provided, including the furniture there, will all be fully accessible to people with disabilities, and will be designed based on the principle of universal design.

#2-5. Patients with disabilities will be able to seek, receive and fully benefit from the health care services and products that are available in the health care system and which they require.

#2-6. Health care providers will consistently and reliably know how to meet the needs of patients with disabilities and where needed, any patients’ support people with disabilities, to ensure that patients with disabilities fully benefit from their health care services.

#2-7. Patients with disabilities, and where needed, any patients’ support people with disabilities, will be able to effectively communicate with health care providers and health care staff in connection with requesting or receiving health care services and products throughout each stage of the healthcare process. This will include face-to-face interactions, telephone or alternates to telephone use, accessible information and forms as well as alternate arrangements for providing one’s signature. For example, health care facilities and ambulances will be equipped with needed equipment to ensure effective communication with people with communication-related disabilities.

#2-8. Patients with disabilities, and where needed, any patients’ support persons with disabilities, will have prompt, effective and easy access to user-friendly information in accessible formats and in multiple languages on the health care options, programs, services, supports and accommodations available for their disability, and on the process for seeking these. As well, printed, online and other written information about available health care services, diagnoses, prognosis, treatments, exercises, medications, and other information provided to or available to patients with disabilities and, where needed, any patients’ support people with disabilities in connection with health care services and products, will be readily and easily available in an accessible format. This includes, for example, a patient’s health care records and labels/instructions for prescription drugs.

#2-9. Patients with disabilities, and where needed, any patients’ support people with disabilities will be able to get and receive information relevant to their health care needs in private, e.g. when giving information at a health care provider’s office or when seeking or receiving information about their medication at a pharmacy, rather than in a public place where others can overhear. Effective procedures will protect the confidentiality of private information relating to patients with disabilities who rely on others to assist them with communication.

#2-10. Information technology and applications which patients can use at home, or at a health care facility in connection with seeking and receiving health care services, will be designed based on principals of universal design and will be accessible to and usable by patients with disabilities, and where needed, to any patients’ support people with disabilities. Where needed for effective communication, health care facilities will also provide alternatives to telephone use including email, text, video and authorized human assistance.

#2-11. Health care products, and any instructions for their use, will be designed and available based on principles of universal design so that people with disabilities and not just people with no disability can use and benefit from them.

#2-12. Diagnostic and treatment equipment and furniture will be designed based on principles of universal design and will be fully accessible to patients with disabilities.

#2-13. Support services such as sighted guides for visually impaired patients and attendant care will be available to patients with disabilities who need them while going to or at a facility to receive health care services.

#2-14. Publicly funded appointments for receiving health care services will be sufficiently long to enable a patient with a disability, who needs more time, to be able to receive the health care services they need. If a patient with disabilities cannot attend a health care provider’s premises due to their disability, there will be in place measure whenever possible for remote appointments or home visits.

#2-15. Where patients with disabilities or any patients’ support people with disabilities need a disability-related accommodation in connection with health care services, there will be a prompt, user-friendly process for requesting and obtaining the needed accommodations.

#2-16. Patients will be free to use their own accommodation supports, such as service animals, when seeking or obtaining health care services and products.

#2-17. Where patients with disabilities or where needed, any patients’ support people with disabilities, believe that a health care provider is not effectively meeting the patient’s disability-related needs, they will have access to a prompt, fair, open and arms-length review process, including an offer of a voluntary Alternative Resolution Process if needed, conducted by someone who was not involved in the original decision or activity and who does not oversee the work of those involved in the patient’s health care services.

#2-18. There will be no bureaucratic, procedural or policy barriers that impede the effective accommodation of individual patients with disabilities or, where needed, any patients’ support people with disabilities, at any levels of Ontario’s health care system.

#2-19. New Government strategies, services and facilities in Ontario’s health care system will be proactively designed from the start and operated to fully include the needs of patients with disabilities. Those responsible at the provincial and local levels for leading, overseeing and operating Ontario’s health care system will have strong and specific requirements to address disability accessibility and inclusion in their mandates and will be accountable for their work on this issue. Ontario’s disability community will have ongoing and effective input into public decisions on the design and operation of Ontario’s health care system to ensure that existing disability accessibility barriers are removed and no new ones are created.

#2-20. An accessible health care system is one where people with disabilities can work in a barrier-free workplace. The barriers which impede people with disabilities as patients and their family members and caregivers often also impede health care providers and workers with disabilities.

3. General Provisions that the Health Care Accessibility Standard Should Include

The intent or rationale of the following recommendations is for the Health Care Accessibility Standard to include general requirements across the health care system that will ensure that its specific accessibility requirements are effective.

#3-1. The Health Care Accessibility Standard should address the accessibility needs of patients with any kind of disability, and the accessibility needs of any patients’ support people with any kind of disability. The term “disability” should be defined broadly to include any disability within the meaning of the AODA or the Ontario Human Rights Code.

#3-2. The Health Care Accessibility Standard should cover and apply to all public and private health care programs, services and products available in Ontario, whether or not they are offered in a hospital and whether or not OHIP covers them. It should cover all health care providers and professions, whether or not Ontario recognizes, regulates or licenses them. It should cover every location or facility where health care services can be delivered in Ontario, including e.g. hospitals, long term care facilities, offices and clinics for physicians, dentists, physiotherapists, psychologists, occupational therapists, speech language pathologists, and all other health care professions and providers. It should cover ambulances and other vehicles which can transport patients in connection with health care services. It should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic or other communities within Ontario.

#3-3. The Health Care Accessibility Standard should not be limited to hospitals and the hospital sector. Most people get most health care services outside of hospitals. If the Health Care Accessibility Standard were limited to barriers in hospitals, it would leave out most of the health care system and most of the barriers in the health care system. It would force people with disabilities to go to overcrowded hospitals to get their health care services, since hospitals would be the only place where accessible services would be assured to them.

The fact that the Government’s terms of reference for the Health Care Standards Development Committee focus on the hospital sector does not prevent this Standards Development Committee from making recommendations that go beyond the hospital sector. A number of earlier AODA Standards Development Committees have made recommendations beyond their terms of reference. We ask the Health Care Standards Development Committee to do the same.

Most if not all of the barriers identified in this Framework occur both in hospitals and in other places where health care services and products are provided. At the very least, the Health Care Standards Development Committee should make recommendations about all of these barriers proposed in this Framework as they relate to hospitals, and then should recommend that the Health Care Accessibility Standard require the same action on the same barriers where they occur anywhere else in the health care system where health care services or products are provided to patients.

#3-4. The Health Care Accessibility Standard should cover ambulances and other vehicles that transport patients in connection with the receipt of health care services.

#3-5. The Health Care Accessibility Standard should cover all parts of Ontario. It should address accessibility barriers that are distinctive to the north, to remote communities, as well as the distinctive barriers facing different racialized, ethnic, indigenized or other communities within Ontario.

#3-6. The Health Care Accessibility Standard should require the removal of existing barriers, and not only the prevention of new barriers.

#3-7. If the Health Care Standards Development Committee identifies a recurring accessibility barrier in Ontario’s health care system, it should make recommendations on how to remove or prevent that barrier, even if there is a less effective or comprehensive existing health care regulation or statute that may already apply to it in whole or in part.

The Health Care Accessibility Standard will take precedence and prevail over any other laws, if those other laws either create or permit health care accessibility barriers, or if they do not effectively remedy those barriers, or if they provide less accessibility than the Health Care Accessibility Standard. If an existing law, such as a statute or regulation governing the health care system, creates an accessibility barrier or impedes the removal or prevention of a health care barrier, the Health Care Standards Development Committee should recommend measures to be included in the Health Care Accessibility Standard that would remove or prevent those barriers. It should recommend the modification or repeal of any law that itself creates or permits health care barriers. Any provincial legislation or regulations that create accessibility barriers against patients with disabilities are contrary to the guarantees of equality to people with disabilities in the Ontario Human Rights Code and the Charter of Rights.

#3-8. The Health Care Accessibility Standard should require each health care facility and health care provider to create a welcoming environment for patients with disabilities and any patients’ support people with disabilities to seek accommodations for their disabilities when receiving health care services.

#3-9. Each major health care facility such as each hospital should be required to establish a permanent committee of its board to be called the “Accessibility Committee.” This Accessibility Committee should have responsibility for overseeing the facility’s compliance with the AODA, and with the requirements of the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms in so far as they guarantee the right of people with disabilities to fully participate in and fully benefit from the health care services that the facility provides. It should endeavour to reflect the spectrum of disability needs.

#3-10. Each major health care facility such as each hospital should be required to establish or designate the position of Chief Accessibility/Accommodation Officer, reporting to the Chief Executive Officer. Their mandate, responsibility and authority should be to ensure proper leadership on the facility’s accessibility and accommodation obligations under the Ontario Human Rights Code, the Canadian Charter of Rights and Freedoms and the AODA, including the requirements of this accessibility standard. This responsibility may be assigned to an existing senior management official.

#3-11. Beyond the specific measures to remove and prevent barriers set out in the Health Care Accessibility Standard and in other accessibility standards enacted under the AODA, each health care facility and health care provider should be required to periodically and systematically review its health care services, facilities, equipment and products to identify recurring accessibility barriers that can impede the provision of health care services to patients with disabilities. A comprehensive plan for removing and preventing these accessibility barriers should be developed, implemented and made public with clear timelines, with clear assignment of responsibilities for action, monitoring for progress, and reporting to the facility’s accessibility committee. This plan should aim at all accessibility barriers that can impede patients with disabilities from fully benefiting from the facility’s health care services, whether or not they are specifically identified in the Health Care Accessibility Standard or in any other AODA accessibility standards.

4. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Know About the Health Care Services Available to Them, About Available Disability-Related Supports and Accommodations, About Important Information Regarding Their Diagnosis and Treatment and About How to Access Them

Barriers: Patients with disabilities and support people with disabilities too often find it difficult to get accessible information to find out from their health care facility from their health care provider, from the health care system at large and/or from the Ontario Government about the health care services that are available, or about where and how to get them.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support people with disabilities can find out what health care services are available to them and where to obtain them.

#4-1. Each health care provider or facility should be required to make readily available, in an accessible format, information about the health care services or products they offer and about where and how to arrange to get them. If the health care provider or facility has a website, this information should be accessibly posted prominently on that facility or provider’s website in plain language. Where communication supports or assistance is needed to access this information, those supports should be made available (See below regarding communication supports).

#4-2. The Ontario Government or any provincial organization mandated to oversee or deliver health care services should be required to make readily available to the public in accessible formats, including on the internet, detailed information on the menu of health care services available in Ontario, and on how and where to arrange to get those services.

5. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Physically Get to Health Care Services

Barriers: Obstacles that impede people with disabilities from physically getting to places where they need to go to receive health care services and products, include, such things as:

  1. a) The many public transit barriers that the Transportation Accessibility Standard has not removed or prevented. This results in such things as health care facilities and providers that are not on an accessible public transit route, and restrictions on para-transit services being able to cross over municipal boundaries to get to them. The Transportation Standards Development Committee’s spring 2018 final report to the Ontario Government left out many important revisions needed to the 2011 Transportation Accessibility Standard (part of the 2011 Integrated Accessibility Standards Regulation), that were identified in the July 31, 2017 joint brief by the AODA Alliance and the ARCH Disability Law Centre.
  1. b) Health care funding conditions that require that a patient must attend a physician’s office to receive health care services can impede access to health care services for whose disability prevents them from travelling to that office.
  1. c) “One issue per visit” policies in physicians’ offices can prevent those with multiple disabilities, or disabilities plus illness/ailment from receiving adequate treatment. This discourages them from seeking treatment.
  1. d) The new ‘mega hospitals’ that replace smaller, older hospitals create transportation barriers for those who live in rural areas. They also create access barriers for people with lung disease or fatiguing conditions who must walk long distances from the parking lot to the entrance and through the building to get to elevators.
  1. e) Limited accessible parking lots and spaces near hospitals i.e. which cannot accommodate modified vans with raised roof or side lift for wheelchair.
  1. f) When a para-transit service fails to show up on time, a patient can arrive late to a doctor’s office, and have the doctor’s office impose a financial penalty for supposedly missing the appointment.
  1. g) Reductions or elimination of funding for house visits by a health care provider preclude the possibility of home visits for patients who are physically incapable of going to the health care provider’s office or facility to get treatment. For 2019 provincial cuts to OHIP coverage for a physician’s house visit to a patient, see http://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/11000/bul11214.aspx

The intent/rationale of the following recommendations is to ensure that patients with disabilities and any patients’ support persons with disabilities can get to the places where health care services and products are provided.

We ask the Health Care Standards Development Committee to make the following recommendations. These could be incorporated either or both into the promised Health Care Accessibility Standard or into the Transportation Accessibility Standard, to address those transportation barriers in the health care context. In 2011, the Ontario Government enacted the Transportation Accessibility Standard, as part of the 2011 Integrated Accessibility Standards Regulation.

In 2016, the Ontario Government appointed the Transportation Standards Development Committee to review the 2011 Transportation Accessibility Standard and to make recommendations where needed, to strengthen it. In 2018, the Transportation Standards Development Committee made very weak recommendations for revisions to the 2011 Transportation Accessibility Standard. The Transportation Standards Development Committee did not recommend many if not most of the improvements that the AODA Alliance and the ARCH Disability Law Centre called for, in their joint July 31, 2017 brief to the Transportation Standards Development Committee. In over two years since then, the Ontario Government has announced no plans to implement any improvements to strengthen the 2011 Transportation Accessibility Standard.

The Transportation Standards Development Committee’s 2018 recommendations to revise the 2011 Transportation Accessibility Standard, if adopted, would not fix any of the deficiencies in the 2011 Transportation Accessibility Standard. Since receiving the final recommendation of the Transportation Standards Development Committee over one and a half years ago, the Ontario Government has not announced any revisions to the 2011 AODA Transportation Accessibility Standard. It is therefore still open to the Ontario Government to make improvements under the AODA to the 2011 Transportation Accessibility Standard beyond the weak ones that the Transportation Standards Development Committee recommended in 2018.

#5-1. Wherever possible, any new health care facility or provider receiving public funds that is setting up a new location should be required to locate at or near an accessible public transit stop on an accessible public transit route, with an accessible path of travel from the public transit stop to the health care facility or provider. Similarly, where an existing health care facility or provider is going to move to another location, it should be required to attempt to relocate to a location that is on an accessible public transit route.

#5-2. Where it is medically possible for a patient to take part in a health care service without physically attending at the health care facility or provider, an option should be provided for taking part remotely, e.g. via Facetime or other remote video conferencing. The Health Care Accessibility Standard should also require the removal of the OHIP barrier to funded physicians house calls.

#5-3. Where OHIP or a health care facility or provider has a policy or practice of permitting only one health issue per visit, an exception should be created for patients with disabilities for whom transportation to the health care facility is impeded by accessibility barriers.

#5-4. A health care facility or provider should not be permitted to charge a late fee or a missed appointment fee where a patient with a disability has in good faith attempted to attend on time but was made late or precluded from attending by transportation barriers (such as being made late for the appointment by the community’s para-transit service).

#5-5. When the Ontario Government is undertaking planning for new health care services, or for improvements to health care services, it should be required to include in those plans, and to make public, requirements to ensure that wherever possible, health care services and facilities are provided in locations on accessible public transit routes, with an accessible path of travel from the accessible public transit stop to the facility or provider.

#5-6. The 2011 Transportation Accessibility Standard should be amended to set accessibility requirements for public transit stations and stops, as the joint July 31, 2017 AODA Alliance/ARCH brief to the Transportation Standards Development Committee recommended.

#5-7. The Health Care Accessibility Standard should set technical specifications to ensure the full accessibility of ambulances and other vehicles that transport patients, including patients with disabilities, to or from health care services. See also below re: the need to include in those vehicles equipment for communication with patients with communication-related disabilities.

6. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Get into and Around Facilities Where Health Care Services are Provided

Barriers: Barriers in the built environment where health care services are provided that impede people with disabilities from getting into places where health care services and products are offered, or from safely and independently getting around these places, such as:

  1. a) Older hospitals and other facilities where health care services are provided that lack obvious and basic accessibility features like ramps, accessibility features in washrooms like transfer spaces at toilets, grab bars, accessible signage to departments or elevators, etc.
  1. b) New hospitals, such as Toronto’s Women’s College Hospital, that have obvious accessibility problems despite being opened eleven years after the AODA was passed.
  1. c) Parking facilities with automated parking payment kiosks that are inaccessible to wheelchair users.
  1. d) Health care facilities with inaccessible doors to the check-in/waiting areas.
  1. e) Health care facilities including reception areas that use print signs to communicate important information or directions to patients and which offer no accessible means for people with vision loss or dyslexia to obtain this information, e.g. dim signage lighting making it hard to read the sign for people with low vision, signage that does not use plain language for those with intellectual or cognitive disabilities.
  1. f) Facilities where health care services are provided that are obstacle courses, e.g. with chairs, tables, signs or other obstacles blocking parts of hallways or other paths of travel.
  1. g) Diagnostic, isolation, consultation, waiting and/or treatment rooms that are too small to accommodate wheelchairs or other mobility devices or support people or service animals.
  1. h) Reception desks behind windows with “speakers”, making it hard to communicate for those with hearing loss, and which are placed too high for those in wheelchairs or those having smaller stature. These also can cause privacy issues.
  1. i) Reception desks, where access to them is blocked, or where knee space is blocked, preventing face to face access.
  1. j) Doorways within a health care facility that are too tight to allow a wheelchair or other mobility device to pass through.
  1. k) Elevators lacking audio floor announcements and elevator buttons that lack braille and colour-contrasted large print for use by persons with vision loss.
  1. l) The absence of way-finding guidance such as tactile floor strips or signage to direct people with vision loss or cognitive or intellectual disabilities through a health care facility, e.g. through large open areas like hospital lobbies.
  1. m) Health care facilities that have fragrances or other substances affecting those with environmental sensitivities.
  1. n) Equipment e.g. commode, alternating mattresses, nurse call switches, etc., that are not accessible for use by a person with a motor disability.
  1. o) Children’s play areas in a health care facility that lack furniture that accommodates children using a mobility device like a wheelchair.

The Ontario Building Code and current AODA accessibility standards are substantially inadequate to meet the need for fully accessible facilities where health care services are provided. A new building in which health care services are provided, that is fully compliant with the Ontario Building Code and current AODA accessibility standards, can still have serious accessibility barriers. See generally https://www.aodaalliance.org/category/built-environment/

As such, the promised Health Care Standards Development Committee needs to set built environment accessibility standard requirements to address existing barriers, and to prevent the creation of new barriers, in places where health care services and products are provided to patients. As far as we can tell, the Ontario Government has in place no mandatory accessibility standard, required for the design of a new health care facility such as a hospital or long-term care facility, beyond the inadequate Ontario Building Code, to ensure that it is fully accessible. Similarly, the Government has no such accessibility standard, beyond the inadequate Ontario Building Code, for retrofitting an existing health care facility which is undergoing a major renovation. As well, the Government has in place no detailed accessibility standard whatsoever for a health facility to be retrofitted for accessibility, if that facility has no major renovation underway.

The Ontario Government has announced no plan to develop a comprehensive Built Environment Accessibility Standard under the AODA. Yet the Ontario Human Rights Code, and in some cases, the Charter of Rights, require these facilities to become disability-accessible.

As a result, each time a new hospital or other health care facility is built, or a renovation to one is undertaken, the organization needs to individually hire consultants to reinvent the accessibility wheel. Their advice need not be followed, or even disclosed to the public. This wastes public money. It leads to patchworks of varying levels of accessibility from organization to organization.

The 2019 final report of David Onley’s Independent Review of the AODA concluded that Ontario’s laws on the accessibility of the built environment are inadequate and that design professionals such as architects are not trained to ensure that they design buildings that everyone can access. However, the Ontario Government has announced no plans to upgrade the Ontario Building Code ‘s accessibility provisions, or to enact an AODA Built Environment Accessibility Standard, despite our repeated requests.

The Health Care Standards Development Committee should get direct input for technical requirements on these issues from qualified accessibility consultants, preferably ones who have experience giving advice regarding the accessibility of health care facilities.

The intent/rationale of the following recommendations is to ensure that patients and their support people with disabilities can get into and around facilities or other built environment where health care services and products are provided. The following lists examples of needed requirements but is not exhaustive.

#6-1. The Health Care Accessibility Standard should set specific and detailed accessibility requirements to ensure the accessibility of the built environment where health care services and products are provided, beyond the weak Ontario Building Code and the existing AODA accessibility standards. These should include accessibility requirements in new construction and major renovations. These should also include readily achievable retrofit requirements for existing facilities that are not undergoing a major renovation. Here is a sample of requirements for which detailed standards should be set:

#6-2. The front area or drop-off areas for a hospital or other health care facility should be accessible, with automatic power doors that do not require a button to be found and pressed, and with tactile walking surface indicators both to warn when a person is walking into a driving area and to guide a person to the facility’s entrance. All other entrances and exits should be fully accessible, with automatic power door operators and an accessible path of travel to the door. This includes entrances from indoor or underground parking to the health care facility.

#6-3. Inside the health care facility, major public areas such as emergency room doors should always be fully accessible and have automatic power door openers.

#6-4. For the benefit of patients and others with learning and cognitive disabilities, vision loss or other disabilities that can affect mobility or way-finding, hospitals and other health care facilities should have way-finding markings in important areas such as the main lobby from the front door to the help desk and other major routes such as to main elevators, including colour contrasted markings such as a carpeted path or tactile walking surface indicators.

#6-5. Hospitals and other health care facilities with elevators should have accessible elevators that can accommodate people using mobility devices. They should also have accessible elevator buttons (with braille and large print on or beside each button), braille and large print floor numbers just outside elevator doors, and audible floor announcements on elevators. Elevator button panels should be consistent in layout from one elevator to the next.

#6-6. Health care facilities, including hospitals, should never install “destination elevators” which require a person to pre-select the floor to which they are going before entering the elevators. These present unfixable accessibility problems.

#6-7. Hospitals and other health care facilities should have accessible signage throughout, including braille and large print, for key locations. For example, public bathrooms should have accessible braille and large print signs on them. These signs should be placed in consistent and predictable locations.

#6-8. Where a health care facility has power doors that require a button to be pushed (i.e. they don’t open automatically), the button should always be located throughout the health care facility in a consistent place to make it easier to find. The button should be located near the door, so that a slow-moving individual can make it through the open door after pressing the button before the door closes. The button should always be located on the wall, and not on a free-standing post or bollard.

#6-9. Despite weaker requirements in other AODA accessibility standards, the Health Care Accessibility Standard should set out specific and strong requirements for the accessibility of any electronic kiosks in hospitals and other health care facilities, such as:

  1. a) specifying their required end-user functionality that effectively address recurring known needs arising from specific disabilities, and,
  1. b) ensuring that they are at an accessible height e.g. for those using a wheelchair or other mobility device.

As a starting point, see the US Access Board’s standard for accessible electronic kiosks.

#6-10. Patient consultation or treatment rooms should have enough space to enable people using mobility devices to navigate in them and reach any treatment or consultation area. They should have enough space to enable a Sign Language interpreter to be positioned in the room to interpret for a deaf patient or support person.

#6-11. Movable furniture such as desks, tables or chairs should not obstruct accessible paths of travel around a facility where health care services are delivered, such as a doctor’s office, e.g. in their hallways or treatment rooms.

#6-12. Major health care facilities should provide accessible waiting areas for accessible transit pickup and drop-off, close to the pickup/drop-off point, with clear sight lines.

#6-13. Major health care facilities such as hospitals should be designed to avoid major sensory overstimulation or acoustic overloads, such as bright lights, loud music, large atrium areas, or frequent loud announcements. This is especially important in treatment areas or hospital rooms.

#6-14. Throughout a health care facility, proper colour contrasting should be required to assist people with low vision and cognitive disabilities, such as around elevator opening, doorways, and on the edge of stairs and handrails.

#6-15. Health care facilities should be required to have accessible bathrooms so that all patients can use the facilities, including adult change tables, sufficient transfer space and maneuvering room for mobility devices.

#6-16. Major health care facilities should include sensory rooms for people with sensory overload issues, such as in hospital emergency rooms.

#6-17. In a health care facility, all stairs and staircases, including “feature staircases” (included as aesthetic design enhancements) should be accessible, e.g. with tactile warnings at the top and bottom of each set of stairs, no open risers and with proper colour contrast on railings and step edges. There should never be curving staircases.

#6-18. Health care facilities should provide charging areas for electric mobility devices.

#6-19. Hospital rooms should be able to accommodate a patient’s mobility device so they can keep theirs with them and readily available when admitted to hospital.

#6-20. In a health care facility, waiting areas, isolation areas, breastfeeding rooms, staff areas and volunteer areas should be designed to be accessible.

#6-21. Accessible and bariatric paths of travel should be provided in health care facilities.

#6-22. Despite the more limited provisions regarding the provision of accessible parking spaces in other AODA accessibility standards, the Health Care Accessibility Standard should set higher and more specific requirements for accessible parking spaces for health care facilities, such as:

  1. a) requiring a greater number of accessible parking spots for the facility, where possible.
  1. b) requiring that the accessible parking spots be located as close as possible to the doors of the health care facility.
  1. c) requiring that at least some of the accessible parking spots have larger dimensions to accommodate larger accessible vans, so that a passenger with a disability can park in that spot and have sufficient room to exit the vehicle, and
  1. d) requiring that there be accessible curb cuts and an accessible path of travel from the accessible parking spots to the health care facilities’ entrances.

#6-23. Health Care facilities should have designated snow-piling areas outside, to prevent snow from being shoveled onto accessible paths of travel.

#6-24. Major health care facilities such as hospitals should provide service animal relief areas close to the facility’s door, covered wherever possible, with an accessible path of travel to them.

#6-25. When a major new health care facility like a hospital is being designed, or a major new wing or renovation is being planned, especially if public money is helping fund it, a properly trained and qualified accessibility consultant should be required to be engaged on the project from the very beginning. Their accessible design advice should be transmitted unedited to the Government or other organization for whom the project is being built and should be made public. Direct consultation with end-users with disabilities should be part of the design process from the beginning.

7. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Accessible Furniture and Floor Plans in Health Care Facilities

Barrier: Furniture, related equipment and floor plan layouts in health care facilities too often were chosen or designed without taking into account the accessibility needs of patients with disabilities and any patients’ support people with disabilities.

The intent/rationale of the following recommendations is to ensure that health care facilities create barrier-free spaces for patients and support people with disabilities. The following list of examples of needed requirements is not exhaustive.

#7-1. Each hospital patient’s bed should have an accessible means for a patient with disabilities to notify the nursing station of a health care need, not just a button or pull-string that they may not be able to reach and operate.

#7-2. Furniture such as seating in health care facilities should be designed with accessibility features and positioned in a manner that does not block accessible paths of travel.

#7-3. A Help Desk should be positioned immediately inside the main entrance of any major health care facility, including hospitals, to assist patients, including patients with disabilities, to get directions or help to their destination within the facility, or to request other accommodation supports.

#7-4. In any discrete department or area where health care services are provided, (such as an area for day surgery), the check-in desk should be located immediately adjacent to the entrance to that area, so that patients and support people with disabilities can easily reach it after entering the room or area.

#7-5. Accessible public service counters should be installed, even in existing health care facilities, with a specified height requirement, no glass barrier creating barriers for people with hearing loss and knee space for people using a mobility device.

#7-6. A large health care facility like a hospital should have rest areas along routes through the building so that people with fatiguing conditions can stop and rest along their route to get health care services.

#7-7. Health care facilities such as hospitals should have emergency areas of refuge with separate ventilation in case of fire, so that people with disabilities who cannot escape the building have safe areas to wait, while being protected from life-threatening smoke.

#7-8. The Ontario Government should make available to health care facilities and providers:

  1. a) guides on accessible procurement including procurement of accessible furniture
  1. b) lists of venders of accessible furniture

#7-9. The Ontario Government should provide a hub for procuring accessible furniture to help health care facilities and providers reduce the cost of their acquisition.

