After the Federal Election, New Opportunities for People with Disabilities in Canada and a Pressing Need for the Media to Take a Hard Look at the Short Shrift It Too Often Gave Disability Issues


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

September 21, 2021

1. Canada’s Media Must Take a Long Hard Look at Its Troubling Treatment of Disability Election Issues

We can be proud that we and the disability community managed to get more media coverage of at least some of this election’s disability issues than we have ever achieved in the past. As discussed further below, these issues got nowhere near the attention they deserve. However, the media coverage of them in the 2015 and 2019 federal elections was even worse. Very slowly we are making progress.

Canada’s media now needs to take a long and hard look at its troubling approach to disability issues, especially during an election. Six million people with disabilities in Canada matter and deserve better.

Some news outlets did not cover disability issues at all, as far as we have been able to tell. CBC gave the issue some coverage, but only over the past few days before the election.

For example, it was not until 2 pm on Sunday, September 19, 2021, the last day before the election, that CBC posted a specific report comparing the platforms of the parties on disability issues. We set that story out below. By that time, some six million voters had voted by mail or at advance polls. If it was newsworthy then, it was equally newsworthy weeks earlier.

A stunning illustration of the short shrift some media gave disability election issues concerns the Toronto Star and Globe and Mail. On September 14, 2021, both newspapers commendably printed a Canadian Press report on the fact that the mail-in ballot was inaccessible for voters with vision loss. However, the original CP story included a passage on the fact that of all the major parties, only the NDP had responded to the AODA Alliance’s request for accessibility pledges. Yet both the Globe and the Star cut that important paragraph right out of that story. Here is the pivotal information that both the Star and Globe decided was not newsworthy enough for their readers:

” Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.””

Below, we set out the September 13, 2021 CP report in full published by the Chat News website, and the edited version that the Globe and Mail published.

We know of no reporter who pressed party leaders on their failure to answer our request for election commitments on accessibility.

Late in the campaign, a number of reporters who spoke to the AODA Alliance about disability issues in the election commented that this is an important story, and it is too bad they had not known of it earlier. Yet we sent several news releases to the media during the election campaign, as no doubt did other disability organizations.

2. Voting Barriers Must Go

Voting barriers impeding voters with disabilities were even worse in this election than in the past. Because of COVID-19, more voters wanted to resort to the mail-in ballot. Yet the mail-in ballot lacks accessibility for voters with disabilities like vision loss who cannot mark their own ballot in secret and verify their choice.

Moreover, the reduction in the number of polling stations per riding in this election meant further distances to travel and longer lineups for voters. This obviously generates more voting barriers for voters with disabilities, such as those facing public transit barriers, and those who lack the stamina to stay in a long lineup for a long time.

This was covered in Karlene Nation’s interview with AODA Alliance Chair David Lepofsky on voting day September 20, 2021 on Sauga Radio in Mississauga. Below we set out a September 20, 2021 article from CBC News that reported on long lineups, fewer polling stations, and barriers facing voters with disabilities.

That CBC report incorrectly states:

” Lepofsky said accessibility was not considered by Elections Canada at polling stations.”

What AODA Alliance Chair David Lepofsky had said is that Elections Canada does not have a record of ensuring accessibility for voters with disabilities at polling stations.

In its August 3, 2021 letter, the AODA Alliance asked the major parties to commit to election reform to make federal elections accessible for voters with disabilities. Only the NDP agreed to this or even replied.

3. What’s Next on the Federal Front

For many, the election’s outcome is frustrating. For us disability advocates, it presents new opportunities. We always are ready to work with any and all parties in our spirit of non-partisanship.

In Canada’s new Parliament, we aim to urge the NDP to act on its commitments to us. Even though no other party answered our August 3, 2021 letter, seeking election pledges, we intend to ask Erin O’Toole to stand by the Conservative Party’s 2018 commitment in the House of Commons to strengthen the Accessible Canada Act, if elected. Stay tuned.

4. And It’s Time to Focus Again on Provincial Issues in Ontario

With the federal election behind us, we will now turn prime attention to accessibility battles on the provincial front. Will the new COVID-19 vaccine be disability-accessible? Is the return to school treating students with disabilities better than in the past? With the fourth COVID-19 wave upon us, will the Ford Government eliminate the disability discrimination that seriously infects the critical care triage protocol that has been embedded in Ontario hospitals since January? Here again, stay tuned!

MORE DETAILS

CBC News September 20, 2021

Originally posted at https://www.cbc.ca/news/canada/toronto/long-lines-polling-stations-toronto-1.6182540 GTA voters contend with long lines, missing voter lists as election day draws to a close

Many ridings had significantly fewer polling stations than last election

Voters at a University-Rosedale polling station on Monday. Some people reported it had been a busy, and at times frustrating day for voters in the city. (Evan Mitsui/CBC)

Some frustrated voters at polling stations across the Greater Toronto Area on Monday found themselves dealing with long queues as they attempted to cast their ballots.

Lines outside polling stations, which closed at 9:30 p.m. ET, were longer this year in some cases due to COVID-19 precautions, logistical errors in voter ID cards and lists and a greatly reduced number of polling stations for some ridings.

In some cases, long lines stretched well into the evening.

At a polling station in King-Vaughan, voters reported a lineup of more than two hours and very little parking.

Aaron Kaufman, who lives in the area, said he gave up trying to vote because the line was so long and he had trouble finding parking shortly before 8 p.m. He never got out of his car but rolled down his window. People on the sidewalk told him not to bother trying to vote, he said.

“It was more than a long lineup. It was absolutely ridiculous,” Kaufman said after the polls closed on Monday night.

“The lineup for the actual polling station went around a giant sportsplex, across the street, around another building, and down the off ramp to the 400 Highway.”

Staff Sgt. Dave Mitchell of York Regional Police said there was a surge of voters at a polling station at 601 Cityview Blvd. in the Teston Road and Highway 400 area near Canada’s Wonderland before 8 p.m.

An estimated 1,500 to 2,000 people tried to vote at that time, he said.

Mitchell said some people, in an effort to find parking, were getting out of their vehicles on the off ramp of Highway 400 at Teston Road and walking up on the ramp.

Kaufman said the experience left him angry. Not enough planning and thought went into the logistics of voting, he said.

“It’s unacceptable, to be honest in a country like ours, the organization around voting was so poor that people couldn’t even make their voice heard.”

King-Vaughan had 28 fewer polling locations than in 2019, which was a 62 per cent drop in locations.

Earlier Monday at the Bentway polling station for Spadina-Fort York, voters lined up for about an hour or more before they got in, but the balmy weather helped keep frustrations at bay.

“It’s fine, I was able to take some work calls in line, [it’s] not too bad. The weather’s pretty nice, been waiting for about an hour,” one voter at the Bentway polling station said.

“We’re all outside, so that makes me feel good. People are reasonable.”

A polling station at Oriole Park Public School, like many across Toronto, had long queues for most of the day, frustrating some voters.

Some ridings have fewer polling stations this year

It’s important to note that some electoral districts in the Greater Toronto Area have remarkably fewer polling stations than they did in the 2019 federal election.

Toronto Centre had 91 in 2019, and has 15 polling stations this year. Spadina-Fort York had 56, but has 15 today. Those are the two ridings with the largest decrease in polling stations at 84 per cent and 73 per cent fewer than the last election, respectively.

