An Important New Report to the Ontario Government Calls on the Government and School Boards to Take Action Now to Ensure that One Third of a Million Students with Disabilities are Able to Fully Participate in Ontario Schools as They Re-Open This Fall


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/

An Important New Report to the Ontario Government Calls on the Government and School Boards to Take Action Now to Ensure that One Third of a Million Students with Disabilities are Able to Fully Participate in Ontario Schools as They Re-Open This Fall

August 14, 2020

          SUMMARY

We today share with you a very important new report that bears on the needs of a third of a million students with disabilities in Ontario-funded schools, as the COVID-19 pandemic continues. Three weeks ago, the Ford Government received a detailed report on the steps it needs to take to meet the needs of students with disabilities now and into the fall, in the face of the ongoing COVID-19 crisis. This thorough report, which we set out in full below, was written by a subcommittee of the Government-appointed K-12 Education Standards Development Committee. AODA Alliance Chair David Lepofsky serves on that Standards Development Committee and was one of the members of the subcommittee that collectively developed this report. The subcommittee included representation from the disability sector and the school board community.

We are delighted that this report includes the substance of all the recommendations that the AODA Alliance put forward in its June 19, 2020 brief to the Ontario Government on how to meet the needs of students with disabilities during school re-opening. It expands and enhances on the recommendations in the AODA Alliance‘s June 19, 2020 brief to the Ontario Government. This report also goes further, adding other important recommendations.

With school re-opening fast approaching, it is important for the Ford Government to now announce a plan to implement these recommendations. Until the Ford Government does so, we call on all Ontario school boards to review this report and implement its recommendations in their plans for school re-opening.

We encourage one and all to send this report to your member of the Ontario legislature, your school board trustee, and your local media. Email Premier Doug Ford and Education Minister Stephen Lecce. Emphasize to all of them that this report needs immediate action.

The AODA Alliance has been spearheading a campaign for over a decade to tear down the barriers facing students with disabilities in Ontario’s education system. We led the multi-year campaign to get the Ontario Government to agree to create an Education Accessibility Standard under the Accessibility for Ontarians with Disabilities Act .

For more background on these issues, please visit the AODA Alliances COVID-19 web page and our education web page. Check out the widely-viewed online video of the May 4, 2020 virtual Town Hall on meeting the needs of students with disabilities during the COVID-19 crisis, co-organized by the Ontario Autism Coalition and the AODA Alliance.

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

          MORE DETAILS

July 24, 2020 Letter to the Ontario Minister of Education and Minister for Accessibility from the Chair of the K-12 Education Standards Development Committee

Date: Friday, July 24, 2020

The Honourable Stephen Lecce

Minister of Education

5th Floor, 438 University Avenue,

Toronto, Ontario M7A 2A5

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5th Floor, 777 Bay Street,

Toronto, Ontario M7A 1S5

Dear Minister Lecce and Minister Cho,

Re: K-12 Education Standards Development Committee: Planning for Emergencies and Safety Small Group Report

On behalf of the members of the Planning for Emergencies and Safety small group (the small group), I am pleased to submit the small group’s advice and recommendations on emergency planning and safety for students with disabilities in K-12 education during the COVID-19 pandemic.

The K-12 Education Standards Development Committee (The Committee) formed the small group when the Ministry of Education was seeking feedback from the Committee on the barriers and issues identified through the COVID-19 pandemic. The small group’s mandate includes using experiential learning from the COVID-19 pandemic to:

  • identify new and reoccurring accessibility barriers to learning for students with disabilities in the context of remote learning; and
  • develop an emergency plan framework (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency.

The small group members have put incredible effort, time and passion to complete this report that includes valuable advice and recommendations for government consideration. The report addresses the following 9 barriers for students with disabilities as a result of COVID-19:

  1. organizational, policy and procedural barriers
  2. mental health and well being
  3. academic (learning inequities for students with disabilities)
  4. support for secondary school students with disabilities
  5. transitions between in school and virtual learning
  6. accessible communication and technology
  7. training on the integration of digital technology into learning
  8. transportation
  9. recommendations addressing barriers for the Government and School Boards in emergency planning and safety

Thank you for your shared commitment to ensuring accessibility and inclusion for students with disabilities in Ontario. We have appreciated the discussions with Minister Lecce on Grants for Students Needs funding and the school board memos that address the current work being done to support students. The barriers in our report reflect what we have heard from various educational partners, families of student with disabilities and students within Ontario. I would be happy to meet with you to discuss these additional recommendations. The work and passion of the Committee continues, and we look forward to more opportunities to share our advice and feedback with you.

Together we can create an accessible and inclusive education system for students with disabilities during this unprecedented time.

Sincerely,

(Original signed by)

 

 

Lynn Ziraldo,
Chair, K-12 Education Standards Development Committee

Attachments:

  1. Small group report

July 24, 2020 Report to the Ontario Government from the Planning for Emergencies and Safety Subcommittee of the K-12 Education Standards Development Committee

July 24, 2020

Introduction

The COVID-19 Pandemic has tested emergency plans for all levels of government, businesses, agencies, education systems, communities, families, and citizens in the province of Ontario. Many risks have been identified and challenges have arisen because of the pandemic and more continue to be identified as we move through the stages of the emergency. Emergency plans, response and procedures need to be reviewed to address these risks and barriers immediately and to improve responses to emergencies in the future.

As the Ministry of Education was seeking feedback on barriers and emerging issues identified during the COVID-19 Pandemic, the K-12 Standards Development Committee formed the Planning for Emergency and Safety Working Group with a focus on students with disabilities with the following mandate:

Using experiential learning from the COVID-19 pandemic:

  • Identify new and reoccurring accessibility barriers to learning for students with disabilities in the context of remote learning
  • Develop an emergency plan framework (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency.

Methodology

The Planning for Emergencies & Safety Working Group gathered resources from experts including the Framework for Reopening Schools developed by UNICEF, SickKids recommendations to Reopening Schools, Letters to Minister Lecce from the Ontario Human Rights Commission of July 14, 2020; and various other resources and articles from educational partners within Ontario, other provinces and countries (See Resource Section). While reviewing the documents, the Working Group identified barriers and subsequently developed recommendations to address said barriers.

Organizational Challenges and Barriers during COVID-19

Through a review of resources, feedback from parents and guardians, agencies, health professionals and educational stakeholders’ opinions expressed, the Working Group found that students with disabilities have faced challenges compounded by COVID-19.  Their needs have been inconsistently addressed or not at all. These are some organizational, policy and procedural barriers identified:

  • Inconsistent or unclear messaging from varying levels of government, health agencies and school boards
  • Lack of or unable to access consistent data from all regions and school boards to support data driven decisions and implement actions quickly and effectively.
  • Policies and procedures outdated, non-existent, or inflexible to accommodate this type of emergency – COVID-19 pandemic.
  • Emergency response teams not reflecting the different subject knowledge needed to support decision making and development of a plan that reflects the needs of students with disabilities.
  • Inter-governmental, health service, service agencies and school board service agreements did not reflect the ability to provide services in a virtual learning environment
  • Service delivery models used by government, health services, service agencies and school boards not conducive to virtual service delivery.
  • The extent to which Board’s utilized or sought feedback from its SEACs in developing response or action plans to the COVID-19 pandemic varied from none to fully participated.
  • Not all school boards have an Accessibility Standards Committee or for those school boards that do have members of the community or people with disabilities who have lived experience that can help plan and implement the Public Health Guidelines to mitigate risks of COVID-19 in schools for students with disabilities
  • School board Accessibility Standards Committee can be helpful in helping to plan and implement the Public Health Guidelines to mitigate risks of COVID-19 in schools for students with disabilities. However, not all school boards have such committees, or committee membership that includes members of the community or people with disabilities who have lived experience that can inform planning and implementation.

Key Recommendations for Planning for Emergencies

It is important in planning for return to school, the opportunity is taken to review and create structures, policy and procedures that can adapt and be more flexible for a 2nd wave or future emergencies.

By learning from innovations and emergency processes, systems can adapt and scale up the more effective solutions. In doing so, they could become more effective, more agile, and more resilient” – (quoted from THE COVID-19 PANDEMIC: SHOCKS TO EDUCATION AND POLICY RESPONSES, World Bank).

There are 5 known steps to Emergency Planning and Preparedness: 1) Know your risk, 2) Build your Team, 3) Make critical information accessible quickly, 4) Update alert and response procedure, 5) Test the plan and revise.

To eliminate barriers identified, that a return to school plan has input from end users, be designed through an inclusive process and not by one team or group. A team of subject expertise from across the organization is critical for developing a strong plan.

Recommendations – Government

For the above reasons, it is recommended that

  • The Ministry of Education should establish a Central Education Leadership Command Table with responsibilities for ensuring that students with disabilities have access to all accommodations and supports they require during the present COVID-19 pandemic. The responsibilities of the Command Table shall include:
    1. immediately develop a comprehensive plan to meet the urgent learning needs of students with disabilities during COVID-19 pandemic quickly and resolve issues for students with disabilities as they arise. The comprehensive plan should be shared for implementation by school boards. This plan should include and incorporate the three options for education:
  • normal school day routine with enhanced public health protocols
  • modified school day routine based on smaller class sizes, cohorting and alternative day or week delivery, and,
  • at-home learning with ongoing enhanced remote delivery
    1. collect and share data on existing and emerging issues as a result of COVID-19, the effective responses of other jurisdictions in supporting students with disabilities during the current emergency, using evidence base data collection method for people with disabilities
    2. establish a fully accessible centralized hub, and share and publicize the hub, for sharing of effective practices about supporting students with disabilities
    3. develop a 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
    4. provide clear communication and guidance on school opening, health service delivery, etc. based on data collected.
  • The government/Ministry of Education shall establish a cross sectorial Partnership Table at provincial and regional levels with the responsibility to integrate, coordinate and foster cross sector planning and response to emergencies. Responsibilities of this table are to:
    1. enhance an interlinked, coordinated and inter-ministerial approach in providing a seamless service delivery model to provide services and supports to students with disabilities (Psychology, Physical Therapy, Speech Therapy, Mental Health, etc.).
    2. collect data now, from respective sectors, health services, education, service agencies, etc. to identify existing and emerging barriers, know exactly which students with disabilities and how they are impacted, their needs, and how to better direct resources to support them
    3. provide clear communication and guidance on school opening, health service delivery, etc. based on data collected to ensure accessibility for students with disabilities.
  • The Ministry of Education provincial and regional partnership tables should include advisors that can provide insight on the needs and challenges of students with disabilities from lived experience and the collective experience of disability support groups, as well as students with disabilities.
  • The Ministry of Education should assign staff to assist the Central Educational 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.
  • The Ministry of Education should direct that each school board shall establish a similar Board Command table. (See recommendation 12 for School Boards).
  • The provincial government continue and enhance an interlinked, coordinated and inter-ministerial approach in providing a seamless service delivery model to provide services and supports to students with disabilities (Psychology, Physical Therapy, Speech Therapy, Mental Health, etc.).
  • The Ministry of Education should collect and aggregate International data, resources and information from other countries experiences for use in planning transitions between in-school and distance education, including continuation of virtual learning at home.
  • The Ministry of Education should developed comprehensive plans for students with disabilities that addresses the surge in demand and increase capacity to provide specialized disability supports, including enhanced staffing, for the return to in-class and distance learning (increase in in-class supports, social workers, psychologists, guidance counsellors)
  • The Ministry of Education should develop guidelines that provide for alternate or enhanced childcare opportunities to be made available to families of students with a disability, for students required to stay home due to adapted model classroom scheduling. (Excludes childcare needs that are related to quarantine self-isolation for child or family due to exposure or a local outbreak of the virus.)
  • 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
  2. b) Frequently gather input from SEACs around Ontario about the experiences of students with disabilities during the COVID-19 crisis to inform future policies and regulations and directions for school boards.
  • To promote transparency, accountability and identify trends, the Ministry of Education should immediately issue a policy direction for boards to create an exclusion policy, that imposes restrictions on when and how a principal may exclude a student from school, including directions that:
  1. a) Does not impede, create barrier, or disproportionally increase burdens for students with disabilities the right to attend school for the entire 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.
  2. b) Tracks exclusions and provide a transparent procedure and practice to parents/guardians, by requiring a principal who refuses to admit a student to school during the school re-opening process to immediately give the student and their parent/guardian 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 parent/guardian’s right to appeal this refusal to admit to the school board.
  3. c) Tracks exclusions, increases accountability and informs policies by requiring a principal who refuses to admit a student to school for all or part of the school day 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 regular basis to the board of trustees, the public and the Ministry of Education (with individual information totally anonymized).
  • The Ministry of Education should provide clear guidelines and expectations to school boards on the implementation of Public Health Guidelines to mitigate risks of COVID-19 to ensure that school buildings and grounds be fully accessible for students with disabilities.

Recommendations – School Boards

  • School Boards should establish a similar Board Command/Central table as the Ministry of Education’s Central Education Command/Central Table, 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. The Table will quickly network with similar offices/Tables at other school boards and can report recurring issues to the Ministry’s command table.
  • School Boards should utilize the expertise of the Special Education Advisory Committee members by directly involving members in the planning for the delivery of remote learning, other emergency plans, through regular meetings and frequent communications.
  • School Boards should enhance its hub of resources with successful practices, lesson plans, resources specific to students with disabilities in a virtual learning environment for ease of access and support teachers and students in their learning.
  • School Boards should involve their Accessibility Committee, or if there is no committee to establish an Accessibility Advisory Committee which will review all plans at the school board and school level for mitigating risk of COVID-19 meet the accessibility requirements of all students or people with disabilities.
  • School Boards should assign a leadership staff member responsible for ensuring that all changes at schools in response to COVID-19 maintain accessibility for all students with disabilities.

Mental Health & Well Being

As found through the review of resources, student and family mental health & wellbeing needs have soared to due to the traumatic effects of COVID-19. Students wellbeing has suffered for a variety of barriers: effects of isolation from social distancing, increased rise in domestic violence, lack of access to school breakfast programs, lack of access to mental health & therapeutic services, and negative financial impact to family’s income to name a few.

Barriers

  • Agencies, different levels of government and school boards developing plans and working on solutions to barriers with little or no coordination
  • Support for parents with students with complex needs are insufficient
  • Health services and supports not consistently or sufficiently prepared to provide health and mental health services in a virtual setting
  • There is a flood of information and resources being presented to teachers, parents and students
  • More inter-ministerial leadership and collaboration between Ministries of Education (MOE), Community, Children & Social Services (MCCSS) and Health (MOH) is required
  • School Boards and staff must be equipped with appropriate PPE for their own health and wellbeing
  • Need to safely deliver additional supports such and as breakfast & nutrition programs provided by community agencies
  • Plans for the next phase include a return to in-class and virtual instruction, including adapted models whereby some students will be scheduled at home on an alternate day or alternate week basis. Having students at home for short or long periods (alternate day to full semester) will be a significant challenge for families and may prevent the return to work for many parents. Some parents of children with disabilities face barriers to employment, and many others are overburdened with providing 24-hour care to students with complex care needs.