8. The Right of Patients with Disabilities to Identify their Disability-Related Accessibility Needs in Advance and to Request Accessibility/Accommodation from a Health Care Provider or Facility

Barrier: Health care providers, and especially large facilities, too often do not provide an easy-to-access way for a patient with disabilities or for any patients’ support people to notify the health care provider of their need for a disability accommodation or accessibility, so that these can be provided in a timely fashion.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people can easily alert a health care facility or provider, in advance, of any disability-related accessibility or accommodation needs, and can arrange to have these met in connection with their receiving health care services and products.

#8-1. Each health care provider and facility should be required to put in place a system and designate a person to solicit and receive requests from patients or their support people for disability accommodations in connection with health care services or products.

#8-2. Each health care provider or facility should be required to make readily-available to the public, including to their patients, in an accessible format, information about how to identify themselves in advance to the health care provider as having disability-related accessibility or accommodation needs, and to ask to arrange for these needs to be met.

#8-3. Each hospital and larger health care facility should be required to collect anonymized information on disability-related accessibility and accommodation requests received from or on behalf of patients with disabilities, to assist that health care provider or facility in planning for future disability accessibility and accommodation. This anonymized information should be available for study by the Government or other health policy planners.

#8-4. The Chief Executive Officer of any hospital or large health care facility should annually review the information that the facility has collected on the requests for disability accessibility and accommodation that the facility has received and report to the board of directors on measures that could improve the facility’s capacity to meet these needs.

9. The Right of Patients with Disabilities to Accessible Diagnostic and
Treatment Equipment

Barrier: Too often, diagnostic and treatment equipment used by health care facilities or health care providers are not designed based on principles of universal design. Too often they are instead designed without sufficient regard to the needs of patients with disabilities.

The intent/rationale of the following recommendations is to systematically replace inaccessible diagnostic and treatment equipment over time with accessible equipment, while maximizing patient access to accessible equipment in the meantime.

#9-1. The Health Care Accessibility Standard should set specific technical requirements for the accessibility of diagnostic and treatment equipment. As a starting point, the Health Care Standards Development Committee should consider the accessible medical diagnostic equipment standards that the US Access Board has formulated. The needs of patients with all kinds of disabilities, and not only those with mobility disabilities, should be met by the technical requirements that the Health Care Accessibility Standard sets.

#9-2. The Ontario Government should impose a strict funding condition on the purchase or rental of any new health care diagnostic or treatment equipment anywhere in the health care system requiring that it must be accessible to patients with disabilities and designed based on principles of universal design, in compliance with the technical standards to be included in the Health Care Accessibility Standard.

#9-3. The Ontario Government should be required to make readily available to health care providers and facilities, and to the public, an up-to-date list of accessible health care diagnostic and treatment equipment and venders, so that each health care provider and facility does not have to re-invent the wheel by re-investigating these same issues.

#9-4. To save money, the Ontario Government should be required to attempt to negotiate bulk purchasing of accessible diagnostic and treatment equipment so that health care facilities and providers can obtain them at lower prices.

#9-5. When health care facilities and providers purchase, rent or otherwise acquire new or replacement diagnostic or treatment equipment, these should be required to be accessible to patients with disabilities and to be designed based on principles of universal design.

#9-6. Health care facilities and providers should survey their existing diagnostic or treatment equipment, and take the following steps to address any accessibility problems they have, if that equipment is not now being replaced:

  1. a) Identify where the nearest place is where a patient can get diagnosis or treatment services where there is accessible diagnostic and treatment equipment, and to help facilitate the access of the patient with disabilities to health care services from that provider or facility.
  1. b) Adopt and implement an interim plan to make any readily achievable accessibility improvements to the health care facility’s or provider’s existing diagnostic or treatment equipment.
  1. c) Develop plans to purchase, rent or otherwise acquire accessible diagnostic or treatment equipment over a period of up to five years.

#9-7. These accessibility/universal design requirements should also apply to consumer health care products, such as for example, pill bottles.

10. The Right of Patients with Disabilities to the Privacy of Their Health Care Information

Barrier: Too often, patients with disabilities are not assured a chance to give and receive information regarding their health care needs in private, when dealing with health care providers or facilities. This can include e.g. having a health professional’s assistant assist a patient with disabilities to fill out a printed medical history form in the office’s open reception area rather than in private. Another common example is a pharmacy giving private information about medications to a patient over the counter in a pharmacy, where others can easily overhear this.

The intent/rationale of the following recommendations is to ensure that the privacy of patients with disabilities is fully respected in connection with health care services.

#10-1. Any health care facility or provider, including such places as doctors’ offices and pharmacies, should be required to designate an accessible private area where patients with disabilities can give and receive private information in connection with their health care services or products without others being able to overhear this.

#10-2. Health care facilities and providers should be required to notify all patients, including patients with disabilities, of their right to have their health care needs and issues discussed and information exchanged in a private location, and should instruct their staff, including any who deal with patients or the public, of their duty to fully respect this right.

11. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Information and Communication in Connection with Health Care

Barrier: Too often, critical health care information in the health care system is provided in inaccessible formats, or via inaccessible websites or other technology, or without the communication supports that people with communication-related disabilities need.

The 2011 Information and Communication Accessibility Standard, enacted as part of the 2011 Integrated Accessibility Standards Regulation, has not ensured that these barriers to health care-related information are removed and prevented. The July 24, 2019 draft recommendations of the Information and Communication Standards Development Committee, while helpful, would not fully address all the concerns identified here. See further the AODA Alliance’s November 26, 2019 brief to the Information and Communication Standards Development Committee.

The intent/rationale of the following recommendations is to ensure that patients with disabilities and their support people with disabilities can effectively communicate with health care providers in connection with receiving health care services and products and will get accessible information needed for that purpose.

Beyond the following recommendations, we strongly encourage the Health Care Standards Development Committee to get input on detailed requirements to include regarding accessible information and communication in connection with health care from Communication Disabilities Access Canada. CDAC is a widely respected and leading national expert in this area.

#11-1. Without limiting the information and communications to which this part of the Health Care Accessibility Standard should apply, it should address:

  1. a) Information or communications needed to provide a health care provider with the patient’s history, needs, symptoms or other health problems.
  1. b) Information and communications regarding the patient’s diagnosis, prognosis or treatment, including any risks, follow-up or other health care services to secure.
  1. c) A health care facility’s discharge instructions.

#11-2. Health Care facilities should be equipped with assistive listening devices to enable patients with hearing loss and support people with hearing loss to be able to effectively communicate e.g. at nursing stations, help desks, and when dealing directly with health care providers.

#11-3. Health care-related products such as prescription and non-prescription medications should be provided when needed with accessible labels, instructions or users’ manuals, available in accessible formats. Those who sell or rent these to the public should be required to regularly notify the public, including their customers, that accessible labels, instructions, and users’ manuals are available on request. See e.g. work on developing standards and practices for accessible prescription drug container labels by the US Access Board. See also the February 6, 2020 news release announcing that the Empire chain of stores, including all Sobeys Stores, will provide accessible prescription labels to customers with disabilities free of charge on request. If they can, so can all other drug stores.

#11-4. Where a health care facility or health care provider provides information about their services or facilities in print or via the internet, they should be required to ensure that their website meets current international accessibility requirements along prompt time lines, even if the Information and Communication Accessibility Standard does not now require this. Currently, the Information and Communication Accessibility Information and Communication Accessibility Standard has too many exemptions, leaves out too many providers of goods and services, and has timelines that are too long. Whether or not those exemptions, exclusions and long timelines are justified for other sectors, they are unjustified for a sector as important as the health care sector.

#11-5. Ambulances and other vehicles that transport patients should include equipment to facilitate communication with patients with communication disabilities, such as remotely-accessed sign language interpretation and other communication supports.

#11-6. The Health Care Accessibility Standard should set more specific and detailed requirements than the Information and Communication Accessibility Standard, to require hospitals, other health care facilities and other health care providers to ensure that patients with communication-related disabilities get the communication supports they need in a timely fashion to ensure that they can effectively communicate with their health care provider in connection with their health care services and products.

#11-7. The Ontario Government should be required to set up hubs or centralized services to enable health care facilities and providers, including small providers, to quickly and easily access communication supports needed for patients with communication-related disabilities (for example Sign Language interpreters and real time captioning). The Ontario Government should fund these services as part of its funding of the health care system, in furtherance of the Supreme Court of Canada’s Eldridge decision.

#11-8. Any prepared information on health care conditions, treatment instructions, prognoses, risks, laboratory or other test results and the like which a health care facility or provider makes available to patients, whether in print or electronic form, should be made available at the same time on request in an accessible format. The standard should direct that PDF format is not sufficient to be accessible, and that if information is available in a PDF document, it should also be posted in an accessible format such as HTML or MS Word. Health care facilities and providers should be required to notify patients, including patients and their support people with disabilities, that any hard copy or electronic documents provided to them can be requested and obtained in an accessible format on request.

#11-9. Where a health care facility or provider asks patients or their support people to use information technology hardware or software in connection with the delivery of health care services (such as asking them to fill out their medical history on a portable computer or tablet device), the facility or provider shall:

  1. a) In the case of new or updated information technology or equipment to be acquired, ensure that it is accessible to people with disabilities and is designed based on principles of universal design;
  1. b) In the case of existing information technology now being used, retrofit to be accessible except where this would pose an undue hardship and,
  1. c) As an alternative, ensure that patients with disabilities or their support people with disabilities are assisted to use that technology, in private, at the same time as others would use it, where this would not reduce their access to the health care services to which it pertains.

#11-10. Because Ontario’s system for electronic health care records has been centrally created, the Health Care Accessibility Standard should require the Ontario Government and any provincial agency that is responsible for overseeing the design, procurement or operation of the system for electronic health care records in Ontario to ensure that these records will be kept and available in accessible formats for patients and support people with disabilities, and, as a related benefit, to health care providers and their staff with disabilities. The same requirement as above should apply regarding the use of PDF format.

#11-11. Individual health care organizations or facilities, including laboratories, that create their own health care records in electronic form should also be required to ensure that they are readily available in accessible formats for patients with disabilities and any patients’ support people with disabilities, and, as a side benefit, for health care providers and their staff with disabilities.

#11-12. The Ontario Government should be required to develop and make public a strategy for ensuring that health care promotion initiatives in Ontario are accessible to people with disabilities. For example, it should require that:

  1. a) All advertisements for health care promotion should have captioning and audio description.
  1. b) All mail-out, printed and online materials focusing on health promotion should be required to be in accessible formats, regardless of any exemptions in the Information and Communication Accessibility Standard.

Barrier: Healthcare providers:

  1. a) may not recognize a patient who has an invisible communication disability;
  1. b) may not know how to communicate with a patient if the patient uses ways other than speech to communicate;
  1. c) may overestimate or underestimate a patient’s comprehension and ability to give informed consent;
  1. d) may erroneously assume the patient’s incapacity based on their communication disability;
  1. e) may not know how and/or when to provide communication accommodations and supports for effective communication.

The intent/rationale of the following recommendations is to ensure that patients who have disabilities that affect their communication have timely accommodations and supports for their effective two-way communication at all times with healthcare providers and throughout the healthcare process.

#11-13. The Healthcare Accessibility Standards should require:

  1. a) Intake procedures that identify, document and share a patient’s communication profile with their healthcare team. For example, the patient’s preferred communication method, home language and authorized communication assistant.
  1. b) Procedures to ensure privacy and confidentiality of information if third parties are present to assist with communication.
  1. c) Provision of required communication accommodations and supports. Accommodations include items that patients need to communicate, such as pen, paper, boogie board, picture, letter board and communication devices. Supports include strategies that healthcare providers can use to facilitate communication with a patient as well as assistance from people who know the patient well, a sign language interpreter, a language translator, a speech language pathologist.
  1. d) Engagement when needed of Speech-Language Pathology services to provide appropriate accommodations and supports, in situations where a patient has no means to communicate or to ensure authenticity of communication in high stake consent situations.
  1. e) Access to generic, commercial picture/word displays for emergency, ICU and inpatient use.

#11-14. To facilitate the provision of these communication supports and accommodations to patients with communication disabilities and to reduce or eliminate wasteful duplication of efforts, the Ontario Government should be required to:

  1. a) Ensure in any education program for health care providers or professionals (including first responders and emergency care staff), training on core competencies on communicating with patients who may have unclear speech, reduced comprehension of spoken language or who may use sign language, writing, picture, letter boards, communication devices and/or someone else to assist a patient with communication.
  1. b) Establish and fund a central hub for rapid provision of communication supports referred to here, which health care facilities and providers can use.
  1. c) Create, widely distribute and publicize readily available and easy-to-use kits and guides for health care facilities and providers, including first responders, on how to arrange for effective communication with a patient with communication disabilities.

12. The Right of Patients with Disabilities to the Support Services They Need to Access Health Care Services

Barrier: Too often, health care facilities can lack the essential support services that patients with disabilities need to be able to access the health care services that the facility offers. Examples include hospital patients with disabilities who need help with eating, patients who need attendant care, or patients with vision loss who need to be guided to and from their destinations within a health care facility.

The intent/rationale of the following recommendations is to ensure that patients with disabilities get the support services they need to be able to make use of and fully benefit from the health care services and facilities that are offered to the public in Ontario’s health care system.

#12-1. Hospitals and other major health care facilities should be required to provide support services for patients with disabilities when needed to ensure that those patients can fully access and benefit from the health care services that the facility offers, such as:

  1. a) Attendant care.
  1. b) Assistance with meals.
  1. c) Assistance being guided to and getting around the health care facility e.g. for patients with vision loss or cognitive disabilities.

#12-2. In a hospital or other major health care facility, there should be one nurse at each nursing station designated to receive training and to be responsible for addressing the needs of patients with complex needs due to their disability.

#12-3. No health care facility or provider will refuse to allow a patient with disabilities or any patients’ support people with disabilities to use their own needed accommodations, such as a service animal, when seeking or obtaining health care services or products.

13. The Right of Patients with Disabilities and Any Patients’ Support People with Disabilities to Health Care Providers Free from Knowledge and Attitude Barriers Regarding Disabilities

Barrier: Too often, front-line workers in Ontario’s health care system including professional health care providers and their staff and volunteers have knowledge and attitude gaps regarding patients with disabilities that create barriers to equal services, due to the lack of sufficient training on this.

The intent/rationale of the following recommendations is to ensure that those who work directly with patients with disabilities and with any patients’ support people with disabilities have proper training on how to meet the needs of people with disabilities so that people with disabilities are freed from stereotypes, patronization and paternalism.

#13-1. Each of the self-governing colleges that regulates a health care profession in Ontario should set detailed requirements for specific and sufficient training that must be obtained before a person can qualify to get a license to practice in Ontario in that profession, such as for physicians, nurses, dentists, etc. For those who already have a license to practice, those colleges should be required to set mandatory specific training to be obtained in this area, with time lines for doing so, as part of their licensees’ continuing professional development requirements. This training should include requirements for the health care professional to train their staff who interact with patients and the public.

#13-2. The Ontario Government should be required to impose a condition of its funding for post-secondary education programs to train anyone in a health care discipline, profession or field that the college or university must include a sufficient designated and mandatory curriculum on meeting the needs of patients with disabilities.

#13-3. The training requirements under the 2011 Integrated Accessibility Standards Regulation should be revised to provide that the training for any employees or volunteers in an organization of any size that provides any health care services or products must include training specific to the barriers facing patients with disabilities and any patients’ support people with disabilities in the health care system.

14. The Right of Patients with Disabilities and of Any Patients’ Support People with Disabilities to Accessible Complaint Processes at Health Care Providers’ Self-Governing Colleges, and to Have Those Colleges Ensure that the Profession They Regulate Are Trained to Meet the Needs of Patients with Disabilities

Barrier: The self-governing colleges that govern some 26 kinds of health care professionals in Ontario are not assured to have in place sufficient ways to ensure that their members are providing accessible health care services to patients with disabilities.

The intent/rationale of the following recommendations is to ensure that health care professionals’ self-governing colleges effectively oversee the profession that they govern to ensure that they are providing accessible services to patients with disabilities, and have a fully accessible complaint process for the public to use.

#14-1. Each health care profession’s self-governing college should be required to:

  1. a) Review its public complaints process to identify any barriers at any stage in that process that could adversely affect people with disabilities filing a complaint, or about whom a complaint is filed.
  1. b) Develop a plan for removing and preventing any accessibility barriers identified whether or not those barriers are specified in any current AODA accessibility standards.
  1. c) Publicly report to its governing board of directors and the public on these barriers and the college’s plans to remove and prevent such barriers, in order to achieve a barrier-free complaints process.
  1. d) Establish and maintain a standing committee of its governing board of directors responsible for the accessibility of the services that the college offers the public, including, but not limited to its public complaints process.
  1. e) Regularly consult with the public, including people with disabilities, on barriers that people with disabilities experience when seeking the services of the health care professionals that that profession regulates, to be shared with the board’s Accessibility Committee.
  1. f) As provided in Recommendation #13-1 above, set specific curriculum requirements that a person must complete on providing accessible services to patients with disabilities, in order to qualify to get a license to practice in the profession they regulate.
  1. g) As required by Recommendation #13-1 above, for those already licensed to practice in the profession they regulate, set continuing professional development training requirements on providing accessible services to patients with disabilities that a licensed professional must complete.

15. The Right of Patients with Disabilities to Systemic Action and Safeguards to Remove and Prevent Barriers in Ontario’s Health Care System, and to the Removal of Existing Systemic Barriers to Accessible Health Care

Barrier: Too often, the Ontario Government and individual health care facilities go about their business planning for and operating Ontario’s health care system without taking into account the needs of patients with disabilities. This results in systemic barriers being left in place and new ones being created.

The intent/rationale of the following recommendations is to ensure that each health care facility and the Ontario Government effectively take into account the needs of patients with disabilities when designing and planning for Ontario’s health care system and when operating it on a day-to-day basis, and have safeguards in place to catch recurring accessibility gaps. The Supreme Court’s Eldridge decision requires the Government to do this.

#15-1. The Ministry of Health should be required to designate a senior official at the “Assistant Deputy Minister” level as the leading public official who is responsible for ensuring accessibility, accommodation and inclusion for patients with disabilities in Ontario’s health care system. They should be responsible for ensuring that any policies, plans or proposals regarding the health care system are screened to ensure that they will not create any new barriers for patients with disabilities, and will instead remove barriers.

#15-2. The Ministry of Health should be required to conduct a system-wide review of the health care system for any systemic barriers, in consultation with the public including people with disabilities. It should identify and make public a plan to remove and prevent systemic or system-wide barriers that impede patients with disabilities from receiving accessible health care, along time lines that the Health Care Accessibility Standard will set.

#15-3. Each hospital and other major health care facility should be required to establish and regularly publicize a dedicated disability accessibility/accommodation complaints hotline, to trigger prompt action when problems are raised.

#15-4. The Ministry of Health should be required to establish and regularly publicize a hotline to receive complaints about accessibility problems facing patients and support people with disabilities in Ontario’s health care system. The Ministry should be required to annually publish a report with an anonymized summary of the substance of complaints received and action taken to prevent their recurrence.

Barrier: OHIP fee schedules for medical services that assume a patient has no disability and requires no additional time for the health appointment. For example, some patients with disabilities need more time to undress, get on the assessment table, and then get dressed again. Communication disabilities may lead to needing more time to discuss a patient’s condition with them, including such things as their medical history, diagnosis, and treatment options. Patients with complex disabilities can require more time for their condition to be medically assessed and treatment to be provided or discussed. The individual physician should not be required to personally finance all of this. The current OHIP funding model creates a harmful economic incentive for physicians to avoid taking on patients with significant or complex disabilities as their patient.

#15-5. The OHIP fee schedule should be revised provide for added time to serve the needs of patients with disabilities who need more time for assessment, diagnosis and treatment, to eliminate the harmful financial incentive that the Ontario Government now creates for physicians to avoid treating taking on those patients.

16. The Need to Harness the Experience and Expertise of People with Disabilities Working in the Health Care System to Expedite the Removal and Prevention of Barriers Facing Patients and Their Support People with Disabilities

Barrier: People with disabilities working or volunteering in the health care system too often face accessibility barriers in the workplace that also hurt people with disabilities who seek health care services.

The intent/rationale of the following recommendations is to ensure that the experience and expertise of people with disabilities working for pay or as volunteers in the health care system is effectively harnessed to help root out the accessibility barriers that impede patients with disabilities and any patients’ support people with disabilities. This is because workplace disability barriers and health care service disability barriers often are the same or substantially overlap.

#16-1. Each hospital and major health care facility should be required to establish a committee of those employees and volunteers with disabilities who wish to voluntarily join it, to give the facility’s senior management feedback on the barriers in the health care facility that could impede patients with disabilities or any patients’ support people with disabilities, and/or employees/volunteers with disabilities.



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Help Us Make Information and Communication Accessible to Ontarians with Disabilities — Please Tell the Ford Government If You Support the AODA Alliance’s Finalized Brief to the Information and Communication Standards Development Committee on that Committee’s Draft Recommendations to Improve the 2011 Information and Communication Accessibility Standard


Accessibility for Ontarians with Disabilities Act Alliance Update

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

www.aodaalliance.org [email protected] Twitter: @aodaalliance

Help Us Make Information and Communication Accessible to Ontarians with Disabilities — Please Tell the Ford Government If You Support the AODA Alliance’s Finalized Brief to the Information and Communication Standards Development Committee on that Committee’s Draft Recommendations to Improve the 2011 Information and Communication Accessibility Standard

November 26, 2019

          SUMMARY

It’s finished and delivered! The AODA Alliance has submitted its final brief to the Information and Communication Standards Development Committee. In that brief we give that Committee our feedback on its July 24, 2019 draft recommendations for improving Ontario’s 2011 Information and Communication Accessibility Standard that was enacted under the (AODA).

Our detailed brief, which we set out below, includes all the content that was in our draft brief that we circulated for public comment on November 5, 2019. There has been minor editing and a small amount of additional material, thanks to the helpful feedback we received on that draft. Thanks to all who read our draft and offered their feedback.

Let’s build support for our cause. Help in a snap, by notifying the Information and Communication Standards Development Committee if you support the AODA Alliance’s brief. We encourage individuals and disability organizations to do so. Even though the deadline for submitting feedback to the Committee has passed, nothing stops you from sending a short email stating your support. Write the Information and Communication Standards Development Committee at [email protected]

You could simply say: “I support the November 25, 2019 brief on the Information and Communication Accessibility Standard.”

Here is a short summary of what we say in this brief. This is the summary that is also included in the brief itself.

  1. The 2011 Information and Communication Accessibility Standard was the strongest of the accessibility standards that the Ontario Government has enacted under the AODA. Despite this, it has several significant deficiencies. If every organization fully complied with it, it would not ensure that information and communication is accessible to people with disabilities by 2025, or ever.
  1. The Information and Communication Accessibility Standard, while helpful, does not address all of the recurring information and communication barriers that people with disabilities face. Where it does address a known recurring accessibility barrier, its guarantees are too often too weak. They have too many exemptions that are too broad, and that fall below requirements in the Ontario Human Rights Code.
  1. We agree with many, if not most or all, of the Information and Communication Standards Development Committees findings of deficiencies in the Information and Communication Accessibility Standard. Many, if not most, of the Committee s draft recommendations in its Phase 1 discussion are quite good and commendable. For the most part, we approve them “as is” or make recommendations for modest refinements or additions to them.
  1. We also offer additional recommendations to address deficiencies in the Information and Communication Accessibility Standard that the Committee’s draft recommendations do not fix. Overall, our recommendations aim to ensure that the Information and Communication Accessibility Standard is strengthened so that it addresses the full range of accessibility barriers that people with disabilities face in relation to information and communication, to ensure that it specifies the actions that organizations need to take to ensure that information and communication becomes accessible, and to narrow the excessively broad exemptions in the standard.
  1. In its draft Phase 2 recommendations, the Information and Communication Accessibility Standard Makes a commendable effort to find ways to make the AODA work more effectively. We do not endorse certain parts of the Committee’s Phase 2 recommendations, because they raise legal issues that we have not had time to address, and because they would necessitate amendments to the AODA itself. We would object to any effort to re-open the AODA in the Ontario Legislature or any effort to amend it, as we do not want to risk having the AODA weakened by the Legislature.
  1. Some of the Committee’s specific suggestions that form part of its Phase 2 draft recommendations can be implemented without requiring amendments to the AODA. We identify those that fit this description and with which we agree.

If you want more background on this issue, you can explore the time line of our efforts to get a strong Information and Communication Accessibility Standard enacted in Ontario by visiting https://www.aodaalliance.org/category/infoandcom/

Now 299 days have passed since the Ford Government received the blistering final report of the Independent Review of the AODA’s implementation and enforcement conducted by former Lieutenant Governor David Onley. The Onley Report found that the Government’s implementation and enforcement of the AODA has been too weak. The Ford Government has announced no plan to implement that report.

          MORE DETAILS

Accessibility for Ontarians with Disabilities Act Alliance

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

www.aodaalliance.org [email protected] Twitter: @aodaalliance

Brief to the Ontario Information and Communication Standards Development Committee on Its Draft Recommendations for Revisions to the 2011 Information and Communication Accessibility Standard

November 25, 2019

Via email to: [email protected]

A. Introduction

1. Overview

This is the AODA Alliance’s brief to the Information and Communication Standards Development Committee on its draft recommendations for revisions to the 2011 Information and Communication Accessibility Standard.

The Accessibility for Ontarians with Disabilities Act (AODA) requires the Government to lead Ontario to become fully accessible by 2025. The Government must enact and effectively enforce all the accessibility standards needed to ensure that the AODA’s goal is achieved. An accessibility standard is a provincial regulation that spells out what an obligated organization must do to prevent and remove accessibility barriers and that sets timelines for action.

In 2011, the Ontario Government passed the Integrated Accessibility Standards Regulation (IASR) under the AODA. Among other things, that regulation includes a series of provisions on the accessibility of information and communication. That is usually referred to in this brief as the Information and Communication Accessibility Standard. At other points, this brief at times refers to the IASR, of which that Standard is a part.

In 2016, the Ontario Government appointed the Information and Communication Standards Development Committee under the Accessibility for Ontarians with Disabilities Act (AODA) to review the 2011 Information and Communication Accessibility Standard, enacted under the AODA, and to recommend any revisions needed so that this accessibility standard would best achieve the AODA’s purposes.

The Information and Communication Standards Development Committee has developed draft recommendations on how to strengthen the 2011 Information and Communication Accessibility Standard. On July 24, 2019, the Ontario Government posted those draft recommendations online and invited public input on them. The Ontario Government was required to do this under the AODA. The feedback which the Government receives is to be submitted to the Information and Communication Standards Development Committee. That committee is then required to consider that feedback, as it finalizes its recommendations to the Government.

This brief provides the Information and Communication Standards Development Committee with our feedback on the Committee’s draft recommendations. Our 49 recommendations throughout this brief are also gathered together in one place in Appendix 1. We hope that this feedback will assist the Committee as it finalizes its recommendations to the Government.

This brief embodies the accumulated input that we have received over the years from a broad and diverse spectrum of sources across the disability community. That includes feedback both disability organizations and individuals with disabilities. Over the years, we have found that many from within the disability community have come to rely on the AODA Alliance’s work formulating briefs such as this.

^The AODA Alliance welcomes this opportunity to offer our input. We ask that the Accessibility Ministry ensure that all members of the Information and Communication Standards Development Committee receive this brief as a whole, and not just a summary of it that the Accessibility Directorate of Ontario prepares. We have received informal word that in the past, at least some Standards Development Committees only receive a summary of feedback from such mandatory public consultations. That summary was evidently prepared by the Accessibility Directorate of Ontario. To fulfil the spirit and purposes of the AODA’s public consultation provisions, it is important for all Standards Development Committee members to hear directly from the public, including the AODA Alliance, without having their input filtered by the Ontario Government.

We have offered to make an in-person presentation directly to the Information and Communication Standards Development Committee on our feedback. We thank the Information and Communication Standards Development Committee for accepting this offer, and look forward to presenting to the Committee on January 22, 2020. Given the extensive detail in this brief, we would appreciate it if the Committee was able to give us more than 15 minutes to present. The Transportation Standards Development Committee and Employment Standards Development Committee each gave us 30 minutes to present. We realize that the Committee’s time is limited, and welcome whatever time can be provided. We would also welcome guidance from the Committee on which topics, covered in this brief, would be most helpful for us to concentrate on during our presentation.

When it comes time for the Information and Communication Standards Development Committee to vote on the recommendations that it will present to the Ontario Government, we ask the Committee to vote separately on each of the recommendations that we present in this brief.