In York Region, Aurora-Oak Ridges-Richmond Hill went from 39 to 12, and in Peel Region, Brampton East and Mississauga-Malton are down to 12 and 15 stations from 26 and 31, respectively, in 2019.

Elections Canada website errors

Several people also reported being unable to locate their polling station on the Elections Canada website Monday.

“A message comes up saying they aren’t able to find my polling station,” Daniel Mustard said. “It then asks you to call a 1-800 number to speak to an agent, but when I did that the agency also can’t find the address.”

“I’m lucky as I have all day to figure this out and vote. Others who may not be as keen might give up at this point,” Mustard added.

Others who chose to vote by mail were experiencing similar frustrations. Barbara Allemeersch said she only received her ballot on Friday afternoon and was questioning whether her returned vote will be received in time. Mail-in votes had to be received by 6 p.m. Monday.

Elections Canada responded on Twitter to the numerous complaints and concerns of voters being unable to find their polling station.

“Please note that we are experiencing technical difficulties with the Voter Information Service application on our website,” the agency said in a tweet on Monday morning. “Please check your voter information card or call us at 1-800-463-6868 to find your assigned polling location.”

A couple of hours later that was followed by a tweet saying the online information system was back online.

Elderly, people with disabilities face obstacles

Meanwhile, advocates for seniors and people with disabilities also said they believe there could have been a drop in voter turnout in their communities this year due to accessibility issues and a lack of aid available due to the pandemic.

Laura Tamblyn Watts, the CEO of CanAge, a national seniors’ advocacy organization, said while Elections Canada had done as “much as possible” this year to ensure seniors were provided for at polling stations, “that doesn’t mean that seniors are able to get to polling stations easier.”

Many community and aid organizations, as well as political parties, were not offering seniors transport to polling stations this year due to the pandemic, she said. That, coupled with the fact that many seniors are reluctant to enter large group settings right now, will likely mean a drop in older voters this year, Tamblyn Watts said.

“Eighty per cent of all seniors vote in every election, but I think this year the barriers to voting are so significant that we will see a shift in voting patterns,” she said.

David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, said it could be a similar story for his community.

Lepofsky, who is blind, said Canada had “never had properly accessible elections for Canadians with disabilities,” and this year was no exception.

“The private, secret ballot is a sacred thing. The ability to mark your own ballot in private and not to have to tell anyone else who you’ve voted for and to be able to verify that it’s been marked correctly is fundamental to a democracy and yet as a blind person, I don’t have that right in Canada,” he said.

Lepofsky said accessibility was not considered by Elections Canada at polling stations. While mail-in votes offered an alternative, many still relied on loved ones to fill out their ballots for them.

“If people have any disability that relates to marking your own ballet, if it’s a paper ballot, you’ve got a terrible choice: either go to a polling station where you face barriers or use a mail-in ballot where you face barriers.”

“For any number of people with disabilities in Canada we do not have barrier-free, accessible voting and we do not have a plan in place to get us there.”

With files from Ali Raza, Ashleigh Stewart, Muriel Draaisma and Chris Glover

CBC News September 19, 2021

Originally posted at https://www.cbc.ca/news/politics/ask-party-promises-people-with-disabilities-1.6180063

What the parties have promised for people with disabilities

CBC News Loaded
Politics
ASK CBC NEWS

What the main political parties are pledging to do for the disabilities community Tyler Bloomfield
CBC News
Posted: Sep 19, 2021 2:00 PM ET |

A taxi cab loads a walker into a wheelchair accessible van cab in Vancouver. (Ben Nelms/CBC)

This story idea came from an audience member, like you, who got in touch with us. Send us your questions and story tips. We are listening: [email protected]

Advocates for Canadians with disabilities say they feel like their needs have not been a priority for the major political parties as campaigns draw to a close.

Priorities for millions of Canadians with disabilities left out of election campaign, say advocates
??That could leave just over 1 in 5 Canadians on the outside looking in. There are more than six million Canadians aged 15 and over who say they have a disability, according to Statistics Canada. And the actual numbers could be even higher.

Ask CBC News heard from some of those Canadians and family members of those Canadians. They wanted to know what specifically the major political parties are promising for people with disabilities.

What the parties are promising

It’s worth noting that each party has a number of different platform planks that may not be covered below, many of which would affect all Canadians, including people with disabilities. With this in mind, here’s what each of the parties’ platforms say explicitly about some of the issues important to the disability community.

Liberals

If re-elected, the Liberals promise to reintroduce a Disability Benefit Act that will create a direct monthly payment for low-income Canadians with disabilities and between the ages of 18 to 64. They say the new benefit will reduce disability poverty, by using the same approach they took with the Guaranteed Income Supplement and the Canada Child Benefit.

The Liberals say in the Disability Statement in their platform that they “have moved to a human rights-based approach to disability inclusion and are moving away from the medical and charity models, to a social model of disability and a focus on poverty reduction.”

They also point to the fact that during their time in office they have established Accessible Standards Canada, appointed Canada’s first minister responsible for disability inclusion. As well as making investments in disability-specific programs, including the Opportunities Fund, Enabling Accessibility Fund, the Ready, Willing & Able inclusive hiring program ??and Canada Student Grants for people with disabilities.

A Liberal government also promises a “robust employment strategy for Canadians with disabilities,” focused on support for workers and employers to create “inclusive and welcoming workplaces.”

They also say they are in the process of consulting the disability community to implement a Disability Inclusion Action Plan.

Conservatives

The Conservatives promise to double the Disability Supplement in the Canada Workers Benefit to $1,500, from $713. They are also committing to ensuring that going to work never costs a disabled person money, saying they want to work with the provinces to be sure that programs are designed to “ensure that working always leaves someone further ahead.”

They say in their platform that they will boost the Enabling Accessibility Fund with an additional $80 million per year to provide incentives for small business and community projects to improve accessibility, grants and support for accessibility equipment that disabled Canadians need to work. They say that would be on top of “enhancements to existing programs that will get more disabled Canadians into the workforce.”

The Conservatives want to make it easier to qualify for the Disability Tax Credit (DTC) and the Registered Disability Savings Plan. Conservatives say their changes to the DTC will save a qualifying person with disabilities an average of $2,100 per year.

Conservative Leader Erin O’Toole breaks down part of his party’s plan to help Canadians with disabilities during a campaign stop in Edmonton. 1:06

NDP

The New Democrats promise to uphold the United Nations Convention on the Rights of Persons with Disabilities and to strengthen the Accessibility Act to empower all federal agencies to make and enforce accessibility standards in a timely manner.

For income security, the NDP says it wants to expand support programs to ensure Canadians living with a disability have a guaranteed livable income, and to work to deliver a new federal disability benefit “immediately.” The party says this benefit would come in at $2,200 per month.

In its platform, the party promises to extend Employment Insurance (EI) sickness benefits to 50 weeks of coverage, to allow workers with episodic disabilities to access benefits as needed and to expand employment programs to ensure quality job opportunities are available.

On the issue of accessible housing, the NDP says it will create “affordable, accessible housing in communities across the country.”

For people with disabilities, it’s also worth noting the NDP platform includes a publicly funded national pharmacare and dental care program, a national autism strategy and a commitment to restore door-to-door mail delivery.