Recommendations – Government

  • The government should enhance the central hub of mental health & wellbeing information resources at provincial and regional levels with key messages and links to other resources. Ensure all resources are in an accessible digital format (as per Integrated Accessibility Standards Regulation), well publicised and shared with school boards.
  • Ministries should review and increase capacity of Ontario Telehealth Network (OTN) and other privacy protected health platforms to allow for boards to use (even in non-emergency times) and deliver services by regulated health care professionals that protect the privacy of the health services and IPRCs.
  • Ministries of Education, Health and Children, Community & Social Services should remove any cross-jurisdictional barriers related to the provision of health and education services to ensure students with disabilities can be provided with the mental health & wellbeing services they require to be delivered remotely. (For example, under Policy/Program Memorandum (PPM) 149, Protocol for Partnerships with External Agencies for Provision of Services by Regulated Health Professionals, Regulated Social Service Professionals, and Paraprofessionals permit electric consent for services and virtual access to services for students with disabilities).
  • The Ministry of Education should provide funding and clear guidelines on use of Personal Protective Equipment (PPE) and protocols for detection and containment of COVID-19 for boards, staff and all students, including those with disabilities. Public health authorities should establish clear protocols for the detection and containment of COVID-19 (and other infectious diseases) for school boards. The guidelines and protocols should be flexible for school boards to react to local situations to mitigate risks.
  • The Ministry of Education’s plan for school re-openings must include detailed directions on required measures to mitigate risk for students with disabilities from COVID-19 to maintain their health and wellbeing 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 Special Needs Assistants (SNA) and Educational Assistants (EA) they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that EAs or SNAs do not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.
  • Ministries should review policies and regulations to continue to permit the virtual provision of therapy supports and services that have transitioned successfully to a virtual learning environment and where possible, permit and foster increased access to therapies and services to areas in province where a lack of services exists.

Recommendations – School Boards

  • Many students with disabilities volunteer at school events, in school daycares, kindergarten classes as part of their learning plan, IEP or fulfilling the 40 hours volunteer requirement. School Boards should develop/review guidelines for students with disabilities who volunteer in school to limits risk to health and safety but does not stop this valuable learning experience for students with disabilities.
  • Many adults with disabilities volunteer in schools and school daycares for the opportunity to exist as a valued contributing member within their community. School Boards should develop guidelines for people with disabilities who volunteer within the school that limits risk to the health and safety but continues to have the opportunity to be a contributing member of the school community.
  • School Board should provide virtual learning opportunities for volunteering and co-op courses for students with disabilities. Resources and guidelines should be developed to create the opportunity for the student to complete volunteering hours or cooperative credits successfully.
  • School Boards should develop and/or review guidelines for transitions plans for students with disabilities to outline supports and accommodations that may be offered in a virtual learning environment or enhanced by online tools and resources to support the physical and emotions wellbeing of student with disabilities when transitioning back to school. Accommodations or strategies should be reviewed and adapted to the virtual learning environment to support transitions. (An example would be for students with disabilities have access to audio described (DV) and closed-captioned (CC) virtual tours of the school facilities, so students could familiarize themselves with the school prior to the start of school. (See also Transition section).
  • In consultation with community agencies, School Boards should develop/revise procedures and protocols for volunteers and community agencies that support the health and wellbeing of students with disabilities continue to operate in the school (Example, Food nutrition programs, clothing exchanges, etc.)
  • In consultation with Public Health Regional Health, School Boards must develop clear protocols and procedures with accommodations for students with disabilities for the detection, isolation, tracing and follow up those students who develop symptoms for the virus, flu, respiratory infection, etc. For example: Ensure dedicated space to isolate students with disabilities who may need to return home is accessible and provides the accommodations required to meets the needs of any students with disabilities.

Academic

The pandemic has had profound impacts to student’s learning and staff’s ability to provide a learning environment that promotes student success and achievement. Learning inequities for students with disabilities have increased throughout the pandemic due to barriers faced. Some of the barriers identified were:

Barriers

  • Ongoing accessibility issues with online and virtual learning resources provided for learning at home
  • Wealth of resources, tools, etc. being developed by Boards, Agencies and Associations with limited sharing of resources. Resources developed may not be accessible.
  • Virtual learning is not working for many students with disabilities
  • Many students with disabilities were not effectively engaged in virtual learning for a variety of reasons, including accessibility challenges with the internet, computer software and hardware, nature of resources provided, individual challenges related to format, capacity of family, or behaviour.
  • Closure of schools for 3 months has resulted in significant loss of learning for many students
  • Special Education Advisory Committees meetings have been cancelled and some the skills and knowledge of SEAC members has not been fully utilized.
  • Teachers, students and parents were not prepared for the sudden transition from in-class instruction to the virtual learning environment and planning for future interruptions of schools would benefit from proactive planning for education in a virtual instruction and learning environment.

Recommendations – Government

  • The Ministry of Education should develop curriculum for students from Kindergarten to Grade 12 to enable students to develop the skills and knowledge they need for learning in a virtual learning environment. In the interim, the Ministry should share existing, accessible resources on this topic to teachers and School Boards (Please see Training for additional recommendations)
  • The Ministry of Education should collect and make readily available resources/information on practices, effective strategies in learning environment, and alternate approaches for students struggling with online learning, etc. from School Boards, agencies and disability specific associations.
  • Ministry of Education should provide clear expectations for teacher led instruction, synchronous learning, and weekly teacher student-teacher connections for students who are participating in virtual instruction and learning. Expectations should include monitoring if students with disabilities are fully participating, learning and benefiting from these activities; and if not, action to address barriers or issues identified.

Recommendations – School Board

  • School Boards should assess and document accommodations, modifications, resources and supports for all students with disabilities to plan for transition back to school and continuation of virtual instruction and learning. (Please see Transitions Recommendations for details)
  • School Boards should develop and provide all resources for instruction and assessment materials, homework assignments in an accessible digital format (See Communications & Technology section for recommendation on accessible digital format).

Secondary School

The secondary school experience is different from elementary school. It is where students develop, time management, organizational, advocacy skills, networking and social skills, become more aware of community and identify career paths. It is for this reason, the Working Group felt it was important to identify barriers and make recommendations specific to secondary students. Many of these recommendations can benefit the entire secondary school student population.

Barriers

  • Students with disabilities have experienced little to no personal contact with their school community social network supports (classroom teachers, Educational Assistants, custodians, administrative assistants, etc.), who rely on this contact to maintain their engagement within the school community and preserve their mental health.
  • At any time, students with disabilities have very limited opportunity to fulfill the 40 hours of volunteering required for graduation and rely heavily on volunteering at their high school or local elementary school events. All opportunities for volunteering were eliminated during the pandemic.
  • Many students with disabilities take optional specialized courses such as Specialized High School Major (SHSM), cooperative credits, etc. which provide hands on and participation within the community. Hands on learning, skills in applicable to trades and life skills were significantly diminished during COVID-19.
  • Clubs, councils, sports teams and extracurricular activities are a formative and important part of the high school experience. Often these extracurricular activities are the only opportunity students with disabilities has to socialize with their peers. Not having access to extracurricular activities has impacted their mental health and well-being.
  • Many students with disabilities rely on in class instruction be it due to learning disability, anxiety, learning style, ADHD, or simply due to preference in the way they individually learn, among others. The loss of in-class instruction has significantly impacted their learning and future for success.
  • Learning at home during school closure has been challenging for students in terms of academic achievement, mental health and wellbeing
  • All four years of high school are an integral part of a young person’s development and a multitude of students require and rely on in class instruction be it for specialized courses That require specialized equipment, trained staff;
  • The experience of four years of high school are incredibly formative of a young person’s social, emotional, mental and physical relationship with society, the world around them and indeed the values they will build their life around;
  • Return to school planning must consider the impacts on minority & racialized students, students in abusive households, students with limited access to technology or broadband, students with disabilities and students with other complex learning needs;
  • Many students rely on in class instruction be it due to learning disability, anxiety, learning style, ADHD, or simply due to preference in the way they individually learn, among others;

Recommendations – Ministry

  • The Ministry of Education should allow high school in-class instruction to operate for the 2020-2021 school year, if authorized by Ontario’s Chief Medical Officer of Health.
  • The Minister should direct School Boards to continue courses which require specialized forms of equipment, classrooms, teaching staff and/or resources (science labs, shops, media classrooms) continue to operate, in accordance with local public health advice.
  • As per the Canadian Mental Health Association, 70% of mental health challenges have their onset in childhood or youth and the Kids Help Phone Line has seen a increase in demand, The Ministries of Education and Health should increase capacity of mental health professionals and supports for School Boards, to ensure there is no waitlist for any secondary student requiring support.
  • The Ministry of Education should include student voice through student trustees’ association or other student leaders, when developing a plan for return to school.
  • The Ministry of Education should waive the compulsory credit in Health & Physical Education for students who have entered secondary school in the 2020-21 school or whose timetable will be negatively impacted, should Physical Education classes not operate in the conventional manner.
  • If required by Public Health, the Ministry of Education should fund PPE for students and staff to mitigate risks of infection.
  • The Ministry should direct School Boards to develop a prioritization and execution plan for conducting clinical assessments (e.g., psycho–educational assessments) that students with disabilities require in order to access necessary supports and services as they transition from secondary to post-secondary destinations.

Recommendations – School Board

  • School Boards and Schools should include student voice, including students with disabilities in developing the Board return to school plan, as well as, individual school return plans respectively.
  • School Boards and Schools should provide clear instruction on proper personal protection equipment (PPE) and safety measures to students, parents, and staff.
  • School Boards should follow or mirror Public Health protocols prescribed by the local Public Health. If PPE is not required by the local Public Health, student have the choice to wear PPE. If PPE is required, that school boards are funded appropriately to provide PPE for all students and staff.
  • Where local public health advice can be adhered to, Schools should continue to offer extracurricular activities such as clubs, councils, teams using proper social distancing and general safety protocols.
  • Where applicable, School Boards should waive parking fees for students to reduce financial burdens and help mitigate health risks for students by not riding on a crowded public transit bus.
  • School Boards should make decisions pertaining to cancellation of extracurricular activities in school mirror that of activities outside of school. (Example: If soccer clubs operate locally, then soccer clubs in schools should continue to operate).
  • School Boards should develop and offer online programming for students who cannot or wish not to attend school in person, but not be considered a long-term alternative to in class instruction.
  • School Boards and schools seek out the voice of students, including voices of students with disabilities, when they develop return to school plan options.
  • School Board should develop guidelines for clubs or programs that supplement or enhance education for students with disabilities so they can continue to operate upon return to school.
  • School Boards should continue to offer where possible, alternate classrooms, quiet workspaces, and other special education requirements prescribed in a student’s Individual Education Plan (IEP).
  • School Boards should research and investigate potential online coop placements that may be available for all students; including students with disabilities.
  • When permitted under local health advice, the School Board should review new health and safety protocols with student and the coop placement provider.

Transitions

An impact of the pandemic for students with disabilities is that learning has been lost or stagnant. Learning recovery will be important when returning to school. This will mean targeted measures to reversing learning loss or closing gaps. There will be a need for clear system wide guidance for in-class and central assessments to inform and plan for curriculum delivery, supports and service upon return to school.

Transition planning will occur at the provincial, local and student level. The Ministry of Education will need to identify barriers and gaps from all educational stakeholders to develop an informed return to school plan. School boards will need identify barriers and gaps at a system and individual student level to create an informed back to school plan as well as address the needs for students with disabilities.

The Individual Education Plan (IEP) is a tool for documenting student strengths and needs and the accommodations, programs and services they require to be successful. IEPs are a valuable tool in documenting the student’s current level of achievement and transition plans for planned changes in grades, schools, and life after secondary school. The IEP can also be used to plan for return to school, full time or in an adapted model, or for continued virtual learning.

Barriers

  • During the school closure gaps in student skills and knowledge related to on-line and distance learning has been evident
  • Planning for school year 2020-2021 will include in school and distance learning
  • School staff will need to assess student’s with disabilities to determine their accessibility and learning needs
  • Students with disabilities individual IEPs and transitions plans need to be reviewed to address barriers and gaps to allow for student success.
  • Student voice often forgotten in the planning process
  • Students and prospective students cannot visit the physical environments of schools during the COVID-19 pandemic and do not have the opportunity to check for physical accessibility and familiarize themselves with environment

Recommendations – Government

  • The Ministry of Education should direct School Boards to develop a prioritization and execution plan for conducting clinical assessments (e.g., psycho–educational assessments) that students with disabilities require, in order to access necessary supports and services as they transition from secondary to post-secondary destinations.
  • The Ministry of Education, in partnership with MCCSS should work with school boards to identify their cohorts of students with intellectual and other disabilities who completed their school careers in June 2020 and identify and assess if barriers faced during COVID-19 did not allow for successful student transitions to their chosen pathway (Examples: to work, volunteer work, recreation/leisure programs, and post-secondary education) as outlined in their transition plans. Jointly, the Ministries and School Boards should develop plans to help this cohort of students with disabilities achieve their individual transition goals.

Recommendations – School Boards

  • School Boards should be independently collecting board wide data on gaps, barriers, emerging issues, transition challenges, technology challenges, additional students’ needs and supports arising or as a result of COVID-19 through assessment, student and parent feedback to address and plan for system wide supports and services required by students with disabilities upon return to school.
  • To help with successful transitions for student with disabilities in returning to school, School Boards shall contact parent/guardians, as soon as possible, to discuss and identify learning gaps, individual needs arising from school shutdown and distance learning, transition challenges, social and emotional needs to inform and revise/or create individualized transition plans for students with disabilities.
  • To help reduce stress and anxiety and prepare themselves for return to school, students with disabilities should be involved with discussions and decision made in developing their Transition Plan.
  • School Boards and Administrators shall ensure Individual Education Plans for students with disabilities are revised/created to reflect specific goals and activities to address the individual needs identified in Recommendation #3 to help increase academic and transition success for each student with a disability upon returning to school.
  • School Boards shall include the student when developing their individualized Transition and IEP. All
  • When School Boards develop the Individualized Transition Plans for each student, it should be:
    1. flexible to accommodate the stop and start of in class learning. All methods of instruction should be considered for learning to ensure students have access to an education (virtual instruction, in home instruction, etc.)
    2. include a flexible and hybrid model for entry needs to accommodate the varying student needs. Any model developed for return to school shall be developed in consultation with parent/guardians and student
    3. include strategies for students around social/physical distancing. Social distancing guidelines should be developed in consultation with parents/guardians and student.
    4. Include steps for follow up and checking in with the student
    5. All documentation or information be provided to the parent/guardian and student before the meeting with enough time to review. Documents should be provided in an accessible format.
  • School Boards should take more interactive approaches to collect on-going feedback from parents, students and staff (i.e. “Thought exchange”) to guide and inform changes to policies and procedures impacted by COVID-19.
  • School Boards should develop a clear system wide plan to address increased classroom and school supports and services (Educational Assistants, Education Works, social workers, psychologists, guidance councillors) identified through assessments to help mitigate issues and support learning for students with disabilities.
  • School Boards should create audio described (DV) and closed-captioned (CC) virtual tours of their school. The virtual tour must be fully accessible and thoroughly provide information on accessibility and locations at the schools. Virtual tours should be made permanently available; not just during the pandemic.