We thank the members of the Information and Communication Standards Development Committee for their commendable efforts to strengthen the Information and Communication Accessibility Standard. We also acknowledge with thanks the feedback and input that we regularly receive from our supporters that enable us to provide informed feedback to the Government and the public in areas such as this. For example, we publicly circulated a draft of this brief on November 5, 2019 for comment. We have incorporated the feedback received into this finalized brief.

2. Who Are We?

The AODA Alliance is a voluntary non-partisan coalition of individuals and organizations. Our mission is:

“To contribute to the achievement of a barrier-free Ontario for all persons with disabilities, by promoting and supporting the timely, effective, and comprehensive implementation of the Accessibility for Ontarians with Disabilities Act.”

To learn about us, visit: https://www.aodaalliance.org.

Our coalition is the successor to the Ontarians with Disabilities Act Committee. The ODA Committee advocated more than ten years for the enactment of strong, effective disability accessibility legislation. Our coalition builds on the ODA Committee’s work. We draw our membership from the ODA Committee’s broad, grassroots base. To learn about the ODA Committee’s history, visit: http://www.odacommittee.net.

We have been widely recognized by the Ontario Government, by all political parties in the Ontario Legislature, within the disability community and by the media, as a key voice leading the non-partisan campaign for accessibility in Ontario. In every provincial election since 2005, parties that made election commitments on accessibility did so in letters to the AODA Alliance.

Our efforts and expertise on accessibility for people with disabilities have been recognized in MPPs’ speeches on the floor of the Ontario Legislature, and beyond. Our website and Twitter feed are widely consulted as helpful sources of information on accessibility efforts in Ontario and elsewhere. We have achieved this as an unfunded volunteer community coalition.

Beyond our work at the provincial level in Ontario, over the past four years, the AODA Alliance has been active, advocating for strong and effective national accessibility legislation for Canada. Our efforts influenced the development of the Accessible Canada Act. We have been formally and informally consulted by the Federal Government and some federal opposition parties on this issue.

The AODA Alliance has also spoken to or been consulted by disability organizations, individuals, and governments from various parts of Canada on disability accessibility issues. For example, we have been consulted by the Government of Manitoba and by Barrier-Free Manitoba (a leading grassroots accessibility advocacy coalition in Manitoba) in the design and implementation of the Accessibility for Manitobans Act 2013. We twice made deputations to a Committee of the Manitoba Legislature on the design of that legislation. We have been consulted by the BC Government on whether to create a BC Disabilities Act, and by Barrier-Free BC in its grassroots advocacy for that desired legislation.

We have also been consulted outside Canada on this topic, most particularly, in Israel and New Zealand. In addition, in June 2016, we presented on this topic at the UN annual international conference of state parties to the Convention on the Rights of Persons with Disabilities.

The AODA Alliance has played a leading and highly-visible role in Ontario in raising a wide range of accessibility issues, including in the information and communication context. We have connections across Canada and internationally with, and are regularly consulted by accessibility advocates and governments as they grapple with how to tackle these kinds of issues.

As but one example, the AODA Alliance played a leading role in campaigning to enable the Information and Communication Standards Development Committee to get back to work in 2018 after the work of all Standards Development Committees was frozen in the wake of the 2018 Ontario election. We were happy and relieved when the Ontario Government lifted that freeze on the Information and Communication Standards Development Committee in the fall of 2018 and allowed it to go back to work.

3. Summary of this Brief

The AODA Alliance has solicited input from its supporters through its website, its mass email list, and on Twitter. Drawing on that feedback and on our extensive involvement in advocacy on accessibility issues in Ontario, this brief provides our feedback on those draft recommendations.

Our feedback set out in this brief is summarized as follows:

  1. The 2011 Information and Communication Accessibility Standard was the strongest of the accessibility standards that the Ontario Government has enacted under the AODA. Despite this, it has several significant deficiencies. If every organization fully complied with it, this would not ensure that information and communication would be accessible to people with disabilities by 2025, or ever.
  1. The Information and Communication Accessibility Standard, while helpful, does not address all the known recurring information and communication barriers that people with disabilities face. Where it does address a known recurring accessibility barrier, its guarantees are too often too weak. There are too many exemptions that are too broad, and that fall below requirements of the Ontario Human Rights Code.
  1. We agree with many, if not most or all of the Information and Communication Standards Development Committees findings of deficiencies in the Information and Communication Accessibility Standard. Many, if not most of the Committee’s draft recommendations in its Phase 1 discussion are quite good and commendable. For the most part, we agree with them “as is” or make recommendations for modest refinements or additions to them.
  1. We also offer additional recommendations to address deficiencies in the Information and Communication Accessibility Standard that the Committee’s draft recommendations do not fix. Overall, our recommendations aim to ensure that the Information and Communication Accessibility Standard is strengthened so that it addresses the full range of accessibility barriers that people with disabilities face in relation to information and communication. We aim to ensure that it specifies the actions that organizations need to take to ensure that information and communication becomes accessible, and to narrow the Standard’s excessively broad exemptions.
  1. In its draft Phase 2 recommendations, the Information and Communication Accessibility Standard Makes a commendable effort to find ways to make the AODA work more effectively. We do not endorse certain parts of the Committee’s Phase 2 recommendations, because they raise legal issues that we have not had time to address, and because they would necessitate amendments to the AODA itself. We strongly oppose any effort to re-open the AODA in the Ontario Legislature or any effort to amend it. This is because we do not want to risk the Legislature weakening the AODA.
  1. Some of the Committee’s suggestions in its Phase 2 draft recommendations can be implemented without requiring amendments to the AODA. We identify those that fit this description and with which we agree.

4. Preliminary Thoughts Before Proceeding to Our Specific Recommendations

Here are three important themes which we ask the Committee to bear in mind as it reviews our recommendations.

a) A Commendable Start

First, we strongly commend and congratulate the Committee for its efforts and for the draft recommendations. As will become evident, we agree with many if not most of the Committee’s Phase 1 draft recommendations. We urge adjustments to several of those recommendations to further strengthen them. These are in a number of cases minor adjustments or refinements to the Committee’s work. We also point out several additional improvements to the Information and Communication Accessibility Standard, to supplement those which the Committee suggested.

Based on its work so far, the Information and Communication Standards Development Committee has done by far the best job of any Standards Development Committee that has been appointed to review an existing AODA accessibility standard. It prepared far stronger draft recommendations for reform than did the Accessibility Standards Advisory Council (ASAC) when it reviewed the 2007 Customer Service Accessibility Standard or the Transportation Standards Development Committee when it reviewed the 2011 Transportation Accessibility Standard.

b) Committee’s Job Not Merely to Assess if the Information and Communication Accessibility Standard Has Been Working “As Intended”

Second, it appears that several Standards Development Committees that reviewed an existing AODA accessibility standard got substantially erroneous advice from the Accessibility Directorate of Ontario. The Transportation Standards Development Committee, Employment Standards Development Committee and the current Information and Communication Standards Development Committee, each stated that its job, when reviewing an existing AODA accessibility standard, is to determine if the standard is working “as intended”. The Information and Communication Standards Development Committee’s draft recommendations state in the introduction:

“The Act requires that each of Ontario’s accessibility standards be reviewed within five years of becoming law, to determine whether they are working as intended and to allow for changes to be made if they are required.”

Substantially the same erroneous language was included in the initial draft recommendations of the Transportation Standards Development Committee that were circulated in 2017 for public comment and the draft recommendations of the Employment Standards Development Committee which were circulated earlier this year for public comment.

For a Standards Development Committee to merely look to see if the standard is working “as intended” seriously and substantially understates the goal of this mandatory review of the 2011 Information and Communication Accessibility Standard. The AODA does not limit a Standards Development Committee to inquiring on such a review to see if the standard is working “as intended”.

Rather, this mandatory review’s purpose is to ascertain whether the Information and Communication Accessibility Standard is working sufficiently to ensure that information and communication will become fully accessible to people with disabilities by 2025, the AODA’s goal. This Review should recommend any improvements needed to ensure that the Standard will achieve that goal.

It is not sufficient for the Standards Development Committee to just ask if the Information and Communication Accessibility Standard is working “as intended.” By that lesser and palpably weak approach, the Information and Communication Accessibility Standard would be fine, and would need no improvements, if it led obligated organizations to merely do whatever the original 2011 Information and Communication Accessibility Standard spelled out. That would leave information and communication in Ontario full of disability barriers long after 2025.

As this brief documents, the 2011 Information and Communication Accessibility Standard, while helpful, was not capable of ensuring that information and communication will become fully accessible by 2025, or ever. We have publicly shared our strong disagreement with the Accessibility Directorate’s substantial dilution of the aim of these five year reviews of AODA accessibility standards. We have alerted the Directorate about our concerns. Despite this, and with no explanation or justification, that Directorate appears to have persisted in pressing Standards Development Committees to adopt this incorrect and unduly restrictive understanding of their mandate. We identified this concern in our briefs to the Transportation and Employment Standards Development Committees. We also identified it in Chapter 5 of our January 15, 2019 brief to the Third AODA Independent Review conducted by David Onley. It appears under the heading: “Inappropriate Government Attempts to Unduly Restrict the Work of Standards Development Committees”.

Even though the Information and Communication Standards Development refers to this erroneous “working as intended” approach to its review, it is clear from the draft recommendations that the Committee did not allow itself to be improperly hog-tied by the Directorate’s erroneous advice or direction. We congratulate the Committee for this.

c) Committee Should Use the Findings in the Moran and Onley Reports As Its Starting Point

Third, we agree with the Standards Development Committee’s draft recommendations’ general assessment of the 2011 Information and Communication Accessibility Standard, as summarized in this paragraph:

“The Committee’s discussions reflected a consensus that the current standards are not keeping pace with technology. There was mention that the standards are not always strong enough and are often too difficult to apply. The Committee also discussed the fact that the standards are confusing and prevent innovation in accessible technology. Overall, Committee members agreed that the standards need to be modernized and crafted to ensure they remain relevant in the future, as technology changes at an increasingly rapid pace.”

However, it is vital for the Committee to proceed from the starting point that the Information and Communication Accessibility Standard is substantially more deficient than that, even though it is the strongest of the accessibility standards enacted to date. The Committee should work from the starting point established by the second AODA Independent Review conducted by Mayo Moran and the third AODA Independent Review conducted by David Onley. The key findings in the reports of those reviews appear to come directly from the detailed briefs that the AODA Alliance submitted to those reviews.

In 2014, the second mandatory Independent Review of the AODA, conducted by Mayo Moran, found that there are very serious deficiencies in the accessibility standards enacted to date. These included the 2011 Information and Communication Accessibility Standard. Nothing in that accessibility Standard has been changed since that report to address those concerns. Appendix 1 to this brief sets out key excerpts from the Moran Report.

The third Independent Review of the AODA, conducted by David Onley, reinforced and supplemented the Moran Report’s overall findings. It did not disagree with the Moran Report’s findings regarding the IASR’s deficiencies. In 2019, the third AODA Independent Review conducted by David Onley accepted the earlier Moran Report as a correct starting point. It did not contradict any of the Moran Report’s findings about the problems with the accessibility standards enacted to date. It did not find that in the intervening four years, the Ontario Government had done anything to reduce those serious deficiencies.

To the contrary, the Onley Report made even more pointed and blistering findings about the AODA’s overall implementation. It did not exempt the Information and Communication Accessibility Standard from those blistering findings.

Based on public feedback, Onley’s report found that the pace of change regarding accessibility since 2005 for people with disabilities has been “glacial.” With then under six years left before 2025, the report found that “…the promised accessible Ontario is nowhere in sight.” He concluded that progress on accessibility under this law has been “highly selective and barely detectable.”

David Onley found “…this province is mostly inaccessible.” The Onley report correctly concluded:

“For most disabled persons, Ontario is not a place of opportunity but one of countless, dispiriting, soul-crushing barriers.”

The Onley report had damning things to say about years of the Ontario Government’s implementation and enforcement of the AODA. It in effect found that there has been a protracted, troubling lack of Government leadership on this issue, even though two prior Government-appointed AODA Independent Reviews called for renewed, strengthened leadership. The Onley Report recommended:

“The Premier of Ontario could establish accessibility as a government-wide priority with the stroke of a pen. Our previous two Premiers did not listen to repeated pleas to do this.”

Since the Onley Report was received some ten months ago, the Ontario Government has announced no comprehensive plan to implement it, nor has it publicly said that it will do so in the future. Ontario keeps slipping further behind the goal of full accessibility, while the 2025 deadline looms closer.

d) The Bottom Line for This Committee

As such, the Information and Communication Standards Development Committee’s job is pivotal. It should recommend fixes to the Information and Communication Accessibility Standard that will rectify the substantial deficiencies in the AODA’s implementation in so far as they pertain to the accessibility of information and communication. This brief aims to help the Committee with that task.

If the Information and Communication Accessibility Standard is to be strengthened in order to ensure that the AODA’s goal is achieved by 2025 in relation to information and communication, this must happen now. The next mandatory review of the Information and Communication Accessibility Standard does not have to be appointed until the eve of the 2025 deadline. By then, if Ontario is not back on schedule for the 2025 deadline in connection with the accessibility of information and communication, it will be too late to meet that deadline.

Substantial progress on accessibility is easier to achieve in the area of information and communication than in many other areas like the built environment. Information technology is rapidly evolving and replacing earlier products. The inaccessible technology, websites or mobile apps of last year will often be superceded in the next months or years.

In the following discussion, our recommendations track the sequence of the Committee’s draft recommendations. We insert additional topics where they best fit, following the structure of the Information and Communication Accessibility Standard itself.

B. Our Specific Feedback on the Draft Recommendations’ Phase 1 Proposals

1. Accessibility Standard’s Long Term Objective

We commend the Committee for reviewing the Information and Communication Accessibility Standard’s long term objective, and for trying to simplify it. We believe that all that needs to be added to the Committee’s proposed simplified language is the AODA’s 2025 deadline.

We therefore recommend that:

#1. The Standard’s long term objective should be:

“By no later than 2025 and thereafter, people with disabilities will be able to participate fully and equally in the creation and use of information and communications.”

2. Section 2 – Definitions

The term “accessible formats” should be clarified so that organizations know that digital formats are an option, but only if they are in a format that is screen-reader-friendly.

We therefore recommend that:

#2. The Committee’s recommendations should recommend that the definition of “accessible formats” in s. 2 of the Standard should be expanded to add “digital accessible formats that are readily readable on computers and portable technologies such as smart phones, using adaptive technology, but does not include documents in PDF format unless also accompanied by other accessible digital formats.”

3. Definition of Electronic Self-Serve Kiosks

The IASR’s definition of an electronic self-serve kiosk is far too narrow.

We therefore recommend that:

#3. Section 5(5) of the IASR should be amended to provide:

“(5) In this section, “kiosk” means an interactive electronic terminal intended for public use that allows users to access one or more services, facilities, or products or a combination of them, and, without limiting the generality of the foregoing, includes any device used by a member of the public to make in whole or in part a transaction relating to a product, good, service or facility or combination thereof, such as a point of sale device that allows the customer to pay for items with a debit, credit or other electronic funds card.”

4. Committee’s Recommendation 1 Consolidating the Regulation’s Feedback Requirements

We agree with the Committee’s Recommendation 1 that it would be good to immediately consolidate in one place in the IASR all feedback requirements, in language that makes them clear and consistent as long as this makes it clear that this that does not reduce any existing obligations.

5. Section 9 – Definitions and Exceptions

The Standard’s definition of “conversion-ready” information is too loose. Section 9 provides:

“conversion ready” means an electronic or digital format that facilitates conversion into an accessible format;”

That definition does not ensure that the material is capable of ready conversion into an accessible format.

We therefore recommend that:

#4. The Committee should recommend that section 9(1) of the Standard should be amended to define “conversion-ready” as follows:

“conversion ready” means an electronic or digital format that ensures ready conversion into an accessible format that effectively retains the information content that can be read on a computer using widely available adaptive technology, and on hand-held or portable digital technology such as smart phones;”

Section 9(4) of the IASR defines unconvertible information in a manner that is far too broad. It weakens the rights of people with disabilities. Section 9(4) provides:

“For the purposes of this Part, information or communications are unconvertible if,

(a) it is not technically feasible to convert the information or communications; or

(b) the technology to convert the information or communications is not readily

available.”

That provision dramatically reduces obligations of organizations below what they are required to do under the Human Rights Code, and, where applicable, the Charter of Rights. Our proposal for amending s. 9(2) makes s. 9(4) unnecessary.

We therefore recommend that:

#5. The Committee should recommend that either:

(a) Section 9(4) should be deleted, or

(b) Section 9(4) should be amended to provide as follows:

“(4) For purposes of this Part, information or communications are unconvertible if,

  1. a) It is not possible to convert the information or communications without undue hardship; or
  2. b) The technology to convert the information or communications is not available without undue hardship.”

6. Committee’s Draft Recommendation 2 PDF Documents

We agree with the Committee’s draft recommendations where they conclude that PDF documents are often inaccessible and that the required expertise to make them accessible is seldom present in obligated organizations.

The Committee’s draft recommendations indicate that they do not propose banning PDF formats. We have never proposed banning anyone from creating a PDF document. It has always been our position, which we urge here, that if an obligated organization creates a pdf document in connection with activities to which this accessibility standard would apply, an accessible alternate format document, such as an MS Word, txt or HTML document should also be posted and made available at the same time.

The Committee’s draft recommendations state that the Committee considered non-regulatory measures such as education for Government employees, but did not vote on this. We do not believe that such non-regulatory measures are sufficient. They would not solve this persistent but easily-remedied problem.

As an example, we have been struggling for well over a decade to get the Ontario Government to change its own practices with PDFs, so that it will always simultaneously post an accessible format for a document whenever it publicly posts a PDF. This has too often been a frustrating and futile effort, even after we repeatedly raised this at the highest levels within the Ontario Public Service. We still continue to face serious problems.

The Ontario Government has repeatedly claimed to be leading Ontario by its example on accessibility. Yet its poor example in this context is not one by which we would want Ontario to be led. For example, the Ontario Government even released in inaccessible PDF documents such important things as the 2014 final report of Mayo Moran’s Independent Review of the AODA, and the previous Government‘s long-awaited anti-poverty strategy. Years after being told that PDFs present an accessibility problem, the Ministry of Education continues to make important publicly-facing documents regarding Ontario’s education system available via PDF documents.

A simple, clear enforceable rule in the Information and Communication Accessibility Standard is the only effective measure that will have a hope of success, not only for the Ontario Government, but for other obligated organizations as well.

Some may think that a PDF can be made fully accessible. With such a view, we strongly and respectfully disagree, based on years of ample experience. However, this is a moot point.

First, as the Committee correctly recognizes, obligated organizations mostly do not have the expertise to make a PDF accessible, even if it is assumed that this goal can be accomplished. Second, when a person receives a PDF, there is no way to know from the file name whether anyone has even attempted to incorporate accessibility features in it, and if so, how many such features. Third, it makes no sense to ask obligated organizations to divert their resources into trying in vain to remediate a new PDF, when they could instead quickly, easily and at no cost simply post the document in an accessible format like MS Word, whenever they post a PDF.

It would take enormous resources to try to persuade obligated organizations to voluntarily change their practices. It is far more effective to set a simple rule which obligated organizations can readily understand and which is easy to enforce.

Documents are not written in PDF. They are written in another application like MS Word. Typically, they are accessible when initially created. After they are written, accessibility is stripped from that document when it is converted to a PDF.

We therefore recommend that:

#6. The Committee should recommend the addition to the standard of a requirement that if an obligated organization posts a PDF online, it should also simultaneously post the same document in an accessible format such as MS Word, txt or html.

7. Committee’s Draft Recommendation 4: Products and Product Labels

We agree with the Committee’s Draft Recommendation 4 that the loophole in the 2011 Information and Communication Accessibility Standard must be closed which exempts products and product labels from information and communication accessibility. Section 9(2) of the Standard states:

“(2) The information and communications standards do not apply to the following:

  1. Products and product labels, except as specifically provided by this Part.”

We commend the Committee for attempting to address this. However the draft recommendations do not go far enough to address this. The Committee’s draft recommendations call on the Ontario Government to try to work out a shared regulatory solution with the Federal Government and/or in the interim, that the Ontario Government explore non-regulatory solutions with obligated organizations.

Here again, an enforceable mandatory and specific standard is needed to change practices on the ground. Almost 15 years into the AODA, Ontarians with disabilities do not have time to hope that non-regulatory voluntary measures will change practices that have not substantially changed. In this context, we re-emphasize the finding in the Onley Report that progress on accessibility has been far too slow, and that Ontario remains a province full of “soul-crushing barriers.”

To hold off any regulatory action on this pending Ontario working out a coordinated action by the Federal Government would, we regret, indefinitely delay any regulatory action. Getting agreement with the Federal Government will predictably take years. The Federal Government will no doubt want to try to work out a common approach for all the provinces. While that might at first seem appealing, it will take even longer. It will risk the standard being diluted down to the lowest common denominator among the provinces. Ontario should lead with the strongest standard, and not follow others to the weakest standard.

In the recent federal election, most of the federal parties were not prepared to make any commitments at all on new measures they would take to promote accessibility for people with disabilities. Only one party was prepared to make commitments with any detail or that embodied real change for disability accessibility. After the election, there is little reason to expect that they will become more eager to make accessibility a priority.

There is no compelling reason to await federal regulatory action in this sphere, as the Committee’s draft recommendations propose. The Committee is worried about the possible overlap between federal and provincial jurisdiction. Yet in any area of public regulation of economic activity, there are innumerable situations where there may be an overlap between federal and provincial jurisdiction. Ontario nevertheless regularly takes action, without waiting for the Federal Government. We have a federal labour board and a provincial labour board. We have a national building code and the Ontario Building Code. The list goes on.

Our constitution fully accommodates this without a province having to withhold regulatory action. In 2011, it is commendable that the Ontario Government did not withhold enacting regulatory standards for the accessibility of websites. For the same reason, it can and should act now in the area of the accessibility of product labels. If the Federal Government later decides to take action in this area, Ontario can then of course discuss ways to harmonize their requirements. However this should not reduce Ontario’s accessibility protections.

While it would be helpful for the Ontario Government to work with industries to come up with creative new solutions in this area as the Committee proposes, that too is no reason to withhold the enactment now of a regulatory requirement. Indeed, the presence of a mandatory Ontario regulatory accessibility requirement would help motivate industries to develop creative new solutions, including harnessing new technologies.

We therefore recommend that:

#7. The Committee’s Draft Recommendation 4 should be revised to recommend that the Information and Communication Accessibility Standard should be amended now to set enforceable accessibility standards for products and product labels. This should not await Ontario working out a joint approach to this with the Federal Government, or the Ontario Government working with the private sector on developing non-regulatory innovations in this area. Section 9(2) (should be amended to provide an exemption only for:

“Products and product labels, where compliance with the information and communication requirements would impose an undue hardship on the organization.”

8. Committee’s Draft Recommendation 5 Alternative Formats and Communication Supports

We agree with the Committee’s concern with s. 12 of the Information and Communication Accessibility Standard. It requires an obligated organization to consult with a person with a disability on a needed accessible document format. It leaves the ultimate decision to the obligated organization in unilateral terms. The Committee’s draft recommendation commendably found:

“The Committee noted that this is resulting in the provision of formats that do not meet the needs of people with disabilities.”

We agree with the Committee that this provision needs to be strengthened. We also agree with the Committee’s proposal that the obligated organization should endeavour to get the agreement of the person requesting the alternative format. However, we are concerned that this does not go far enough.

The Supreme Court of Canada has held that obligated organizations have a duty to investigate alternative solutions in “duty to accommodate” cases. (See D. Lepofsky “Ontario’s Human Rights Tribunal Bungles the School Boards’ Human Rights Duty to Accommodate Students with Disabilities – J.F. v Waterloo District Catholic School Board – An Erroneous Rejection of A Student’s Request to Bring His Autism Service Dog to School” to be published in 2020 40.1 National Journal of Constitutional Law) We anticipate that many obligated organizations do not know of their existing procedural duty to accommodate that includes investigating alternative solutions up to the point of undue hardship.

We therefore recommend that:

#8. The Committee’s Draft Recommendation 5 should be expanded to propose that s. 12 of the Information and Communication Accessibility Standard be amended to state that where an obligated organization does not agree to provide the accessible format which the person with a disability requested, the obligated organization must investigate alternative ways to meet this need, up to the point of undue hardship.

9. Committee’s Draft Recommendation 6 and 7

We agree with the Committee where it states that s. 12 of the Information and Communication Accessibility Standard is unduly vague, where it requires that an alternative format document must be provided in a timely manner. We also agree with the Committee’s Draft Recommendation 6 that the obligated organization and the requesting individual should endeavour to reach an agreement on the time frame for this.

However we do not agree with the Committee’s Draft Recommendation 5 through 7 where these propose to refer to the Accessibility Standards Advisory Council (ASAC) the task of developing an alternative dispute resolution mechanism for addressing situations where the obligated organization and requesting individual cannot reach an agreement. We commend the Committee here for trying to be creative. Yet we fear that it might take years to develop that new mechanism.

Moreover, it is not clear to us that ASAC even now exists. At the time of writing, the Government’s website only lists one person as a member of ASAC. We do not know if ASAC has been meeting since the 2018 Ontario election, much less that it has been meeting with sufficient frequency to do this work in a timely way. ASAC’s membership has, in the past, not been selected based on its expertise in designing alternative dispute resolution mechanisms.

The creation of the required legal machinery to which the Committee’s draft recommendations refer might require a legislative amendment, if there is to be an enforceable requirement and monetary penalties for non-compliance. We have not had a chance to investigate that complex question. As further addressed later in this brief, we do not want the Government to re-open the AODA’s provisions in the Legislature.

The development of recommendations for the content of an element of an accessibility standard should not be sub-delegated to ASAC. The AODA requires that the development of such ideas and recommendations for accessibility standards be developed initially through a Standards Development Committee which is subject to the AODA’s procedural safeguards and openness requirements (including requirements for public input). ASAC is not bound by any of those safeguards, for which we fought so hard. For example, its meeting minutes are not required to be made public. In contrast, the minutes of meetings of a Standards Development Committee must be made public, according to the AODA.

To strengthen requirements in this area to address the shortcomings which the Information and Communication Standards Development Committee commendably identified, it would be helpful for the Information and Communication Accessibility Standard to be amended to set clear timelines, or presumptive timelines for an organization to respond to a request. This could vary depending on the organization’s size and the importance of the requested information. For example, if the information is to come from a hospital and relates to a patient’s medical condition, then the required response time should be very short. Given the readily-available availability of technology to produce alternative formats for documents, and the low cost for doing so, there is no reason for such timelines to ever be lengthy. If the Ontario Government were to post online helpful information on how to convert documents to accessible formats, and a list of venders who can be retained to do this, then an obligated organization should easily be able to act quickly when a request is received.

We therefore recommend that:

#9. Section 12 of the Information and Communication Accessibility Standard should be amended to set specific fixed or presumptive timelines for an obligated organization to provide an accessible alternative format for a document when requested. If the timeline is to be a presumptive one, rather than a categorical one, it should only be subject to an undue hardship defence for non-compliance. The Committee should recommend timelines that are short e.g. 48-72 hours, where the obligated organization is a large one, and/or where the requested information relates to important matters such as health, safety, or other vital services. Otherwise, nothing longer than a 7-day timeline should apply.

10. Committee’s Draft Recommendation 8

We agree with the aim of the Committee’s Draft Recommendation 8. It calls for the IASR’s requirements to provide accessible formats and communication supports to be brought together in one place in the IASR, as long as nothing is done to weaken them. We would want to screen the proposed wording of any regulatory changes to be sure that they do not reduce any rights of people with disabilities.

 11. Committee’s Draft Recommendation 9: On-Demand Conversion Ready Formats

We agree with the Committee’s Draft Recommendation 9. It would require the Ontario Government and the Legislature to immediately ensure that all publicly-facing documents are available in an accessible format. If this is required for new documents, this is not a major burden for the Ontario Government. As noted earlier, documents are typically first created in an accessible format like MS Word, and then are counterproductively rendered inaccessible by converting them to formats such as PDF.