Laura Beaudin, a student, single mother and disabled Canadian asks NDP Leader Jagmeet Singh about his plan to support people with disabilities during CBC The National’s Face to Face series. 1:11

Bloc Québécois

While there are no specific plans to specifically support people with disabilities laid out in the Bloc Québécois platform, some of its other policies might offer some relief to the community. For example, the Bloc has been vocal about wanting to establish its own standards for long-term care.

People’s Party of Canada

The people’s party of Canada doesn’t have much in their platform that pertains to people with disabilities, but it does offer some promises to veterans with disabilities.

It says it wants to “reinstate the fair disability pension as previously provided for by the Pension Act. The pension will apply retroactively to 2006 and lump sum payments received since then will be treated as advance payments.”

Green Party

A Green government promises to create a Canada Disabilities Act and to support a national equipment fund to provide accessibility tools to help persons with disabilities.

When it comes to accessible housing, the platform says the party will “invest in adaptable social housing to meet particular needs, with both rental and purchase options.”

The Greens say they are willing to work with the provinces on disability issues as well. They say they will provide federal health transfer payments to provinces and territories directed to rehabilitation for those who have become disabled. They also suggest their equipment fund could be a joint program with provinces, for the sake of “equal access and common standards.”

For income support for Canadians with disabilities, the Green Party wants to institute a guaranteed livable income to lift anyone living with disabilities out of poverty. They are also committed to enforcing the Employment Equity Act, converting the Disability Tax Credit (DTC) to a refundable credit and redesigning the Canada Pension Plan/Disability Benefit to incorporate the DTC definition of disability and permit employment.

The Globe and Mail September 14, 2021
News

Lawyer says lack of accessible, private voting options a violation of Charter

THE CANADIAN PRESS
OTTAWA

David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Mr. Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of Section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press. “The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, or ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday, saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Mr. Lepofsky said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

Chat News Today September 13, 2021

Originally posted at https://chatnewstoday.ca/2021/09/13/blind-lawyer-says-lack-of-accessible-private-voting-options-violates-charter/

Blind lawyer says lack of accessible, private voting options violates Charter

Maan Alhmidi
The Canadian Press
SEPTEMBER 13, 2021 01:31 PM

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta

OTTAWA David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press.

“The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, or ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Lepofsky said describing the situation as being “not ideal” is an “offensive understatement” because the mail-in ballots are not accessible.

He said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

According to Statistics Canada, about three per cent of Canadians aged 15 years and older, or about 750,000 people, have a seeing disability that limits their daily activities and 5.8 per cent of this group are legally blind.

Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.”

He said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”

Last year, Elections BC provided a telephone voting option for voters who are unable to vote independently, including people who have vision loss, those who have a disability or an underlying health condition that prevents them from voting independently and those who were self-isolating during the last week of the campaign and unable to vote by mail.

McKenna said introducing other voting options requires a law change.

“Changes to the way Canadians vote, including telephone voting, would in almost all cases require authorization from Parliament, typically in the form of legislative change,” he said.

“When assessing new voting processes or services, we undertake significant planning and testing to ensure that the new option is accessible, and that the confidentiality, secrecy, reliability and integrity of the vote are preserved.”

Mr. Lepofsky said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”




Source link

After the Federal Election, New Opportunities for People with Disabilities in Canada and a Pressing Need for the Media to Take a Hard Look at the Short Shrift It Too Often Gave Disability Issues


Accessibility for Ontarians with Disabilities Act Alliance Update

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

Web: www.aodaalliance.org

Email: [email protected]

Twitter: @aodaalliance

Facebook: www.facebook.com/aodaalliance/

After the Federal Election, New Opportunities for People with Disabilities in Canada and a Pressing Need for the Media to Take a Hard Look at the Short Shrift It Too Often Gave Disability Issues

September 21, 2021

1. Canada’s Media Must Take a Long Hard Look at Its Troubling Treatment of Disability Election Issues

We can be proud that we and the disability community managed to get more media coverage of at least some of this election’s disability issues than we have ever achieved in the past. As discussed further below, these issues got nowhere near the attention they deserve. However, the media coverage of them in the 2015 and 2019 federal elections was even worse. Very slowly we are making progress.

Canada’s media now needs to take a long and hard look at its troubling approach to disability issues, especially during an election. Six million people with disabilities in Canada matter and deserve better.

Some news outlets did not cover disability issues at all, as far as we have been able to tell. CBC gave the issue some coverage, but only over the past few days before the election.

For example, it was not until 2 pm on Sunday, September 19, 2021, the last day before the election, that CBC posted a specific report comparing the platforms of the parties on disability issues. We set that story out below. By that time, some six million voters had voted by mail or at advance polls. If it was newsworthy then, it was equally newsworthy weeks earlier.

A stunning illustration of the short shrift some media gave disability election issues concerns the Toronto Star and Globe and Mail. On September 14, 2021, both newspapers commendably printed a Canadian Press report on the fact that the mail-in ballot was inaccessible for voters with vision loss. However, the original CP story included a passage on the fact that of all the major parties, only the NDP had responded to the AODA Alliance’s request for accessibility pledges. Yet both the Globe and the Star cut that important paragraph right out of that story. Here is the pivotal information that both the Star and Globe decided was not newsworthy enough for their readers:

” Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.””

Below, we set out the September 13, 2021 CP report in full published by the Chat News website, and the edited version that the Globe and Mail published.

We know of no reporter who pressed party leaders on their failure to answer our request for election commitments on accessibility.

Late in the campaign, a number of reporters who spoke to the AODA Alliance about disability issues in the election commented that this is an important story, and it is too bad they had not known of it earlier. Yet we sent several news releases to the media during the election campaign, as no doubt did other disability organizations.

2. Voting Barriers Must Go

Voting barriers impeding voters with disabilities were even worse in this election than in the past. Because of COVID-19, more voters wanted to resort to the mail-in ballot. Yet the mail-in ballot lacks accessibility for voters with disabilities like vision loss who cannot mark their own ballot in secret and verify their choice.

Moreover, the reduction in the number of polling stations per riding in this election meant further distances to travel and longer lineups for voters. This obviously generates more voting barriers for voters with disabilities, such as those facing public transit barriers, and those who lack the stamina to stay in a long lineup for a long time.

This was covered in Karlene Nation’s interview with AODA Alliance Chair David Lepofsky on voting day September 20, 2021 on Sauga Radio in Mississauga. Below we set out a September 20, 2021 article from CBC News that reported on long lineups, fewer polling stations, and barriers facing voters with disabilities.

That CBC report incorrectly states:

” Lepofsky said accessibility was not considered by Elections Canada at polling stations.”

What AODA Alliance Chair David Lepofsky had said is that Elections Canada does not have a record of ensuring accessibility for voters with disabilities at polling stations.

In its August 3, 2021 letter, the AODA Alliance asked the major parties to commit to election reform to make federal elections accessible for voters with disabilities. Only the NDP agreed to this or even replied.

 3. What’s Next on the Federal Front

For many, the election’s outcome is frustrating. For us disability advocates, it presents new opportunities. We always are ready to work with any and all parties in our spirit of non-partisanship.

In Canada’s new Parliament, we aim to urge the NDP to act on its commitments to us. Even though no other party answered our August 3, 2021 letter, seeking election pledges, we intend to ask Erin O’Toole to stand by the Conservative Party’s 2018 commitment in the House of Commons to strengthen the Accessible Canada Act, if elected. Stay tuned.