Communications & Technology

For our purpose, communication includes technologies, systems, protocols and procedures that enable an organization to effectively communicate to its employees, partners and community. During an emergency, communication is essential and should ensure all relevant personnel can quickly and effectively communicate with each other during such crises, sharing information that will allow the organization to quickly rectify the situation, protect employees and assets, and allows the business to continue.

To relate this to Education – government, school boards, agencies, staff, students, parent/caregivers, should have the ability to communicate effectively during a crisis, while the business of providing learning continues.

Barriers

  • Ongoing accessibility issues with virtual learning environment or platform (Examples: no closed captions, compatibility issues with screen readers, lack of support or knowledge of accessibility features, no ASL interpretation)
  • Ongoing accessibility issue with information and resources provided
  • Conflicting guidelines provided by different ministries and level of government.

Recommendations – Government

  • That a designated communication lead should be assigned at the provincial and regional level for consistent messaging.
  • For efficiency and elimination of duplication of effort for School Boards, The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital learning and virtual learning environments or 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 instruction environments or platforms.
  • The Ministry of Education should provide a list of acceptable accessible, cross platform virtual learning environments and synchronous teaching systems to be used by school boards.
  • 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.
  • The Ministry of Education should immediately direct TVO/TFO 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. The implementation of this recommendation has become urgent since Royal Assent was given to Bill 197, COVID-19 Economic Recovery Act, 2020 as amends to the Ontario Educational Communications Authority Act broaden the mandates of both TVO and TFO to position them to provide centralized support for online learning in the English-language and French-language publicly-funded education systems, respectively.
  • The Ministry of Education should direct its entire staff and all School Boards that whenever making information public in a Portable Document Format (PDF), it must at the same time, make available a textual format such as an accessible Microsoft Word (MSWord) or accessible HTML document. Videos must be audio described (DV) and closed captioned (CC). Templates and technical guides should be developed and provided to school boards.

Recommendations – School Boards

  • For consistent messaging, that the School board should designate a communication lead for COVID-19 related issues.
  • School Boards should develop protocols and procedures to mitigate security risks for online and virtual learning platforms to help protect privacy of students with disabilities and staff. Online and virtual learning platforms should also be accessible for all students with disabilities.
  • That School Boards should provide clear communication around protocols and return to school plans. Boards should make written communications readily available and accessible by everyone in the community, parents and students.
  • School Boards should review and revise instructional videos for parents around virtual learning tools used in the school board. Videos must be clear and accessible.
  • School Boards should provide solely dedicated or designated staff, who are available to support technology including accessibility needs to parents who are supporting the learning needs of students with disabilities at home.

Training

The COVID-19 Pandemic has changed the way in which education is delivered. Students, parents/guardians, teachers, staff, school boards and government had to change the way they access, support or deliver education. The pandemic highlighted gaps in digital skills, adaptation of technology to teaching and learning. It has also increased demand for technology and the need to integrate technology effectively into teaching and learning. With this increased demand in the use of technology and the gaps in digital skills identified, it is imperative to train students, parent/guardians and staff in the use and integration of technology in teaching and learning.

Barriers

  • Teachers, students and parent/guardians unprepared for learning at home and use of virtual platforms such as google classroom, Microsoft teams, Zoom for individual and synchronous learning
  • Teachers, ECEs, Staff need training in virtual online learning platforms
  • Teachers, ECEs, Staff need training in strategies to support students with disabilities around transitions between education models, including preparation for changing environments and self regulation
  • Teachers, ECEs lack training in strategies to support Public Health directed precautions, such as social distancing, sanitizing procedures and use of PPE when required to support students
  • School closures have had a significant impact on the mental health and well being of students with disabilities and teachers, ECEs, staff will require training on child development and trauma informed practice to assist them in supporting students in transitioning back to school or continuation of virtual education.
  • The expectation on parent/guardians to support students with learning at home were significant and parents need supports and training in virtual learning software and how they can effectively support their child’s learning.

Recommendations – Government

  • That Ministry of Education should model leadership to School Boards and provide accessible virtual learning webinars, templates for learning, etc. to be utilized in training administrators and teachers.
  • The Ministry of Education should direct School Boards to provide all staff training in child development, mental health and wellbeing to support the wellbeing and learning of students with disabilities.
  • The Government should provide direction to School Boards and Public Service agencies to develop a coordinated training delivery model to support parents of students with rehabilitation needs, mental health concerns or who have complex or significant medically needs, with the delivery of virtual care, including privacy protected health platforms such as OTN, ADcare.

Recommendations – School Boards

  • School Boards should provide focused, practical training for administrators and teachers to support students with disabilities’ health, wellbeing and learning in a mixed or virtual environment.
  • School Boards should provide administrators training and guidelines on supporting students with disabilities through transitioning and change.
  • School Boards should develop parent training modules and resources to enable parent/guardians to develop the skills and knowledge required to support online and virtual learning at home for students with disabilities.
  • School Boards should provide training for teachers and staff on specific tips and solutions, successful and evidence based promising practices by disability to support teachers and students with disabilities learning. These should be made available as soon as possible or at the latest, during the first days of PD before school instruction begins.

Transportation

School Bus operation and delivery of bus services is regulated and governed both federally and provincially. Transport Canada has consulted with the Public Health Agency of Canada to provide guidelines around bus operations during the pandemic. The National Association for Pupil Transportation (NAPT) has also provided general guidelines for the provision of student (pupil) transportation services.

The Ministry of Education’s Return to School Framework directs School Boards to follow these federal guidelines.

To accommodate Federal Transportation and Public health guideline that require social and physical distancing, School Boards will have to revise transportation services delivery that will impact bus routes, increase the number of buses and drivers required, increase ridership time, etc. to mitigate risks to students with disabilities while transporting to and from school.

Barriers

  • Lack of or reduced public transportation available for students with disabilities, particularly for secondary students who take public transit. Municipal governments eliminated routes or reduced schedules during COVID-19. Municipalities have not made public transportation plans for when students return to school.
  • As School Boards and Consortiums plan transportation services to meet the Transport Canada guidelines, current challenges of inadequate buses, shortage of drivers and increasing fuel costs will be a barrier to boards.
  • Changes to routine can have a significant impact to a student with disabilities’ mental health, success for the start of school day and learning. Predictable changes to transportation for students with disabilities can include, increased ridership time, bus route, bus type (72-passenger, small bus), supports or accommodations required for a successful ride, etc. while maintaining safety and mitigating risks for infection.
  • Many School Boards currently overspend the transportation grant, while still achieving a high efficiency rating from the Ministry of Education. The additional requirements defined under the Transport Canada Guidelines will increase cost pressures to provide transportation services to students with disabilities while maintaining safety and mitigating risk of infection.
  • As students with disabilities require may require specific transportation accommodations such as a safety harness, seat belt, wheelchair accessible which cannot be accommodated in all vehicle types.

Recommendations – School Boards

  • As many School Boards overspend its transportation grant while maintaining a high efficiency rating, the Ministry of Education should provide school boards with additional COVID-19 specific funding to follow the guidelines as provided by Transport Canada around:
    • Measures to mitigate risk of exposure
    • Procedures to be taken before a trip, during a trip and at the end of the trip
    • PPE guidelines
    • Physical Distancing
    • Shield and Enclosure system guidelines (if bus operators choose to do so)
  • School Boards should review transportation accommodations and requirements, in consultation with parents and student, IEPs of students with disabilities who require transportation services to identify any change/modifications to accommodations required. The student’s IEP shall be modified to reflect additional requirements to transport the student safely on the bus. The review for medically fragile students should include professionals, such as nurses, occupational therapists, as well as parents. All transportation requirements shall be relayed to the Bus Consortia and administrator of the school for implementation.
  • School Boards must create/revise a protocol for the safe gathering of all students and parent/guardians at bus stops and safety on the bus. It is important that student with disabilities be included and familiarized with these protocols with their peers.
  • School Boards and Bus Consortia should provide bus drivers with training on new health and safety protocols for students with disabilities on a regular bus, small bus and wheelchair accessible bus.
  • Bus Consortia should minimize changes to routes, vehicle type, and schedules for students with disabilities while developing changes to routes, to limit increased anxiety or behaviours as a result of the changes. When changes are considered, parents and student should be consulted about changes.
  • School Boards and Bus Consortia should review procedures and protocols for persons responsible for putting a student with disability’s harness on/off or supporting a student on the school bus to mitigate health risks for the student, bus driver and support person.
  • School Boards and Bus Consortia should revise/develop, implement and disseminate bus safety protocol Information for parents needs to help mitigate health and safety risks and assuage parent’s fears. This includes protocols around harnesses. All communications should be clear and made readily available on the Board and Bus Consortia website in an accessible digital format.
  • Students with disabilities should be included in any training that is provide for all students on enhanced safety rules on the bus.
  • As students with disabilities are statistically proven to be at a higher risk of infection, School Boards and Bus Consortia should implement enhanced student bus ridership attendance procedures to aid in tracing of COVID-19 and mitigating health risks.
  • Traffic volume, student and road safety is always a concern around schools. It is expected for vehicle traffic to increase when school returns, as parent/caregiver or a secondary student chooses to drive to school. School Boards should work collaboratively with Municipalities to develop safe arrival and departure awareness campaigns for students, parents/caregivers and buses. These campaigns could include guidelines for kiss & ride, audio described (DV) and closed captioned (CC) virtual or diagrams of vehicle traffic flows for entering and exiting school property from the street, identifying school bus only access areas, promote other methods of transportation, etc.

Conclusion

The Planning for Emergencies are please to provide its draft recommendations related to the COVID-19 pandemic. The Working Group will continue to review resources and information on barriers and issues arising from COVID-19 and as students return to school. It will start work on its mandate to develop an emergency plan framework focused on students with disabilities (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency.

Thank you to all the members of the Planning for Emergencies Working Group for their dedication in developing this draft set of recommendations. Working Group members are:

  • Donna Edwards (Chair – Working Group)
  • Stephan Andrews
  • David Lepofsky
  • Dr. Ashleigh Malloy
  • Alison Morse
  • Rana Nasrazadani
  • Ben Smith
  • Angelo Tocco
  • Dr. Lindy Zaretsky
  • Lynn Ziraldo (Chair K-12 SDC)

Glossary

Accessibility: a general term for the degree of ease that something (e.g., device, service, physical environment and information) can be accessed, used and enjoyed by persons with disabilities. The term implies conscious planning, design and/or effort to make sure something is barrier-free to persons with disabilities. Accessibility also benefits the general population, by making things more usable and practical for everyone, including older people and families with small children.

Accessible: does not have obstacles for people with disabilities – something that can be easily reached or obtained; facility that can be easily entered; information that is easy to access.

Accessible digital format: Information that is provided in digital form that is accessible such as HTML and MS Word.

Synchronous learning: is the kind of learning that happens in real time. This means that you, your classmates, and your instructor interact in a specific virtual place, through a specific online medium, at a specific time. In other words, it’s not exactly anywhere, anyhow, anytime. Methods of synchronous online learning include video conferencing, teleconferencing, live chatting, and live-streaming lectures.

Asynchronous learning: happens on your schedule. While your course of study, instructor or degree program will provide materials for reading, lectures for viewing, assignments for completing, and exams for evaluation, you have the ability to access and satisfy these requirements within a flexible time frame. Methods of asynchronous online learning include self-guided lesson modules, streaming video content, virtual libraries, posted lecture notes, and exchanges across discussion boards or social media platforms.

Distance Education Program: Programs to provide courses of study online, through correspondence, or by other means that do not require the physical attendance by the student at a school. (From Bill 197)

Special Education Services – As defined in the Education Act, “facilities and resources, including support personnel and equipment, necessary for developing and implementing a special education program”.

Virtual learning: is defined as learning that can functionally and effectively occur in the absence of traditional classroom environments (Simonson & Schlosser, 2006).

Virtual education: refers to instruction in a learning environment where teacher and student are separated by time or space, or both, and the teacher provides course content through course management applications, multimedia resources, the Internet, videoconferencing, etc. Students receive the content and communicate with the teacher via the same technologies.

Virtual learning environment: refers to a system that offers educators digitally-based solutions aimed at creating interactive, active learning environments. VLEs can help educators create, store and disseminate content, plan courses and lessons and foster communication between student and educator. Virtual learning environments are often part of an education institution’s wider learning management system (LMS).

Virtual instruction: is a method of teaching that is taught either entirely online or when elements of face-to-face courses are taught online through learning management systems and other educational tools and platforms. Virtual instruction also includes digitally transmitting course materials to student.

Resources

Mental Health

Public Health Guidance and Safety

 

Tools/Best Practices

Stakeholder Reports and Information

Additional Reading



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An Important New Report to the Ontario Government Calls on the Government and School Boards to Take Action Now to Ensure that One Third of a Million Students with Disabilities are Able to Fully Participate in Ontario Schools as They Re-Open This Fall


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/

August 14, 2020

SUMMARY

We today share with you a very important new report that bears on the needs of a third of a million students with disabilities in Ontario-funded schools, as the COVID-19 pandemic continues. Three weeks ago, the Ford Government received a detailed report on the steps it needs to take to meet the needs of students with disabilities now and into the fall, in the face of the ongoing COVID-19 crisis. This thorough report, which we set out in full below, was written by a subcommittee of the Government-appointed K-12 Education Standards Development Committee. AODA Alliance Chair David Lepofsky serves on that Standards Development Committee and was one of the members of the subcommittee that collectively developed this report. The subcommittee included representation from the disability sector and the school board community.

We are delighted that this report includes the substance of all the recommendations that the AODA Alliance put forward in its June 19, 2020 brief to the Ontario Government on how to meet the needs of students with disabilities during school re-opening. It expands and enhances on the recommendations in the AODA Alliances June 19, 2020 brief to the Ontario Government. This report also goes further, adding other important recommendations.

With school re-opening fast approaching, it is important for the Ford Government to now announce a plan to implement these recommendations. Until the Ford Government does so, we call on all Ontario school boards to review this report and implement its recommendations in their plans for school re-opening.

We encourage one and all to send this report to your member of the Ontario legislature, your school board trustee, and your local media. Email Premier Doug Ford and Education Minister Stephen Lecce. Emphasize to all of them that this report needs immediate action.