12. Committee’s Draft Recommendation 10: On-Demand ASL and LSQ Translations

The Committee’s Draft Recommendation 10 commendably aims to find a creative way to address the need for on-demand Government information in ASL and LSQ. We share the intent of that proposal. We believe it should be strengthened.

We therefore recommend that:

#10. The Committee’s Draft Recommendation 10 should be expanded to:

  1. a) propose an amendment to the Information and Communication Accessibility Standard to require the Committee’s proposed measures regarding the Ontario Government translating certain information into the Sign Languages ASL and LSQ on demand, and
  1. b) expand that requirement to include captioning for any such video content, for the benefit of people with hearing loss who need captioning and not Sign Language.

13. Other Deficiencies with Section 12 that the Committee’s Draft Recommendations Do Not Fix

Section 12(1)(a) of the Standard sets the obligation too low. It states:

“12. (1) Except as otherwise provided, every obligated organization shall upon request provide or arrange for the provision of accessible formats and communication supports for persons with disabilities,

(a) in a timely manner that takes into account the person’s accessibility needs due to disability; and

(b) at a cost that is no more than the regular cost charged to other persons.”

It is not sufficient for an obligated organization to take “into account” the needs of people with disabilities. The requirement should be to provide supports that meet the needs of people with disabilities unless to do so is shown to cause the organization undue hardship.

We therefore recommend that:

#11. The Committee should recommend that section 12(1) of the Standard be amended to provide:

“12. (1) Except as otherwise provided, every obligated organization shall upon request provide or arrange for the provision of accessible formats and communication supports for persons with disabilities,

(a)   in a timely manner that meets the person’s accessibility needs due to disability, except where doing so would cause an undue hardship to the organization; and

(b)   at a cost that is no more than the regular cost charged to other persons.”

It is commendable that section 12(3) requires organizations to notify the public about the availability of accessible formats and communication supports. However the provision is too vague. It requires more detail to make it effective. Section 12(3) provides:

“(3) Every obligated organization shall notify the public about the availability of accessible formats and communication supports.”

We therefore recommend that:

#12. Section 12(3) of the Standard should be amended to provide:

“(3) Every obligated organization shall notify the public in an accessible format about the availability of accessible formats and communication supports, and, without limiting the generality of the foregoing, shall post such notification in an accessible format on the organization’s website, if it has one.”

Unlike the clear language used in a number of other parts of the IASR, section 12(4) is unintelligible. An organization needs a lawyer to figure it out. It states:

“(4) Every obligated organization that is required to provide accessible formats or accessible formats and communication supports by section 3, 4, 11, 13, 19, 26, 28, 34, 37, 44 or 64 shall meet the requirements of subsections (1) and (2) but shall do so in accordance with the schedule set out in the referenced section and shall do so only to the extent that the requirements in subsections (1) and (2) are applicable to the requirements set out in the referenced section.”

We do not know what this provision means. We fear others will also not know what it means. Whatever it means to say, it should be said in much clearer language – language that lets an organization and persons with disabilities understand it without needing to pay a lawyer to decipher it.

We therefore recommend that:

#13. Section 12(4) of the Standard should be re-written in plain language to make it intelligible.

We commend and endorse the concerns and advice that Communication Disabilities Access Canada CDAC provided to Accessibility Minister Raymond Cho in its January 19, 2019 letter to the minister. CDAC is an amazing and well-respected expert in its field. It has cutting-edge knowledge and good ideas on how to make progress.

We quote from the key part of that letter here:

“Communication Disabilities Access Canada (CDAC) is a national and provincial, non-profit organization that addresses accessibility for people who have speech, language and communication disabilities. Over 165,000 Ontarians have disabilities that affect their communication, that are not caused primarily by deafness or significant hearing loss. Diverse disabilities such as physical, neurological, cognitive, learning, hearing, vision, and linguistic disabilities can affect one or more areas of a person’s speech, comprehension, reading and writing.

Communication access to goods and services is as important as physical access for people who have little or no speech and who use picture, symbol, letter boards and devices to convey their messages.

The current integrated standards do not provide sufficient directives for businesses and organizations on ways to make their services accessible for people with speech, language and communication disabilities. For example, most people with speech and language disabilities experience significant barriers to services in face-to-face and telephone interactions, group meetings and forums and written communication. These contexts are not adequately or comprehensively addressed in any of the standards. They are either oversimplified or omitted.

At this time, the Information and Communications Standard primarily focuses on making written information (print and digital) accessible. Examples of accessible formats cited on the Accessibility Directorate’s website, include human assistance, large print, text transcripts of audio or visual information, handwritten notes instead of speech, plain language and electronic documents.

Many of these accessibility accommodations are extremely useful and appropriate for people who have speech and language disabilities. However, the accessibility needs of people with speech and language disabilities go beyond access to written information and occur in face-to-face and telephone interactions, group meetings and written communication. Many of these contexts are critical communication situations, such as police, legal and justice services, where communication barriers can have serious consequences.

To address this significant gap in the standards, we propose that the Information and Communications (IC) Standard expand its mandate to include regulations that address two-way, interactive communication for people who have disabilities that affect their communication.

We are recommending:

  • The IC Standards Development Committee should include people who have a thorough knowledge and proven track record to represent the communication access needs of people with diverse speech and language disabilities.
  • The mandate of this committee should go beyond “processes that businesses and organizations must follow to create, provide, and receive information and communications that are accessible to people with disabilities” to include “processes, and resources to ensure effective two-way communication in face-to-face, telephone and group interactions and written communication.
  • Development of regulations, guidelines and resources for: Face-to-face, telephone and group interactions. Standards and guidelines are required for all service providers who interact with the public within these contexts, so that they have the knowledge, skills and resources to interact with people who communicate in ways other than speech. They need to know how-to make telephone services accessible and how to make meetings and public forums inclusive for people who have communication disabilities.
  • Communication supports: Service providers need information about how and when to provide and work with communication assistants, communication intermediaries, Sign Language interpreters and other formal communication support services. Formal communication assistance services are essential in critical communication contexts such as health care, police, legal and justice services. In these situations, appropriate communication support services must be mandatory.
  • Communication accommodations: Service providers need information about simple, non-technical communication tools that they may provide when a person has no effective means to communicate. They need clarification on the use of communication devices that people may use.
  • Writing: Regulations are required to address writing activities for people who cannot physically write or who cannot write due to learning or linguistic disabilities. Writing includes accessible forms, procedures for note taking and signatures.
  • Environmental accommodations: Services need guidelines on creating and designing accessible signage and wayfaring, counter spaces, and elevators with a communication access lens.
  • Policies are required for communication procedures in emergency evacuation situations, as well as authentic assistance in critical contexts, including medical assistance in dying, police, legal and justice settings.

We believe that many of these accessibility features could be included in the IC Standard to provide a foundation upon which sector-specific communication standards could be developed, such as transportation, healthcare, education and employment. An example of a generic baseline communication standard would-be mandatory training for all service providers on how to communicate with a person who has unclear speech or who uses a communication device. An example of a sector-specific communication standard would be that health care providers must ensure that a communication assistant is authorized by a patient when supporting them in the provision of informed consent to treatment.

Existing resources:

CDAC has developed a range of free guidelines and resources on ways to make services communication accessible. These resources are available for the Accessibility Directorate to promote and use across the province, resources include:

  1. A database of qualified Communication Intermediaries to assist people with speech and language disabilities communicating in police, legal and justice situations

http://www.cdacanada.com/communication-assistance-database/.

We have information about making justice services accessible at

http://www.access-to-justice.org/

  1. A database of communication assistants who are available to support people with speech and language disabilities communicating at meetings, forums and on committees at http://www.cdacanada.com/communication-assistance-database/
  1. A webinar on making services accessible at

Making your services accessible for people with communication disabilities

  1. Written guidelines on communication access at

http://www.communication-access.org/wp-content/uploads/2018/12/Guidelines-for-Communication-Access-1.pdf”

We therefore recommend that:

#14. The Information and Communication Standards Development Committee should seek direct input including a face-to-face meeting with Communications Disabilities Access Canada and address its concerns regarding the Standard.

14. Part 3: Section 13 Emergency Plans Generally

We share the Committee’s commendable call for greater action to ensure the accessibility of information regarding emergency plans and procedures.

15. Committee’s Draft Recommendation 11: Emergency Requirements

We agree with the Committee’s Draft Recommendation 11 that all the IASR’s various provisions regarding emergency plans and procedures should be consolidated in one part of the regulation. We add that nothing should be done to weaken these provisions.

16. Committee’s Draft Recommendation 12: Unacceptable Emergency Outcomes and Preparedness

The Committee concluded that “the preparedness of all levels of Government for emergencies involving people with disabilities is unacceptable.” We share this concern.

The Committee commendably recommended that the Government should review overall emergency preparedness measures from a disability perspective. However, it did not recommend anything to strengthen s. 13 of the Information and Communication Accessibility Standard. We turn attention to that here.

Section 13 does not spell out a most obvious and important aspect of emergency procedures in this area. It does not explicitly require an organization to incorporate in any emergency procedure, a process for ensuring that it makes emergency announcements in an accessible format or manner during an emergency or crisis. Even if it is implicitly covered by earlier provisions in the IASR, it is very important to have a specific, clear and strong requirement here.

We therefore recommend that:

#15. Section 13 of the Standard should be expanded to impose a requirement that an organization include in any emergency procedures plan, specific measures to ensure that emergency announcements (such as fire alarms) are provided in an accessible means (e.g. flashing lights for the benefit of persons with hearing loss).

17. Part 4: Section 14 Website and Web Content Accessibility Generally

We share the Committee’s view that the Standard’s website accessibility provisions need to be strengthened.

18. Committee’s Recommendation 15: Differentiating Organizations/High Impact Organizations

We strongly and heartily endorse the Committee’s proposal that an organization’s number of employees should not be the sole determinant of an organization’s accessibility obligations. We have been urging that view upon the Ontario Government for over a decade without success.

The Committee’s idea of defining high impact organizations for purposes of defining their accessibility obligations has merit. We would add a few refinements.

First, the Information and Communication Accessibility Standard, as now constituted, has an erroneous upside-down approach to organizations’ duties and timelines. As in all other areas of the IASR, the Information and Communication Accessibility Standard starts from a mechanistic approach whereby the bigger the organization, the more it must do, and the sooner it must do it.

That is inappropriate here. In the case of small organizations, such as smaller businesses, website and mobile app accessibility should be attainable more quickly than by larger organizations, especially where the measures are required on a go-forward basis. A small company with a small website can ensure the accessibility of its entire web footprint much more quickly than the Ontario Government. Yet the Information and Communication Accessibility Standard erroneously places the least obligations on that small company and gives it the longest timelines. It places the greatest obligations on the Ontario Government and gives it the shortest timelines. This makes no sense.

The Information and Communication Accessibility Standard should be revised where needed to correct this incorrect approach. It is irrelevant for those timelines that have already expired.

Second, the measure of what constitutes a high impact organization should include more than does the Committee’s Draft Recommendation 15.

We therefore recommend that:

#16. The Committee’s Draft Recommendation 15, to create a category of high-impact private organizations, should be refined to:

  1. a) Create criteria that will be easily measured and enforced, where possible.
  1. b) measure the number of an organization’s users, customers or interactions inside or outside Ontario. If for example, the organization has a huge customer base around the world, the fact that a smaller number of users in Ontario should not militate against it being categorized as a high-impact organization.
  1. c) Make the threshold revenue as $1 million not $10 million as the Committee’s draft recommendations propose.
  1. d) Recommend the revision of s. 14 (website accessibility) to make website requirements extend further within the private sector, beyond the proposed new category of high impact organizations.

19. Extending the Information and Communication Accessibility Standard to Require WCAG 2.1, Not the Current 2.0

At present, the specific standard for website accessibility that the Information and Communication Accessibility Standard sets is Web Content Accessibility Group (WCAG) 2.0. That was established by the W3C consortium at least a decade ago. Since then, we understand that it has been updated much more recently to WCAG 2.1. As we read it, the Committee’s recommendations merely refer to the old WCAG 2.0. They do not recommend updating the Information and Communication Accessibility Standard to require WCAG 2.1. The Committee’s draft recommendations do not explain this. It is critically important.

We therefore recommend that:

#17. Section 14 of the Standard should be revised to require websites to comply with the new international standard of WCAG 2.1, not the old WCAG 2.0 which the Information and Communication Accessibility Standard now requires.

As well, it is entirely unjustifiable in late 2019 for the standard to lead any organization to think that it is sufficient in the interim to only meet WCAG 2.0 Level A, and not, as a bare minimum, Level AA. Yet s. 14(3) still provides as follows, with an end date of 2021:

“(2) Designated public sector organizations and large organizations shall make their internet websites and web content conform with the World Wide Web Consortium Web Content Accessibility Guidelines (WCAG) 2.0, initially at Level A and increasing to Level AA, and shall do so in accordance with the schedule set out in this section.”

No organization should now waste its efforts at merely meeting Level A as an interim goal, when it makes more sense to set Level AA as its goal from the outset.

We therefore recommend that:

#18. As an alternative, section 14(2) should be amended to eliminate WCAG 2.0 Level A, and not Level AA, as a bare minimum for any organization, in the event that WCAG 2.1 is not set as the new standard to meet.

20. Committee’s Draft Recommendation 13: Mobile Applications & New Technologies

We agree with the Committee’s Draft Recommendation 13. It would extend the Information and Communication Accessibility Standard’s website accessibility requirements to mobile applications. However we do not agree that all small organizations should be exempted from this requirement, just as we do not believe that all small organizations should be categorically exempted from the Information and Communication Accessibility Standard’s website accessibility requirements.

If anything, a well-resourced small organization could at least in some cases find it easier to make its website and mobile apps accessible than can a larger organization. The IASR arbitrarily defines the size of an organization solely by its number of employees, regardless of the organization’s resources or its impact on the market. If for example a small organization has a broadly-selling app, there is no reason why it should not meet accessibility requirements. The Ontario Human Rights Code does not grant any such exemption for small organizations.

We therefore recommend that:

#19. The Committee’s Draft Recommendation 13 should recommend that section 14 of the Standard should be amended to set full accessibility requirements to mobile applications, and to the websites, web applications and mobile applications of small organizations where compliance would not pose an undue hardship.

21. Committee’s Recommendation 16: Significant Refresh

The Committee’s draft recommendations correctly identify another serious deficiency with s. 15 of the Information and Communication Accessibility Standard, namely that key requirements are only triggered by an obligated organization creating a new website or undertaking a significant refresh of an existing site. We agree with the Committee that this vague threshold provides obligated organizations with an easy, undeserved and unacceptable end-run around the provision.

We also agree with the Committee’s Draft Recommendation 16 to fix this, and the stated intent underlying it, namely:

“•    Any content that is new or which an obligated organization changes, updates or adds to a web site must meet the accessibility requirements of Section 14

  • Furthermore, when content is added, changed or updated, it is recommended that organizations take the opportunity to make all content accessible
  • The Committee recommends that content should include all functions, interactions and ‘branding’ (look and feel) for a site. It is recommended that Section 14 include examples for the sake of clarity
  • Timeline: Regulation to be changed immediately, to be effective six months after the new regulation comes into force.”

22. Committee’s Recommendation 17: Practicability

We agree with the Committee’s concern that s. 14(5) includes too broad an exemption to its website accessibility requirements, by only requiring obligated organizations to take the required action to make websites accessible “where practicable”. We agree with the Committee that

“…this term is too vague and might allow some organizations to avoid doing something they are actually able to do.”

We encourage the Committee to fortify and further reinforce this serious concern. The sweeping “where practicable” exemption is far broader than the relevant Human Rights Code exemption from the duty to accommodate people with disabilities, which is only available where it is impossible to provide more accessibility without undue hardship. “Undue hardship” is a much more exacting requirement than mere practicability. Moreover the Standard’s failure to use the stronger undue hardship terminology sends a harmful and erroneous signal to obligated organizations that they need not meet this higher undue hardship test. It misleads obligated organizations. This is a disservice to obligated organizations and people with disabilities.

To define the existing term “practicable” in s. 14(5) to mean the same as undue hardship, as the Committee is contemplating, risks confusing obligated organizations or suggesting to them that undue hardship means the same as merely not practicable. It is neater and cleaner, and less risk-prone, to simply replace the term “not practicable” in the Standard with the correct “undue hardship”.

We would prefer if no “exception” clause was included. Compliance with well-established international standards for new web postings simply does not create an undue hardship. At the very least, if there is to be an exemption clause, the exemption should be no broader than that provided under the Human Rights Code.

We therefore recommend that:

#20. The Committee’s Draft Recommendation 17 should be replaced with a recommendation that the Standard’s not practicable exception from website accessibility is removed from section 14. As a weaker and less desirable alternative, if there is to remain some sort of exemption in s. 14(5), it should provide that an obligated organization need not meet these accessibility requirements only if it can show that it would be impossible to meet such requirements without causing that organization undue hardship, and that the obligated organization has the duty to never less take all accessibility action that is possible up to the point of undue hardship.

It is important for the Standard to make it clear that all organizations covered by this provision have a clear duty to promptly provide people with disabilities, on request, in an accessible format, with any information on their website that is inaccessible. This would include, for example, any information that need not yet be made accessible because of the timelines in the regulation, or any archival material that need never be made accessible on the website.

We therefore recommend that:

#21. Section 14 of the Standard should be amended to require any organization to promptly make available, on the request of a person with a disability, and in an accessible format that meets his or her needs, any information on the organization’s website that is not accessible to that person because of his or her disability.

23. Part 4, Subpart 1: Section 14 Exemptions Generally

We agree that the Standards’ exemptions are too broad and need to be narrowed.

24. Committee’s Recommendation 19: Extranet Exemption

We agree with the intent and content of the Committee’s Draft Recommendation 19 that the exemption for public-facing websites with a log-in should be removed and that these types of websites should be required to comply with the Information and Communication Accessibility Standard. We however believe that the proposed 2023 deadline for all publicly-facing websites, other than new ones, is too long a timeline, especially where meeting it would not provably pose an undue hardship.

We therefore recommend that:

#22. The Committee’s Draft Recommendation 19 should be revised to set the deadline for all publicly-facing websites to meet accessibility requirements as 2022, not 2023.

25. Committee’s Recommendation 20: Intranet Exemption

We agree with the Committee’s important finding that “technology has advanced to the point where all organizations should be able to make their websites accessible under Section 14.” We therefore agree with extending this requirement to the broader public sector and large organizations, including employee-facing websites. As such, we agree with the Committee that “all definitions related to a type of website be removed and that Section 14 simply apply to all websites, internet or intranet for all obligated organizations”. Indeed this is a critical reform to strengthen the current weak Employment Accessibility Standard. As indicated earlier, we would go further and urge that it be extended to at least some small organizations, even if they do not fit within the proposed definition of a high impact organization.

26. Committee’s Recommendation 21: Pre-2012 Exemption

We agree with the Committee’s view that the Information and Communication Accessibility Standard’s exemption for pre-2012 web content is overbroad and should be narrowed. The Committee’s Draft Recommendation 21 seems on first examination to be sensible. We would add that where historic, archived content is available on the web, and where a customer or employee needs it in an accessible format for purposes of seeking or using an obligated organization’s goods, services or facilities, or for purposes of their employment, the obligated organization should be required to make that content available on request in an accessible format.

We therefore recommend that:

#23. The Committee’s Draft Recommendation 21 should be expanded to require an obligated organization to provide an item of pre-2012 inaccessible online content or document in an accessible format on request if needed for purposes of seeking or using that organization’s goods, services or facilities or for purposes of employment.

27. Committee’s Recommendation 22: Live Captioning and Audio Description

We agree with the Committee’s Draft Recommendation 22 that sets out requirements so that by 2025, the Standard’s live captioning and audio description exemptions will be eliminated. We would add that by 2021, this exemption should be lifted for the city of Toronto, a public sector organization which is larger and more resourced than a number of entire provinces in Canada.

We therefore recommend that:

#24. The Committee’s Draft Recommendation 22 should be revised to provide that the current exemption for live captioning and audio description should be lifted by 2021 for the City of Toronto.

28. Committee’s Recommendation 23: Web Hosting Location

We agree with the Committee’s Draft Recommendation 23 which would clarify that s. 14 obligations apply to a website whether or not it is hosted in Ontario. This is a loophole that should not be permitted to remain.

29. Chief Information Officer

A number of larger organizations in the public and private sector now have a senior executive position often called the Chief Information Officer (CIO) or Chief Technology Officer (CTO). This is a critical position that could be decisive in enhancing the accessibility of information, especially digital information.

At present, there is nothing in place in the Standard to help ensure that a CIO or CTO has sufficient knowledge and training on digital accessibility, or that requires them to have lead responsibility for digital accessibility or that ensures that they know that they have that lead responsibility. There is similarly nothing in place to require that a CIO or CTO is held accountable within the organization for the organization’s efforts at ensuring digital accessibility.

We therefore recommend that:

#25. a) Where a large organization, a high impact organization or a public sector organization has a Chief Information Officer or Chief Technology Officer position or their equivalent:

  1. a) The CIO is responsible and accountable for leading the organization’s efforts at ensuring digital information accessibility in the organization’s internal and external digital communications.
  1. b) If the organization has a performance contract or performance review process for its officers, it shall be a condition of the CIO’s or CTO’s performance contract that the CIO or CTO is responsible and accountable for ensuring digital information accessibility and for ensuring that Accessibility is an integrated component of Performance and Security design requirements.
  1. c) In any performance review, performance-based pay review or promotion processes, the CIO’s or CTO’s performance on digital information accessibility shall be considered as a relevant factor.
  1. d) In considering whom to hire as CIO or CTO, a hiring factor or criterion should be a candidate’s knowledge and experience with respect to digital information accessibility and assistive technology.

30. Teleconference Platforms Used by Public Sector Organizations

Increasingly, organizations use web-based teleconferencing and meeting platforms for internal meetings of their employees or officials, and for public-facing meetings, such as electronic town hall meetings. Some of these platforms are more accessible than others. It is critical that organizations only use the most accessible ones. A requirement to this effect in the Standard would help pressure all such platforms to become accessible.

We therefore recommend that:

#26. The Standard should be amended to require that when any public sector organization, large organization or high impact private sector organization uses a web-based teleconferencing platform, it should only use a platform that is accessible. If no such platforms are fully accessible, then such organizations should be required to use the most accessible platforms of those which are available. The Standard should provide key criteria for assessing the accessibility of such platforms.

31. Digital Information Accessibility Statement

The Standard does not require any obligated organization to prepare and make public a comprehensive statement of the status of the accessibility of its website or related mobile apps. This might be covered to some extent in an accessibility plan or progress report on accessibility that the organization must prepare under the IASR. However, there is no assurance that the needed information will be included and will be comprehensive.

Excellent research provided to the AODA Alliance by Emily Prosser, an Osgoode Hall Law School, which she prepared at the ARCH Disability Law Centre, includes the following:

“The United Kingdom Statutory Instrument 2018 No.952, entitled The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the “Regulation”) is comparable to certain provisions within the AODA Information and Communication Accessibility Standard. There is also a Directive (EU) 2016/2102 of the European Parliament and of the Council of 26 October 2016 on the accessibility of the websites and mobile applications of public sector bodies (the “Directive”) which is relevant.

 

Both the Regulation and the Directive require public organizations to create an “Accessibility Statement”.[1]

That research also stated:

“An Accessibility Statement as defined by the Regulation and Directive is: “a detailed, comprehensive and clear statement produced by a public sector body on the compliance of its website or mobile application with these Regulations”.[2] The Accessibility Statement is a useful tool especially where an organization determines it is unable to meet accessibility standards. The Regulation requires a public sector body to explain in its Accessibility Statement any instances where it cannot comply with the accessibility requirement and provide accessible alternatives where appropriate.[3]

Under the AODA Information and Communication Accessibility Standard, obligated organizations are required to provide a requesting party with an explanation when it determines that it is unable to convert information and communications to an accessible format.[4] This requirement is similar to the Accessibility Statement required under the Regulation and Directive. However, Accessibility Statements are more robust. Accessibility Statements outline both an organization’s compliance and lack thereof meaning they go beyond simply addressing instances where an organization cannot comply with standards. Additionally, Accessibility Statements are required whether or not there is a ‘requesting party’ who has been denied accessible/convertible information. Further, the term ‘explanation’ is undefined in the Information and Communication Standard and so it lacks the formal requirements of an Accessibility Statement. As a result, there is no guarantee as to the quality of an explanation given to a requesting party under the Information and Communication Accessibility Standard.”

We therefore recommend that:

#27. The Standard should be revised to require that public sector organizations, large private sector organizations and high impact private sector organizations shall prepare an annual or biennial accessibility statement and make it public on its website which:

  1. a) Specifies in detail the extent to which the organization’s website and mobile apps are accessible and specifies where they are not and
  1. b) Gives reasons for any deficiencies in the accessibility of the website or mobile apps and indicates what the organization plans to do to rectify this, and by when.

32. Committee’s Recommendation 14: Procurement

We agree with the Committee’s draft recommendations that the IASR’s general provisions regarding procurement of accessible goods, services and facilities “…are not strong enough to result in accessible digital procurement.” We also agree with the general thrust of the ideas in the Committee’s Draft Recommendation 14 on the substantive requirements to add to the IASR regarding procurement of accessible information technology. We need the Information and Communication Accessibility Standard to go further. It should spell out specifics of what kinds of accessibility features or functionality should be required. These should be expressed in terms of end-user-usability, and not the specific technology to include. This is so because technology in this area is so rapidly evolving. In other words, these amendments to the Standard should not only set process requirements, but also requirements for end results in terms of functional end-user experience. We anticipate that obligated organizations often know little or nothing about this and need as much regulatory direction as possible.

We therefore recommend that:

#28. Beyond the measures in the Committee’s Draft Recommendation 14, the IASR’s general procurement provisions should be strengthened to specify end-user functionality requirements that are sufficiently flexible to accommodate emerging technologies.

We agree with the Committee that beyond the specific context of procuring information technology, the IASR’s general provisions regarding procurement need to be strengthened. We do not agree with the Committee’s suggestion that this be referred to ASAC. As noted earlier, under the AODA, the review of any accessibility standard must be conducted at least every five years by a Standards Development Committee that is appointed for that purpose.

The members of the Standards Development Committee appointed to conduct that review should be chosen based on their expertise and experience in this specific area. No Standards Development Committee has been appointed since 2011 to review any of the IASR’s general provisions, such as its procurement provisions. It would be open to the Government to assign that review to an existing Standards Development Committee that was already appointed to review any other parts of the IASR or to recommend new accessibility standards.

The Government is in violation of the AODA for not having done so. That review was required to have been started in 2016. As noted earlier, the Standards Development Committee that conducts such a review should comply with all the procedural safeguards in the AODA that involve conducting a review of an accessibility standard.

We therefore recommend that:

#29. The Government should fulfil its overdue duty under the AODA to appoint a Standards Development Committee to review all the general provisions in the IASR, sections 1 through 8.

We agree that the Government and public sector organizations need to be given some time to implement any changes in the area of procurement. However, we do not agree that this should extend out to 2021, as the Committee’s draft recommendations propose. This is so for several reasons.

First, public sector organizations have had accessible procurement duties under the AODA for years. They are not starting from scratch.

Second, their duty not to create new barriers is enshrined in pre-existing human rights law. It is not a new creation of the AODA or the IASR.

Third, 2025 is not far away. We cannot afford any delays, especially on the part of public sector organizations that are supposed to be leading by example.

Fourth, any such delay inappropriately suggests to public sector organizations that it is okay for them to continue to use public money to create new disability barriers. Yet that harmful use of public money must stop.

This is especially so as it applies to the Ontario Government that is the very body that is creating this regulation. As noted earlier, the Ontario Government has claimed for years to be leading Ontario by example in the area of accessibility. The Ontario Government is hardly caught by surprise by new regulatory provisions in this area.

For the same reasons, we respectfully disagree with the Committee’s Draft Recommendation 14 where it proposes that an obligated organization should be exempt from any of this new requirement if it has entered into a contract regarding the matter before January 1, 2021. That would let an obligated organization disregard this new requirement even if it was amply aware that it was coming e.g. because it was earlier posted in a draft regulation.

We therefore recommend that:

#30. Any changes to the requirements for procurement of goods, services or facilities should go into effect within six months of the new regulation being enacted, and should apply to any procurement thereafter, or for which a contract was signed after the draft of this new regulation was publicly posted for comment, unless the obligated organization can show that to comply would cause it an undue hardship.