4. And It’s Time to Focus Again on Provincial Issues in Ontario

With the federal election behind us, we will now turn prime attention to accessibility battles on the provincial front. Will the new COVID-19 vaccine be disability-accessible? Is the return to school treating students with disabilities better than in the past? With the fourth COVID-19 wave upon us, will the Ford Government eliminate the disability discrimination that seriously infects the critical care triage protocol that has been embedded in Ontario hospitals since January? Here again, stay tuned!

MORE DETAILS

CBC News September 20, 2021

Originally posted at https://www.cbc.ca/news/canada/toronto/long-lines-polling-stations-toronto-1.6182540

 

GTA voters contend with long lines, missing voter lists as election day draws to a close

Many ridings had significantly fewer polling stations than last election

Voters at a University-Rosedale polling station on Monday. Some people reported it had been a busy, and at times frustrating day for voters in the city. (Evan Mitsui/CBC)

Some frustrated voters at polling stations across the Greater Toronto Area on Monday found themselves dealing with long queues as they attempted to cast their ballots.

Lines outside polling stations, which closed at 9:30 p.m. ET, were longer this year in some cases due to COVID-19 precautions, logistical errors in voter ID cards and lists and a greatly reduced number of polling stations for some ridings.

In some cases, long lines stretched well into the evening.

At a polling station in King-Vaughan, voters reported a lineup of more than two hours and very little parking.

Aaron Kaufman, who lives in the area, said he gave up trying to vote because the line was so long and he had trouble finding parking shortly before 8 p.m. He never got out of his car but rolled down his window. People on the sidewalk told him not to bother trying to vote, he said.

“It was more than a long lineup. It was absolutely ridiculous,” Kaufman said after the polls closed on Monday night.

“The lineup for the actual polling station went around a giant sportsplex, across the street, around another building, and down the off ramp to the 400 Highway.”

Staff Sgt. Dave Mitchell of York Regional Police said there was a surge of voters at a polling station at 601 Cityview Blvd. in the Teston Road and Highway 400 area near Canada’s Wonderland before 8 p.m.

An estimated 1,500 to 2,000 people tried to vote at that time, he said.

Mitchell said some people, in an effort to find parking, were getting out of their vehicles on the off ramp of Highway 400 at Teston Road and walking up on the ramp.

Kaufman said the experience left him angry. Not enough planning and thought went into the logistics of voting, he said.

“It’s unacceptable, to be honest in a country like ours, the organization around voting was so poor that people couldn’t even make their voice heard.”

King-Vaughan had 28 fewer polling locations than in 2019, which was a 62 per cent drop in locations.

Earlier Monday at the Bentway polling station for Spadina-Fort York, voters lined up for about an hour or more before they got in, but the balmy weather helped keep frustrations at bay.

“It’s fine, I was able to take some work calls in line, [it’s] not too bad. The weather’s pretty nice, been waiting for about an hour,” one voter at the Bentway polling station said.

“We’re all outside, so that makes me feel good. People are reasonable.”

A polling station at Oriole Park Public School, like many across Toronto, had long queues for most of the day, frustrating some voters.

Some ridings have fewer polling stations this year

It’s important to note that some electoral districts in the Greater Toronto Area have remarkably fewer polling stations than they did in the 2019 federal election.

Toronto Centre had 91 in 2019, and has 15 polling stations this year. Spadina-Fort York had 56, but has 15 today. Those are the two ridings with the largest decrease in polling stations at 84 per cent and 73 per cent fewer than the last election, respectively.

In York Region, Aurora-Oak Ridges-Richmond Hill went from 39 to 12, and in Peel Region, Brampton East and Mississauga-Malton are down to 12 and 15 stations from 26 and 31, respectively, in 2019.

Elections Canada website errors

 

Several people also reported being unable to locate their polling station on the Elections Canada website Monday.

“A message comes up saying they aren’t able to find my polling station,” Daniel Mustard said. “It then asks you to call a 1-800 number to speak to an agent, but when I did that the agency also can’t find the address.”

“I’m lucky as I have all day to figure this out and vote. Others who may not be as keen might give up at this point,” Mustard added.

Others who chose to vote by mail were experiencing similar frustrations. Barbara Allemeersch said she only received her ballot on Friday afternoon and was questioning whether her returned vote will be received in time. Mail-in votes had to be received by 6 p.m. Monday.

Elections Canada responded on Twitter to the numerous complaints and concerns of voters being unable to find their polling station.

“Please note that we are experiencing technical difficulties with the Voter Information Service application on our website,” the agency said in a tweet on Monday morning. “Please check your voter information card or call us at 1-800-463-6868 to find your assigned polling location.”

A couple of hours later that was followed by a tweet saying the online information system was back online.

Elderly, people with disabilities face obstacles

 

Meanwhile, advocates for seniors and people with disabilities also said they believe there could have been a drop in voter turnout in their communities this year due to accessibility issues and a lack of aid available due to the pandemic.

Laura Tamblyn Watts, the CEO of CanAge, a national seniors’ advocacy organization, said while Elections Canada had done as “much as possible” this year to ensure seniors were provided for at polling stations, “that doesn’t mean that seniors are able to get to polling stations easier.”

Many community and aid organizations, as well as political parties, were not offering seniors transport to polling stations this year due to the pandemic, she said. That, coupled with the fact that many seniors are reluctant to enter large group settings right now, will likely mean a drop in older voters this year, Tamblyn Watts said.

“Eighty per cent of all seniors vote in every election, but I think this year the barriers to voting are so significant that we will see a shift in voting patterns,” she said.

David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, said it could be a similar story for his community.

Lepofsky, who is blind, said Canada had “never had properly accessible elections for Canadians with disabilities,” and this year was no exception.

“The private, secret ballot is a sacred thing. The ability to mark your own ballot in private and not to have to tell anyone else who you’ve voted for and to be able to verify that it’s been marked correctly is fundamental to a democracy and yet as a blind person, I don’t have that right in Canada,” he said.

Lepofsky said accessibility was not considered by Elections Canada at polling stations. While mail-in votes offered an alternative, many still relied on loved ones to fill out their ballots for them.

“If people have any disability that relates to marking your own ballet, if it’s a paper ballot, you’ve got a terrible choice: either go to a polling station where you face barriers or use a mail-in ballot where you face barriers.”

“For any number of people with disabilities in Canada we do not have barrier-free, accessible voting and we do not have a plan in place to get us there.”

With files from Ali Raza, Ashleigh Stewart, Muriel Draaisma and Chris Glover

CBC News September 19, 2021

Originally posted at https://www.cbc.ca/news/politics/ask-party-promises-people-with-disabilities-1.6180063

What the parties have promised for people with disabilities

CBC News Loaded

Politics

ASK CBC NEWS

What the main political parties are pledging to do for the disabilities community

Tyler Bloomfield

CBC News

Posted: Sep 19, 2021 2:00 PM ET |

A taxi cab loads a walker into a wheelchair accessible van cab in Vancouver. (Ben Nelms/CBC)

This story idea came from an audience member, like you, who got in touch with us. Send us your questions and story tips. We are listening: [email protected]

Advocates for Canadians with disabilities say they feel like their needs have not been a priority for the major political parties as campaigns draw to a close.