The AODA Alliance has been spearheading a campaign for over a decade to tear down the barriers facing students with disabilities in Ontarios education system. We led the multi-year campaign to get the Ontario Government to agree to create an Education Accessibility Standard under the Accessibility for Ontarians with Disabilities Act .

For more background on these issues, please visit the AODA Alliances COVID-19 web page and our education web page. Check out the widely-viewed online video of the May 4, 2020 virtual Town Hall on meeting the needs of students with disabilities during the COVID-19 crisis, co-organized by the Ontario Autism Coalition and the AODA Alliance.

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

MORE DETAILS

July 24, 2020 Letter to the Ontario Minister of Education and Minister for Accessibility from the Chair of the K-12 Education Standards Development Committee

Date: Friday, July 24, 2020

The Honourable Stephen Lecce
Minister of Education
5th Floor, 438 University Avenue,
Toronto,Ontario M7A 2A5

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5th Floor, 777 Bay Street,
Toronto, Ontario M7A 1S5

Dear Minister Lecce and Minister Cho,

Re: K-12 Education Standards Development Committee: Planning for Emergencies and Safety Small Group Report

On behalf of the members of the Planning for Emergencies and Safety small group (the small group), I am pleased to submit the small groups advice and recommendations on emergency planning and safety for students with disabilities in K-12 education during the COVID-19 pandemic.

The K-12 Education Standards Development Committee (The Committee) formed the small group when the Ministry of Education was seeking feedback from the Committee on the barriers and issues identified through the COVID-19 pandemic. The small groups mandate includes using experiential learning from the COVID-19 pandemic to:

* identify new and reoccurring accessibility barriers to learning for students with disabilities in the context of remote learning; and
* develop an emergency plan framework (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency.
The small group members have put incredible effort, time and passion to complete this report that includes valuable advice and recommendations for government consideration. The report addresses the following 9 barriers for students with disabilities as a result of COVID-19: 1. organizational, policy and procedural barriers
2. mental health and well being
3. academic (learning inequities for students with disabilities) 4. support for secondary school students with disabilities
5. transitions between in school and virtual learning
6. accessible communication and technology
7. training on the integration of digital technology into learning 8. transportation
9. recommendations addressing barriers for the Government and School Boards in emergency planning and safety

Thank you for your shared commitment to ensuring accessibility and inclusion for students with disabilities in Ontario. We have appreciated the discussions with Minister Lecce on Grants for Students Needs funding and the school board memos that address the current work being done to support students. The barriers in our report reflect what we have heard from various educational partners, families of student with disabilities and students within Ontario. I would be happy to meet with you to discuss these additional recommendations. The work and passion of the Committee continues, and we look forward to more opportunities to share our advice and feedback with you.

Together we can create an accessible and inclusive education system for students with disabilities during this unprecedented time.

Sincerely,

(Original signed by)

Lynn Ziraldo,
Chair, K-12 Education Standards Development Committee

Attachments:
1. Small group report

July 24, 2020 Report to the Ontario Government from the Planning for Emergencies and Safety Subcommittee of the K-12 Education Standards Development Committee

July 24, 2020

Introduction
The COVID-19 Pandemic has tested emergency plans for all levels of government, businesses, agencies, education systems, communities, families, and citizens in the province of Ontario. Many risks have been identified and challenges have arisen because of the pandemic and more continue to be identified as we move through the stages of the emergency. Emergency plans, response and procedures need to be reviewed to address these risks and barriers immediately and to improve responses to emergencies in the future.
As the Ministry of Education was seeking feedback on barriers and emerging issues identified during the COVID-19 Pandemic, the K-12 Standards Development Committee formed the Planning for Emergency and Safety Working Group with a focus on students with disabilities with the following mandate: Using experiential learning from the COVID-19 pandemic:
* Identify new and reoccurring accessibility barriers to learning for students with disabilities in the context of remote learning
* Develop an emergency plan framework (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency. Methodology
The Planning for Emergencies & Safety Working Group gathered resources from experts including the Framework for Reopening Schools developed by UNICEF, SickKids recommendations to Reopening Schools, Letters to Minister Lecce from the Ontario Human Rights Commission of July 14, 2020; and various other resources and articles from educational partners within Ontario, other provinces and countries (See Resource Section). While reviewing the documents, the Working Group identified barriers and subsequently developed recommendations to address said barriers. Organizational Challenges and Barriers during COVID-19
Through a review of resources, feedback from parents and guardians, agencies, health professionals and educational stakeholders opinions expressed, the Working Group found that students with disabilities have faced challenges compounded by COVID-19. Their needs have been inconsistently addressed or not at all. These are some organizational, policy and procedural barriers identified:
– Inconsistent or unclear messaging from varying levels of government, health agencies and school boards
– Lack of or unable to access consistent data from all regions and school boards to support data driven decisions and implement actions quickly and effectively.
– Policies and procedures outdated, non-existent, or inflexible to accommodate this type of emergency COVID-19 pandemic.
– Emergency response teams not reflecting the different subject knowledge needed to support decision making and development of a plan that reflects the needs of students with disabilities.
– Inter-governmental, health service, service agencies and school board service agreements did not reflect the ability to provide services in a virtual learning environment
– Service delivery models used by government, health services, service agencies and school boards not conducive to virtual service delivery.
– The extent to which Boards utilized or sought feedback from its SEACs in developing response or action plans to the COVID-19 pandemic varied from none to fully participated.
– Not all school boards have an Accessibility Standards Committee or for those school boards that do have members of the community or people with disabilities who have lived experience that can help plan and implement the Public Health Guidelines to mitigate risks of COVID-19 in schools for students with disabilities
– School board Accessibility Standards Committee can be helpful in helping to plan and implement the Public Health Guidelines to mitigate risks of COVID-19 in schools for students with disabilities. However, not all school boards have such committees, or committee membership that includes members of the community or people with disabilities who have lived experience that can inform planning and implementation. Key Recommendations for Planning for Emergencies
It is important in planning for return to school, the opportunity is taken to review and create structures, policy and procedures that can adapt and be more flexible for a 2nd wave or future emergencies.
By learning from innovations and emergency processes, systems can adapt and scale up the more effective solutions. In doing so, they could become more effective, more agile, and more resilient (quoted from THE COVID-19 PANDEMIC: SHOCKS TO EDUCATION AND POLICY RESPONSES, World Bank).
There are 5 known steps to Emergency Planning and Preparedness: 1) Know your risk, 2) Build your Team, 3) Make critical information accessible quickly, 4) Update alert and response procedure, 5) Test the plan and revise.
To eliminate barriers identified, that a return to school plan has input from end users, be designed through an inclusive process and not by one team or group. A team of subject expertise from across the organization is critical for developing a strong plan. Recommendations Government

For the above reasons, it is recommended that
1) The Ministry of Education should establish a Central Education Leadership Command Table with responsibilities for ensuring that students with disabilities have access to all accommodations and supports they require during the present COVID-19 pandemic. The responsibilities of the Command Table shall include:
a) immediately develop a comprehensive plan to meet the urgent learning needs of students with disabilities during COVID-19 pandemic quickly and resolve issues for students with disabilities as they arise. The comprehensive plan should be shared for implementation by school boards. This plan should include and incorporate the three options for education: * normal school day routine with enhanced public health protocols
* modified school day routine based on smaller class sizes, cohorting and alternative day or week delivery, and, * at-home learning with ongoing enhanced remote delivery
b) collect and share data on existing and emerging issues as a result of COVID-19, the effective responses of other jurisdictions in supporting students with disabilities during the current emergency, using evidence base data collection method for people with disabilities
c) establish a fully accessible centralized hub, and share and publicize the hub, for sharing of effective practices about supporting students with disabilities
d) develop a 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
e) provide clear communication and guidance on school opening, health service delivery, etc. based on data collected.

2) The government/Ministry of Education shall establish a cross sectorial Partnership Table at provincial and regional levels with the responsibility to integrate, coordinate and foster cross sector planning and response to emergencies. Responsibilities of this table are to:
a) enhance an interlinked, coordinated and inter-ministerial approach in providing a seamless service delivery model to provide services and supports to students with disabilities (Psychology, Physical Therapy, Speech Therapy, Mental Health, etc.).
b) collect data now, from respective sectors, health services, education, service agencies, etc. to identify existing and emerging barriers, know exactly which students with disabilities and how they are impacted, their needs, and how to better direct resources to support them
c) provide clear communication and guidance on school opening, health service delivery, etc. based on data collected to ensure accessibility for students with disabilities.
3) The Ministry of Education provincial and regional partnership tables should include advisors that can provide insight on the needs and challenges of students with disabilities from lived experience and the collective experience of disability support groups, as well as students with disabilities.
4) The Ministry of Education should assign staff to assist the Central Educational 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.
5) The Ministry of Education should direct that each school board shall establish a similar Board Command table. (See recommendation 12 for School Boards).
6) The provincial government continue and enhance an interlinked, coordinated and inter-ministerial approach in providing a seamless service delivery model to provide services and supports to students with disabilities (Psychology, Physical Therapy, Speech Therapy, Mental Health, etc.).
7) The Ministry of Education should collect and aggregate International data, resources and information from other countries experiences for use in planning transitions between in-school and distance education, including continuation of virtual learning at home.
8) The Ministry of Education should developed comprehensive plans for students with disabilities that addresses the surge in demand and increase capacity to provide specialized disability supports, including enhanced staffing, for the return to in-class and distance learning (increase in in-class supports, social workers, psychologists, guidance counsellors)
9) The Ministry of Education should develop guidelines that provide for alternate or enhanced childcare opportunities to be made available to families of students with a disability, for students required to stay home due to adapted model classroom scheduling. (Excludes childcare needs that are related to quarantine self-isolation for child or family due to exposure or a local outbreak of the virus.)
10) 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-19 crisis to inform future policies and regulations and directions for school boards.
11) To promote transparency, accountability and identify trends, the Ministry of Education should immediately issue a policy direction for boards to create an exclusion policy, that imposes restrictions on when and how a principal may exclude a student from school, including directions that:
a) Does not impede, create barrier, or disproportionally increase burdens for students with disabilities the right to attend school for the entire 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) Tracks exclusions and provide a transparent procedure and practice to parents/guardians, by requiring a principal who refuses to admit a student to school during the school re-opening process to immediately give the student and their parent/guardian 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 parent/guardians right to appeal this refusal to admit to the school board.
c) Tracks exclusions, increases accountability and informs policies by requiring a principal who refuses to admit a student to school for all or part of the school day 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 regular basis to the board of trustees, the public and the Ministry of Education (with individual information totally anonymized).
12) The Ministry of Education should provide clear guidelines and expectations to school boards on the implementation of Public Health Guidelines to mitigate risks of COVID-19 to ensure that school buildings and grounds be fully accessible for students with disabilities. Recommendations School Boards

13) School Boards should establish a similar Board Command/Central table as the Ministry of Educations Central Education Command/Central Table, 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. The Table will quickly network with similar offices/Tables at other school boards and can report recurring issues to the Ministrys command table.
14) School Boards should utilize the expertise of the Special Education Advisory Committee members by directly involving members in the planning for the delivery of remote learning, other emergency plans, through regular meetings and frequent communications.
15) School Boards should enhance its hub of resources with successful practices, lesson plans, resources specific to students with disabilities in a virtual learning environment for ease of access and support teachers and students in their learning.
16) School Boards should involve their Accessibility Committee, or if there is no committee to establish an Accessibility Advisory Committee which will review all plans at the school board and school level for mitigating risk of COVID-19 meet the accessibility requirements of all students or people with disabilities.
17) School Boards should assign a leadership staff member responsible for ensuring that all changes at schools in response to COVID-19 maintain accessibility for all students with disabilities. Mental Health & Well Being
As found through the review of resources, student and family mental health & wellbeing needs have soared to due to the traumatic effects of COVID-19. Students wellbeing has suffered for a variety of barriers: effects of isolation from social distancing, increased rise in domestic violence, lack of access to school breakfast programs, lack of access to mental health & therapeutic services, and negative financial impact to familys income to name a few. Barriers

* Agencies, different levels of government and school boards developing plans and working on solutions to barriers with little or no coordination * Support for parents with students with complex needs are insufficient
* Health services and supports not consistently or sufficiently prepared to provide health and mental health services in a virtual setting
* There is a flood of information and resources being presented to teachers, parents and students
* More inter-ministerial leadership and collaboration between Ministries of Education (MOE), Community, Children & Social Services (MCCSS) and Health (MOH) is required
* School Boards and staff must be equipped with appropriate PPE for their own health and wellbeing
* Need to safely deliver additional supports such and as breakfast & nutrition programs provided by community agencies
* Plans for the next phase include a return to in-class and virtual instruction, including adapted models whereby some students will be scheduled at home on an alternate day or alternate week basis. Having students at home for short or long periods (alternate day to full semester) will be a significant challenge for families and may prevent the return to work for many parents. Some parents of children with disabilities face barriers to employment, and many others are overburdened with providing 24-hour care to students with complex care needs.