We propose further measures to strengthen the IASR procurement provisions, whether they apply to information technology or other goods, services or facilities.

Section 5 of the IASR falls well short of the duty to prevent the creation of new barriers that the Supreme Court of Canada recognized years ago in Council of Canadians with Disabilities v. VIA Rail Canada Inc., [2007] 1 S.C.R. 650.

This section of the Standard unjustifiably exempts any organization from even having to ask for accessible goods, services or facilities when seeking to procure them, “where it is not practicable to do so.” We know of no situation where it is impracticable to even ask vendors for accessible goods, services or facilities, as part of procurement. Moreover, the “not practicable” standard erroneously falls substantially short of the “without undue hardship” standard in the Human Rights Code. It is counterproductive and harmful for the Standard to point obligated organizations to a test that is transparently lower than the Human Rights Code.

If there were to be any exemption clause in this part of the IASR at all, it should be considerably narrowed. We here draw on the Committee’s commendable recommendation, further addressed later in this brief, that the Standard should also be amended to create a class of “high impact” private sector organizations.

We therefore recommend that:

#31. Section 5(1) of the IASR should be amended to read:

“5. (1) The Government of Ontario, Legislative Assembly and designated public sector organizations shall

(a) Incorporate accessibility criteria and features when procuring or acquiring goods, services or facilities, for purposes of acquiring or procuring goods, services or facilities that are accessible to persons with disabilities, and

(b) Acquire or procure goods, services and facilities for use in their organization, or for the benefit of the public, that are accessible to persons with disabilities, except where it is not possible to procure or acquire them without undue hardship.”

#32. Section 5(2) of the IASR should be amended to provide:

“(2) If the Government of Ontario, Legislative Assembly or a designated public sector organization determines that it was not able to acquire or procure accessible goods, services or facilities without undue hardship in accordance with paragraph 5(1) (b), it shall provide, upon request, an explanation in writing.”

The duty to procure accessible goods, services and facilities should be extended to large or high impact private sector organizations. This is important for ensuring accessibility of goods, services, facilities and employment.

We therefore recommend that:

#33. Sections 5(1) and (2) should be amended to extend their requirements to large private sector organizations and high-impact private sector organizations.

Moreover, these procurement requirements should be extended to apply to any private sector organization when engaging in a project or contract for the Ontario Government. The Government should not be able to get around these procurement requirements by contracting out some of its work to the private sector.

We therefore recommend that:

#34. The IASR’s procurement requirements should be amended to apply to any private sector organization in connection with any work it is doing for or on behalf of the Ontario Government.

33. Section 6 – Self-Service Kiosks

Related to the issue of procurement, the IASR’s section regarding electronic kiosks, s.6, remains far too weak. Its requirements should be strengthened. Features of the Information and Communication Accessibility Standard bear on such kiosks, just as they can apply to other customer-facing technology. These requirements should extend further in the private sector than at present.

We therefore recommend that:

#35. Section 6(1) of the IASR should be amended to read:

“6. (1) Without limiting the generality of section 5, the Government of Ontario, Legislative Assembly, designated public sector organizations, large private sector organizations and high impact private sector organizations shall incorporate accessibility features when designing, procuring or acquiring self-service kiosks or any point-of-sale technology for use by the public, to ensure that they are accessible to and usable by persons with disabilities.”

It is also important for private sector organizations with less than 50 employees to take serious action on this front, especially where they offer technology for use by the public during point-of-sale transactions.

We therefore recommend that:

#36. Section 6(2) of the IASR should be amended to read:

“(2) Small organizations shall have regard to the accessibility for persons with disabilities when designing, procuring or acquiring self-service kiosks or any other point-of-sale technology for use by the public, and in any event, shall use accessible point-of-sale equipment when acquiring new point-of-sale equipment for use by customers, or replacing existing point-of-sale equipment.”

#37. Section 5(5) of the IASR should be amended to provide:

“(5) In this section,

“kiosk” means an interactive electronic terminal intended for public use that allows users to access one or more services, facilities, or products or a combination of them, and, without limiting the generality of the foregoing, includes any device used by a member of the public to make in whole or in part a transaction relating to a product, good, service or facility or combination thereof, such as a point of sale device that allows the customer to pay for items with a debit, credit or other electronic funds card.”

34. Committee’s Recommendation 18: Harmonization and Application across Requirements

We agree with the Committee’s Draft Recommendation 18 that the IASR should be amended to make it clear that its website accessibility provisions in s. 14 apply to all websites that are referred to across the IASR. We go further. The IASR should be refined to make it clear that these website accessibility requirements apply to any website specified in any provincial legislation or regulations, such as any provincial law that requires anything to be posted on a website.

We therefore recommend that:

#38. The Committee’s Draft Recommendation 18 should be amended to call for the website accessibility requirements in s. 14 to apply to any website to which provincial legislation or regulations apply, such as a provincial law that requires specified information to be posted on a website.

35. Part 5: Sections 15, 16, 17 and 18 Generally

It is inexcusable that in 2019, over 14 years after the AODA was enacted, students continue to face difficulties in getting timely access to needed educational materials in an accessible format that they can read.

The AODA Alliance has released a proposed Framework for the Education Accessibility Standard and has submitted it to the K-12 Education Standards Development Committee. We set out the relevant passages below. We do however urge the Information and Communication Standards Development Committee to press forward with its recommendations in this area, as elaborated upon below. If the K-12 Education Standards Development Committee or the post-Secondary Education Standards Development Committee opt to make further recommendations on point, that can only enrich the discussion. However, we ask the Information and Communication Standards Development Committee not to hold off proceedings on these recommendations due to the forthcoming work of the two Education Standards Development Committees.

In the key part of the AODA Alliance’s proposed Framework for the Education Accessibility Standard, a vision is offered of what an accessible education system would look like. This vision includes, among other things:

“2.5 Instructional materials used in Ontario’s education system would be available in formats that are fully accessible to students with disabilities who need to use them and would be available in accessible formats when needed.

2.6 All digital technology used in Ontario’s education system, such as hardware, software and online learning, used in class or from home, would be fully accessible and would fully embody the principle of universal design. Education staff working with students with disabilities would be properly trained to use the accessibility features of that hardware, software and online learning technology, and to effectively assist students with disabilities to use them.”

Among the recommendations in that proposed Framework for the contents of the Education Accessibility Standard is the following:

“8. Ensuring Digital Accessibility at School

Barrier: School boards using classroom technology, such as hardware, software, online learning systems and internal or external websites that lack digital accessibility; school board policies that can be obstacles to using adaptive technology designed for people with disabilities; Insufficient staff training and familiarity with the use of accessibility features of mainstream technology, and with disability-specific adaptive technology.

8.1 Each school board should ensure that:

Educational equipment and technology, including hardware, software, and tablet/mobile apps deployed in educational settings should be designed based on universal design principles, to ensure that students with disabilities can use them.

  1. a) A school board’s Learning Management Systems (LMS) should be accessible to staff and students with disabilities, including those who use adaptive technology. They should have all accessibility features turned on and available to ensure that information posted through them will be accessible to students with disabilities, including those using adaptive technology such as screen readers or voice recognition tools. Each school board should ensure that no teacher is able to turn off any feature of the LMS that is accessible in favour of one that is not.
  1. b) Each school board’s internal and external websites and intranet content, including internet content available to students for learning purposes, including all online learning programs, should be fully accessible, with all new information posted on them to be fully accessible.
  1. c) Electronic documents created at the school board for use in education and other programming and activities should be created in accessible formats unless there is a compelling and unavoidable reason requiring otherwise. PDF format should be avoided. If a PDF document is created, an alternate version of the content should be simultaneously provided and posted in an accessible Microsoft Word or HTML format.
  1. d) Software used to produce a school board’s documents such as report cards, Individual Education Plans, or other key documents should be designed to ensure that they produce these documents in accessible formats.
  1. e) Textbooks and learning software should be procured only if they include full information technology accessibility. Any textbook used in any learning environment must be accessible to teachers and students with disabilities at the time of procurement. Here again, PDF should not be used unless an accessible alternative format such as MS Word is also simultaneously available. For example, if a textbook is available in EPUB format, the textbooks must meet the international standard for that file format. For EPUB it is the W3C Digital Publishing Guidelines currently under review. If a textbook is available in print, the publisher should be required to provide the digital version of the textbook in an accessible format at the same time the print version is delivered to the school/Board.

8.2 The Ministry of Education and each school board should establish, implement, publicize and enforce information technology procurement accessibility requirements, to ensure that no technology is purchased either by a school board, or by the Ministry for use by school boards, unless it ensures full digital accessibility. Digital and information technology accessibility should be included in all Requests for Proposal (RFP) or other tenders for sale of products and services to a school board or the Ministry.”

The proposed Framework also includes:

“12. Ensuring Accessibility of Instructional Materials that Students with Disabilities Use

Barrier: Instructional materials, such as textbooks and other instructional materials and teaching resources that are not provided at the same time in an accessible format for students with disabilities.

Section 15 of the Integrated Accessibility Standards Regulation, enacted in June 2011, and in force for school boards since 2013 or 2015 (depending on their size) requires education organizations to provide instructional materials on request in an accessible format, and to make this part of their procurement of such resources. However, this provision has not been effective and sufficient to effectively ensure that students with disabilities face no barriers in this context. Therefore, stronger measures are needed.

12.1 To ensure that instructional materials are fully accessible on a timely basis to students with disabilities such as vision loss and those with learning disabilities that affect reading, each school board should:

  1. a) Survey students with disabilities who need accessible instructional materials, and their teachers and families, to get their front-line experiences on whether they get timely access to accessible instructional materials, and to get specifics on where this has been most lacking.
  1. b) Establish a dedicated resource within the school board, or shared among school boards, to convert instructional materials to an accessible format, where needed, on a timely basis, either alone or in combination with other school boards.
  1. c) Review its procurement practices to ensure that any new instructional materials that are acquired is fully accessible or conversion-ready and monitor to ensure that this is always done in practice. A condition of procurement should be a requirement that the supplier or vender must remediate any inaccessible materials at its own expense.

12.2 The Education Accessibility Standard should require the Ministry of Education to implement, monitor and publicly report on province-wide strategies to ensure the procurement of and use of accessible instructional materials across school boards.”

We therefore recommend that:

#39. Sections 15 to 18 of the Standard should be amended to ensure the accessibility of instructional and other information in Ontario’s education system, in accordance with Recommendations 8.1, 8.2, 12.1 and 12.2 of the AODA Alliance’s October 10, 2019 proposed framework for the contents of the K-12Education Accessibility Standard.

36. Committee’s Recommendation 24: Purchase of Accessible Teaching/Training Materials

We agree with the Committee’s Draft Recommendation 24 that “obligated organizations that are educational or training institutions be required to order textbooks or other printed curricula materials from producers who agree to provide accessible or conversion-ready versions, in the same time frame as print copies.” This should apply to both print and electronic teaching materials.

We therefore recommend that:

#40. The Committee’s Recommendation 24 should be expanded to also require that obligated organizations that are educational or training institutions be required to order electronic textbooks or other electronic curricula materials from producers who agree to provide accessible or conversion-ready versions, in the same time frame as non-accessible versions.

37. Section 15 – Educational and Training Resources and Materials

Beyond this, s. 15, on providing accessible educational and training materials, while helpful, needs to be strengthened. It now provides:

“15. (1) Every obligated organization that is an educational or training institution shall do the following, if notification of need is given:

  1. Provide educational or training resources or materials in an accessible format that takes into account the accessibility needs due to a disability of the person with a disability to whom the material is to be provided by,
  2. Procuring through purchase or obtaining by other means an accessible or conversion ready electronic format of educational or training resources or materials, where available, or
  3. Arranging for the provision of a comparable resource in an accessible or conversion ready electronic format, if educational or training resources or materials cannot be procured, obtained by other means or converted into an accessible format.
  4. Provide student records and information on program requirements, availability and descriptions in an accessible format to persons with disabilities.

(2) For the purposes of this section and sections 16, 17 and 18, an obligated organization is an educational or training institution if it falls into one of the following categories:

  1. It is governed by the Education Act or the Private Career Colleges Act, 2005.
  2. It offers all or part of a post-secondary program leading to a degree pursuant to a consent granted under the Post-secondary Education Choice and Excellence Act, 2000.
  3. It is a designated public sector organization described in paragraph 3 or 4 of Schedule 1.
  4. It is a public or private organization that provides courses or programs or both that result in the acquisition by students of a diploma or certificate named by the Minister of Education under paragraph 1 of subsection 8 (1) of the Education Act.
  5. It is a private school within the meaning of the Education Act.”

We therefore recommend that:

#41. Section 15 of the Standard should be amended to:

(a) Amend the opening words of section 15(1) to provide:

“1.   Provide educational or training resources or materials in an accessible format that meet the accessibility needs due to a disability of the person with a disability to whom the material is to be provided by…”

(b) Require each obligated organization that is an educational or training institution to notify their students, applicants for admission and faculty/teachers, via accessible means, of their commitment to provide accessible curriculum and teaching materials;

(c) Post on their website, if any, their commitment to provide accessible teaching and curriculum materials, and an indication of who within the organization is responsible for their provision;

(d) Add to ss. 15(1) and (2) a requirement that these teaching and curriculum materials are to be available at the same time as the same teaching or curriculum materials are provided to students in the same program or course, except in exceptional cases where it is impossible to do so, in which case alternative measures will be immediately taken to enable a person with a disability to fully participate in the course or program.

(e) Add to section 15 a requirement that where curriculum materials such as textbooks are to be ordered from other sources, the curriculum materials shall be in an accessible format or conversion-ready, except where it can be shown that these cannot be obtained without undue hardship.

(f) Add to section 15 a requirement that notwithstanding the timelines for accessible websites, any information posted to a website for use by students shall be in an accessible format and shall comply forthwith with WCAG 2.0 Level AA unless it can be shown that to do so is impossible without undue hardship, in which case accessible alternative format materials shall be provided immediately on request.

(g) No school, college or university shall provide books or other like materials via paperless technology such as on mobile apps on the iPad or Kindle unless that technology has become accessible for persons with disabilities.

38. Section 17 – Producers of Educational or Training Material

It is helpful that s. 17 requires publishers to make accessible educational textbooks and certain other printed instructional materials available on request, in an accessible format. It however needs to be expanded. It now only applies to textbooks. Section 17 provides:

“17. (1) Every obligated organization that is a producer of educational or training textbooks for educational or training institutions shall upon request make accessible or conversion ready versions of the textbooks available to the institutions. O. Reg. 191/11, s. 17 (1).

(2) Every obligated organization that is a producer of print-based educational or training supplementary learning resources for educational or training institutions shall upon request make accessible or conversion ready versions of the printed materials available to the institutions. O. Reg. 191/11, s. 17 (2).”

It should also apply to any other course materials produced in printed form, as well as course materials and books produced in electronic form. With the spread of e-books, this is increasingly important.

We therefore recommend that:

#42. Section 17(1) and (2) of the Standard should be amended to provide:

“17. (1) Every obligated organization that is a producer of education or training textbooks or other teaching materials (whether in printed form or electronic form) for educational or training institutions shall upon request, promptly make accessible or conversion ready versions of the textbooks or other teaching materials available to the institutions.

(2) Every obligated organization that is a producer of print-based or electronic educational or training supplementary learning resources for educational or training institutions shall upon request, promptly make accessible or conversion ready versions of the printed or electronic materials available to the institutions.”

39. Committee’s Recommendation 25: Definition of Educational and Training Institutions

We agree that the Standard’s requirements for educational organizations should extend to any organization that provides any education or training programs, whether or not they meet the Standard’s current definition of an education organization.

We therefore recommend that:

#43. The Committee’s Recommendation 25 should be expanded to define the scope of education programs to which its obligations should attach. This should be tied to the nature of the program and the extent to which ensuring accessibility would trigger an undue hardship

40. Section 18 – Libraries of Educational and Training Institutions

Section 18 is a helpful provision addressing accessibility at public libraries. However, it has an exception for “special collections” that, if not defined, could sweep away much-needed protections. Section 18 provides:

“18. (1) Subject to subsection (2) and where available, the libraries of educational or training institutions that are obligated organizations shall provide, procure or acquire by other means an accessible or conversion ready format of print, digital or multimedia resources or materials for a person with a disability, upon request.

(2) Special collections, archival materials, rare books and donations are exempt from the requirements of subsection (1).

(3) Obligated organizations to which this section applies shall meet the requirements under this section in accordance with the following schedule:

  1. In respect of print-based resources or materials, January 1, 2015.
  2. In respect of digital or multimedia resources or materials, January 1, 2020.”

A law school at a university might argue that its entire law library is a “special collection”, that is thus exempt from any accessibility requirements. We do not anticipate that this was what the Government meant to achieve here.

We therefore recommend that:

#44. Section 18(2) of the Standard should be amended to include a clear and narrow definition of “special collection”, or that exemption should be removed from this provision.

41. Committee’s Recommendation 26: Increasing Captionist Capacity

We share the Committee’s concern that there is a limited number of trained captionists in Ontario. We agree with the need for new efforts to increase their numbers. The Committee appears to make a non-regulatory recommendation.

We add that technology exists now to facilitate off-site captioning from distant locations. The captionist can be anywhere in the world. An audio hookup is set up via the web so the captionist can hear the spoken words to transcribe.

The Government can further facilitate this by either creating or funding a start-up that would crowdsource these services, so that captionists around Ontario, or indeed around the world, could get quick and easy access to customers in Ontario. This could be part of an economic development strategy. A well-run Ontario-based service could sell its services around the world, bringing in new revenues to Ontario.

We therefore recommend that:

#45. The Committee’s Recommendation 26 should be expanded to recommend that the Government create or fund the creation of an Ontario-based remote captioning service that could service clients in Ontario and around the world by remotely-located captionists, providing their services online.

42. Committee’s Recommendation 27: Accessibility in Education

We agree with the Committee’s advice that the disability accessibility curriculum should be included at all levels of Ontario’s education system.

We therefore recommend that:

#46. The Committee’s Recommendation 27 should be expanded to incorporate the AODA Alliance’s proposed Framework for the Education Accessibility Standard, which includes:

“11.1 To eliminate attitudinal barriers among students, school board employees and some families of students, each school board should:

  1. a) Develop and implement a multi-year program/curriculum for teaching students, school board staff and families of school board students, about inclusion and full participation of students with disabilities, tailored to age levels. Because online courses are inadequate for this, where possible, this should include hearing from, meeting and interacting with people with disabilities e.g. at assemblies and/or via guest presentations.
  1. b) Post in all schools and send information to all families of the school board’s students, on the school board’s commitment to inclusion of students with disabilities, and the benefits this brings to all students.
  1. c) Provide specific training to all school board staff that deal with parents or students, on the importance of inclusion.
  1. d) Implement human resources policies and practices to expand school board staff knowledge and skills regarding inclusion.”

43. Committee’s Recommendation 28: Accessibility in Information and Communications Tools and Systems

We agree with the Committee that:

“There is often a lack of knowledge regarding the needs of people with disabilities on the part of the designers of information and communications tools and systems, and this leads to a lack of accessibility in these products.”

We also agree with the Committee’s Draft Recommendation 28 where it proposes that “all obligated organizations which provide education or training on the design, production, innovation, maintenance or delivery of information and communication tools and systems shall include curricula that address the needs of people with disabilities…” We see value in this recommendation being further refined.

We therefore recommend that:

#47. The Committee’s Draft Recommendation 28 (calling for obligated organizations which provide education or training on the design, production, innovation, maintenance or delivery of information and communication tools and systems to include curricula that address the needs of people with disabilities) should give some specific examples of the needed training, including differently affected disabilities, beyond its reference to Sign Language.

The Ontario Government’s economic development strategy has tried to promote the development of the information technology sector in Ontario, to serve both the Ontario market and markets around the world. However, as far as we can tell, the Ontario Government has never acted on our advice in this area, which we repeatedly gave over several years. We had recommended to the Ontario Government that it should attach strings to its funding in that sector that require that sector to develop expertise in accessible information technology design. That would promote the expansion of Ontario’s technology sector so that it has more accessible design expertise to offer organizations around the world.

We therefore recommend that:

#48. The Committee should recommend that the Ontario Government should now adopt a concerted strategy, as part of its economic development efforts, of promoting the expansion of Ontario’s technology development sector with expertise in accessible design.

44. Committee’s Recommendation 29: Accessibility in Provincially Regulated Professions

We endorse the Committee’s Draft Recommendation 29. It provides:

“Certification requirements of provincially regulated professions must include knowledge and application of accessibility (including accessible formats, language, communication and IT support) and the prevention of attitudinal barriers.”

The AODA Alliance’s proposed Framework for the Education Accessibility Standard points in a similar direction. It includes:

“Barrier: Too often, teachers and other school staff who work with students are not sufficiently trained on how to teach all students, including students with disabilities. Teacher’s colleges and other programs that are publicly funded to train professionals who will work with students in Ontario schools are therefore creating new generations of barriers that will impede students with disabilities.”

The solution requires both reforms to the required training of future new teachers while they are in teachers’ college, and measures to expand the training of those who are already graduates of teachers’ college and who are already working as teachers. This also applies to other school staff with teaching-related roles, such as principals and education assistants.

9.2 The Ontario Government should require that to be qualified to teach or serve as a principal in an Ontario-funded school, a teacher or principal must have specified training in the education of students with disabilities, covering the spectrum of different learning needs and learning styles. Any teacher’s college or like program that receives any provincial funding should require, as part of its degree programming, specified course contents on the education of students with disabilities for all teachers, and not only for special education teachers. Time lines for implementing this should be specified for the transition to this new approach. Each school board should be required to train school board staff, including teachers and other staff who work with students, on ensuring digital/information technology accessibility in the classroom, on the use of access technology (where needed) and on steps how to create accessible documents and web content.”

Section 16 of the Standard commendably requires training organizations to provide for their teachers, training on the needs of students with disabilities. However, it does not require any of their employees to ever take that training.

Regarding teacher training, we therefore recommend that:

#49. Section 16(1) of the Standard should be amended to provide:

“16. (1) In addition to the requirements under section 7, obligated organizations that are school boards or educational or training institutions shall provide educators with accessibility awareness training related to accessible program or course delivery and instruction, and their educators shall satisfactorily complete that training.”

It is essential that the Committee’s proposal take the form of a mandatory regulation, and not merely a policy or “best practice”. Too many professions need this reform to try to convince them voluntarily, one profession at a time.

Moreover, the AODA Alliance has been trying without success to secure voluntary action by the Ontario Government for over a decade. In the 2007 Ontario election, the AODA Alliance asked the parties to commit to ensure that relevant professions require their members to have sufficient accessibility training. In that election, the McGuinty Government promised to advocate to self-governing professions on this. In the ensuing 11 years that the Liberal Government was in power, we repeatedly asked it to keep this promise. We never saw or were shown any Government action to act on this promise.

45. Committee’s Recommendation 30: Education Standards

This recommendation only deals with where to locate certain requirements within the IASR. We take no issue with this as a pure housekeeping matter.

C. Our Feedback on The Committee’s Proposed Phase 2

In Phase 2 of the Committee’s draft recommendations, it proposes a major overhaul of how accessibility barriers should be regulated under the AODA. We commend the Committee for trying to take a broad and creative look at how progress is going under the AODA, and for trying to come up with innovative solutions, thinking beyond the regulatory status quo. Any effort in that regard should be encouraged.

Below we offer a few general responses to the Committee’s proposed reforms to the AODA’s overall design. These are only preliminary thoughts. A fuller response requires substantially more time and research than is currently available. The Committee’s Phase 2 proposal goes far beyond the scope of the Information and Communication Accessibility Standard.

The Committee’s Phase 2 reforms call, among other things, for the creation of a new public authority. The Committee calls it the “Trusted Authority”. That new public agency would have a series of new powers, including powers which bear directly on the AODA’s interpretation, implementation and enforcement.

These reforms would require the Legislature to amend the AODA itself. These are not measures which can be enacted as accessibility standard regulations under the AODA, as it is now written.

As noted earlier, we are opposed to the Ontario Legislature re-opening the AODA and considering making any amendments to it at this time. We don’t want there to be any risk that the Government would try to weaken or reduce any provisions in the AODA. Re-opening the legislation would create such a risk. We would react very strenuously against any Government effort to re-open the AODA’s terms in any way.

Even if we had wanted the Government to re-open the legislation, the likelihood of it doing so now is extremely low. Throughout the first third of its mandate the current Government treated the AODA as a very low priority. It took months and months for the Government just to unfreeze the work of existing AODA Standards Development Committees, including the Information and Communication Standards Development Committee. It took more months after that to get the Government to re-start the important work of the Education and Health Care Standards Development Committees. This was so even though while in opposition, the Conservatives criticized the former Ontario Government for dragging its feet on appointing an Education Standards Development Committee.

Over two thirds of a year has passed since the Government received the blistering report of David Onley’s AODA Independent Review. Despite our pressure, the Government has announced no comprehensive plan to implement the Onley Report.

As such, we would not agree to the Government proceeding with the Committee’s Phase 2 proposal, in so far as it requires legislative amendments. There is a second important reason why the Committee’s Phase 2 proposal should not proceed at this time. The Committee’s Phase 2 proposal contemplates delegation of certain powers to the proposed Trusted Authority which itself raises a number of significant legal concerns, beyond any policy discussion over the proposal’s pros and cons. We have not had the time or opportunity to explore those issues in preparation for this brief. They would have to be resolved before a profitable discussion of the proposal’s pros and cons should be undertaken.

There are other important avenues and arenas for such proposals regarding reform of the AODA to be presented. For example, there have been three successive Government-appointed Independent Reviews of the AODA, by Charles Beer in 2010, by Mayo Moran in 2014 and by David Onley in 2018-19. Another AODA Independent Review will have to be appointed by March 7, 2022. Those are but one appropriate place to present such suggestions. We do not know if the Information and Communication Standards Development Committee or any of its members presented these ideas to any of the three AODA Independent Reviews for their consideration.

As a visible player on the provincial front regarding the AODA, the AODA Alliance would want to be a major player in any such discussions. For our part, we pointed out serious problems with the way the AODA has been operating, in our proposals to the Federal Government regarding the design of the new Accessible Canada Act. See for example our Discussion Paper on what Canada’s national accessibility law should include, published in the National Journal of Constitutional Law and available at https://www.AODAalliance.org/whats-new/click-here-to-download-the-discussion-paper-on-what-canadas-promised-accessibility-legislation-should-include-as-published-last-year-in-the-national-journal-of-constitutional-law/

The same goes for our recent proposals to the BC Government on what the promised BC accessibility law should include, available at https://www.AODAalliance.org/whats-new/the-british-columbia-government-commits-to-provincial-accessibility-legislation-and-seeks-public-input-on-a-proposed-framework-for-a-bc-disabilities-act-read-the-AODA-alliances-submission-to-the-b/

Despite the foregoing concerns, some parts of the Committee’s Phase 2 proposal can be undertaken now, without needing any reforms to the AODA or to any accessibility standards. For example, the Committee raises concerns about the use of the term “obligated organization.” The term “obligated organization” can be changed, in the Government’s communications on the AODA. The term “obligated organization” does not itself appear in the AODA.

Similarly, the Government could do a far better job of outreach to and inclusion of people with disabilities in its ongoing AODA consultation and implementation efforts, including in its consultation on the Information and Communication Standards Development Committee’s draft recommendations which are the focus of this brief. That too requires no amendment to the AODA.

The Government could now create far better resources to guide obligated organizations. At least two of the AODA Independent Reviews have called for that very action. We strongly support the need for that.

Finally, it is open to the Government to review the Information and Communication Accessibility Standard more frequently than every five years, in order to keep it up to date in connection with new developments, such as new developments in the world of information technology or the creation of new international standards for the accessibility of information technology.

We also want to alert the Committee that we respectfully disagree with some of the key points in its Phase 2 discussion. We agree that the AODA’s implementation has fallen far short of what we all expected, what we all need and what the AODA promised. Our 450-page January 15, 2019 brief to the David Onley Independent Review may be the most detailed documentation of this failure. It explores in detail the causes of this failure and offers constructive proposals to get the AODA back on track. The Onley Report echoes our analysis in key ways, as did the 2015 Moran AODA Independent Review Report that proceeded it and on which it built.