Priorities for millions of Canadians with disabilities ‘left out’ of election campaign, say advocates

​​That could leave just over 1 in 5 Canadians on the outside looking in. There are more than six million Canadians aged 15 and over who say they have a disability, according to Statistics Canada. And the actual numbers could be even higher.

Ask CBC News heard from some of those Canadians and family members of those Canadians. They wanted to know what specifically the major political parties are promising for people with disabilities.

What the parties are promising

It’s worth noting that each party has a number of different platform planks that may not be covered below, many of which would affect all Canadians, including people with disabilities. With this in mind, here’s what each of the parties’ platforms say explicitly about some of the issues important to the disability community.

Liberals

If re-elected, the Liberals promise to reintroduce a Disability Benefit Act that will create a direct monthly payment for low-income Canadians with disabilities and between the ages of 18 to 64. They say the new benefit will reduce disability poverty, by using the same approach they took with the Guaranteed Income Supplement and the Canada Child Benefit.

The Liberals say in the Disability Statement in their platform that they “have moved to a human rights-based approach to disability inclusion and are moving away from the medical and charity models, to a social model of disability and a focus on poverty reduction.”

They also point to the fact that during their time in office they have established Accessible Standards Canada, appointed Canada’s first minister responsible for disability inclusion. As well as making investments in disability-specific programs, including the Opportunities Fund, Enabling Accessibility Fund, the Ready, Willing & Able inclusive hiring program ​​and Canada Student Grants for people with disabilities.

A Liberal government also promises a “robust employment strategy for Canadians with disabilities,” focused on support for workers and employers to create “inclusive and welcoming workplaces.”

They also say they are in the process of consulting the disability community to implement a Disability Inclusion Action Plan.

Conservatives

The Conservatives promise to double the Disability Supplement in the Canada Workers Benefit to $1,500, from $713. They are also committing to ensuring that going to work never costs a disabled person money, saying they want to work with the provinces to be sure that programs are designed to “ensure that working always leaves someone further ahead.”

They say in their platform that they will boost the Enabling Accessibility Fund with an additional $80 million per year to provide incentives for small business and community projects to improve accessibility, grants and support for accessibility equipment that disabled Canadians need to work. They say that would be on top of “enhancements to existing programs that will get more disabled Canadians into the workforce.”

The Conservatives want to make it easier to qualify for the Disability Tax Credit (DTC) and the Registered Disability Savings Plan. Conservatives say their changes to the DTC will save a qualifying person with disabilities an average of $2,100 per year.

Conservative Leader Erin O’Toole breaks down part of his party’s plan to help Canadians with disabilities during a campaign stop in Edmonton. 1:06

NDP

 

The New Democrats promise to uphold the United Nations Convention on the Rights of Persons with Disabilities and to strengthen the Accessibility Act to empower all federal agencies to make and enforce accessibility standards in a timely manner.

For income security, the NDP says it wants to expand support programs to ensure Canadians living with a disability have a guaranteed livable income, and to work to deliver a new federal disability benefit “immediately.” The party says this benefit would come in at $2,200 per month.

In its platform, the party promises to extend Employment Insurance (EI) sickness benefits to 50 weeks of coverage, to allow workers with episodic disabilities to access benefits as needed and to expand employment programs to ensure quality job opportunities are available.

On the issue of accessible housing, the NDP says it will create “affordable, accessible housing in communities across the country.”

For people with disabilities, it’s also worth noting the NDP platform includes a publicly funded national pharmacare and dental care program, a national autism strategy and a commitment to restore door-to-door mail delivery.

Laura Beaudin, a student, single mother and disabled Canadian asks NDP Leader Jagmeet Singh about his plan to support people with disabilities during CBC The National’s Face to Face series. 1:11

Bloc Québécois

 

While there are no specific plans to specifically support people with disabilities laid out in the Bloc Québécois platform, some of its other policies might offer some relief to the community. For example, the Bloc has been vocal about wanting to establish its own standards for long-term care.

People’s Party of Canada

 

The people’s party of Canada doesn’t have much in their platform that pertains to people with disabilities, but it does offer some promises to veterans with disabilities.

It says it wants to “reinstate the fair disability pension as previously provided for by the Pension Act. The pension will apply retroactively to 2006 and lump sum payments received since then will be treated as advance payments.”

Green Party

 

A Green government promises to create a Canada Disabilities Act and to support a national equipment fund to provide accessibility tools to help persons with disabilities.

When it comes to accessible housing, the platform says the party will “invest in adaptable social housing to meet particular needs, with both rental and purchase options.”

The Greens say they are willing to work with the provinces on disability issues as well. They say they will provide federal health transfer payments to provinces and territories directed to rehabilitation for those who have become disabled. They also suggest their equipment fund could be a joint program with provinces, for the sake of “equal access and common standards.”

For income support for Canadians with disabilities, the Green Party wants to institute a guaranteed livable income to lift anyone living with disabilities out of poverty. They are also committed to enforcing the Employment Equity Act, converting the Disability Tax Credit (DTC) to a refundable credit and redesigning the Canada Pension Plan/Disability Benefit to incorporate the DTC definition of disability and permit employment.

The Globe and Mail September 14, 2021

News

Lawyer says lack of accessible, private voting options a violation of Charter

THE CANADIAN PRESS

OTTAWA

David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Mr. Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of Section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press. “The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, or ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday, saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Mr. Lepofsky said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

Chat News Today September 13, 2021

Originally posted at https://chatnewstoday.ca/2021/09/13/blind-lawyer-says-lack-of-accessible-private-voting-options-violates-charter/

Blind lawyer says lack of accessible, private voting options violates Charter

Maan Alhmidi

The Canadian Press

SEPTEMBER 13, 2021 01:31 PM

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta

OTTAWA — David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press.

“The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, or ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Lepofsky said describing the situation as being “not ideal” is an “offensive understatement” because the mail-in ballots are not accessible.

He said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

According to Statistics Canada, about three per cent of Canadians aged 15 years and older, or about 750,000 people, have a seeing disability that limits their daily activities and 5.8 per cent of this group are legally blind.

Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.”

He said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”

Last year, Elections BC provided a telephone voting option for voters who are unable to vote independently, including people who have vision loss, those who have a disability or an underlying health condition that prevents them from voting independently and those who were self-isolating during the last week of the campaign and unable to vote by mail.

McKenna said introducing other voting options requires a law change.

“Changes to the way Canadians vote, including telephone voting, would in almost all cases require authorization from Parliament, typically in the form of legislative change,” he said.

“When assessing new voting processes or services, we undertake significant planning and testing to ensure that the new option is accessible, and that the confidentiality, secrecy, reliability and integrity of the vote are preserved.”

Mr. Lepofsky said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”



Source link

Some Media Cover the Federal Election’s Disability Accessibility Issues and/or the Inaccessibility of Mail-In Ballots


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

September 14, 2021

SUMMARY

Canada’s September 20, 2021 election is just six days away. We have been trying very hard to get the media to cover this election’s disability issues, especially as they relate to the requirement in the Accessible Canada Act that Canada become accessible by 2040. It should be extremely newsworthy that only one of the federal party leaders has even answered the AODA Alliance’s August 3, 2021 written request for 12 specific commitments regarding disability accessibility.