Recommendations Government

18) The government should enhance the central hub of mental health & wellbeing information resources at provincial and regional levels with key messages and links to other resources. Ensure all resources are in an accessible digital format (as per Integrated Accessibility Standards Regulation), well publicised and shared with school boards.
19) Ministries should review and increase capacity of Ontario Telehealth Network (OTN) and other privacy protected health platforms to allow for boards to use (even in non-emergency times) and deliver services by regulated health care professionals that protect the privacy of the health services and IPRCs.
20) Ministries of Education, Health and Children, Community & Social Services should remove any cross-jurisdictional barriers related to the provision of health and education services to ensure students with disabilities can be provided with the mental health & wellbeing services they require to be delivered remotely. (For example, under Policy/Program Memorandum (PPM) 149, Protocol for Partnerships with External Agencies for Provision of Services by Regulated Health Professionals, Regulated Social Service Professionals, and Paraprofessionals permit electric consent for services and virtual access to services for students with disabilities).
21) The Ministry of Education should provide funding and clear guidelines on use of Personal Protective Equipment (PPE) and protocols for detection and containment of COVID-19 for boards, staff and all students, including those with disabilities. Public health authorities should establish clear protocols for the detection and containment of COVID-19 (and other infectious diseases) for school boards. The guidelines and protocols should be flexible for school boards to react to local situations to mitigate risks.
22) The Ministry of Educations plan for school re-openings must include detailed directions on required measures to mitigate risk for students with disabilities from COVID-19 to maintain their health and wellbeing 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 Special Needs Assistants (SNA) and Educational Assistants (EA) they will need to ensure the safety of students with disabilities. It also requires safeguards to ensure that EAs or SNAs do not work at multiple sites and risk transmitting the COVID-19 virus from one location to another.
23) Ministries should review policies and regulations to continue to permit the virtual provision of therapy supports and services that have transitioned successfully to a virtual learning environment and where possible, permit and foster increased access to therapies and services to areas in province where a lack of services exists. Recommendations School Boards

24) Many students with disabilities volunteer at school events, in school daycares, kindergarten classes as part of their learning plan, IEP or fulfilling the 40 hours volunteer requirement. School Boards should develop/review guidelines for students with disabilities who volunteer in school to limits risk to health and safety but does not stop this valuable learning experience for students with disabilities.
25) Many adults with disabilities volunteer in schools and school daycares for the opportunity to exist as a valued contributing member within their community. School Boards should develop guidelines for people with disabilities who volunteer within the school that limits risk to the health and safety but continues to have the opportunity to be a contributing member of the school community.
26) School Board should provide virtual learning opportunities for volunteering and co-op courses for students with disabilities. Resources and guidelines should be developed to create the opportunity for the student to complete volunteering hours or cooperative credits successfully.
27) School Boards should develop and/or review guidelines for transitions plans for students with disabilities to outline supports and accommodations that may be offered in a virtual learning environment or enhanced by online tools and resources to support the physical and emotions wellbeing of student with disabilities when transitioning back to school. Accommodations or strategies should be reviewed and adapted to the virtual learning environment to support transitions. (An example would be for students with disabilities have access to audio described (DV) and closed-captioned (CC) virtual tours of the school facilities, so students could familiarize themselves with the school prior to the start of school. (See also Transition section).
28) In consultation with community agencies, School Boards should develop/revise procedures and protocols for volunteers and community agencies that support the health and wellbeing of students with disabilities continue to operate in the school (Example, Food nutrition programs, clothing exchanges, etc.)
29) In consultation with Public Health Regional Health, School Boards must develop clear protocols and procedures with accommodations for students with disabilities for the detection, isolation, tracing and follow up those students who develop symptoms for the virus, flu, respiratory infection, etc. For example: Ensure dedicated space to isolate students with disabilities who may need to return home is accessible and provides the accommodations required to meets the needs of any students with disabilities. Academic
The pandemic has had profound impacts to students learning and staffs ability to provide a learning environment that promotes student success and achievement. Learning inequities for students with disabilities have increased throughout the pandemic due to barriers faced. Some of the barriers identified were: Barriers

* Ongoing accessibility issues with online and virtual learning resources provided for learning at home
* Wealth of resources, tools, etc. being developed by Boards, Agencies and Associations with limited sharing of resources. Resources developed may not be accessible. * Virtual learning is not working for many students with disabilities
* Many students with disabilities were not effectively engaged in virtual learning for a variety of reasons, including accessibility challenges with the internet, computer software and hardware, nature of resources provided, individual challenges related to format, capacity of family, or behaviour.
* Closure of schools for 3 months has resulted in significant loss of learning for many students
* Special Education Advisory Committees meetings have been cancelled and some the skills and knowledge of SEAC members has not been fully utilized.
* Teachers, students and parents were not prepared for the sudden transition from in-class instruction to the virtual learning environment and planning for future interruptions of schools would benefit from proactive planning for education in a virtual instruction and learning environment. Recommendations Government

30) The Ministry of Education should develop curriculum for students from Kindergarten to Grade 12 to enable students to develop the skills and knowledge they need for learning in a virtual learning environment. In the interim, the Ministry should share existing, accessible resources on this topic to teachers and School Boards (Please see Training for additional recommendations)
31) The Ministry of Education should collect and make readily available resources/information on practices, effective strategies in learning environment, and alternate approaches for students struggling with online learning, etc. from School Boards, agencies and disability specific associations.
32) Ministry of Education should provide clear expectations for teacher led instruction, synchronous learning, and weekly teacher student-teacher connections for students who are participating in virtual instruction and learning. Expectations should include monitoring if students with disabilities are fully participating, learning and benefiting from these activities; and if not, action to address barriers or issues identified.

Recommendations School Board

33) School Boards should assess and document accommodations, modifications, resources and supports for all students with disabilities to plan for transition back to school and continuation of virtual instruction and learning. (Please see Transitions Recommendations for details)
34) School Boards should develop and provide all resources for instruction and assessment materials, homework assignments in an accessible digital format (See Communications & Technology section for recommendation on accessible digital format). Secondary School
The secondary school experience is different from elementary school. It is where students develop, time management, organizational, advocacy skills, networking and social skills, become more aware of community and identify career paths. It is for this reason, the Working Group felt it was important to identify barriers and make recommendations specific to secondary students. Many of these recommendations can benefit the entire secondary school student population. Barriers
* Students with disabilities have experienced little to no personal contact with their school community social network supports (classroom teachers, Educational Assistants, custodians, administrative assistants, etc.), who rely on this contact to maintain their engagement within the school community and preserve their mental health.
* At any time, students with disabilities have very limited opportunity to fulfill the 40 hours of volunteering required for graduation and rely heavily on volunteering at their high school or local elementary school events. All opportunities for volunteering were eliminated during the pandemic.
* Many students with disabilities take optional specialized courses such as Specialized High School Major (SHSM), cooperative credits, etc. which provide hands on and participation within the community. Hands on learning, skills in applicable to trades and life skills were significantly diminished during COVID-19.
* Clubs, councils, sports teams and extracurricular activities are a formative and important part of the high school experience. Often these extracurricular activities are the only opportunity students with disabilities has to socialize with their peers. Not having access to extracurricular activities has impacted their mental health and well-being.
* Many students with disabilities rely on in class instruction be it due to learning disability, anxiety, learning style, ADHD, or simply due to preference in the way they individually learn, among others. The loss of in-class instruction has significantly impacted their learning and future for success.
* Learning at home during school closure has been challenging for students in terms of academic achievement, mental health and wellbeing
* All four years of high school are an integral part of a young persons development and a multitude of students require and rely on in class instruction be it for specialized courses That require specialized equipment, trained staff;
* The experience of four years of high school are incredibly formative of a young persons social, emotional, mental and physical relationship with society, the world around them and indeed the values they will build their life around;
* Return to school planning must consider the impacts on minority & racialized students, students in abusive households, students with limited access to technology or broadband, students with disabilities and students with other complex learning needs;
* Many students rely on in class instruction be it due to learning disability, anxiety, learning style, ADHD, or simply due to preference in the way they individually learn, among others; Recommendations Ministry

35) The Ministry of Education should allow high school in-class instruction to operate for the 2020-2021 school year, if authorized by Ontarios Chief Medical Officer of Health.
36) The Minister should direct School Boards to continue courses which require specialized forms of equipment, classrooms, teaching staff and/or resources (science labs, shops, media classrooms) continue to operate, in accordance with local public health advice.
37) As per the Canadian Mental Health Association, 70% of mental health challenges have their onset in childhood or youth and the Kids Help Phone Line has seen a increase in demand, The Ministries of Education and Health should increase capacity of mental health professionals and supports for School Boards, to ensure there is no waitlist for any secondary student requiring support.
38) The Ministry of Education should include student voice through student trustees association or other student leaders, when developing a plan for return to school.
39) The Ministry of Education should waive the compulsory credit in Health & Physical Education for students who have entered secondary school in the 2020-21 school or whose timetable will be negatively impacted, should Physical Education classes not operate in the conventional manner.
40) If required by Public Health, the Ministry of Education should fund PPE for students and staff to mitigate risks of infection.
41) The Ministry should direct School Boards to develop a prioritization and execution plan for conducting clinical assessments (e.g., psycho–educational assessments) that students with disabilities require in order to access necessary supports and services as they transition from secondary to post-secondary destinations. Recommendations School Board

42) School Boards and Schools should include student voice, including students with disabilities in developing the Board return to school plan, as well as, individual school return plans respectively.
43) School Boards and Schools should provide clear instruction on proper personal protection equipment (PPE) and safety measures to students, parents, and staff.
44) School Boards should follow or mirror Public Health protocols prescribed by the local Public Health. If PPE is not required by the local Public Health, student have the choice to wear PPE. If PPE is required, that school boards are funded appropriately to provide PPE for all students and staff.
45) Where local public health advice can be adhered to, Schools should continue to offer extracurricular activities such as clubs, councils, teams using proper social distancing and general safety protocols.
46) Where applicable, School Boards should waive parking fees for students to reduce financial burdens and help mitigate health risks for students by not riding on a crowded public transit bus.
47) School Boards should make decisions pertaining to cancellation of extracurricular activities in school mirror that of activities outside of school. (Example: If soccer clubs operate locally, then soccer clubs in schools should continue to operate).
48) School Boards should develop and offer online programming for students who cannot or wish not to attend school in person, but not be considered a long-term alternative to in class instruction.
49) School Boards and schools seek out the voice of students, including voices of students with disabilities, when they develop return to school plan options.
50) School Board should develop guidelines for clubs or programs that supplement or enhance education for students with disabilities so they can continue to operate upon return to school.
51) School Boards should continue to offer where possible, alternate classrooms, quiet workspaces, and other special education requirements prescribed in a students Individual Education Plan (IEP).
52) School Boards should research and investigate potential online coop placements that may be available for all students; including students with disabilities.
53) When permitted under local health advice, the School Board should review new health and safety protocols with student and the coop placement provider. Transitions
An impact of the pandemic for students with disabilities is that learning has been lost or stagnant. Learning recovery will be important when returning to school. This will mean targeted measures to reversing learning loss or closing gaps. There will be a need for clear system wide guidance for in-class and central assessments to inform and plan for curriculum delivery, supports and service upon return to school.
Transition planning will occur at the provincial, local and student level. The Ministry of Education will need to identify barriers and gaps from all educational stakeholders to develop an informed return to school plan. School boards will need identify barriers and gaps at a system and individual student level to create an informed back to school plan as well as address the needs for students with disabilities.
The Individual Education Plan (IEP) is a tool for documenting student strengths and needs and the accommodations, programs and services they require to be successful. IEPs are a valuable tool in documenting the students current level of achievement and transition plans for planned changes in grades, schools, and life after secondary school. The IEP can also be used to plan for return to school, full time or in an adapted model, or for continued virtual learning. Barriers
* During the school closure gaps in student skills and knowledge related to on-line and distance learning has been evident
* Planning for school year 2020-2021 will include in school and distance learning
* School staff will need to assess students with disabilities to determine their accessibility and learning needs
* Students with disabilities individual IEPs and transitions plans need to be reviewed to address barriers and gaps to allow for student success. * Student voice often forgotten in the planning process
* Students and prospective students cannot visit the physical environments of schools during the COVID-19 pandemic and do not have the opportunity to check for physical accessibility and familiarize themselves with environment Recommendations Government

54) The Ministry of Education should direct School Boards to develop a prioritization and execution plan for conducting clinical assessments (e.g., psycho–educational assessments) that students with disabilities require, in order to access necessary supports and services as they transition from secondary to post-secondary destinations.
55) The Ministry of Education, in partnership with MCCSS should work with school boards to identify their cohorts of students with intellectual and other disabilities who completed their school careers in June 2020 and identify and assess if barriers faced during COVID-19 did not allow for successful student transitions to their chosen pathway (Examples: to work, volunteer work, recreation/leisure programs, and post-secondary education) as outlined in their transition plans. Jointly, the Ministries and School Boards should develop plans to help this cohort of students with disabilities achieve their individual transition goals. Recommendations School Boards

56) School Boards should be independently collecting board wide data on gaps, barriers, emerging issues, transition challenges, technology challenges, additional students needs and supports arising or as a result of COVID-19 through assessment, student and parent feedback to address and plan for system wide supports and services required by students with disabilities upon return to school.
57) To help with successful transitions for student with disabilities in returning to school, School Boards shall contact parent/guardians, as soon as possible, to discuss and identify learning gaps, individual needs arising from school shutdown and distance learning, transition challenges, social and emotional needs to inform and revise/or create individualized transition plans for students with disabilities.
58) To help reduce stress and anxiety and prepare themselves for return to school, students with disabilities should be involved with discussions and decision made in developing their Transition Plan.
59) School Boards and Administrators shall ensure Individual Education Plans for students with disabilities are revised/created to reflect specific goals and activities to address the individual needs identified in Recommendation #3 to help increase academic and transition success for each student with a disability upon returning to school.
60) School Boards shall include the student when developing their individualized Transition and IEP. All
61) When School Boards develop the Individualized Transition Plans for each student, it should be:
a) flexible to accommodate the stop and start of in class learning. All methods of instruction should be considered for learning to ensure students have access to an education (virtual instruction, in home instruction, etc.)
b) include a flexible and hybrid model for entry needs to accommodate the varying student needs. Any model developed for return to school shall be developed in consultation with parent/guardians and student
c) include strategies for students around social/physical distancing. Social distancing guidelines should be developed in consultation with parents/guardians and student. d) Include steps for follow up and checking in with the student
e) All documentation or information be provided to the parent/guardian and student before the meeting with enough time to review. Documents should be provided in an accessible format.
62) School Boards should take more interactive approaches to collect on-going feedback from parents, students and staff (i.e. Thought exchange) to guide and inform changes to policies and procedures impacted by COVID-19.
63) School Boards should develop a clear system wide plan to address increased classroom and school supports and services (Educational Assistants, Education Works, social workers, psychologists, guidance councillors) identified through assessments to help mitigate issues and support learning for students with disabilities.
64) School Boards should create audio described (DV) and closed-captioned (CC) virtual tours of their school. The virtual tour must be fully accessible and thoroughly provide information on accessibility and locations at the schools. Virtual tours should be made permanently available; not just during the pandemic. Communications & Technology
For our purpose, communication includes technologies, systems, protocols and procedures that enable an organization to effectively communicate to its employees, partners and community. During an emergency, communication is essential and should ensure all relevant personnel can quickly and effectively communicate with each other during such crises, sharing information that will allow the organization to quickly rectify the situation, protect employees and assets, and allows the business to continue.
To relate this to Education government, school boards, agencies, staff, students, parent/caregivers, should have the ability to communicate effectively during a crisis, while the business of providing learning continues. Barriers
* Ongoing accessibility issues with virtual learning environment or platform (Examples: no closed captions, compatibility issues with screen readers, lack of support or knowledge of accessibility features, no ASL interpretation) * Ongoing accessibility issue with information and resources provided
* Conflicting guidelines provided by different ministries and level of government. Recommendations Government

65) That a designated communication lead should be assigned at the provincial and regional level for consistent messaging.
66) For efficiency and elimination of duplication of effort for School Boards, The Ministry of Education should immediately engage an arms-length digital accessibility consultant to evaluate the comparative accessibility of different digital learning and virtual learning environments or 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 instruction environments or platforms.
67) The Ministry of Education should provide a list of acceptable accessible, cross platform virtual learning environments and synchronous teaching systems to be used by school boards.
68) 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.
69) The Ministry of Education should immediately direct TVO/TFO 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. The implementation of this recommendation has become urgent since Royal Assent was given to Bill 197, COVID-19 Economic Recovery Act, 2020 as amends to the Ontario Educational Communications Authority Act broaden the mandates of both TVO and TFO to position them to provide centralized support for online learning in the English-language and French-language publicly-funded education systems, respectively.
70) The Ministry of Education should direct its entire staff and all School Boards that whenever making information public in a Portable Document Format (PDF), it must at the same time, make available a textual format such as an accessible Microsoft Word (MSWord) or accessible HTML document. Videos must be audio described (DV) and closed captioned (CC). Templates and technical guides should be developed and provided to school boards. Recommendations School Boards