The Committee’s Phase 2 discussion seems in no small part to be constructed on the premise that the AODA has failed because it has been undertaken as an exercise of a regulator compelling compliance through enforcement, rather than by trying to get obligated organizations to understand that it is in their self-interest to ensure that their goods, services, facilities, and employment are accessible. For example, the Committee’s Phase 2 discussion states:

“In the current model, the primary participants are the participating organizations and the provincial government compliance authority. The relationship is one of obligation and policing. The primary questions from obligated organizations are about what is required of them, and whether there might be exemptions. Their primary motivation for complying is avoiding penalties and/or reputational damage.

It is hard to blame organizations for this approach, because accessibility and inclusive design have traditionally been framed primarily as something that organizations must be legally compelled to do, rather than something that is also in their best interests. The fact is however, that there is significant evidence showing that inclusive design is in the interests of business. Research has shown that an organization that attends to inclusive design and accessibility, for customers and employees with disabilities, will garner economic, social and innovation benefits. There are both micro and macro-economic gains to be made for the participating company and for Ontario society as a whole, but that case is not being made clearly or often enough.”

As our brief to the Onley AODA Independent Review and our website amply documents, the opposite has in fact been the case. We have demonstrated over and over that the Ontario Government has throughout this decade taken an extremely weak and minimalist approach to AODA enforcement. For years, it would barely if ever even utter the word “enforcement” in public in connection with the AODA. It conducts “audits” of very few organizations each year.

These are only paper audits. We have only seen documentation of one on-site AODA audit or inspection from the day the AODA was passed up to at least 2017. That was a pre-announced inspection of one Government ministry by another Government ministry. In that case, the deputy minister of the inspecting ministry gave written prior notice to the deputy minister of the ministry to be inspected, that an inspection would be upcoming.

Despite knowing year after year about rampant AODA violations since 2013, the Government has only imposed a tiny number of monetary penalties. In 2015, 2016 and 2017 combined, for the thousands of private sector organizations known to have violated this legislation, the Government only imposed a total of five monetary penalties. That’s less than two monetary penalties for each of those years. That conveys the clear message to violators that their risk of a monetary penalty is extremely slim.

The Toronto Star has run editorials that support our concern in this regard. It has slammed the Ontario Government for its weak AODA enforcement. Contrary to the Committee’s characterization of events, Minister after Minister responsible for the AODA has publicly said that their primary focus is on doing exactly what the Committee proposed in the passage quoted above, i.e. showing businesses the business case for accessibility. A good example of this is the following passage from the February 26, 2015 interview on CBC Radio Toronto’s flagship Metro Morning program by the previous Liberal Government’s Economic Development Minister Brad Duguid (then responsible for AODA implementation and enforcement):

“[Matt Galloway] But her, her real, her real thrust in this, in the report, is that Ontario’s not moving quickly enough to reach the 2025 goal of full accessibility. I wanna read something to you that one of your predecessors put together, which was Marie Bountrogianni, who, uh, when the legislature passed the disabilities act said, “What was missing in the previous act was enforcement compliance.

When you leave it to the good will of the people, it doesn’t get done.” What’s changed since then?

[Brad Duguid] Well, there- there’s two things. Number one, you can’t enforce that if the businesses aren’t aware of what their responsibilities are. So, the first thing we need to do is make businesses more aware, and we’re doing that through a number of different initiatives. There’s the advertising campaign. We also have a partnership with the Ontario Chamber of Commerce where we’re reaching out to businesses an- and educating them on what they need to do.

Secondly, and this is the key, and when you, and I, I just recently appointed David Onley as our special advisor, and this is something we’re working very, very closely on. We need to make sure that businesses are, are aware of why there’s a competitive advantage for them to become accessible.

We don’t want businesses just to reach a standard, we want them to go beyond the standard and there’s every- there’s a really good business case for businesses across this province to do this. In fact, the Martin Institute indicates that there’s 7.9 billion dollars in our economy if we can become more accessible.

So, that- what I’m saying there is, I don’t want to come in and, and take a really hard approach on businesses and turn them off. What I wanna do is get businesses to embrace what this will do to their bottom line. There’s a really good business case.”

No minister responsible for this legislation has publicly proclaimed a contrary approach to AODA enforcement. No minister coming after Mr. Duguid has ever disagreed with his view, criticized it, or proclaimed a different approach. Certainly, the new Ford Government has not repudiated it.

The Committee’s Phase 2 discussion addresses a criticism at the AODA itself, which should instead be directed at the Accessibility Directorate of Ontario and the Ontario Government. The Committee’s Phase 2 discussion includes:

“The current model also does not harness the significant energy, knowledge and support of many community stakeholders who are deeply committed to accessibility. These include:

  • Students, many of whom participate in projects such as “mapathons”, design challenges and curriculum-based assignments
  • Ontario’s world-leading cluster of researchers specializing in accessibility and inclusive design
  • Non-obligated organizations that recognize the importance of accessibility without being compelled to comply by law
  • Persons with disabilities and their families or support communities
  • Professional organizations
  • Community volunteers
  • Civil society”

Similarly the Committee’s Phase 2 discussion later states:

“Ontario is home to many innovators, many of whom have turned their ingenuity to addressing accessibility challenges. Unfortunately, there is currently no easy way for these innovators, including obligated organizations or other stakeholders, to propose new and better strategies for addressing barriers. The relationship is strictly one way, with the Act essentially telling organizations what to do. This removes an incentive to innovate in accessibility.”

The Committee has commendably identified a legitimate area for improvement, but is identifying the wrong culprit. Under the AODA as now written, it is open to the Government to do a far more inclusive job of consulting and including the diverse voices to which the Committee points, in its work on the AODA’s implementation and enforcement. For example, Standards Development Committees could readily engage more such voices in their work developing standards. The Accessibility Directorate of Ontario can and should do much more of this within the ample mandate that the AODA gives it. Nothing in the AODA prohibits the Ontario Government from doing so.

As well, the Committee presents a very good series of suggestions for reform in its Appendix B. No Trusted Authority or other amendments to the AODA or to its current overall structure are needed to implement them. The IASR can and should be amended, such as in ss. 5 and 6, to incorporate the very helpful requirements that the Committee formulated in its Appendix B. With such a revision to the IASR we would be in clear support.

Appendix 1 Excerpts from the Mayo Moran Second Independent Review of the AODA

The 2014 Moran Report included;

“However, the Review also heard considerable discussion about the content of the standards. In particular, members of the disability community emphasized that the five standards in place so far – even if complied with to the letter – will not get us to full accessibility by 2025, or in fact ever. They identified two problems. First, the current standards have serious gaps and deficiencies. And second, important aspects of everyday life fall entirely outside the scope of the current requirements. At the same time, obligated organizations also provided valuable feedback about the content of the current standards and some of the challenges that they pose. Below, I summarize the central themes of the feedback on these issues, including both suggestions about where there may be gaps in the existing standards as well as recommendations for additional standards.

Proposed Revisions to Current Standards

The Review heard many comments that suggested revisions to existing standards. Various disability groups advocated specific changes to the standards to better reflect the needs of their members and clients. More generally, many participants believed that timelines in the standards are too long, several requirements are weak, little is being done to remove existing barriers, and exemptions and exceptions are too broad. One disability stakeholder considered the deficiencies in the IASR so serious that the mandatory review of the Transportation, Employment and Information and Communications standards should begin in 2015 instead of 2016 as currently planned. Many obligated organizations in both the public and private sectors had other concerns, emphasizing that the overall AODA regime is too complex and should be simplified as much as possible.

Members of the disability community emphasized that the five standards in place so far – even if complied with to the letter – will not get us to full accessibility by 2025, or in fact ever.

IMPACT ON SPECIFIC DISABILITIES

The Review was told by some participants that they do not believe that the AODA has been effective in addressing non-visible disabilities, such as mental illness, autism, learning disabilities, traumatic brain injuries and others. They suggested that more extensive training requirements to recognize and respond to the needs of people with these disabilities were essential.

The mental health community feels strongly that mental health and other non-visible disabilities should be better integrated into the content of standards. For example, it was suggested that the Employment standard should provide clear guidelines for accommodating employees with mental health disabilities.

Groups supporting people who are deaf or have hearing loss pointed out that the vagueness about support persons leaves doubt about an organization’s responsibility to provide interpreters or other communication facilitators. Individuals with speech and language disabilities not caused by hearing loss believe standards should more fully outline requirements for communications assistance, especially in essential services.

People with environmental sensitivities and multi-chemical sensitivities want to see these conditions explicitly included in the definition of disability. Participants with episodic or fluctuating disabilities likewise urged a direct reference to their type of disability in the definition. Representatives of people with bowel disorders called for a network of open, accessible public toilets to be established through the Customer Service, Transportation and Design of Public Spaces standards.

The Review was told that the AODA has not been effective in addressing non-visible disabilities.

EXEMPTIONS AND EXCEPTIONS

The existing regulations set different requirements based on the size of the organization. Where the line should be drawn between small and large businesses was a major source of contention in the feedback received by this Review. In fact, some felt it was a mistake to create any exemptions on the basis of the number of employees, as very small organizations can have huge revenue streams.

At present, there are many exemptions under the IASR for organizations with under 50 employees. For example, they are exempt from requirements to prepare multi-year accessibility plans, make their websites accessible, develop a written process for employment accommodation, provide accessible exterior paths of travel, prepare written accessibility policies and file compliance reports, among other obligations. It was suggested that one reason the AODA has not lived up to its potential is the number of organizations that are exempt from such obligations.

The Customer Service standard currently sets the threshold for certain requirements at 20 employees rather than 50. Currently, organizations with under 20 employees are exempt from requirements to prepare documents on their accessibility policies – including policies on service animals and support persons and the handling of service disruptions – and to produce copies on request, as well as from obligations to document training policies, keep training records and file accessibility reports. In its review of the Customer Service standard – which coincided with this Review – ASAC proposed to raise that threshold to 50 employees instead of 20 to align with the IASR, and several disability groups voiced their concerns about this proposal to this Review.

In addition to the exemptions based on organizational size, the Review also received some feedback on several other provisions that were questioned including the following:

  • Exemption of owner-operated sole proprietorships from the entire IASR as they have no employees.
  • Exclusion of the entire private sector from the duty to incorporate accessibility criteria and features when acquiring goods, service and facilities.
  • Exclusion of products and product labels from the Information and Communications standard.
  • Exclusion of unconvertible information from accessible format requirements, which some described as a loophole that should be closed.
  • Exemptions for all organizations except the provincial Government from the website provisions on live captioning and pre-recorded audio descriptions.

As well, disability stakeholders took issue with various exceptions that are less exacting than undue hardship under the Human Rights Code. This issue will be addressed later in the section on the AODA’s Relationship with Other Legislation.

GAPS IN STANDARDS

Beyond exemptions and the impact on certain disability groups, participants highlighted a host of gaps in existing standards and put forward numerous suggestions to close them.

Information and Communications

One of the gaps identified that was among the most serious sources of concern was the exclusion of extranets from the website standards. An extranet is a controlled extension of an organization’s internal network that allows access to outside users over the internet. It was pointed out that the standards development committee expected everything behind the log-in to be covered. The fact that this was not done is seen as a step backward.

Unless Ontario keeps standards in line with evolving information technology, we risk reaching 2025 and realizing we have made Ontario accessible, but for the citizens of 2005.

The importance of keeping the Information and Communications standards in line with evolving international standards was also stressed. Unless a mechanism is created to do this, the Review was told, we risk reaching 2025 and realizing we have made Ontario accessible, but for the citizens of 2005.

Some participants raised concerns about the provision of accessible formats for various purposes “on request”. They proposed that all educational resources should be accessible, with no need for a request. On the other hand, some post-secondary stakeholders pointed out that this might not be a wise use of resources as there may turn out to be no demand for many of the materials.”

Appendix 2 List of the AODA Alliance’s Recommendations in this Brief

#1. The Standard’s long term objective should be:

“By no later than 2025 and thereafter, people with disabilities will be able to participate fully and equally in the creation and use of information and communications.”

#2. The Committee’s recommendations should recommend that the definition of “accessible formats” in s. 2 of the Standard should be expanded to add “digital accessible formats that are readily readable on computers and portable technologies such as smart phones, using adaptive technology, but does not include documents in PDF format unless also accompanied by other accessible digital formats.”

#3. Section 5(5) of the IASR should be amended to provide:

“(5) In this section, “kiosk” means an interactive electronic terminal intended for public use that allows users to access one or more services, facilities, or products or a combination of them, and, without limiting the generality of the foregoing, includes any device used by a member of the public to make in whole or in part a transaction relating to a product, good, service or facility or combination thereof, such as a point of sale device that allows the customer to pay for items with a debit, credit or other electronic funds card.”

#4. The Committee should recommend that section 9(1) of the Standard should be amended to define “conversion-ready” as follows:

“conversion ready” means an electronic or digital format that ensures ready conversion into an accessible format that effectively retains the information content that can be read on a computer using widely available adaptive technology, and on hand-held or portable digital technology such as smart phones;”

(b) Section 9(4) should be amended to provide as follows:

“(4) For purposes of this Part, information or communications are unconvertible if,

  1. a) It is not possible to convert the information or communications without undue hardship; or
  2. b) The technology to convert the information or communications is not available without undue hardship.”

#6. The Committee should recommend the addition to the standard of a requirement that if an obligated organization posts a PDF online, it should also simultaneously post the same document in an accessible format such as MS Word, txt or html.

#7. The Committee’s Draft Recommendation 4 should be revised to recommend that the Information and Communication Accessibility Standard should be amended now to set enforceable accessibility standards for products and product labels. This should not await Ontario working out a joint approach to this with the Federal Government, or the Ontario Government working with the private sector on developing non-regulatory innovations in this area. Section 9(2) (should be amended to provide an exemption only for:

“Products and product labels, where compliance with the information and communication requirements would impose an undue hardship on the organization.”

#8. The Committee’s Draft Recommendation 5 should be expanded to propose that s. 12 of the Information and Communication Accessibility Standard be amended to state that where an obligated organization does not agree to provide the accessible format which the person with a disability requested, the obligated organization must investigate alternative ways to meet this need, up to the point of undue hardship.

#9. Section 12 of the Information and Communication Accessibility Standard should be amended to set specific fixed or presumptive timelines for an obligated organization to provide an accessible alternative format for a document when requested. If the timeline is to be a presumptive one, rather than a categorical one, it should only be subject to an undue hardship defence for non compliance. The Committee should recommend timelines that are short e.g. 48-72 hours, where the obligated organization is a large one, and or where the requested information relates to important matters such as health or safety or other vital services. Otherwise nothing longer than a 7 day timeline should apply.

#10. The Committee’s Draft Recommendation 10 should be expanded to:

  1. a) propose an amendment to the Information and Communication Accessibility Standard to require the Committee’s proposed measures regarding the Ontario Government translating certain information into the Sign Languages ASL and LSQ on demand, and
  1. b) expand that requirement to include captioning for any such video content, for the benefit of people with hearing loss who need captioning and not Sign Language.

#11. The Committee should recommend that section 12(1) of the Standard be amended to provide:

“12. (1) Except as otherwise provided, every obligated organization shall upon request provide or arrange for the provision of accessible formats and communication supports for persons with disabilities,

(a)   in a timely manner that meets the person’s accessibility needs due to disability, except where doing so would cause an undue hardship to the organization; and

(b)   at a cost that is no more than the regular cost charged to other persons.”

#12. Section 12(3) of the Standard should be amended to provide:

“(3) Every obligated organization shall notify the public in an accessible format about the availability of accessible formats and communication supports, and, without limiting the generality of the foregoing, shall post such notification in an accessible format on the organization’s website, if it has one.”

#13. Section 12(4) of the Standard should be re-written in plain language to make it intelligible.

#14. The Information and Communication Standards Development Committee should seek direct input including a face-to-face meeting with Communications Disabilities Access Canada and address its concerns regarding the Standard.

#15. Section 13 of the Standard should be expanded to impose a requirement that an organization include in any emergency procedures plan, specific measures to ensure that emergency announcements (such as fire alarms) are provided in an accessible means (e.g. flashing lights for the benefit of persons with hearing loss).

#16. The Committee’s Draft Recommendation 15, to create a category of high-impact private organizations, should be refined to:

  1. a) Create criteria that will be easily measured and enforced, where possible.
  1. b) measure the number of an organization’s users, customers or interactions inside or outside Ontario. If for example, the organization has a huge customer base around the world, the fact that a smaller number of users in Ontario should not militate against it being categorized as a high-impact organization.
  1. c) Make the threshold revenue as $1 million not $10 million as the Committee’s draft recommendations propose.
  1. d) Recommend the revision of s. 14 (website accessibility) to make website requirements extend further within the private sector, beyond the proposed new category of high impact organizations.

#17. Section 14 of the Standard should be revised to require websites to comply with the new international standard of WCAG 2.1, not the old WCAG 2.0 which the Information and Communication Accessibility Standard now requires.

#18. As an alternative, section 14(2) should be amended to eliminate WCAG 2.0 Level A, and not Level AA, as a bare minimum for any organization, in the event that WCAG 2.1 is not set as the new standard to meet.

#19. The Committee’s Draft Recommendation 13 should recommend that section 14 of the Standard should be amended to set full accessibility requirements to mobile applications, and to the websites, web applications and mobile applications of small organizations where compliance would not pose an undue hardship.

#20. The Committee’s Draft Recommendation 17 should be replaced with a recommendation that the Standard’s not practicable exception from website accessibility is removed from section 14. As a weaker and less desirable alternative, if there is to remain some sort of exemption in s. 14(5), it should provide that an obligated organization need not meet these accessibility requirements only if it can show that it would be impossible to meet such requirements without causing that organization undue hardship, and that the obligated organization has the duty to never less take all accessibility action that is possible up to the point of undue hardship.

#21. Section 14 of the Standard should be amended to require any organization to promptly make available, on the request of a person with a disability, and in an accessible format that meets his or her needs, any information on the organization’s website that is not accessible to that person because of his or her disability.

#22. The Committee’s Draft Recommendation 19 should be revised to set the deadline for all publicly-facing websites to meet accessibility requirements as 2022, not 2023.

#23. The Committee’s Draft Recommendation 21 should be expanded to require an obligated organization to provide an item of pre-2012 inaccessible online content or document in an accessible format on request if needed for purposes of seeking or using that organization’s goods, services or facilities or for purposes of employment.

#24. The Committee’s Draft Recommendation 22 should be revised to provide that the current exemption for live captioning and audio description should be lifted by 2021 for the City of Toronto.

#25. a) Where a large organization, a high impact organization or a public sector organization has a Chief Information Officer or Chief Technology Officer position or their equivalent:

  1. a) The CIO is responsible and accountable for leading the organization’s efforts at ensuring digital information accessibility in the organization’s internal and external digital communications.
  1. b) If the organization has a performance contract or performance review process for its officers, it shall be a condition of the CIO’s or CTO’s performance contract that the CIO or CTO is responsible and accountable for ensuring digital information accessibility and for ensuring that Accessibility is an integrated component of Performance and Security design requirements.
  1. c) In any performance review, performance-based pay review or promotion processes, the CIO’s or CTO’s performance on digital information accessibility shall be considered as a relevant factor.
  1. d) In considering whom to hire as CIO or CTO, a hiring factor or criterion should be a candidate’s knowledge and experience with respect to digital information accessibility and assistive technology.

#26. The Standard should be amended to require that when any public sector organization, large organization or high impact private sector organization uses a web-based teleconferencing platform, it should only use a platform which is accessible. If no such platforms are fully accessible, then such organizations should be required to use the most accessible platforms of those which are available. The Standard should provide key criteria for assessing the accessibility of such platforms.

#27. The Standard should be revised to require that public sector organizations, large private sector organizations and high impact private sector organizations shall prepare an annual or biennial accessibility statement and make it public on its website which:

  1. a) Specifies in detail the extent to which the organization’s website and mobile apps are accessible and specifies where they are not and
  1. b) Gives reasons for any deficiencies in the accessibility of the website or mobile apps and indicates what the organization plans to do to rectify this, and by when.

#28. Beyond the measures in the Committee’s Draft Recommendation 14, the IASR’s general procurement provisions should be strengthened to specify end-user functionality requirements that are sufficiently flexible to accommodate emerging technologies.

#29. The Government should fulfil its overdue duty under the AODA to appoint a Standards Development Committee to review all the general provisions in the IASR, sections 1 through 8.

#30. Any changes to the requirements for procurement of goods, services or facilities should go into effect within six months of the new regulation being enacted, and should apply to any procurement thereafter, or for which a contract was signed after the draft of this new regulation was publicly posted for comment, unless the obligated organization can show that to comply would cause it an undue hardship.

#31. Section 5(1) of the IASR should be amended to read:

“5. (1) The Government of Ontario, Legislative Assembly and designated public sector organizations shall

(a) Incorporate accessibility criteria and features when procuring or acquiring goods, services or facilities, for purposes of acquiring or procuring goods, services or facilities that are accessible to persons with disabilities, and

(b) Acquire or procure goods, services and facilities for use in their organization, or for the benefit of the public, that are accessible to persons with disabilities, except where it is not possible to procure or acquire them without undue hardship.”

#32. Section 5(2) of the IASR should be amended to provide:

“(2) If the Government of Ontario, Legislative Assembly or a designated public sector organization determines that it was not able to acquire or procure accessible goods, services or facilities without undue hardship in accordance with paragraph 5(1) (b), it shall provide, upon request, an explanation in writing.”

#33. Sections 5(1) and (2) should be amended to extend their requirements to large private sector organizations and high-impact private sector organizations.

#34. The IASR’s procurement requirements should be amended to apply to any private sector organization in connection with any work it is doing for or on behalf of the Ontario Government.

#35. Section 6(1) of the IASR should be amended to read:

“6. (1) Without limiting the generality of section 5, the Government of Ontario, Legislative Assembly, designated public sector organizations, large private sector organizations and high impact private sector organizations shall incorporate accessibility features when designing, procuring or acquiring self-service kiosks or any point-of-sale technology for use by the public, to ensure that they are accessible to and usable by persons with disabilities.”

#36. Section 6(2) of the IASR should be amended to read:

“(2) Small organizations shall have regard to the accessibility for persons with disabilities when designing, procuring or acquiring self-service kiosks or any other point-of-sale technology for use by the public, and in any event, shall use accessible point-of-sale equipment when acquiring new point-of-sale equipment for use by customers, or replacing existing point-of-sale equipment.”

#37. Section 5(5) of the IASR should be amended to provide:

“(5) In this section,

“kiosk” means an interactive electronic terminal intended for public use that allows users to access one or more services, facilities, or products or a combination of them, and, without limiting the generality of the foregoing, includes any device used by a member of the public to make in whole or in part a transaction relating to a product, good, service or facility or combination thereof, such as a point of sale device that allows the customer to pay for items with a debit, credit or other electronic funds card.”

#38. The Committee’s Draft Recommendation 18 should be amended to call for the website accessibility requirements in s. 14 to apply to any website to which provincial legislation or regulations apply, such as a provincial law that requires specified information to be posted on a website.

#39. Sections 15 to 18 of the Standard should be amended to ensure the accessibility of instructional and other information in Ontario’s education system, in accordance with Recommendations 8.1, 8.2, 12.1 and 12.2 of the AODA Alliance’s October 10, 2019 proposed framework for the contents of the K-12Education Accessibility Standard.

#40. The Committee’s Recommendation 24 should be expanded to also require that obligated organizations that are educational or training institutions be required to order electronic textbooks or other electronic curricula materials from producers who agree to provide accessible or conversion-ready versions, in the same time frame as non-accessible versions.

#41. Section 15 of the Standard should be amended to:

(a) Amend the opening words of section 15(1) to provide:

“1.   Provide educational or training resources or materials in an accessible format that meet the accessibility needs due to a disability of the person with a disability to whom the material is to be provided by…”

(b) Require each obligated organization that is an educational or training institution to notify their students, applicants for admission and faculty/teachers, via accessible means, of their commitment to provide accessible curriculum and teaching materials;

(c) Post on their website, if any, their commitment to provide accessible teaching and curriculum materials, and an indication of who within the organization is responsible for their provision;

(d) Add to ss. 15(1) and (2) a requirement that these teaching and curriculum materials are to be available at the same time as the same teaching or curriculum materials are provided to students in the same program or course, except in exceptional cases where it is impossible to do so, in which case alternative measures will be immediately taken to enable a person with a disability to fully participate in the course or program.

(e) Add to section 15 a requirement that where curriculum materials such as textbooks are to be ordered from other sources, the curriculum materials shall be in an accessible format or conversion-ready, except where it can be shown that these cannot be obtained without undue hardship.

(f) Add to section 15 a requirement that notwithstanding the timelines for accessible websites, any information posted to a website for use by students shall be in an accessible format and shall comply forthwith with WCAG 2.0 Level AA unless it can be shown that to do so is impossible without undue hardship, in which case accessible alternative format materials shall be provided immediately on request.

(g) No school, college or university shall provide books or other like materials via paperless technology such as on mobile apps on the iPad or Kindle unless that technology has become accessible for persons with disabilities.

#42. Section 17(1) and (2) of the Standard should be amended to provide:

“17. (1) Every obligated organization that is a producer of education or training textbooks or other teaching materials (whether in printed form or electronic form) for educational or training institutions shall upon request, promptly make accessible or conversion ready versions of the textbooks or other teaching materials available to the institutions.

(2) Every obligated organization that is a producer of print-based or electronic educational or training supplementary learning resources for educational or training institutions shall upon request, promptly make accessible or conversion ready versions of the printed or electronic materials available to the institutions.”

#43. The Committee’s Recommendation 25 should be expanded to define the scope of education programs to which its obligations should attach. This should be tied to the nature of the program and the extent to which ensuring accessibility would trigger an undue hardship

#44. Section 18(2) of the Standard should be amended to include a clear and narrow definition of “special collection”, or that exemption should be removed from this provision.

#45. The Committee’s Recommendation 26 should be expanded to recommend that the Government create or fund the creation of an Ontario-based remote captioning service that could service clients in Ontario and around the world by remotely-located captionists, providing their services online.

#46. The Committee’s Recommendation 27 should be expanded to incorporate the AODA Alliance’s proposed Framework for the Education Accessibility Standard, which includes:

“11.1 To eliminate attitudinal barriers among students, school board employees and some families of students, each school board should:

  1. a) Develop and implement a multi-year program/curriculum for teaching students, school board staff and families of school board students, about inclusion and full participation of students with disabilities, tailored to age levels. Because online courses are inadequate for this, where possible, this should include hearing from, meeting and interacting with people with disabilities e.g. at assemblies and/or via guest presentations.
  1. b) Post in all schools and send information to all families of the school board’s students, on the school board’s commitment to inclusion of students with disabilities, and the benefits this brings to all students.
  1. c) Provide specific training to all school board staff that deal with parents or students, on the importance of inclusion.
  1. d) Implement human resources policies and practices to expand school board staff knowledge and skills regarding inclusion.”

#47. The Committee’s Draft Recommendation 28 (calling for obligated organizations which provide education or training on the design, production, innovation, maintenance or delivery of information and communication tools and systems to include curricula that address the needs of people with disabilities) should give some specific examples of the needed training, including differently affected disabilities, beyond its reference to Sign language.

#48. The Committee should recommend that the Ontario Government should now adopt a concerted strategy, as part of its economic development efforts, of promoting the expansion of Ontario’s technology development sector with expertise in accessible design.

#49. Section 16(1) of the Standard should be amended to provide:

“16. (1) In addition to the requirements under section 7, obligated organizations that are school boards or educational or training institutions shall provide educators with accessibility awareness training related to accessible program or course delivery and instruction, and their educators shall satisfactorily complete that training.”

[1] The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018, S.8(1). Retrieved at http://www.legislation.gov.uk/uksi/2018/952/made#f00004; Directive (EU) 2016/2102 of the European Parliament and of the Council of 26 October 2016 on the accessibility of the websites and mobile applications of public sector bodies, S.7(1). Retrieved at http://www.legislation.gov.uk/eudr/2016/2102/contents

[2] The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018, s.3; Directive (EU) 2016/2102 of the European Parliament and of the Council, Article 7(1).

[3] The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018, section 4(a)(b).

[4] Integrated Accessibility Standards, s.9(3)(a).