As we have found in past elections, it is very hard to get the media to cover this election issue. This is so, even though major media outlets devote a great deal of time and space to election issues. Of course, the accessibility issue on which the AODA Alliance has concentrated is only one of several important disability issues in this election.

In this Update, we share three recent news reports:
* CTV News Online on September 9, 2021
* The September 13, 2021 report by the Canadian Press, published in different media, including that date’s Chat News Today. This article was picked up by a number of other news outlets, like the Toronto Star and Globe and Mail, but the Star and Globe edited out its references to the party leaders who have not answered the AODA Alliance’s August 3, 2021 request for election pledges on accessibility.

In addition to that coverage, CTV’s September 8, 2021 national “Your Morning”, included a six -minute interview on the federal election’s disability issues. AODA Alliance Chair David Lepofsky was interviewed, as well as accessibility consultant Thea Kurdi. This interview is now available with captions at https://youtu.be/ZJ6yEOvOm8I We are tweeting this interview to as many candidates as possible during the federal election. We invite you to share it with candidates, voters and anyone else. Use email, social media or any other way you can to circulate it. If you want to see the names, email address and Twitter handles for as many of the candidates as our volunteers could dig up, visit https://www.aodaalliance.org/wp-content/uploads/2021/09/2021-federal-Election-Candidates-Final-List.docx

To date, we have not found CBC covering the election’s disability issues. We have reached out to CBC among many other media organizations.

One of the 12 commitments we have sought from the parties relates to making federal elections accessible to voters with disabilities. As with all of our requests, none of the parties have answered except the NDP. In the meantime, mail-in ballots have become much, much more important during the COVID-19 pandemic. The mail-in ballot system operated by Elections Canada is quite substantially inaccessible to voters with certain disabilities such as vision loss or dyslexia. Two of the articles set out below address this obvious barrier.

AODA Alliance Chair David Lepofsky, himself totally blind, used the mail-in ballot. He tweeted about its inaccessibility. Elections Canada heard about these tweets and tweeted to David Lepofsky. David Lepofsky then responded to Elections Canada on Twitter. These tweets are all set out below.

MORE DETAILS

Sept 11 and 12 2021 tweets on accessibility of mail in votes by AODA Alliance Chair David Lepofsky

September 11, 2021
David Lepofsky: I voted by mail to avoid COVID-19 danger. Canada’s mail-in ballot is inaccessible to #blind voters like me. I can’t mark my ballot independently in private & verify my choice. This violates the Charter of Rights & Canada Human Rights Act. #elxn44 #CRPD September 12, 2021

Elections Canada: @DavidLepofsky Hello David, we recognize that the special ballot process is not ideal for an elector who is unable to mark their ballot independently. (1/3)

Elections Canada: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

Elections Canda: @DavidLepofsky You can find the contact information for your local office here: https://www.elections.ca/Scripts/vis/FindED?L=e&QID=-1&PAGEID=20 (3/3)

David Lepofsky: @DavidLepofsky: Not ideal? The mail-in ballot process is totally inaccessible to #blind people like me. That’s much more than “not ideal”! #accessibility #AccessibleCanada #elxn55

@ElectionsCan_E: @DavidLepofsky Hello David, we recognize that the special ballot process is not ideal for an elector who is unable to mark their ballot independently. (1/3)

David Lepofsky: @DavidLepofsky: I don’t want any election officials seeing who I vote for. That violates the secret ballot. #accessibility #AccessibleCanada #Elxn44

@ElectionsCan_E: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

David Lepofsky: @DavidLepofsky: I did not go to the polling station, in order to avoid unnecessary exposure. My wife, who would come with me, has a compromised immune system #accessibility #AccessibleCanada #Elxn44

@ElectionsCan_E: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

CTV News September 9, 2021

Originally posted at https://www.ctvnews.ca/politics/federal-election-2021/canadians-with-disabilities-say-they-re-missing-from-the-election-discussion-1.5577558

Canadians with disabilities say they’re missing from the election discussion

Jeremiah Rodriguez
CTVNews.ca Writer
@jererodriguezzz

TORONTO — Federal party leaders aren’t listening enough to the concerns of disabled Canadians, advocates say. They say key priorities missing from campaign pledges include equitable emergency relief, stronger housing, and workplace polices that address all types of disabilities.

Sarah Jama, co-founder of the Disability Justice Network of Ontario, said this lack of scope boils down to a “lack of understanding of what systemic ableism looks like.”

“Nothing is prioritized by the government unless there’s people campaigning behind it,” she told CTVNews.ca in a phone interview.

She said this could be partially addressed by having more disabled candidates running for office or being key parts of campaign decision-making. Jama said people in power don’t always make appreciate just how many Canadians have some form of a disability.

Disabled people make up approximately 22 per cent of Canada’s entire population. And between 62 and 75 per cent of people with disabilities have disabilities which aren’t immediately apparent, such as deafness, blindness or autism.

One of the biggest issues that Jama says hasn’t received enough attention during this campaign is overhauling care for vulnerable people who currently receive care at home or live in long-term care homes.

Jama said she likes the NDP’s platform commitments to end the private long-term care home system, but wants to see the next government go even beyond that.

“We need to reimagine what long-term care looks like in Canada,” she said. She said she wishes party leaders put forth policies that give vulnerable people more affordable options to receive care at home, keeping them out of long-term care facilities.

Jama also said “it’s also embarrassing” that Canada doesn’t yet have universal pharmacare, and that she wishes all parties agreed that it was essential, especially for people with disabilities.

Both the NDP and the Greens have advocated for a national pharmacare program that would provide prescription drug coverage for all Canadians and permanent residents. And while the Liberals have spent the past few years saying they’re moving forward on pharmacare, their platform only notes existing progress on the file, including the signing of the first provincial-territorial agreement to accelerate its implementation. The Conservatives haven’t endorsed a national pharmacare plan but, in their platform, they promise to negotiate with the pharmaceutical industry to reduce drug prices.

Jama also called for more concrete provisions for disabled people during natural disasters, to ensure they’re prioritized during evacuations.

Many disability advocates have also been critical of recent expansion of access to medical assistance in dying (MAID). They argue that instead of making it easier for disabled people to die, the government should be working to make workplaces and housing more functional for them.

Jama says she supports the parts of the Conservative platform around strengthening protections for disabled people when it comes to MAID, including reinstating the 10-day waiting period, to ensure decisions aren’t made at people’s lowest point. No other major party references further adjustments to MAID in its platform.

ACCESIBILITY TO HOUSING, WORKPLACES TOO MUCH AN ‘AFTERTHOUGHT’

Thea Kurdi, vice president of DesignABLE Environments INC, told CTV’s Your Morning that the situation for disabled people is “much worse than non-disabled people suspect.”

She said accessibility in housing or workplace policies is too often treated as an “afterthought,” instead of a priority aligning with Canada’s commitments to the UN Convention of the Rights of Persons with Disabilities.

Kurdi said that too often, although wheelchair access is prioritized, spaces aren’t also made to be truly accessible to deaf, blind or autistic people. Making spaces accessible for visually-impaired people for example, can mean ensuring braille materials or screen-reading software are available; and, for people with hearing concerns, ensuring there are clear fonts in materials and phone or video relay services.

Jama said any parties’ affordable housing policies must address accessibility concerns but only the Greens and NDP have explicitly connected the two.