71) For consistent messaging, that the School board should designate a communication lead for COVID-19 related issues.
72) School Boards should develop protocols and procedures to mitigate security risks for online and virtual learning platforms to help protect privacy of students with disabilities and staff. Online and virtual learning platforms should also be accessible for all students with disabilities.
73) That School Boards should provide clear communication around protocols and return to school plans. Boards should make written communications readily available and accessible by everyone in the community, parents and students.
74) School Boards should review and revise instructional videos for parents around virtual learning tools used in the school board. Videos must be clear and accessible.
75) School Boards should provide solely dedicated or designated staff, who are available to support technology including accessibility needs to parents who are supporting the learning needs of students with disabilities at home. Training
The COVID-19 Pandemic has changed the way in which education is delivered. Students, parents/guardians, teachers, staff, school boards and government had to change the way they access, support or deliver education. The pandemic highlighted gaps in digital skills, adaptation of technology to teaching and learning. It has also increased demand for technology and the need to integrate technology effectively into teaching and learning. With this increased demand in the use of technology and the gaps in digital skills identified, it is imperative to train students, parent/guardians and staff in the use and integration of technology in teaching and learning. Barriers
* Teachers, students and parent/guardians unprepared for learning at home and use of virtual platforms such as google classroom, Microsoft teams, Zoom for individual and synchronous learning * Teachers, ECEs, Staff need training in virtual online learning platforms
* Teachers, ECEs, Staff need training in strategies to support students with disabilities around transitions between education models, including preparation for changing environments and self regulation
* Teachers, ECEs lack training in strategies to support Public Health directed precautions, such as social distancing, sanitizing procedures and use of PPE when required to support students
* School closures have had a significant impact on the mental health and well being of students with disabilities and teachers, ECEs, staff will require training on child development and trauma informed practice to assist them in supporting students in transitioning back to school or continuation of virtual education.
* The expectation on parent/guardians to support students with learning at home were significant and parents need supports and training in virtual learning software and how they can effectively support their childs learning. Recommendations Government

76) That Ministry of Education should model leadership to School Boards and provide accessible virtual learning webinars, templates for learning, etc. to be utilized in training administrators and teachers.
77) The Ministry of Education should direct School Boards to provide all staff training in child development, mental health and wellbeing to support the wellbeing and learning of students with disabilities.
78) The Government should provide direction to School Boards and Public Service agencies to develop a coordinated training delivery model to support parents of students with rehabilitation needs, mental health concerns or who have complex or significant medically needs, with the delivery of virtual care, including privacy protected health platforms such as OTN, ADcare. Recommendations School Boards

79) School Boards should provide focused, practical training for administrators and teachers to support students with disabilities health, wellbeing and learning in a mixed or virtual environment.
80) School Boards should provide administrators training and guidelines on supporting students with disabilities through transitioning and change.
81) School Boards should develop parent training modules and resources to enable parent/guardians to develop the skills and knowledge required to support online and virtual learning at home for students with disabilities.
82) School Boards should provide training for teachers and staff on specific tips and solutions, successful and evidence based promising practices by disability to support teachers and students with disabilities learning. These should be made available as soon as possible or at the latest, during the first days of PD before school instruction begins.

Transportation
School Bus operation and delivery of bus services is regulated and governed both federally and provincially. Transport Canada has consulted with the Public Health Agency of Canada to provide guidelines around bus operations during the pandemic. The National Association for Pupil Transportation (NAPT) has also provided general guidelines for the provision of student (pupil) transportation services.
The Ministry of Educations Return to School Framework directs School Boards to follow these federal guidelines.
To accommodate Federal Transportation and Public health guideline that require social and physical distancing, School Boards will have to revise transportation services delivery that will impact bus routes, increase the number of buses and drivers required, increase ridership time, etc. to mitigate risks to students with disabilities while transporting to and from school. Barriers

Lack of or reduced public transportation available for students with disabilities, particularly for secondary students who take public transit. Municipal governments eliminated routes or reduced schedules during COVID-19. Municipalities have not made public transportation plans for when students return to school.
As School Boards and Consortiums plan transportation services to meet the Transport Canada guidelines, current challenges of inadequate buses, shortage of drivers and increasing fuel costs will be a barrier to boards.
Changes to routine can have a significant impact to a student with disabilities mental health, success for the start of school day and learning. Predictable changes to transportation for students with disabilities can include, increased ridership time, bus route, bus type (72-passenger, small bus), supports or accommodations required for a successful ride, etc. while maintaining safety and mitigating risks for infection.
Many School Boards currently overspend the transportation grant, while still achieving a high efficiency rating from the Ministry of Education. The additional requirements defined under the Transport Canada Guidelines will increase cost pressures to provide transportation services to students with disabilities while maintaining safety and mitigating risk of infection.
As students with disabilities require may require specific transportation accommodations such as a safety harness, seat belt, wheelchair accessible which cannot be accommodated in all vehicle types.

Recommendations School Boards

83) As many School Boards overspend its transportation grant while maintaining a high efficiency rating, the Ministry of Education should provide school boards with additional COVID-19 specific funding to follow the guidelines as provided by Transport Canada around: o Measures to mitigate risk of exposure
o Procedures to be taken before a trip, during a trip and at the end of the trip o PPE guidelines
o Physical Distancing
o Shield and Enclosure system guidelines (if bus operators choose to do so)
84) School Boards should review transportation accommodations and requirements, in consultation with parents and student, IEPs of students with disabilities who require transportation services to identify any change/modifications to accommodations required. The students IEP shall be modified to reflect additional requirements to transport the student safely on the bus. The review for medically fragile students should include professionals, such as nurses, occupational therapists, as well as parents. All transportation requirements shall be relayed to the Bus Consortia and administrator of the school for implementation.
85) School Boards must create/revise a protocol for the safe gathering of all students and parent/guardians at bus stops and safety on the bus. It is important that student with disabilities be included and familiarized with these protocols with their peers.
86) School Boards and Bus Consortia should provide bus drivers with training on new health and safety protocols for students with disabilities on a regular bus, small bus and wheelchair accessible bus.
87) Bus Consortia should minimize changes to routes, vehicle type, and schedules for students with disabilities while developing changes to routes, to limit increased anxiety or behaviours as a result of the changes. When changes are considered, parents and student should be consulted about changes.
88) School Boards and Bus Consortia should review procedures and protocols for persons responsible for putting a student with disabilitys harness on/off or supporting a student on the school bus to mitigate health risks for the student, bus driver and support person.
89) School Boards and Bus Consortia should revise/develop, implement and disseminate bus safety protocol Information for parents needs to help mitigate health and safety risks and assuage parents fears. This includes protocols around harnesses. All communications should be clear and made readily available on the Board and Bus Consortia website in an accessible digital format.
90) Students with disabilities should be included in any training that is provide for all students on enhanced safety rules on the bus.
91) As students with disabilities are statistically proven to be at a higher risk of infection, School Boards and Bus Consortia should implement enhanced student bus ridership attendance procedures to aid in tracing of COVID-19 and mitigating health risks.
92) Traffic volume, student and road safety is always a concern around schools. It is expected for vehicle traffic to increase when school returns, as parent/caregiver or a secondary student chooses to drive to school. School Boards should work collaboratively with Municipalities to develop safe arrival and departure awareness campaigns for students, parents/caregivers and buses. These campaigns could include guidelines for kiss & ride, audio described (DV) and closed captioned (CC) virtual or diagrams of vehicle traffic flows for entering and exiting school property from the street, identifying school bus only access areas, promote other methods of transportation, etc.

Conclusion
The Planning for Emergencies are please to provide its draft recommendations related to the COVID-19 pandemic. The Working Group will continue to review resources and information on barriers and issues arising from COVID-19 and as students return to school. It will start work on its mandate to develop an emergency plan framework focused on students with disabilities (that covers the phases of preparing, planning, response and recovery) for a systematic response to an emergency.
Thank you to all the members of the Planning for Emergencies Working Group for their dedication in developing this draft set of recommendations. Working Group members are: * Donna Edwards (Chair Working Group)
* Stephan Andrews
* David Lepofsky
* Dr. Ashleigh Malloy
* Alison Morse
* Rana Nasrazadani
* Ben Smith
* Angelo Tocco
* Dr. Lindy Zaretsky
* Lynn Ziraldo (Chair K-12 SDC)

Glossary
Accessibility: a general term for the degree of ease that something (e.g., device, service, physical environment and information) can be accessed, used and enjoyedby persons with disabilities. The term implies conscious planning, design and/or effortto make sure something is barrier-free to persons with disabilities. Accessibility also benefits the general population, by making things more usable and practical for everyone, including older people and families with small children.
Accessible: does not have obstacles for people with disabilities something that can be easily reached or obtained; facility that can be easily entered; information that is easy to access.
Accessible digital format: Information that is provided in digital form that is accessible such as HTML and MS Word.
Synchronous learning: is the kind of learning that happens in real time. This means that you, your classmates, and your instructor interact in a specific virtual place, through a specific online medium, at a specific time. In other words, its not exactly anywhere, anyhow, anytime. Methods of synchronous online learning include video conferencing, teleconferencing, live chatting, and live-streaming lectures.

Asynchronous learning: happens on your schedule. While your course of study, instructor or degree program will provide materials for reading, lectures for viewing, assignments for completing, and exams for evaluation, you have the ability to access and satisfy these requirements within a flexible time frame. Methods of asynchronous online learning include self-guided lesson modules, streaming video content, virtual libraries, posted lecture notes, and exchanges across discussion boards or social media platforms.

Distance Education Program: Programs to provide courses of study online, through correspondence, or by other means that do not require the physical attendance by the student at a school. (From Bill 197)
Special Education Services – As defined in the Education Act, facilities and resources, including support personnel and equipment, necessary for developing and implementing a special education program.
Virtual learning: is defined as learning that can functionally and effectively occur in the absence of traditional classroom environments (Simonson & Schlosser, 2006).

Virtual education: refers to instruction in a learning environment where teacher and student are separated by time or space, or both, and the teacher provides course content through course management applications, multimedia resources, the Internet, videoconferencing, etc. Students receive the content and communicate with the teacher via the same technologies.

Virtual learning environment: refers to a system that offers educators digitally-based solutions aimed at creating interactive, active learning environments. VLEs can help educators create, store and disseminate content, plan courses and lessons and foster communication between student and educator. Virtual learning environments are often part of an education institutions wider learning management system (LMS).

Virtual instruction: is a method of teaching that is taught either entirely online or when elements of face-to-face courses are taught online through learning management systems and other educational tools and platforms. Virtual instruction also includes digitally transmitting course materials to student. Resources
Mental Health
? School Mental Health https://smho-smso.ca/ – a variety of resources for students, parents, educators
? Mental Health and Teachers https://www.tes.com/news/will-fear-coronavirus-affect-your-teaching?utm_campaign=73103_20200608%20Editorial%20Daily%20Register&utm_medium=email&utm_source=Dot_Digital&utm_content=73103_20200608%20Editorial%20Daily%20Register&dm_i=5NNY,1KEN,M10WD,5U5E,1 ? People for Education Educational reading in a Pandemic – https://peopleforeducation.ca/our-work/education-reading-in-a-pandemic/

Public Health Guidance and Safety

? Alberta Public Health guidance for schools –
https://www.alberta.ca/release.cfm?xID=72576418BE34F-D428-6986-0F85E17B91BA2A40#toc-0
? Centre for Disease Control – Case Investigation and Contact Tracing : Part of a Multipronged Approach to Fight the COVID-19 Pandemic –https://www.cdc.gov/coronavirus/2019-ncov/php/principles-contact-tracing.html
? Canada Public Health -Updated: Public health management of cases and contacts associated with coronavirus disease 2019 (COVID-19) = https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/interim-guidance-cases-contacts.html#co ? UNICEF- a framework to reopening schools –
https://www.unicef.org/documents/framework-reopening-schools ? Government of Canada resources for parents –
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/resources-parents-children.html ? SickKids Recommendations for School Reopenings –
https://www.sickkids.ca/PDFs/About-SickKids/81407-COVID19-Recommendations-for-School-Reopening-SickKids.pdf ? Federal Guidance for School Bus Operations during the COVID-19 Pandemic –
https://www2.tc.gc.ca/en/services/road/federal-guidance-school-bus-operations-during-covid-19-pandemic.html).
? National Association for Pupil Transportation (NAPT) Guidelines – https://www.napt.org/covid ? Considerations for Wearing Cloth Face Coverings, Centre for Disease Control –
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#feasibility-adaptations

Tools/Best Practices

? York Catholic District School Board https://sites.google.com/ycdsb.ca/ycdsb-ssd-distance-learning/home – learning from home resource
? Durham District School Board https://www.ddsb.ca/en/programs-and-learning/distance-learning.aspx distance learning resources
? Durham District School Board https://www.ddsb.ca/en/programs-and-learning/resources/Documents/Distance-Learning/IEPs-Documenting-Accommodation-and-Programming-During-Distance-Learning-05-2020.pdf IEPs documenting accommodations and programing during distance learning ? Durham District School Board –
https://www.ddsb.ca/en/programs-and-learning/resources/Documents/Distance-Learning/Distance-Learning–Identification-Placement-and-Review-Committee-IPRC-Process.pdf IPRC process during distance learning ? Thames Valley District School Board –
https://www.tvdsb.ca/en/our-board/learning-at-a-distance.aspx distance learning resources and more ? Ottawa-Carleton District School Board –
https://ocdsb.ca/cms/one.aspx?portalId=55478&pageId=32163119 learning at home resources
? York Region District School Board has a variety of learning resources, resources for parents etc. –
http://www.yrdsb.ca/schools/Repository/NewsEvents/Pages/BoardNews/Coronavirus.aspx
? Toronto District School Board https://sites.google.com/tcdsb.ca/tcdsb-parents-at/home – a guide to assistive technology for parents
? University of Toronto Accessibility formats and communication supports http://aoda.hrandequity.utoronto.ca/communications/ ? Best Practices for Collecting Data on Disabilities, Education Links – https://www.edu-links.org/learning/best-practices-collecting-data-disabilities
? Accessibility for Ontario Disabilities Act, Integrated Guide, Section 12: Accessible Formats and Communication Supports –
https://www.aoda.ca/a-guide-to-the-integrated-accessibility-standards-regulation/#sect12 ? Ontario Human Rights Code Policies and Guidelines on Duty to Accommodate –
http://www3.ohrc.on.ca/sites/default/files/policy%20and%20guidelines%20on%20disability%20and%20the%20duty%20to%20accommodate.pdf
? Preparing K-12 School Administrators for a Safe Return to School in Fall 2020, Centre for Disease Control –
https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/prepare-safe-return.html