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Please Support the AODA Alliance’s Finalized Brief to the David Onley Independent Review of the AODA’s Implementation and Enforcement


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

January 18, 2019

SUMMARY

We wish one and all a happy and barrier-free New Year! We are kicking off 2019 by making public the AODA Alliance’s finalized brief that calls for significant reforms to the Ontario Government’s implementation and enforcement of the Accessibility for Ontarians with Disabilities Act (AODA). We have just submitted this finalized brief to the hon. David Onley, whom the Ontario Government appointed last February to conduct a mandatory Independent Review of the AODA’s implementation and enforcement.

You can download our entire finalized brief in an accessible MS Word document by visiting https://www.aodaalliance.org/wp-content/uploads/2019/01/Jan-15-2019-AODA-Alliance-brief-to-david-onley-AODA-Independent-Review-with-pagination.docx

If you want to just read the findings that we urge David Onley to reach, and the recommendations we urge him to make, you can see all of these gathered, chapter by chapter, in one place, in the brief’s appendix, which you can download in an accessible MS Word document by visiting https://www.aodaalliance.org/wp-content/uploads/2019/01/jan-15-2019-appendix-to-AODA-Alliance-brief-to-david-onley-with-pagination.docx

Late last fall, we made public a draft of this brief, and invited input. Thanks to all who shared their feedback. Our finalized brief includes everything that was in the draft brief. There have been some minor wording adjustments, typos fixed, and formatting adjustments.
We have added three short sections to the brief. We set these out below. They total 12 pages. In summary:

1. In the introductory chapter, we added the new heading 6. It urges Mr. Onley to issue a strong and if at all possible, immediate recommendation that the Ontario Government now lift its freeze on the work of the Health Care Standards Development Committee and the 2 Education Standards Development Committees. We did so after learning that late last month; Minister for Accessibility and Seniors Raymond Cho wrote the Health Care Standards Development Committee and two Education Standards Development Committees to say that the Government is now awaiting David Onley’s report before deciding what to do about the Government’s seven-month-long freeze on the work of those AODA Standards Development Committees. This new part of the brief reproduces what the Ontario Government said in that letter.

2. In Chapter 1, we added the new heading 6. It explains why, in our view, Ontario has fallen behind schedule for reaching its 2025 accessibility deadline.

3. In Chapter 1, we added the new heading 10 at the end of that chapter. It spells out why, in our view, our recommendations fit well within the agenda of Ontario’s new Government. We encourage Mr. Onley to address that topic in his report.

We encourage one and all to send David Onley a short email, voicing your support for the findings and recommendations in the AODA Alliance finalized brief. You can email him at [email protected]

If you don’t have time to say more, you might just say something like this:

“I support the findings and recommendations in the AODA Alliance’s January 15, 2019 brief to the David Onley AODA Independent Review.”

MORE DETAILS

Major New Additions in the AODA Alliance’s finalized January 15, 2019 Brief to the David Onley AODA Independent Review

Introductory Chapter
8. Right Off the Top The Pressing Need for This Independent Review to Recommend that the New Ontario Government Immediately Lift Its Freeze on the AODA Health Care and Education Standards Development Committees

Before diving into the range of issues that this brief explores in depth in the following chapters, we wish as an important preliminary matter to urge this AODA Independent Review to recommend as soon as possible that the Ontario Government should immediately lift its 7-month freeze on the work of the Health Care Standards Development Committee and the two Education Standards Development Committees that have been appointed under the AODA. We encourage this Independent Review to issue a short interim report, in order to make this recommendation, and to get it in the Government’s hands as soon as possible.

Heading 7 in Chapter 5 of this brief addresses the need for Ontario to develop and enact an Education Accessibility Standard to tear down the disability accessibility barriers facing students with disabilities in Ontario’s education system, and a Health Care Accessibility Standard to tear down the barriers facing patients with disabilities in Ontario’s health care system. Students with disabilities face too many disability accessibility barriers in Ontario’s education system. Patients with disabilities face too many barriers in Ontario’s health care system.

That chapter addresses the pressing need for the new Ontario Government to lift its freeze on the work of three Standards Development Committees which were already at work before the 2018 Ontario election. These committees were developing recommendations for an Education Accessibility Standard and a Health Care Accessibility Standard.

It took us many years and tenacious advocacy to eventually get the former Ontario Government to agree to develop new AODA accessibility standards to address those barriers. In 2017, the former Government appointed a Health Care Standards Development Committee. In Early 2018, it appointed a K-12 Education Standards Development Committee and a Post-Secondary Education Standards Development Committee. They were hard at work when their work was frozen last June, in the wake of the June 2018 Ontario election. Their work remains frozen to this day.

Chapter 5 explains why it is essential for these Standards Development Committees to be allowed to resume their work without further delay, and for this seven-month freeze to be lifted. In our unsuccessful efforts over the past seven months to get this freeze lifted, the new Government has never claimed that Ontario’s education system and health care system are barrier-free for people with disabilities, or that there is no need for people with disabilities to have accessibility in the areas of health care or education. However, just days ago, we learned that the Government has said that it is waiting for the report of this AODA Independent Review before it decides whether to lift its freeze on the work of those Standards Development Committees.

On January 9, 2019, we received a copy of the December 20, 2018 letter from Minister for Accessibility and Seniors Raymond Cho to the chair of the K-12 Standards Development Committee. In that letter, Minister Cho stated:

“I am writing to update you on the status of the K-12 Education Standards Development Committee.

As you know, the Hon. David Onleys Third Legislative Review of the Accessibility for Ontarians with Disabilities Act is currently underway and nearing its submission date. At Mr. Onleys request, he has been granted a one-month extension to complete his work, and his report is now due on January 31, 2019. I am looking forward to reading his assessment of the AODA and any proposed recommendations.

In this regard, we will be waiting to review Mr. Onleys report before considering the best path forward to further improving accessibility in Ontario.

Since taking office in June, our new Government for the People has acted swiftly and with determination to implement change that will get Ontario back on track. Once we have analysed and carefully considered the Review, we intend to move forward with the same determination to break down barriers, improve accessibility and make Ontario open for business for everyone.

Your committee has already done meaningful work exploring barriers faced by kindergarten to Grade 12 students. As the Minister for Seniors and Accessibility, I appreciate your valuable contribution. I wish you a happy holiday season and look forward to working with you in the New Year.”

Before this, the Government had not made any public statement that it was awaiting this AODA Independent Review’s report before deciding on the future of these Standards Development Committees. The Government has known of the existence of this AODA Independent Review for months. Had the Government earlier said that it was awaiting this Independent Review’s advice on point, we would have immediately urged this Independent Review to issue a short interim report to recommend that this freeze be lifted.

Much public attention in the past months has focused on the new Government’s concern to reduce the costs of government. Chapter 5 of this brief offers several recommendations on how the standards development process under the AODA can be conducted in a more cost-effective way.

The impact of this freeze has been an increased cost to the public, including people with disabilities. As long as Ontario continues without effective accessibility standards in the areas of health care and education, health care providers and facilities, as well as schools, colleges and universities will continue to create new disability barriers, including doing so with public money. (See further Chapter 7) It will cost the public more for those barriers to later be removed. It also costs the public more when the Government leaves it to each education organization and each health care organization to re-invent the accessibility wheel, rather than having the benefit of the directions of clear and strong accessibility standards in these areas.

There is no need for the Government to study and decide on the other issues that this Independent Review will address before it decides on lifting the freeze on these Standards Development Committees. Last fall, the Government was able to decide, without the benefit of this Independent Review’s report, to lift its freeze on the work of the Employment Standards Development Committee and the Information and Communication Standards Development Committee. As is documented in Chapter 5, the new Government, when in opposition, was sufficiently familiar with these issues to demand that the former Ontario Government agree to develop an Education Accessibility Standard, and to appoint a Standards Development Committee to work on it.

Any further delay in deciding on lifting the freeze only continues to hurt students with disabilities and patients with disabilities. An immediate, short interim report making the recommendation requested here would help more swiftly bring that delay to an end.

If this Independent Review does not issue an interim report on this topic, then we encourage this Independent Review to place a recommendation to lift this freeze close to the start of its final report to the Government, so that it is prominent.

Chapter 1

6. Why is Ontario So Far Behind Schedule for Becoming Accessible to People with Disabilities by 2025?

Pervading this brief is a fundamentally important question: Why is Ontario so far behind schedule for becoming accessible by 2025? How did Ontario find itself in this predicament over 13.5 years after the AODA was enacted, and less than 6 years before the 2025 deadline for becoming accessible?

It is important for this AODA Independent Review to consider this question, in order to formulate appropriate reform recommendations that will hit the mark. We here identify several causes for Ontario’s current accessibility predicament. We do not list them in order of importance or significance. These causes combine together to produce the problem Ontario now faces.

Before listing these causes, we must address one factor that is clearly not a cause for this predicament. The problem is not that the Ontario Government didn’t know what needs to be done to get Ontario on schedule for full accessibility by 2025. What needs to be done has been very clear for years. The AODA spells much of it out in the legislation itself. Two successive Government-appointed AODA Independent Reviews, the 2010 Charles Beer AODA Independent Review and the 2014 Mayo Moran AODA Independent Review, each gave the Ontario Government clear and productive recommendations.

The Government has had ample avenues to get input and advice. AODA Standards Development Committees have given the Government detailed recommendations. The Accessibility Standards Advisory Council has been available to advise the Government. For three years, the Government also had the benefit of the position of Special Advisor on Accessibility, reporting to the minister responsible for the AODA.

As well, community organizations like the AODA Alliance have given the Government advice and detailed recommendations through formal consultation sessions, and informal meetings and discussions. Time and again, this advice pointed in the same direction. As well, needed action has often been spelled out in election promises, by some or all of the political parties, including the Ontario Liberal Party that brought forward the AODA in 2004-2005 and that was in power for most of the time since then. Opposition parties raised concerns and suggestions in debates in the Legislature and through informal discussions with Government MPPs.

Thus, we turn our attention to the causes for this predicament. Prominent among these, especially in recent years, is the fact that there has been a troubling lack of concerted and effective leadership on this issue from Ontario’s Premier and from the Premier’s Office. This chapter later discusses this.

Both the 2010 Charles Beer AODA Independent Review Report and the 2014 Mayo Moran AODA Independent Review Report called for the Ontario Government to show new leadership on the AODA’s implementation and enforcement. Both reports called for the AODA’s implementation to be revitalized, and for new life to be breathed into it. The 2014 final report of the Mayo Moran AODA Independent Review specifically called for new leadership by the Premier, as a priority. Despite these strong recommendations from authoritative reviews that the former Ontario Government itself appointed, none of this new leadership and revitalization ever materialized.

For example, Premier Wynne never kept her 2014 written election promise to the AODA Alliance that she would instruct her ministers on their accessibility obligations and commitments. As this chapter and Chapter 10 discusses, she did not include many if not most of these commitments and obligations in her Mandate Letters to her ministers. No doubt, the ministers got the implicit message from this that these simply were not priorities.

Closely related to that cause for Ontario’s predicament, the lack of effective leadership on this issue thereafter appears to have trickled down to the senior political levels within the Ontario Government. Within any large organization like the Ontario Government, if there is a lack of effective leadership at the top on an issue, this risks spreading in the organization as a negative signal. When this persists over time, it becomes even more embedded within the organization’s DNA and harder to change.

That clearly appears to have occurred within the Ontario Government in the case of the accessibility issue. After the AODA was enacted, there has too often been a demonstrable lack of sustained political will on this issue in the party in power. Ministers periodically make encouraging speeches. During elections, political parties make encouraging pledges on accessibility. Yet at an operational level, it has quite infrequently gone beyond this at senior levels within the Ontario Government. This is so even though there were individuals within the governing party’s caucus, and even within its Cabinet, that wanted to do much more on accessibility.

By now, most of the MPPs who advocated for the enactment of the AODA and who voted for it have left politics. Their replacements came into public life without having taken part in the events leading to the AODA’s enactment.

Further contributing to this predicament are problems at the Accessibility Directorate of Ontario, addressed further later in this chapter and in Chapter 5. The Accessibility Directorate is the Government office that is responsible for leading the AODA’s implementation and enforcement. Here again, within the Accessibility Directorate were any number of dedicated, hard-working individuals who wanted to do a good job. However, despite this, problems persisted. Our brief offers several recommendations to fix this recurring problem.

As Chapter 10 details, the Ontario Public Service appears more generally too often to have served as a barrier to progress on accessibility. There are some within the Ontario Public Service who are dedicated supporters on this issue. However, as an overall organization, it too frequently has served as a collective drag on progress, and even an impediment or opponent to progress.

Chapter 10 of this brief shows that the Ontario Government including the Ontario Public Service has not ensured that it is a fully accessible service-provider and employer. The Ontario Government repeatedly claims to lead by example, but continues to lead by a poor example. Over the years, we have met with successive deputy ministers responsible for the operations of the Ontario Public Service as an employer and service-provider, and with successive Secretaries of Cabinet to highlight this problem and to offer constructive solutions, too often without needed success for our efforts.

Making the foregoing worse as a cause of this problem has been the Government’s excessive secrecy around the operations of the Government on this issue, addressed later in this chapter and in Chapter 5. As but one example, the Ontario Government went to excessive lengths to throw obstacles in the AODA Alliance’s path when we tried to get access to information about the AODA’s enforcement in 2013 and 2015. They even sent an armada of fully five lawyers to an Information and Privacy Commission hearing in opposition to the AODA Alliance, in order to further that goal. Similarly, undue secrecy surrounds the work of AODA Standards Development Committees, and conceals the Government’s planning process for new public infrastructure. Thus, bureaucrats and private contractors can with impunity resist efforts at ensuring that this new infrastructure is accessible, without being subject to effective and timely public scrutiny or accountability. Chapters 1, 2, 5 and 7 7 further address this.

Also, slowing progress has been the lack of a multi-year provincial plan for the AODA’s implementation and enforcement to get Ontario to reach the 2025 deadline on time. This chapter later explores this.

Progress on accessibility has also been slowed by weak and ineffective AODA enforcement. Chapter 2 addresses this in detail. Those who violate the AODA, even knowingly and repeatedly, have little if anything to fear in the way of real and practical consequences. This is so despite the Government knowing of rampant AODA violations in the private sector for years, and despite ample unused funds being on hand for AODA enforcement.

Also, slowing progress on accessibility has been the fact that the AODA accessibility standards enacted to date, while helpful, are too weak and limited, as Chapter 3 addresses. Even if fully obeyed, the existing AODA accessibility standards won’t ensure that obligated organizations will become accessible by 2025, or ever. The Ontario Government has done very little to address this problem which the 2014 final report of the Mayo Moran AODA Independent Review had amply documented. Chapter 4 of this brief also shows several important areas where new accessibility standards are needed under the AODA, including, for example, a strong, effective and comprehensive Built Environment Accessibility Standard. Our efforts to get the Ontario Government to develop and enact a Health Care Accessibility Standard for patients with disabilities and an Education Accessibility Standard for students with disabilities have met with years of foot-dragging by the previous Government, exacerbated by more foot-dragging by the new Ontario Government.

Creating new accessibility standards and reviewing the sufficiency of existing accessibility standards every five years is core to the AODA’s capacity to lead Ontario to 2025 as a fully accessible province. The process for developing new AODA accessibility standards and for conducting periodic reviews of existing standards is fraught with problems, as Chapter 5 demonstrates. Chapter 5 of this brief shows that there is a need to substantially reform and strengthen the process for developing AODA accessibility standards.

Also exacerbating this predicament, there remain serious problems with the Ontario Government’s efforts at educating the public, including obligated organizations, about accessibility and the AODA. As but two examples, there is a pressing need for schools to provide students with curriculum on accessibility standards, and for there to be mandatory accessibility training for professionals in fields like architecture and interior design. Chapter 6 describes this problem and recommends reforms.

Further slowing progress towards 2025, there remain in place several levers of readily available public power that the Ontario Government could easily and far more effectively use to promote progress on accessibility, but which the Government has not effectively used. Chapter 7 of this brief demonstrates that the Ontario Government has failed to ensure that public money is never used to create or perpetuate disability accessibility barriers. Chapter 8 of this brief shows that the Ontario Government has not effectively reviewed all Ontario laws to ensure that they do not create or permit disability accessibility barriers. This is so even though all parties in the 2007 election promised that such a review would be completed. Chapter 9 of this brief explains that the Ontario Government has not acted effectively to ensure that provincial and municipal elections in Ontario are accessible to voters and candidates with disabilities.

Finally, Chapter 11 shows that there is a pressing need for the Ontario Government to implement a strong and effective new strategy, beyond enacting an Employment Accessibility Standard, to substantially increase the opportunities for the employment of people with disabilities in Ontario. The former Ontario Government promised action in this area. Yet it dragged its feet for years, and then announced a strategy in June 2017 that is too weak and high-level.

All of the above explains the causes for Ontario being behind schedule up to the June 2018 Ontario election. Over the past seven months since then, an additional cause has arisen. The new Ontario Government has not implemented any new action to kick-start new efforts on the AODA’s implementation and enforcement. In addition, it injected more delay, by maintaining for months a freeze on the work of AODA Standards Development Committees. This is addressed in Chapters 4 and 5. That freeze was lifted later last fall in the case of two of the frozen Standards Development Committees. That freeze remains in effect for three other Standards Development Committees, as is addressed at several points in this brief, including in the Introduction.

It is, of course, entirely understandable that a new Government will take some time to get up to speed on the wide range of issues it must handle. However, to reduce this risk, we had provided assistance to Ontario’s new government early on, by:

* Briefing Ontario’s Progressive Conservative Party over the months in advance of the election on key accessibility issues that the Government is facing.

* Last spring, sending all party leaders a detailed list of commitments on disability accessibility that we sought in the June 2018 election. It briefs all parties on the key issues.

* Sending Premier Doug Ford and Minister for Accessibility and Seniors Raymond Cho detailed letters in July 2018 that spell out the key actions needed in this area, as are referenced throughout this brief.

All political parties have agreed that Ontario should become accessible to people with disabilities by 2025, and that the Ontario Government, through the AODA, should lead our concerted efforts towards that goal. Any comprehensive strategy to get Ontario back on schedule needs to address all the multiple causes for our current predicament of being far behind schedule. This brief offers concrete and constructive recommendations to that end. At one time or other, and often on many occasions, we have pressed the Ontario Government to take all of these measures. As this brief details, in a good number of cases, the former Ontario Government promised any number of these actions, but too often failed to keep its word. We urge this AODA Independent Review to make all the recommendations we propose so that Ontario’s new Government and the public have a constructive action plan that can be implemented to kick-start a new era of faster and more effective progress on accessibility.

Chapter 1

10. Why Strong Action on Accessibility Fits within the Agenda of Ontario’s New Government

Strong, effective Government action on accessibility fits well within the agenda of Ontario’s new Government. In addressing this, we emphasize that this AODA Independent Review, like the AODA Alliance, is strictly non-partisan.

Accessibility for Ontarians with disabilities is a non-partisan issue. All parties in the Legislature have, at various times, brought forward legislation or amendments, and pressed for more action on accessibility. All parties have emphasized that disability barriers eventually hurt everyone, since everyone eventually is bound to get a disability. Each party has emphasized that accessibility is good for people with disabilities, for all members of the public, and for business.

Ontario’s Progressive Conservative Party has made written election commitments on the need for disability accessibility legislation in elections in 1995, 2007, 2014 and 2018. These letters were signed by PC leaders Mike Harris, John Tory, Tim Hudak, and most recently, by Doug Ford.

On October 29, 1998, when Mike Harris was Ontario’s premier, the Legislature unanimously passed an historic resolution. It adopted eleven important principles that a strong and effective Disabilities Act should fulfil. Each PC MPP in the Legislature voted for that resolution.

In 2005, all parties, including each PC MPP, voted unanimously to pass the AODA, and gave it a standing ovation. The AODA requires Ontario to become accessible to people with disabilities by 2025. It requires the Government to lead Ontario to that goal by enacting and effectively enforcing regulations called accessibility standards.

During the 2005 clause-by-clause debate on the AODA, the PC Party proposed amendments at the request of our predecessor coalition, to make the bill even stronger. After the AODA was enacted, the PC leader congratulated the Government for passing it. On a number of occasions while in opposition, the Ontario PC Party has put questions to the Ontario Government at our request, to press for more action on the AODA’s implementation.

In his May 15, 2018 letter to the AODA Alliance, Doug Ford continued the PC Party’s commitment to this legislation and its goal, reaffirming:

“Making Ontario fully accessible by 2025 is an important goal under the AODA and its one that would be taken seriously by an Ontario PC government.”

That record fits within a bigger picture. In each of the three Canadian provinces which enacted accessibility legislation, namely Ontario (2005), Manitoba (2013) and Nova Scotia (2017), that legislation unanimously passed. Each Conservative Party supported it.

Similarly, last fall, when the House of Commons passed Bill C-81, the proposed Accessible Canada Act, it was unanimously supported, including by the Conservative Party of Canada. On behalf of the disability community, the Conservative Party of Canada proposed amendments in the House of Commons that would have strengthened Bill C-81 amendments which the Federal Government voted down.

Looking more broadly. The Americans with Disabilities Act was proudly signed into law in 1990 by Republican US President George H.W. Bush. Earlier, when he was US Vice President, President Ronald Reagan appointed him to chair a national de-regulation task force. The Americans with Disabilities Act was supported in the US Congress by Democrats and Republicans alike, including by Senator Bob Dole, who later ran for president as Republican nominee.

The need for the Ontario Government to lead Ontario to disability accessibility by 2025 aligns with the PC Party’s current agenda. In Doug Ford’s May 15, 2018 letter to the AODA Alliance, he committed:

“Your issues are close to the hearts of our Ontario PC Caucus” and
“they will play an outstanding role in shaping policy for the Ontario PC Party.”

He committed during the 2018 election to lead a Government “for the people”. At least 1.9 million of the people of Ontario now have a disability. The rest are bound to later get a disability, as they grow older. “The people” are, at some time in their lives, all people with disabilities.

The Government has announced the goal to make Ontario open for business. This needs to include ensuring that Ontario is open for employees, job-seekers, business owners and customers with disabilities.

The new Government said it aims to be responsible in the use of taxpayers’ money. We suggest it was irresponsible for public money to be used in the past to create or perpetuate accessibility barriers against people with disabilities, as we address further in Chapter 7. An ounce of barrier prevention is worth many pounds of cure. A firm commitment to accessibility saves taxpayers the expense of re-doing projects after the fact, to fix accessibility barriers that should have been prevented. Clear and time-based accessibility standards promote stability for businesses, who can then plan with those standards in mind.

In Doug Ford’s May 15, 2018 letter to the AODA Alliance, written during the 2018 election campaign, he made a number of important points. These show why it is so important for the AODA to be effectively implemented.

As we explain in Chapter 3, the 2011 AODA Employment Accessibility Standard, now under review by the Employment Standards Development Committee, needs to be strengthened to ensure that the workplaces of tomorrow are barrier-free for job-seekers and employees with disabilities. To do so fits well within the position of the PC Party. In his May 15, 2018 letter to the AODA Alliance, Doug Ford wrote:

“When it comes to people with disabilities, we have a moral and an economic responsibility to focus on their abilities and not just on what holds them back. Our family members, friends and neighbours who have a disability of some kind are a wellspring of talent and determination.

It’s also completely unacceptable that someone should be passed over for a job because of the myth that people with disabilities can’t do the work. We have a moral and social responsibility to change this.”

As Chapter 9 of this brief shows, voters with disabilities can still encounter unfair voting barriers in elections in Ontario. Fixing this problem with new legislation is well within the PC Party’s record. It was commendable that in 2010, when the Legislature was considering bill 231 (intended to modernize Ontario elections), the PC Party proposed a number of good amendments at our request to make voting fully accessible to voters with disabilities. The previous Government defeated those amendments.

Further showing that action in this area fits within the new Government’s agenda, in his May 15, 2018 letter, Doug Ford also wrote:

“There’s no good reason why a person with a disability should not be able to cast a vote in an election.”

Creating, enacting and enforcing a strong Education Accessibility Standard under the AODA falls well within the PC Party’s platform and perspective. While in opposition, the PC Party helped us in Question Period over the past three years to get the previous Government to agree to create an Education Accessibility Standard under the AODA. Moreover, in his May 15, 2018 letter to the AODA Alliance, Doug Ford also wrote:

“The Ontario PC Party believes our education system must minimize barriers for students with disabilities, providing the skills, opportunities and connections with the business community that are necessary to enter the workforce.”

Developing needed accessibility standards, including in the area of the built environment, is also well within the PC Party’s platform. As well, Doug Ford wrote:

“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.”

Doug Ford’s May 15, 2018 letter highlighted Christine Elliot’s important role within the PC Party on disability issues. The PC Party designated her to speak on behalf of the Ontario PC Party at the May 16, 2018 provincial all-candidates’ debate on disability issues, held in Toronto. She there made important commitments on the PC Party’s behalf, on issues such as the AODA’s implementation and enforcement, on ensuring that students with disabilities can fully participate in education at school, colleges and university, on ODSP reform, on the need for affordable, accessible and, where needed, supportive housing, and other topics.

In his letter, Doug Ford expressed a strong desire to work with the AODA Alliance on disability accessibility issues. He wrote:

“Building a strong, open dialogue with your organization is most certainly a priority for our party. We encourage you to continue this dialogue and share your ideas and solutions for Ontarians with disabilities.”

The new Government ran for office on a platform to try to make the Ontario Government a more efficient operation. This brief identifies a number of troubling inefficiencies in how the Ontario Government has approached accessibility and recommends cost-effective improvements.

The new Government ran for office on an agenda to reduce the number of regulations, particularly as they apply to businesses. That platform doesn’t stand in the way of the Government effectively implementing and enforcing the AODA, including through the enactment of needed accessibility standards under the AODA.

The points made above give illustrations where AODA accessibility standard regulations fit within the PC agenda. Moreover, it was not the new Government’s platform to eliminate all regulations in Ontario, or to refuse to ever enact any new regulations in any circumstance.

Conservative governments with a strong de-regulation agenda can nevertheless enact and enforce regulations where they are needed. As noted above, US Vice President Bush led a national de-regulation task force in the US, and yet, when later elected president, proudly supported the enactment of the Americans with Disabilities Act, a landmark new regulatory law.

Moreover, Ontario’s Conservative Party had a similar platform in favour of a reduction in regulatory burdens when its MPPs unanimously voted to pass the AODA. That party, with that platform, made commendable efforts on behalf of Ontarians with disabilities to get the AODA’s regulatory requirements strengthened in 2005, when it was still a bill before the Legislature.

As well, nothing in Premier Ford’s May 15, 2018 letter to the AODA Alliance, quoted earlier, signals any reluctance to or objection to the use of regulatory measures to achieve accessibility for people with disabilities in Ontario. As just noted above, and as is addressed at various points in this brief, the PC Party did not run on a platform to reduce the AODA’s implementation and enforcement. When in opposition, the PC Party supported the AODA Alliance’s efforts to get a new regulation developed in Ontario under the AODA, an Education Accessibility Standard.

The new Government is concerned about regulatory burdens on small business. The AODA was carefully designed so that accessibility standards need not be “one size fits all.” accessibility standards can and do set different requirements for big business than for small businesses, and can set different timelines for big business than for small business. In fact all accessibility standards to date enacted under the AODA do so. If anything, accessibility standards to date exempt or provide substantially reduced provisions for small business.

Finally, in the end, any AODA accessibility standard regulations do not impose any new substantive obligations on businesses or other organizations. Rather, they implement the rights which are already guaranteed to people with disabilities under the Ontario Human Rights Code, and where applicable, the Charter of Rights. If those regulations are developed properly and are effective, they can help businesses in Ontario make money. Accessibility means a business gets access to a wider customer base and a wider pool of potential employees. They help a business retain existing employees as they acquire disabilities, through illness, injury or the natural aging process. They are able to serve a huge international market. There are upwards of one billion people with disabilities around the world.

Therefore, Ontario’s new Government should be open to consider, to accept and to welcome the recommendations for action that this brief proposes.