The Greens are calling for housing developments receiving federal funding to ensure that 30 per cent of all units are affordable and/or available to people with disabilities. The NDP has advocated for accessibility in housing as well.

The Liberals’ platform says only that affordable housing should keep people with disabilities in mind, while the Conservatives haven’t explicitly linked housing and accessibility in their platform.

ACCESSIBLE CANADA ACT STILL TOO WEAK: ADVOCATE

David Lepofsky, the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said people with disabilities were left out of decision-making throughout the pandemic, including when it came to recovery programs and vaccine prioritization.

“We’ve disproportionately suffered the consequences of the pandemic, and disproportionately been left out of the proper planning for urgent needs during the pandemic,” he told CTV’s Your Morning on Wednesday. He cited the federal government’s one-time payment took months to get to recipients.

Lepofsky also said that the Accessible Canada Act, which passed two years ago, is still far too weak because it doesn’t include enforceable regulations nor adequate compensation for victims of discrimination.

“We’ve written all the parties to ask them if they will strengthen and offered 12 ways to make things better,” said Lepofsky. Only the NDP responded and pledged to make many of the commitments, he said.

Lepofsky said Liberal Party Leader Justin Trudeau who promised ambitious implementation of the act and his government have been “dragging their feet.”

As for Conservative Party Leader Erin O’Toole, he hasn’t pledged to make any of the commitments put forth by Lepofsky’s advocacy group —
despite the fact that during parliamentary debates in 2018, his party said it would strengthen the Accessible Canada Act, if the Liberals didn’t.

“We’re not partisan. We want all of the party leaders to make those commitments,” he said.

Chat News Today September 13, 2021

Originally posted at https://chatnewstoday.ca/2021/09/13/blind-lawyer-says-lack-of-accessible-private-voting-options-violates-charter/

Blind lawyer says lack of accessible, private voting options violates Charter

Maan Alhmidi
The Canadian Press
SEPTEMBER 13, 2021

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta., Thursday, Sept. 2, 2021

David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press.

“The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, for ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Lepofsky said describing the situation as being “not ideal” is an “offensive understatement” because the mail-in ballots are not accessible.

He said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

According to Statistics Canada, about three per cent of Canadians aged 15 years and older, or about 750,000 people, have a seeing disability that limits their daily activities and 5.8 per cent of this group are legally blind.

Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.”

He said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”

Last year, Elections BC provided a telephone voting option for voters who are unable to vote independently, including people who have vision loss, those who have a disability or an underlying health condition that prevents them from voting independently and those who were self-isolating during the last week of the campaign and unable to vote by mail.

McKenna said introducing other voting options requires a law change.

“Changes to the way Canadians vote, including telephone voting, would in almost all cases require authorization from Parliament, typically in the form of legislative change,” he said.

“When assessing new voting processes or services, we undertake significant planning and testing to ensure that the new option is accessible, and that the confidentiality, secrecy, reliability and integrity of the vote are preserved.”

CTV News September 6, 2021

Originally posted at: https://www.ctvnews.ca/politics/federal-election-2021/mail-in-ballots-still-inaccessible-for-blind-voters-advocates-say-1.5575148

Mail-in ballots still inaccessible for blind voters, advocates say

Alexandra Mae Jones
CTVNews.ca

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta., Thursday, Sept. 2, 2021.

TORONTO — The Council of Canadians with Disabilities (CCD) is calling on the government to do more for blind Canadians, pointing out that the Special Ballot to vote by mail is useless to blind voters unless they gain aid from a sighted person, impeding their right to vote in secret.

In a press release Friday, the organization said it was time to fix the discrimination that leaves out these voters, saying they expected more since this election follows the passage of the Accessible Canada Act, which aiming to introduce more legislation to aid those with disabilities.

“Due to the pandemic, there are voters who want to vote by mail,” the release stated. “For blind voters, for whom print is a barrier, the mail-in Special Ballot, which is a printed paper ballot, is proving problematic.”

Since ballots need to be filled out exactly in order to be counted, a blind voter would need the assistance of a sighted person to verify that they had filled out the ballot correctly.

“The inaccessible Special Ballot robs blind voters of the right to vote in secret, which is a key principle of democracy,” the release states.

The release added that the requirement to upload scanned identification to register for mail-in ballots online also requires a blind voter to seek help from a sighted person, and that there is no information about candidates in Braille at advance polls.

“We have been hearing that the mail-in ballot process is not one that can be negotiated independently by all blind voters,” Heather Walkus, CCD 1st vice chair, stated in the release. “As this election follows the passage of the Accessible Canada Act, which promised no new barriers, this is all very disappointing. Blind voters were expecting to finally exercise their franchise in secret this election the same as other voters.”

Elections Canada said in an email statement to CTVNews.ca that they are “committed to responding to the diverse needs of Canadians.”

They said that among the accessibility services they offer, they have sign language interpretation and have redesigned the ballot to improve readability for people who use screen readers.

Elections Canada added that they have a number of tools and services for voting in person, such as large-print candidates lists on advance polling and election days, and Braille lists of candidates on election day. There are also Braille voting templates available on advance polling and election days, they stated.

“We recognize that the special ballot process is not ideal for electors who are unable to mark their own ballot,” the statement continued. “Instead of voting by mail, electors who need help marking their ballot may contact their local Elections Canada office to make an appointment to vote with the assistance of an election officer, who will complete their registration and mark their ballot on their behalf.”

This does not address the issue of voters being entitled to a secret voting process, CCD pointed out. The CCD release stated that they have been calling for other methods to vote for years, such as adding the ability to vote through accessible voting machines and electronic voting.

“We are not seeking an end to the paper ballot, but the addition of accessible voting options so that all voters can exercise their franchise independently and in secret,” Walkus said.

The Accessible Canada Act, which came into effect in 2019, was intended to eliminate barriers and provide greater opportunities for disabled Canadians. It did not specifically include promises for making the voting process more accessible.




Source link

Some Media Cover the Federal Election’s Disability Accessibility Issues and/or the Inaccessibility of Mail-In Ballots – AODA Alliance


Accessibility for Ontarians with Disabilities Act Alliance Update

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

Web: www.aodaalliance.org

Email: [email protected]

Twitter: @aodaalliance

Facebook: www.facebook.com/aodaalliance/

Some Media Cover the Federal Election’s Disability Accessibility Issues and/or the Inaccessibility of Mail-In Ballots

September 14, 2021

        SUMMARY

Canada’s September 20, 2021 election is just six days away. We have been trying very hard to get the media to cover this election’s disability issues, especially as they relate to the requirement in the Accessible Canada Act that Canada become accessible by 2040. It should be extremely newsworthy that only one of the federal party leaders has even answered the AODA Alliance’s August 3, 2021 written request for 12 specific commitments regarding disability accessibility.

As we have found in past elections, it is very hard to get the media to cover this election issue. This is so, even though major media outlets devote a great deal of time and space to election issues. Of course, the accessibility issue on which the AODA Alliance has concentrated is only one of several important disability issues in this election.

In this Update, we share three recent news reports:

  • CTV News Online on September 9, 2021
  • The September 13, 2021 report by the Canadian Press, published in different media, including that date’s Chat News Today. This article was picked up by a number of other news outlets, like the Toronto Star and Globe and Mail, but the Star and Globe edited out its references to the party leaders who have not answered the AODA Alliance’s August 3, 2021 request for election pledges on accessibility.