Stakeholder Reports and Information

? OHRC Letter to the Minister of Education about convening a return-to-school partnership table –
http://www.ohrc.on.ca/en/news_centre/letter-minister-education-about-convening-return-school-partnership-table
? OHC Letter to the Minister of Education, school leaders on respecting the rights of students with disabilities –
http://www.ohrc.on.ca/en/news_centre/letter-minister-education-school-leaders-respecting-rights-students-disabilities
? OHRC Letter to Ministers re: accessible education for students with disabilities –
http://www.ohrc.on.ca/en/letter-ministers-re-accessible-education-students-disabilities
? Report of The Third Review Of The Accessibility For Ontarians With Disabilities Act, 2005 By The Honourable David C. Onley – https://files.ontario.ca/seniors-accessibility-third-review-of-aoda-en-2019.pdf
? AFT, American Federation of Teachers https://www.aft.org/sites/default/files/guide_reopen-america-schools.pdf – a guide to safely open schools
? AODA Alliance Final Brief to Ontario Government on Urgent needs of K-12 Students with Disabilities during COVID-19 Crisis –
https://www.aodaalliance.org/whats-new/download-in-ms-word-format-the-aoda-alliances-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-trans/
? AODA Alliance – New Report Reveals that Majority of Ontarios School Boards, Each School Principal can Exclude a Student From School Real Risk of a Rash of Exclusion of Some Students with Disabilities When Schools Re-Open –
https://www.aodaalliance.org/whats-new/new-report-reveals-that-at-majority-of-ontarios-school-boards-each-school-principal-is-a-law-unto-themselves-with-arbitrary-power-to-exclude-a-student-from-school-real-risk-of-a-rash-of-exclusio/
? Wisconsin DPI releases guidelines for reopening schools this fall: Proactive approach –
https://fox6now.com/2020/06/22/wisconsin-department-of-public-instruction-releases-guidelines-for-reopening-schools-this-fall/
? ASCD http://www.ascd.org/publications/newsletters/education-update/may20/vol62/num05/7-Ways-Educators-Can-Help-Students-Cope-in-a-Pandemic.aspx
? Easter Seals https://education.easterseals.org/supporting-learning-at-home-through-the-covid-19-crisis/ – online learning resources ? [email protected] resources for parents – https://www.ldathome.ca/
? [email protected] resources for teachers – https://www.ldatschool.ca/ ? People for Education Effective e-learning need structures and supports –
https://peopleforeducation.ca/our-work/technology-in-schools-a-tool-and-a-strategy/ ? Accessibility Digital Office Project – https://adod.idrc.ocadu.ca/ ? People for Education Educational reading in a Pandemic – https://peopleforeducation.ca/our-work/education-reading-in-a-pandemic

Additional Reading

? How brain research help retool our school schedule for remote learning –
https://www.edsurge.com/news/2020-06-10-how-brain-research-helped-retool-our-school-schedule-for-remote-learning
? Ontario Developmental Services https://www.dsontario.ca/resources/webcasts-podcasts – podcast to Passport Funding
? Survey Place resources https://www.surreyplace.ca/resources-publications/coronavirus-updates-resources/#parents ? Statistics Canada Survey parenting during pandemic –
https://surveys-enquetes.statcan.gc.ca/form-formulaire/q/en/eqgs4b1d8328edfa4922aa915b5436328916/p0 ? Globe & Mail -Children being rendered invisible https://www.theglobeandmail.com/canada/article-children-being-rendered-invisible-by-province-former-ontario-child/
? CTV News – Parents should ‘respect custody arrangements’ during COVID-19 pandemic –
https://toronto.ctvnews.ca/parents-should-respect-custody-arrangements-during-covid-19-pandemic-1.4874720?cache=wcoseppn%3FautoPlay%3Dtrue%3FclipId%3D89680
? Top 10 – A New New Deal For Education: Top 10 Policy Moves For States In The COVID 2.0 Era –
https://www.forbes.com/sites/lindadarlinghammond/2020/05/19/a-new-new-deal-for-education-top-10-policy-moves-for-states-in-the-covid-20-era/#203440f16266
? UNESCO MGIEP Essential SEL Resources: COVID-19 – https://mgiep.unesco.org/covid
? Inter-agency Network for Education in Emergencies https://inee.org/resources/inee-minimum-standards Minimum Standards Handbook: Preparedness, Emergency, Recovery
? George Lucas Foundation https://www.edutopia.org/article/schools-are-opening-worldwide-providing-model-us?utm_source=Edutopia+Newsletter&utm_campaign=9f50493399-EMAIL_CAMPAIGN_052720_enews_schoolsare&utm_medium=email&utm_term=0_f72e8cc8c4-9f50493399-78670447 article on school opening around the world ? Teacher Magazine- How teachers can help students transition back to school –
https://www.teachermagazine.com.au/articles/covid-19-how-teachers-can-help-students-transition-back-to-school ? Tes What 1 week after returning to school looks like –
https://www.tes.com/news/coronavirus-reopening-schools-one-week-back-what-has-return-school-been ? How brain research help retool our school schedule for remote learning –
https://www.edsurge.com/news/2020-06-10-how-brain-research-helped-retool-our-school-schedule-for-remote-learning




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Ford Government to Spend Over a Half Billion Dollars on New Schools and Major School Additions, Without Announcing Effective Measures to Ensure that These Schools Will be Fully Accessible to Students, Parents and School Staff with Disabilities


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/

Ford Government to Spend Over a Half Billion Dollars on New Schools and Major School Additions, Without Announcing Effective Measures to Ensure that These Schools Will be Fully Accessible to Students, Parents and School Staff with Disabilities

July 30, 2020

          SUMMARY

Last week, the Ford Government announced that it is investing over half a billion dollars into building new schools and expanding existing ones, without announcing any effective measures to ensure that those schools will be designed to be accessible to students, parents, teachers, or other school staff with disabilities. Public money should never be used to create new barriers against people with disabilities. If new barriers are created, it costs much more to later renovate to remove them.

For years, Ontario’s Ministry of Education has largely left it to each school board to decide what, if anything, to include in the design of a new school building to ensure it is disability-accessible. Each school board is left to decide on its own whether it will include anything in the building’s design for accessibility, beyond the inadequate accessibility requirements in the Ontario Building Code, in standards enacted under the Accessibility for Ontarians with Disabilities Act, and under a patchwork of local municipal bylaws. The Ontario Government does not have a standard or model design for a new school or for an addition to a school, to ensure its accessibility to students, parents and school staff with disabilities.

On July 23, 2020, the Ford Government announced a major plan to build 30 new schools and to construct additions to another 15 schools, to provide both learning venues and more day care locations for students across Ontario (announcement set out below). The Ford Government has not announced any requirement that this new construction must be disability-accessible. It is wasteful, duplicative and counter-productive for the Ontario Government to leave it to 72 school boards to each re-invent the wheel when it comes to the design of a school building to ensure that it is accessible. Moreover, school boards are not assured to have the requisite expertise in accessible building design. Making this worse, too often architects are not properly trained in accessible design.

This is not a situation where each school board is best situated to assess the unique local needs of its community. A student, parent or school staff member with a disability has the very same accessibility needs, when it comes to getting into and around a school building, whether that school is in Kenora or Cornwall.

It has been well established for years that compliance with the insufficient accessibility requirements in the Ontario Building Code, the Accessibility for Ontarians with Disabilities Act accessibility standards and local municipal bylaws do not ensure that a new building is in fact accessible and barrier-free for people with disabilities. To the contrary, the AODA Alliance has shown how new buildings and major renovations in major public projects can end up having serious accessibility problems. This is illustrated in three online videos, produced by the AODA Alliance, that have gotten thousands of views and extensive media coverage. Those videos focus on:

* the new Ryerson University Student Learning Centre;

* the new Centennial College Culinary Arts Centre and

* several new and recently renovated Toronto area public transit stations.

Over a year and a half ago, the third Government-appointed Independent Review of the implementation of the AODA, conducted by former Lieutenant Governor David Onley, found that progress in Ontario on accessibility has proceeded at a “glacial” pace. Among other things, it recommended that the Ontario Government should treat as a major priority the recurring barriers facing people with disabilities in the built environment. The Onley Report emphasized as an illustration the AODA Alliance’s video depicting serious accessibility problems at Ryerson’s new Student Learning Centre.

Strong, effective and enforceable provincial accessibility standards for the built environment are long overdue. Yet the Government has announced no plans to develop and enact a Built Environment Accessibility Standard under the AODA. Beyond this, for over two and a half years, the Ontario Government has been in direct violation of the AODA. This is because the Government has still not appointed a mandatory Standards Development Committee to review the palpably inadequate “Design of Public Spaces” Accessibility Standard, enacted under the AODA in December 2012. Under section 9(9) of the AODA, the Ontario Government was required to appoint a mandatory Standards Development Committee to review that accessibility standard by December 2017. The former Kathleen Wynne Government is on the hook for failing to appoint that Standards Development Committee for the seven months from December 2017 up to the Wynne Government being defeated in the June 2018 provincial election. The Ford Government is on the hook for violating the AODA for the subsequent two years, from the time it took office up to today.

The Ford Government should now direct all school boards receiving any of the public money that the Government announced on July 23, 2020 that all those new projects must be fully accessible. This must go further than simply meeting the inadequate accessibility requirements in the Ontario Building Code, in AODA accessibility standards enacted to date, and in local bylaws. The Ford Government should set specific accessibility requirements that must be met. A good template for this is set out in the AODA Alliance’s draft Framework for the Post-Secondary Education Accessibility Standard.

There have now been 546 days, or over a full year and a half, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has not announced any comprehensive plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis.

For more background, check out:

* The AODA Alliance website’s Built Environment page, that documents our efforts to get the Ontario Government to enact strong accessibility standards for the built environment.

* The AODA Alliance website’s Education page, documenting the AODA Alliance’s efforts to tear down the many barriers in Ontario’s education system facing students with disabilities.

          MORE DETAILS

 July 23, 2020 Ontario Government News Release

Originally posted at https://news.ontario.ca/opo/en/2020/07/ontario-building-and-expanding-schools-across-the-province-1.html

Ontario Newsroom

News Release

Ontario Building and Expanding Schools across the Province

July 23, 2020

Modern Facilities Will Strengthen Student Learning and Increase Access to Child Care

BRAMPTON — The Ontario government is investing over $500 million to build 30 new schools and make permanent additions to 15 existing facilities, supporting over 25,000 student spaces across the province. These new, modern schools will create the foundation for a 21st century learning environment for thousands of students across the province. This investment will also generate nearly 900 new licensed child care spaces to ensure families across the province are able to access child care in their communities.

Details were provided today by Premier Doug Ford and Stephen Lecce, Minister of Education.

“Our government is making a significant capital investment in our school system,” said Premier Ford. “By making these smart investments today, we will ensure our students and teachers have access to modern facilities to learn with features like high-speed Internet, accessible ramps and elevators, and air conditioning, while providing parents with access to more licensed child care spaces.”

The government is investing over $12 billion in capital grants over 10 years, including over $500 million invested in this year alone to build critical new school capital projects and permanent additions. Today’s announcement continues to build upon the government’s commitment to invest up to $1 billion over five years to create up to 30,000 licensed child care spaces in schools, including 10,000 spaces in new schools. These new projects will also result in the creation of new jobs in the skilled trades as over $500 million of major infrastructure projects break ground in short order.

“It is unacceptable that too many schools in our province continue to lack the investment that our students deserve,” said Minister Lecce. “That is why this government is making a significant investment to build new schools, to extensively renovate existing schools, and expand access to licensed child care spaces in our province. Our government is modernizing our schools, our curriculum, and the delivery of learning, to ensure students are set up to succeed in an increasingly changing world.”

QUICK FACTS

list of 4 items

  • The Ministry of Education reviews all Capital Priorities submissions for eligibility and merit prior to announcing successful projects.
  • The Ministry is working in partnership with school boards to deliver high-speed Internet to all schools in Ontario, with all high schools having access to broadband by September 2020, and all elementary schools having access by September 2021. As of March 31, 2020, broadband modernization has been completed at 1,983 schools, including 403 Northern schools. Installation is currently in progress at 2,954 schools, including 99 northern schools.
  • The Ministry is investing $1.4 billion in renewal funding, which continues to meet the recommended funding level by the Auditor General of Ontario to preserve the condition of Ontario’s school facilities.
  • To find out more about projects in your community, visit the Ontario Builds map.

list end

ADDITIONAL RESOURCES

list of 1 items

  • Learn more about Ontario’s commitment to modernizing schools and child care spaces.

list end

CONTACTS

Ivana Yelich

Premier’s Office

[email protected]

Alexandra Adamo

Minister Lecce’s Office

[email protected]

Ingrid Anderson

Communications Branch

437 225-0321

[email protected]

Office of the Premier

http://www.ontario.ca/premier



Source link

Ford Government to Spend Over a Half Billion Dollars on New Schools and Major School Additions, Without Announcing Effective Measures to Ensure that These Schools Will be Fully Accessible to Students, Parents and School Staff with Disabilities


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/

July 30, 2020

SUMMARY

Last week, the Ford Government announced that it is investing over half a billion dollars into building new schools and expanding existing ones, without announcing any effective measures to ensure that those schools will be designed to be accessible to students, parents, teachers, or other school staff with disabilities. Public money should never be used to create new barriers against people with disabilities. If new barriers are created, it costs much more to later renovate to remove them.

For years, Ontarios Ministry of Education has largely left it to each school board to decide what, if anything, to include in the design of a new school building to ensure it is disability-accessible. Each school board is left to decide on its own whether it will include anything in the buildings design for accessibility, beyond the inadequate accessibility requirements in the Ontario Building Code, in standards enacted under the Accessibility for Ontarians with Disabilities Act, and under a patchwork of local municipal bylaws. The Ontario Government does not have a standard or model design for a new school or for an addition to a school, to ensure its accessibility to students, parents and school staff with disabilities.

On July 23, 2020, the Ford Government announced a major plan to build 30 new schools and to construct additions to another 15 schools, to provide both learning venues and more day care locations for students across Ontario (announcement set out below). The Ford Government has not announced any requirement that this new construction must be disability-accessible. It is wasteful, duplicative and counter-productive for the Ontario Government to leave it to 72 school boards to each re-invent the wheel when it comes to the design of a school building to ensure that it is accessible. Moreover, school boards are not assured to have the requisite expertise in accessible building design. Making this worse, too often architects are not properly trained in accessible design.

This is not a situation where each school board is best situated to assess the unique local needs of its community. A student, parent or school staff member with a disability has the very same accessibility needs, when it comes to getting into and around a school building, whether that school is in Kenora or Cornwall.