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Please Support the AODA Alliance’s Finalized Brief to the David Onley Independent Review of the AODA’s Implementation and Enforcement


Accessibility for Ontarians with Disabilities Act Alliance Update

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

www.aodaalliance.org  [email protected] Twitter: @aodaalliance

Please Support the AODA Alliance’s Finalized Brief to the David Onley Independent Review of the AODA’s Implementation and Enforcement

January 18, 2019

          SUMMARY

We wish one and all a happy and barrier-free New Year! We are kicking off 2019 by making public the AODA Alliance’s finalized brief that calls for significant reforms to the Ontario Government’s implementation and enforcement of the Accessibility for Ontarians with Disabilities Act (AODA). We have just submitted this finalized brief to the hon. David Onley, whom the Ontario Government appointed last February to conduct a mandatory Independent Review of the AODA’s implementation and enforcement.

You can download our entire finalized brief in an accessible MS Word document by visiting https://www.aodaalliance.org/wp-content/uploads/2019/01/Jan-15-2019-AODA-Alliance-brief-to-david-onley-AODA-Independent-Review-with-pagination.docx

If you want to just read the findings that we urge David Onley to reach, and the recommendations we urge him to make, you can see all of these gathered, chapter by chapter, in one place, in the brief’s appendix, which you can download in an accessible MS Word document by visiting https://www.aodaalliance.org/wp-content/uploads/2019/01/jan-15-2019-appendix-to-AODA-Alliance-brief-to-david-onley-with-pagination.docx

Late last fall, we made public a draft of this brief, and invited input. Thanks to all who shared their feedback. Our finalized brief includes everything that was in the draft brief. There have been some minor wording adjustments, typos fixed, and formatting adjustments.

We have added three short sections to the brief. We set these out below. They total 12 pages. In summary:

  1. In the introductory chapter, we added the new heading 6. It urges Mr. Onley to issue a strong and if at all possible, immediate recommendation that the Ontario Government now lift its freeze on the work of the Health Care Standards Development Committee and the 2 Education Standards Development Committees. We did so after learning that late last month; Minister for Accessibility and Seniors Raymond Cho wrote the Health Care Standards Development Committee and two Education Standards Development Committees to say that the Government is now awaiting David Onley’s report before deciding what to do about the Government’s seven-month-long freeze on the work of those AODA Standards Development Committees. This new part of the brief reproduces what the Ontario Government said in that letter.
  1. In Chapter 1, we added the new heading 6. It explains why, in our view, Ontario has fallen behind schedule for reaching its 2025 accessibility deadline.
  1. In Chapter 1, we added the new heading 10 at the end of that chapter. It spells out why, in our view, our recommendations fit well within the agenda of Ontario’s new Government. We encourage Mr. Onley to address that topic in his report.

We encourage one and all to send David Onley a short email, voicing your support for the findings and recommendations in the AODA Alliance finalized brief. You can email him at [email protected]

If you don’t have time to say more, you might just say something like this:

“I support the findings and recommendations in the AODA Alliance’s January 15, 2019 brief to the David Onley AODA Independent Review.”

MORE DETAILS

Major New Additions in the AODA Alliance’s finalized January 15, 2019 Brief to the David Onley AODA Independent Review

Introductory Chapter

8. Right Off the Top – The Pressing Need for This Independent Review to Recommend that the New Ontario Government Immediately Lift Its Freeze on the AODA Health Care and Education Standards Development Committees

Before diving into the range of issues that this brief explores in depth in the following chapters, we wish as an important preliminary matter to urge this AODA Independent Review to recommend as soon as possible that the Ontario Government should immediately lift its 7-month freeze on the work of the Health Care Standards Development Committee and the two Education Standards Development Committees that have been appointed under the AODA. We encourage this Independent Review to issue a short interim report, in order to make this recommendation, and to get it in the Government’s hands as soon as possible.

Heading 7 in Chapter 5 of this brief addresses the need for Ontario to develop and enact an Education Accessibility Standard to tear down the disability accessibility barriers facing students with disabilities in Ontario’s education system, and a Health Care Accessibility Standard to tear down the barriers facing patients with disabilities in Ontario’s health care system. Students with disabilities face too many disability accessibility barriers in Ontario’s education system. Patients with disabilities face too many barriers in Ontario’s health care system.

That chapter addresses the pressing need for the new Ontario Government to lift its freeze on the work of three Standards Development Committees which were already at work before the 2018 Ontario election. These committees were developing recommendations for an Education Accessibility Standard and a Health Care Accessibility Standard.

It took us many years and tenacious advocacy to eventually get the former Ontario Government to agree to develop new AODA accessibility standards to address those barriers. In 2017, the former Government appointed a Health Care Standards Development Committee. In Early 2018, it appointed a K-12 Education Standards Development Committee and a Post-Secondary Education Standards Development Committee. They were hard at work when their work was frozen last June, in the wake of the June 2018 Ontario election. Their work remains frozen to this day.

Chapter 5 explains why it is essential for these Standards Development Committees to be allowed to resume their work without further delay, and for this seven-month freeze to be lifted. In our unsuccessful efforts over the past seven months to get this freeze lifted, the new Government has never claimed that Ontario’s education system and health care system are barrier-free for people with disabilities, or that there is no need for people with disabilities to have accessibility in the areas of health care or education. However, just days ago, we learned that the Government has said that it is waiting for the report of this AODA Independent Review before it decides whether to lift its freeze on the work of those Standards Development Committees.

On January 9, 2019, we received a copy of the December 20, 2018 letter from Minister for Accessibility and Seniors Raymond Cho to the chair of the K-12 Standards Development Committee. In that letter, Minister Cho stated:

“I am writing to update you on the status of the K-12 Education Standards Development Committee.

As you know, the Hon. David Onley’s Third Legislative Review of the Accessibility for Ontarians with Disabilities Act is currently underway and nearing its submission date. At Mr. Onley’s request, he has been granted a one-month extension to complete his work, and his report is now due on January 31, 2019. I am looking forward to reading his assessment of the AODA and any proposed recommendations.

In this regard, we will be waiting to review Mr. Onley’s report before considering the best path forward to further improving accessibility in Ontario.

Since taking office in June, our new Government for the People has acted swiftly and with determination to implement change that will get Ontario back on track. Once we have analysed and carefully considered the Review, we intend to move forward with the same determination to break down barriers, improve accessibility and make Ontario open for business for everyone.

Your committee has already done meaningful work exploring barriers faced by kindergarten to Grade 12 students. As the Minister for Seniors and Accessibility, I appreciate your valuable contribution. I wish you a happy holiday season and look forward to working with you in the New Year.”

Before this, the Government had not made any public statement that it was awaiting this AODA Independent Review’s report before deciding on the future of these Standards Development Committees. The Government has known of the existence of this AODA Independent Review for months. Had the Government earlier said that it was awaiting this Independent Review’s advice on point, we would have immediately urged this Independent Review to issue a short interim report to recommend that this freeze be lifted.

Much public attention in the past months has focused on the new Government’s concern to reduce the costs of government. Chapter 5 of this brief offers several recommendations on how the standards development process under the AODA can be conducted in a more cost-effective way.

The impact of this freeze has been an increased cost to the public, including people with disabilities. As long as Ontario continues without effective accessibility standards in the areas of health care and education, health care providers and facilities, as well as schools, colleges and universities will continue to create new disability barriers, including doing so with public money. (See further Chapter 7) It will cost the public more for those barriers to later be removed. It also costs the public more when the Government leaves it to each education organization and each health care organization to re-invent the accessibility wheel, rather than having the benefit of the directions of clear and strong accessibility standards in these areas.

There is no need for the Government to study and decide on the other issues that this Independent Review will address before it decides on lifting the freeze on these Standards Development Committees. Last fall, the Government was able to decide, without the benefit of this Independent Review’s report, to lift its freeze on the work of the Employment Standards Development Committee and the Information and Communication Standards Development Committee. As is documented in Chapter 5, the new Government, when in opposition, was sufficiently familiar with these issues to demand that the former Ontario Government agree to develop an Education Accessibility Standard, and to appoint a Standards Development Committee to work on it.

Any further delay in deciding on lifting the freeze only continues to hurt students with disabilities and patients with disabilities. An immediate, short interim report making the recommendation requested here would help more swiftly bring that delay to an end.

If this Independent Review does not issue an interim report on this topic, then we encourage this Independent Review to place a recommendation to lift this freeze close to the start of its final report to the Government, so that it is prominent.

Chapter 1

6. Why is Ontario So Far Behind Schedule for Becoming Accessible to People with Disabilities by 2025?

Pervading this brief is a fundamentally important question: Why is Ontario so far behind schedule for becoming accessible by 2025? How did Ontario find itself in this predicament over 13.5 years after the AODA was enacted, and less than 6 years before the 2025 deadline for becoming accessible?

It is important for this AODA Independent Review to consider this question, in order to formulate appropriate reform recommendations that will hit the mark. We here identify several causes for Ontario’s current accessibility predicament. We do not list them in order of importance or significance. These causes combine together to produce the problem Ontario now faces.

Before listing these causes, we must address one factor that is clearly not a cause for this predicament. The problem is not that the Ontario Government didn’t know what needs to be done to get Ontario on schedule for full accessibility by 2025. What needs to be done has been very clear for years. The AODA spells much of it out in the legislation itself. Two successive Government-appointed AODA Independent Reviews, the 2010 Charles Beer AODA Independent Review and the 2014 Mayo Moran AODA Independent Review, each gave the Ontario Government clear and productive recommendations.

The Government has had ample avenues to get input and advice. AODA Standards Development Committees have given the Government detailed recommendations. The Accessibility Standards Advisory Council has been available to advise the Government. For three years, the Government also had the benefit of the position of Special Advisor on Accessibility, reporting to the minister responsible for the AODA.

As well, community organizations like the AODA Alliance have given the Government advice and detailed recommendations through formal consultation sessions, and informal meetings and discussions. Time and again, this advice pointed in the same direction. As well, needed action has often been spelled out in election promises, by some or all of the political parties, including the Ontario Liberal Party that brought forward the AODA in 2004-2005 and that was in power for most of the time since then. Opposition parties raised concerns and suggestions in debates in the Legislature and through informal discussions with Government MPPs.

Thus, we turn our attention to the causes for this predicament. Prominent among these, especially in recent years, is the fact that there has been a troubling lack of concerted and effective leadership on this issue from Ontario’s Premier and from the Premier’s Office. This chapter later discusses this.

Both the 2010 Charles Beer AODA Independent Review Report and the 2014 Mayo Moran AODA Independent Review Report called for the Ontario Government to show new leadership on the AODA’s implementation and enforcement. Both reports called for the AODA’s implementation to be revitalized, and for new life to be breathed into it. The 2014 final report of the Mayo Moran AODA Independent Review specifically called for new leadership by the Premier, as a priority. Despite these strong recommendations from authoritative reviews that the former Ontario Government itself appointed, none of this new leadership and revitalization ever materialized.

For example, Premier Wynne never kept her 2014 written election promise to the AODA Alliance that she would instruct her ministers on their accessibility obligations and commitments. As this chapter and Chapter 10 discusses, she did not include many if not most of these commitments and obligations in her Mandate Letters to her ministers. No doubt, the ministers got the implicit message from this that these simply were not priorities.

Closely related to that cause for Ontario’s predicament, the lack of effective leadership on this issue thereafter appears to have trickled down to the senior political levels within the Ontario Government. Within any large organization like the Ontario Government, if there is a lack of effective leadership at the top on an issue, this risks spreading in the organization as a negative signal. When this persists over time, it becomes even more embedded within the organization’s DNA and harder to change.

That clearly appears to have occurred within the Ontario Government in the case of the accessibility issue. After the AODA was enacted, there has too often been a demonstrable lack of sustained political will on this issue in the party in power. Ministers periodically make encouraging speeches. During elections, political parties make encouraging pledges on accessibility. Yet at an operational level, it has quite infrequently gone beyond this at senior levels within the Ontario Government. This is so even though there were individuals within the governing party’s caucus, and even within its Cabinet, that wanted to do much more on accessibility.

By now, most of the MPPs who advocated for the enactment of the AODA and who voted for it have left politics. Their replacements came into public life without having taken part in the events leading to the AODA’s enactment.

Further contributing to this predicament are problems at the Accessibility Directorate of Ontario, addressed further later in this chapter and in Chapter 5. The Accessibility Directorate is the Government office that is responsible for leading the AODA’s implementation and enforcement. Here again, within the Accessibility Directorate were any number of dedicated, hard-working individuals who wanted to do a good job. However, despite this, problems persisted. Our brief offers several recommendations to fix this recurring problem.

As Chapter 10 details, the Ontario Public Service appears more generally too often to have served as a barrier to progress on accessibility. There are some within the Ontario Public Service who are dedicated supporters on this issue. However, as an overall organization, it too frequently has served as a collective drag on progress, and even an impediment or opponent to progress.

Chapter 10 of this brief shows that the Ontario Government including the Ontario Public Service has not ensured that it is a fully accessible service-provider and employer. The Ontario Government repeatedly claims to lead by example, but continues to lead by a poor example. Over the years, we have met with successive deputy ministers responsible for the operations of the Ontario Public Service as an employer and service-provider, and with successive Secretaries of Cabinet to highlight this problem and to offer constructive solutions, too often without needed success for our efforts.

Making the foregoing worse as a cause of this problem has been the Government’s excessive secrecy around the operations of the Government on this issue, addressed later in this chapter and in Chapter 5. As but one example, the Ontario Government went to excessive lengths to throw obstacles in the AODA Alliance’s path when we tried to get access to information about the AODA’s enforcement in 2013 and 2015. They even sent an armada of fully five lawyers to an Information and Privacy Commission hearing in opposition to the AODA Alliance, in order to further that goal. Similarly, undue secrecy surrounds the work of AODA Standards Development Committees, and conceals the Government’s planning process for new public infrastructure. Thus, bureaucrats and private contractors can with impunity resist efforts at ensuring that this new infrastructure is accessible, without being subject to effective and timely public scrutiny or accountability. Chapters 1, 2, 5 and 7 7 further address this.

Also, slowing progress has been the lack of a multi-year provincial plan for the AODA’s implementation and enforcement to get Ontario to reach the 2025 deadline on time. This chapter later explores this.

Progress on accessibility has also been slowed by weak and ineffective AODA enforcement. Chapter 2 addresses this in detail. Those who violate the AODA, even knowingly and repeatedly, have little if anything to fear in the way of real and practical consequences. This is so despite the Government knowing of rampant AODA violations in the private sector for years, and despite ample unused funds being on hand for AODA enforcement.

Also, slowing progress on accessibility has been the fact that the AODA accessibility standards enacted to date, while helpful, are too weak and limited, as   Chapter 3 addresses. Even if fully obeyed, the existing AODA accessibility standards won’t ensure that obligated organizations will become accessible by 2025, or ever. The Ontario Government has done very little to address this problem which the 2014 final report of the Mayo Moran AODA Independent Review had amply documented. Chapter 4 of this brief also shows several important areas where new accessibility standards are needed under the AODA, including, for example, a strong, effective and comprehensive Built Environment Accessibility Standard. Our efforts to get the Ontario Government to develop and enact a Health Care Accessibility Standard for patients with disabilities and an Education Accessibility Standard for students with disabilities have met with years of foot-dragging by the previous Government, exacerbated by more foot-dragging by the new Ontario Government.

Creating new accessibility standards and reviewing the sufficiency of existing accessibility standards every five years is core to the AODA’s capacity to lead Ontario to 2025 as a fully accessible province. The process for developing new AODA accessibility standards and for conducting periodic reviews of existing standards is fraught with problems, as Chapter 5 demonstrates. Chapter 5 of this brief shows that there is a need to substantially reform and strengthen the process for developing AODA accessibility standards.

Also exacerbating this predicament, there remain serious problems with the Ontario Government’s efforts at educating the public, including obligated organizations, about accessibility and the AODA. As but two examples, there is a pressing need for schools to provide students with curriculum on accessibility standards, and for there to be mandatory accessibility training for professionals in fields like architecture and interior design. Chapter 6 describes this problem and recommends reforms.

Further slowing progress towards 2025, there remain in place several levers of readily available public power that the Ontario Government could easily and far more effectively use to promote progress on accessibility, but which the Government has not effectively used. Chapter 7 of this brief demonstrates that the Ontario Government has failed to ensure that public money is never used to create or perpetuate disability accessibility barriers. Chapter 8 of this brief shows that the Ontario Government has not effectively reviewed all Ontario laws to ensure that they do not create or permit disability accessibility barriers. This is so even though all parties in the 2007 election promised that such a review would be completed. Chapter 9 of this brief explains that the Ontario Government has not acted effectively to ensure that provincial and municipal elections in Ontario are accessible to voters and candidates with disabilities.

Finally, Chapter 11 shows that there is a pressing need for the Ontario Government to implement a strong and effective new strategy, beyond enacting an Employment Accessibility Standard, to substantially increase the opportunities for the employment of people with disabilities in Ontario. The former Ontario Government promised action in this area. Yet it dragged its feet for years, and then announced a strategy in June 2017 that is too weak and high-level.

All of the above explains the causes for Ontario being behind schedule up to the June 2018 Ontario election. Over the past seven months since then, an additional cause has arisen. The new Ontario Government has not implemented any new action to kick-start new efforts on the AODA’s implementation and enforcement. In addition, it injected more delay, by maintaining for months a freeze on the work of AODA Standards Development Committees. This is addressed in Chapters 4 and 5. That freeze was lifted later last fall in the case of two of the frozen Standards Development Committees. That freeze remains in effect for three other Standards Development Committees, as is addressed at several points in this brief, including in the Introduction.

It is, of course, entirely understandable that a new Government will take some time to get up to speed on the wide range of issues it must handle. However, to reduce this risk, we had provided assistance to Ontario’s new government early on, by:

* Briefing Ontario’s Progressive Conservative Party over the months in advance of the election on key accessibility issues that the Government is facing.

* Last spring, sending all party leaders a detailed list of commitments on disability accessibility that we sought in the June 2018 election. It briefs all parties on the key issues.

* Sending Premier Doug Ford and Minister for Accessibility and Seniors Raymond Cho detailed letters in July 2018 that spell out the key actions needed in this area, as are referenced throughout this brief.

All political parties have agreed that Ontario should become accessible to people with disabilities by 2025, and that the Ontario Government, through the AODA, should lead our concerted efforts towards that goal. Any comprehensive strategy to get Ontario back on schedule needs to address all the multiple causes for our current predicament of being far behind schedule. This brief offers concrete and constructive recommendations to that end. At one time or other, and often on many occasions, we have pressed the Ontario Government to take all of these measures. As this brief details, in a good number of cases, the former Ontario Government promised any number of these actions, but too often failed to keep its word. We urge this AODA Independent Review to make all the recommendations we propose so that Ontario’s new Government and the public have a constructive action plan that can be implemented to kick-start a new era of faster and more effective progress on accessibility.

Chapter 1

10. Why Strong Action on Accessibility Fits within the Agenda of Ontario’s New Government

Strong, effective Government action on accessibility fits well within the agenda of Ontario’s new Government. In addressing this, we emphasize that this AODA Independent Review, like the AODA Alliance, is strictly non-partisan.

Accessibility for Ontarians with disabilities is a non-partisan issue. All parties in the Legislature have, at various times, brought forward legislation or amendments, and pressed for more action on accessibility. All parties have emphasized that disability barriers eventually hurt everyone, since everyone eventually is bound to get a disability. Each party has emphasized that accessibility is good for people with disabilities, for all members of the public, and for business.

Ontario’s Progressive Conservative Party has made written election commitments on the need for disability accessibility legislation in elections in 1995, 2007, 2014 and 2018. These letters were signed by PC leaders Mike Harris, John Tory, Tim Hudak, and most recently, by Doug Ford.

On October 29, 1998, when Mike Harris was Ontario’s premier, the Legislature unanimously passed an historic resolution. It adopted eleven important principles that a strong and effective Disabilities Act should fulfil. Each PC MPP in the Legislature voted for that resolution.

In 2005, all parties, including each PC MPP, voted unanimously to pass the AODA, and gave it a standing ovation. The AODA requires Ontario to become accessible to people with disabilities by 2025. It requires the Government to lead Ontario to that goal by enacting and effectively enforcing regulations called accessibility standards.

During the 2005 clause-by-clause debate on the AODA, the PC Party proposed amendments at the request of our predecessor coalition, to make the bill even stronger. After the AODA was enacted, the PC leader congratulated the Government for passing it. On a number of occasions while in opposition, the Ontario PC Party has put questions to the Ontario Government at our request, to press for more action on the AODA’s implementation.

In his May 15, 2018 letter to the AODA Alliance, Doug Ford continued the PC Party’s commitment to this legislation and its goal, reaffirming:

“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.”

That record fits within a bigger picture. In each of the three Canadian provinces which enacted accessibility legislation, namely Ontario (2005), Manitoba (2013) and Nova Scotia (2017), that legislation unanimously passed. Each Conservative Party supported it.

Similarly, last fall, when the House of Commons passed Bill C-81, the proposed Accessible Canada Act, it was unanimously supported, including by the Conservative Party of Canada. On behalf of the disability community, the Conservative Party of Canada proposed amendments in the House of Commons that would have strengthened Bill C-81 – amendments which the Federal Government voted down.

Looking more broadly. The Americans with Disabilities Act was proudly signed into law in 1990 by Republican US President George H.W. Bush. Earlier, when he was US Vice President, President Ronald Reagan appointed him to chair a national de-regulation task force. The Americans with Disabilities Act was supported in the US Congress by Democrats and Republicans alike, including by Senator Bob Dole, who later ran for president as Republican nominee.

The need for the Ontario Government to lead Ontario to disability accessibility by 2025 aligns with the PC Party’s current agenda. In Doug Ford’s May 15, 2018 letter to the AODA Alliance, he committed:

“Your issues are close to the hearts of our Ontario PC Caucus”

and

“they will play an outstanding role in shaping policy for the Ontario PC Party.”

He committed during the 2018 election to lead a Government “for the people”. At least 1.9 million of the people of Ontario now have a disability. The rest are bound to later get a disability, as they grow older. “The people” are, at some time in their lives, all people with disabilities.

The Government has announced the goal to make Ontario open for business. This needs to include ensuring that Ontario is open for employees, job-seekers, business owners and customers with disabilities.

The new Government said it aims to be responsible in the use of taxpayers’ money. We suggest it was irresponsible for public money to be used in the past to create or perpetuate accessibility barriers against people with disabilities, as we address further in Chapter 7.  An ounce of barrier prevention is worth many pounds of cure. A firm commitment to accessibility saves taxpayers the expense of re-doing projects after the fact, to fix accessibility barriers that should have been prevented. Clear and time-based accessibility standards promote stability for businesses, who can then plan with those standards in mind.

In Doug Ford’s May 15, 2018 letter to the AODA Alliance, written during the 2018 election campaign, he made a number of important points. These show why it is so important for the AODA to be effectively implemented.

As we explain in Chapter 3, the 2011 AODA Employment Accessibility Standard, now under review by the Employment Standards Development Committee, needs to be strengthened to ensure that the workplaces of tomorrow are barrier-free for job-seekers and employees with disabilities. To do so fits well within the position of the PC Party. In his May 15, 2018 letter to the AODA Alliance, Doug Ford wrote:

“When it comes to people with disabilities, we have a moral and an economic responsibility to focus on their abilities and not just on what holds them back. Our family members, friends and neighbours who have a disability of some kind are a wellspring of talent and determination….

…It’s also completely unacceptable that someone should be passed over for a job because of the myth that people with disabilities can’t do the work. We have a moral and social responsibility to change this.”

As Chapter 9 of this brief shows, voters with disabilities can still encounter unfair voting barriers in elections in Ontario. Fixing this problem with new legislation is well within the PC Party’s record. It was commendable that in 2010, when the Legislature was considering bill 231 (intended to modernize Ontario elections), the PC Party proposed a number of good amendments at our request to make voting fully accessible to voters with disabilities. The previous Government defeated those amendments.

Further showing that action in this area fits within the new Government’s agenda, in his May 15, 2018 letter, Doug Ford also wrote:

“There’s no good reason why a person with a disability should not be able to cast a vote in an election.”

Creating, enacting and enforcing a strong Education Accessibility Standard under the AODA falls well within the PC Party’s platform and perspective. While in opposition, the PC Party helped us in Question Period over the past three years to get the previous Government to agree to create an Education Accessibility Standard under the AODA. Moreover, in his May 15, 2018 letter to the AODA Alliance, Doug Ford also wrote:

“The Ontario PC Party believes our education system must minimize barriers for students with disabilities, providing the skills, opportunities and connections with the business community that are necessary to enter the workforce.”

Developing needed accessibility standards, including in the area of the built environment, is also well within the PC Party’s platform. As well, Doug Ford wrote:

“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.”

Doug Ford’s May 15, 2018 letter highlighted Christine Elliot’s important role within the PC Party on disability issues. The PC Party designated her to speak on behalf of the Ontario PC Party at the May 16, 2018 provincial all-candidates’ debate on disability issues, held in Toronto. She there made important commitments on the PC Party’s behalf, on issues such as the AODA’s implementation and enforcement, on ensuring that students with disabilities can fully participate in education at school, colleges and university, on ODSP reform, on the need for affordable, accessible and, where needed, supportive housing, and other topics.

In his letter, Doug Ford expressed a strong desire to work with the AODA Alliance on disability accessibility issues. He wrote:

“Building a strong, open dialogue with your organization is most certainly a priority for our party. We encourage you to continue this dialogue and share your ideas and solutions for Ontarians with disabilities.”

The new Government ran for office on a platform to try to make the Ontario Government a more efficient operation. This brief identifies a number of troubling inefficiencies in how the Ontario Government has approached accessibility and recommends cost-effective improvements.

The new Government ran for office on an agenda to reduce the number of regulations, particularly as they apply to businesses. That platform doesn’t stand in the way of the Government effectively implementing and enforcing the AODA, including through the enactment of needed accessibility standards under the AODA.

The points made above give illustrations where AODA accessibility standard regulations fit within the PC agenda. Moreover, it was not the new Government’s platform to eliminate all regulations in Ontario, or to refuse to ever enact any new regulations in any circumstance.

Conservative governments with a strong de-regulation agenda can nevertheless enact and enforce regulations where they are needed. As noted above, US Vice President Bush led a national de-regulation task force in the US, and yet, when later elected president, proudly supported the enactment of the Americans with Disabilities Act, a landmark new regulatory law.

Moreover, Ontario’s Conservative Party had a similar platform in favour of a reduction in regulatory burdens when its MPPs unanimously voted to pass the AODA. That party, with that platform, made commendable efforts on behalf of Ontarians with disabilities to get the AODA’s regulatory requirements strengthened in 2005, when it was still a bill before the Legislature.

As well, nothing in Premier Ford’s May 15, 2018 letter to the AODA Alliance, quoted earlier, signals any reluctance to or objection to the use of regulatory measures to achieve accessibility for people with disabilities in Ontario. As just noted above, and as is addressed at various points in this brief, the PC Party did not run on a platform to reduce the AODA’s implementation and enforcement. When in opposition, the PC Party supported the AODA Alliance’s efforts to get a new regulation developed in Ontario under the AODA, an Education Accessibility Standard.

The new Government is concerned about regulatory burdens on small business. The AODA was carefully designed so that accessibility standards need not be “one size fits all.” accessibility standards can and do set different requirements for big business than for small businesses, and can set different timelines for big business than for small business. In fact all accessibility standards to date enacted under the AODA do so. If anything, accessibility standards to date exempt or provide substantially reduced provisions for small business.

Finally, in the end, any AODA accessibility standard regulations do not impose any new substantive obligations on businesses or other organizations. Rather, they implement the rights which are already guaranteed to people with disabilities under the Ontario Human Rights Code, and where applicable, the Charter of Rights. If those regulations are developed properly and are effective, they can help businesses in Ontario make money. Accessibility means a business gets access to a wider customer base and a wider pool of potential employees. They help a business retain existing employees as they acquire disabilities, through illness, injury or the natural aging process. They are able to serve a huge international market. There are upwards of one billion people with disabilities around the world.

Therefore, Ontario’s new Government should be open to consider, to accept and to welcome the recommendations for action that this brief proposes.



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Click here to download in MS Word format the appendix to the January 15, 2019 finalized AODA Alliance brief to the David Onley AODA Independent Review, to read all the findings we urge and the recommendations we make.



Click here to download in MS Word format the appendix to the January 15, 2019 finalized AODA Alliance brief to the David Onley AODA Independent Review, to read all the findings we urge and the recommendations we make.



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