It has been well established for years that compliance with the insufficient accessibility requirements in the Ontario Building Code, the Accessibility for Ontarians with Disabilities Act accessibility standards and local municipal bylaws do not ensure that a new building is in fact accessible and barrier-free for people with disabilities. To the contrary, the AODA Alliance has shown how new buildings and major renovations in major public projects can end up having serious accessibility problems. This is illustrated in three online videos, produced by the AODA Alliance, that have gotten thousands of views and extensive media coverage. Those videos focus on:

* the new Ryerson University Student Learning Centre;

* the new Centennial College Culinary Arts Centre and

* several new and recently renovated Toronto area public transit stations.

Over a year and a half ago, the third Government-appointed Independent Review of the implementation of the AODA, conducted by former Lieutenant Governor David Onley, found that progress in Ontario on accessibility has proceeded at a glacial pace. Among other things, it recommended that the Ontario Government should treat as a major priority the recurring barriers facing people with disabilities in the built environment. The Onley Report emphasized as an illustration the AODA Alliances video depicting serious accessibility problems at Ryersons new Student Learning Centre.

Strong, effective and enforceable provincial accessibility standards for the built environment are long overdue. Yet the Government has announced no plans to develop and enact a Built Environment Accessibility Standard under the AODA. Beyond this, for over two and a half years, the Ontario Government has been in direct violation of the AODA. This is because the Government has still not appointed a mandatory Standards Development Committee to review the palpably inadequate Design of Public Spaces Accessibility Standard, enacted under the AODA in December 2012. Under section 9(9) of the AODA, the Ontario Government was required to appoint a mandatory Standards Development Committee to review that accessibility standard by December 2017. The former Kathleen Wynne Government is on the hook for failing to appoint that Standards Development Committee for the seven months from December 2017 up to the Wynne Government being defeated in the June 2018 provincial election. The Ford Government is on the hook for violating the AODA for the subsequent two years, from the time it took office up to today.

The Ford Government should now direct all school boards receiving any of the public money that the Government announced on July 23, 2020 that all those new projects must be fully accessible. This must go further than simply meeting the inadequate accessibility requirements in the Ontario Building Code, in AODA accessibility standards enacted to date, and in local bylaws. The Ford Government should set specific accessibility requirements that must be met. A good template for this is set out in the AODA Alliances draft Framework for the Post-Secondary Education Accessibility Standard.

There have now been 546 days, or over a full year and a half, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has not announced any comprehensive plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis.

For more background, check out:

* The AODA Alliance websites Built Environment page, that documents our efforts to get the Ontario Government to enact strong accessibility standards for the built environment.

* The AODA Alliance websites Education page, documenting the AODA Alliances efforts to tear down the many barriers in Ontario’s education system facing students with disabilities.

MORE DETAILS

July 23, 2020 Ontario Government News Release

Originally posted at https://news.ontario.ca/opo/en/2020/07/ontario-building-and-expanding-schools-across-the-province-1.html

Ontario Newsroom

News Release

Ontario Building and Expanding Schools across the Province
July 23, 2020

Modern Facilities Will Strengthen Student Learning and Increase Access to Child Care
BRAMPTON The Ontario government is investing over $500 million to build 30 new schools and make permanent additions to 15 existing facilities, supporting over 25,000 student spaces across the province. These new, modern schools will create the foundation for a 21st century learning environment for thousands of students across the province. This investment will also generate nearly 900 new licensed child care spaces to ensure families across the province are able to access child care in their communities.
Details were provided today by Premier Doug Ford and Stephen Lecce, Minister of Education.
“Our government is making a significant capital investment in our school system,” said Premier Ford. “By making these smart investments today, we will ensure our students and teachers have access to modern facilities to learn with features like high-speed Internet, accessible ramps and elevators, and air conditioning, while providing parents with access to more licensed child care spaces.”
The government is investing over $12 billion in capital grants over 10 years, including over $500million invested in this year alone to build critical new school capital projects and permanent additions. Today’s announcement continues to build upon the government’s commitment to invest up to $1 billion over five years to create up to 30,000 licensed child care spaces in schools, including 10,000 spaces in new schools. These new projects will also result in the creation of new jobs in the skilled trades as over $500 million of major infrastructure projects break ground in short order.
“It is unacceptable that too many schools in our province continue to lack the investment that our students deserve,” said Minister Lecce. “That is why this government is making a significant investment to build new schools, to extensively renovate existing schools, and expand access to licensed child care spaces in our province. Our government is modernizing our schools, our curriculum, and the delivery of learning, to ensure students are set up to succeed in an increasingly changing world.”

QUICK FACTS
list of 4 items
The Ministry of Education reviews all Capital Priorities submissions for eligibility and merit prior to announcing successful projects.
The Ministry is working in partnership with school boards to deliver high-speed Internet to all schools in Ontario, with all high schools having access to broadband by September 2020, and all elementary schools having access by September 2021. As of March 31, 2020, broadband modernization has been completed at 1,983 schools, including 403 Northern schools. Installation is currently in progress at 2,954 schools, including 99 northern schools.
The Ministry is investing $1.4 billion in renewal funding, which continues to meet the recommended funding level by the Auditor General of Ontario to preserve the condition of Ontarios school facilities.
To find out more about projects in your community, visit the Ontario Builds map. list end

ADDITIONAL RESOURCES
list of 1 items
Learn more about Ontarios commitment to modernizing schools and child care spaces. list end

CONTACTS
Ivana Yelich
Premiers Office
[email protected]
Alexandra Adamo
Minister Lecces Office
[email protected]
Ingrid Anderson
Communications Branch
437 225-0321
[email protected]
Office of the Premier
http://www.ontario.ca/premier




Source link

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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First Fully Accessible Universal Washroom Opens at Upper Canada


Accessibility advocates say the new facility at Newmarket’s mall should serve as a benchmark for universal washrooms of the future By: Kim Champion
Dec. 3, 2019

Newmarket resident and chairperson of the Town of Newmarket’s accessibility advisory committee, Steve Foglia (left), and Derek Bunn, a special education teacher who also works with Community Living, were the driving force behind the new fully accessible universal washroom at Upper Canada Mall that’s now open.

A Change.org petition that garnered more than 26,000 signatures to get physically disabled children, adults and seniors off the washroom floor at Upper Canada Mall was instrumental in the official opening today of the first fully accessible universal washroom on the premises.

It’s been a two-year long project that saw many in the community working together to make it happen.

York Region District School Board special education teacher Derek Bunn, who started the petition in 2018, said support poured in from across the community and Canada, the United States and around the world.

He describes the situation for supporting people on a trip to the loo as follows:

“Children, adults and seniors who visit the Upper Canada Mall or any mall, and need to use the washroom, must be physically lifted from their wheelchair and be laid on the floor near toilets and the garbage in order to be changed. This type of activity is happening every day. Does this seem fair? Does this bother you? Does it shock you? I’m one of many who does this when I support someone at the mall. It is really unfair, unhygienic, unsafe and not dignified,” Bunn stated in the petition.

He sent the petition to Upper Canada Mall manager Oxford Properties Group, which helped “push the mall in the right direction,” to design its first fully accessible universal washroom, Bunn said.

Everyone involved in bringing the project to fruition was on hand this morning for the official ribbon-cutting of the 238-square-foot private washroom near the mall food court that could serve as the benchmark for universal washrooms of the future, said Steve Foglia, a Newmarket resident and artist who is chairperson of the Town of Newmarket’s accessibility advisory committee.

Foglia said Bunn mentioned to the committee a few years ago that he was having an issue with being forced to change school children on the floor while they were on outings.

“I thought, that’s got to stop,” Foglia said. “We are so grateful and, honestly, they gave us everything we asked for without even questioning it, everything.”

As it turned out, Upper Canada Mall was undertaking a renovation of its washroom facilities in 2019, and the stage was set for the universal washroom.

The area’s councillor, Christina Bisanz, contacted mall management on behalf of the accessibility advisory committee, and Petroff Partnership Architects were brought in to carry out the vision.

“If you build an accessible washroom by the Ontario Building Code, it’s not accessible,” Foglia said. “If you build it by the Accessibility for Ontarians with Disabilities Act standards, it’s better but it’s still not 100 per cent accessible. This universal washroom is doing everything you could possibly need it to.”

To put the features of the new universal washroom into perspective, Foglia said there’s always an issue for people in wheelchairs to get through the door without banging into the sides. Personally, he can’t wash his hands a lot of the time because he can’t fit his chair underneath the sink.

“So we made an extra wide door that’s 40 inches wide so people can go through the door just like an able-bodied person would,” he said. “We also have a sink that you can access with a wheelchair, along with the soap dispenser and water, and hand dryer.”

“We pulled things away from the wall so you can get under it with a chair,” he said. “And a person can use the sling to transfer themselves out of the chair, onto the adjustable change table, over to the toilet, over to the sink and back to the change table, and back to the chair without anybody having to lift somebody out of the chair, that’s very important. And keeping people off the floor, as it should be.”

Here are the features of the fully accessible universal washroom at Upper Canada Mall:

  • An adult change table complete with a lift and sling (600 lb. capacity) that allows an individual to move around the room
  • Waiting area for support workers
  • Privacy curtain
  • Emergency bars to call for help
  • Accessible toilet, sink, soap dispenser, water, and hand dryer
  • Contrasting floor tiles to help those with a visual impairment navigate the facilities
  • Child-sized toilet and child change table
  • Grab bars fastened to walls
  • Security system that includes guests buzzing in to gain access

“This is how it should be done,” Foglia said.

Upper Canada Mall’s general manager, Ryan DaSilva, thanked the Newmarket community for their help and support on the project, and said the universal washroom ensures “everyone feels welcome at the mall”.

Bunn added that Upper Canada Mall has always been the hub of social and shopping experiences, and it is a great atmosphere for people in wheelchairs to spend the day there.

“What a great economic benefit this is to the mall, and a great social outing to everybody in the GTA,” he said.

Oxford Properties Group declined to provide the cost of the new washroom, but said the project was a custom-build and the first of its kind for the group.

Original at https://www.newmarkettoday.ca/local-news/first-fully-accessible-universal-washroom-opens-at-upper-canada-1897800




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Join the Blitz to Press Candidates Across Ontario for School Board Trustee to Make the “Students with Disabilities Pledge” – Help Ensure Hundreds of Thousands of Students with Disabilities Fully Benefit From Ontario’s Education system


Accessibility for Ontarians with Disabilities Act Alliance Update

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

www.aodaalliance.org [email protected] Twitter: @aodaalliance

Join the Blitz to Press Candidates Across Ontario for School Board Trustee to Make the “Students with Disabilities Pledge” – Help Ensure Hundreds of Thousands of Students with Disabilities Fully Benefit From Ontario’s Education system

July 30, 2018

          SUMMARY

Please join the new non-partisan three month blitz that the AODA Alliance launches today. Help us help tear down the many unfair barriers impeding hundreds of thousands of students with all kinds of disabilities in Ontario schools from fully benefitting from a good education.

On October 22, 2018, voters across Ontario will vote for the school board trustees that will run Ontario’s public and Catholic schools for the next four years. Please press all candidates for school board trustee to make the “Students with Disabilities Pledge!” We seek three commitments from each candidate for school board trustee across Ontario:

The Students with Disabilities Pledge for Candidates for School Board Trustee

  1. Do you agree that students with disabilities should be able to fully participate in and benefit from your school board’s education programs in a barrier-free school board?
  1. Do you support your school board establishing a permanent committee of trustees, the “Students with Disabilities Full Participation Committee,” to oversee action to remove and prevent barriers impeding students with disabilities?
  1. Do you support your school board putting in place a comprehensive plan to remove and prevent disability barriers, with six month progress reports?

To help with our blitz, please:

* Contact candidates for public or Catholic school board trustee in your community. Ask them to make the Students with Disabilities Pledge.

On Twitter, tweet school board trustees with the three commitments. Each of the 3 pledges fits in a single tweet. Your tweet might begin with the candidate’s Twitter name, and then include the following wording:

Tweet #1

Do you agree that students with disabilities should be able to fully participate in & benefit from your school board’s education programs in a barrier-free school board? #SWDP #accessibility

Tweet #2

Do you support your school board establishing a permanent committee of trustees, the “Students with Disabilities Full Participation Committee,” to oversee action to remove and prevent barriers impeding students with disabilities? #SWDP #accessibility

Tweet #3

Do you support your school board putting in place a comprehensive plan to remove and prevent disability barriers, with six month progress reports? #SWDP #accessibility

We use the new hashtag #swdp in our tweets about this topic, which is short for “Students with Disabilities Pledge.”

* Let us know which candidates you asked, and whether they make the pledge. Contact us at [email protected]

* Let your local media know which school board trustees have made the Students with Disabilities Pledge, and which have not. Write a guest column for your local newspaper. Phone in to your local call-in radio station.

* Contact the Special Education Advisory Committee of your local public and Catholic school board. Let them know about your efforts to get school board trustees to make the Students with Disabilities Pledge. Urge them to spread the word about this blitz.

* Circulate this Update to your family and friends. Urge them to help with this campaign.

Below we give you more background. Share that information with candidates, friend, family and the media. Learn more about our ongoing campaign to achieve a fully accessible and barrier-free education system in Ontario for all students with disabilities by visiting www.aodaalliance.org/education

          MORE DETAILS

Ontario publicly-funded schools have about two million students. Of these, over one third of a million are students with special education needs — They have a disability, or are gifted, or both. That number only includes those students with special education needs that school boards have recognized as needing education accommodations. There are no doubt more students with disabilities in Ontario schools who have not been identified or recognized as such.

Students with disabilities include students with any kind of disability, such as a physical disability, a sensory disability (like hearing loss or vision loss), an intellectual disability, a learning disability, a mental health condition, a communication disability, a neurological disability like autism, or any other kind of disability.

These students face all kinds of disability barriers in Ontario schools. These include physical barriers (like steps to get into or around a school), technological barriers (like computers and software used in school that does not accommodate their disability), attitude barriers (like a lack of understanding of how to ensure that students with disabilities can fully participate and fully benefit from the programs in Ontario schools), communication barriers, curriculum barriers, just to name a few. In November 2016, the AODA Alliance made public a Discussion Paper that gives more details on the barriers that students with disabilities in Ontario face.

Ontario has no comprehensive strategy in place to ensure that our education system becomes accessible and barrier-free for students with disabilities.

Ontario’s special education laws are out-of-date. They were largely written before the Charter of Rights and Ontario Human Rights Code guaranteed equal rights in education to students with disabilities.

The former Ontario Government committed to create an Education Accessibility Standard under the Accessibility for Ontarians with Disabilities Act. It is still under development. During the 2018 Ontario election, Doug Ford committed: “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.”

This brings us to our new blitz. Each public school board and Catholic school board is governed by a board of locally-elected school board trustees. They serve for a four year term.

In the October 22, 2018 school board election, we want as many school board trustees as possible to commit to supporting the achievement of a fully accessible education system for all students with disabilities and to take action on that commitment.



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