In addition to that coverage, CTV’s September 8, 2021 national “Your Morning”, included a six -minute interview on the federal election’s disability issues. AODA Alliance Chair David Lepofsky was interviewed, as well as accessibility consultant Thea Kurdi. This interview is now available with captions at https://youtu.be/ZJ6yEOvOm8I We are tweeting this interview to as many candidates as possible during the federal election. We invite you to share it with candidates, voters and anyone else. Use email, social media or any other way you can to circulate it. If you want to see the names, email address and Twitter handles for as many of the candidates as our volunteers could dig up, visit https://www.aodaalliance.org/wp-content/uploads/2021/09/2021-federal-Election-Candidates-Final-List.docx

To date, we have not found CBC covering the election’s disability issues. We have reached out to CBC among many other media organizations.

One of the 12 commitments we have sought from the parties relates to making federal elections accessible to voters with disabilities. As with all of our requests, none of the parties have answered except the NDP. In the meantime, mail-in ballots have become much, much more important during the COVID-19 pandemic. The mail-in ballot system operated by Elections Canada is quite substantially inaccessible to voters with certain disabilities such as vision loss or dyslexia. Two of the articles set out below address this obvious barrier.

AODA Alliance Chair David Lepofsky, himself totally blind, used the mail-in ballot. He tweeted about its inaccessibility. Elections Canada heard about these tweets and tweeted to David Lepofsky. David Lepofsky then responded to Elections Canada on Twitter. These tweets are all set out below.

MORE DETAILS

Sept 11 and 12 2021 tweets on accessibility of mail in votes by AODA Alliance Chair David Lepofsky

September 11, 2021

David Lepofsky: I voted by mail to avoid COVID-19 danger. Canada’s mail-in ballot is inaccessible to #blind voters like me. I can’t mark my ballot independently in private & verify my choice. This violates the Charter of Rights & Canada Human Rights Act. #elxn44 #CRPD

September 12, 2021

Elections Canada: @DavidLepofsky Hello David, we recognize that the special ballot process is not ideal for an elector who is unable to mark their ballot independently. (1/3)

Elections Canada: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

Elections Canda: @DavidLepofsky You can find the contact information for your local office here: https://www.elections.ca/Scripts/vis/FindED?L=e&QID=-1&PAGEID=20 (3/3)

David Lepofsky: @DavidLepofsky: Not ideal? The mail-in ballot process is totally inaccessible to #blind people like me. That’s much more than “not ideal”! #accessibility #AccessibleCanada #elxn55

@ElectionsCan_E: @DavidLepofsky Hello David, we recognize that the special ballot process is not ideal for an elector who is unable to mark their ballot independently. (1/3)

David Lepofsky: @DavidLepofsky: I don’t want any election officials seeing who I vote for. That violates the secret ballot. #accessibility #AccessibleCanada #Elxn44

@ElectionsCan_E: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

David Lepofsky: @DavidLepofsky: I did not go to the polling station, in order to avoid unnecessary exposure. My wife, who would come with me, has a compromised immune system #accessibility #AccessibleCanada #Elxn44

@ElectionsCan_E: @DavidLepofsky If you require assistance to mark your ballot, we recommend you contact your local EC office to request an appointment to vote with the assistance of an election officer. They will help complete your registration process and then can mark your ballot on your behalf. (2/3)

 CTV News September 9, 2021

Originally posted at https://www.ctvnews.ca/politics/federal-election-2021/canadians-with-disabilities-say-they-re-missing-from-the-election-discussion-1.5577558

 

Canadians with disabilities say they’re missing from the election discussion

Jeremiah Rodriguez

CTVNews.ca Writer

@jererodriguezzz

TORONTO — Federal party leaders aren’t listening enough to the concerns of disabled Canadians, advocates say. They say key priorities missing from campaign pledges include equitable emergency relief, stronger housing, and workplace polices that address all types of disabilities.

Sarah Jama, co-founder of the Disability Justice Network of Ontario, said this lack of scope boils down to a “lack of understanding of what systemic ableism looks like.”

“Nothing is prioritized by the government unless there’s people campaigning behind it,” she told CTVNews.ca in a phone interview.

She said this could be partially addressed by having more disabled candidates running for office or being key parts of campaign decision-making. Jama said people in power don’t always make appreciate just how many Canadians have some form of a disability.

Disabled people make up approximately 22 per cent of Canada’s entire population. And between 62 and 75 per cent of people with disabilities have disabilities which aren’t immediately apparent, such as deafness, blindness or autism.

One of the biggest issues that Jama says hasn’t received enough attention during this campaign is overhauling care for vulnerable people who currently receive care at home or live in long-term care homes.

Jama said she likes the NDP’s platform commitments to end the private long-term care home system, but wants to see the next government go even beyond that.

“We need to reimagine what long-term care looks like in Canada,” she said. She said she wishes party leaders put forth policies that give vulnerable people more affordable options to receive care at home, keeping them out of long-term care facilities.

Jama also said “it’s also embarrassing” that Canada doesn’t yet have universal pharmacare, and that she wishes all parties agreed that it was essential, especially for people with disabilities.

Both the NDP and the Greens have advocated for a national pharmacare program that would provide prescription drug coverage for all Canadians and permanent residents. And while the Liberals have spent the past few years saying they’re moving forward on pharmacare, their platform only notes existing progress on the file, including the signing of the first provincial-territorial agreement to accelerate its implementation. The Conservatives haven’t endorsed a national pharmacare plan but, in their platform, they promise to negotiate with the pharmaceutical industry to reduce drug prices.

Jama also called for more concrete provisions for disabled people during natural disasters, to ensure they’re prioritized during evacuations.

Many disability advocates have also been critical of recent expansion of access to medical assistance in dying (MAID). They argue that instead of making it easier for disabled people to die, the government should be working to make workplaces and housing more functional for them.

Jama says she supports the parts of the Conservative platform around strengthening protections for disabled people when it comes to MAID, including reinstating the 10-day waiting period, to ensure decisions aren’t made at people’s lowest point. No other major party references further adjustments to MAID in its platform.

ACCESIBILITY TO HOUSING, WORKPLACES TOO MUCH AN ‘AFTERTHOUGHT’

Thea Kurdi, vice president of DesignABLE Environments INC, told CTV’s Your Morning that the situation for disabled people is “much worse than non-disabled people suspect.”

She said accessibility in housing or workplace policies is too often treated as an “afterthought,” instead of a priority aligning with Canada’s commitments to the UN Convention of the Rights of Persons with Disabilities.

Kurdi said that too often, although wheelchair access is prioritized, spaces aren’t also made to be truly accessible to deaf, blind or autistic people. Making spaces accessible for visually-impaired people for example, can mean ensuring braille materials or screen-reading software are available; and, for people with hearing concerns, ensuring there are clear fonts in materials and phone or video relay services.

Jama said any parties’ affordable housing policies must address accessibility concerns but only the Greens and NDP have explicitly connected the two.

The Greens are calling for housing developments receiving federal funding to ensure that 30 per cent of all units are affordable and/or available to people with disabilities. The NDP has advocated for accessibility in housing as well.

The Liberals’ platform says only that affordable housing should keep people with disabilities in mind, while the Conservatives haven’t explicitly linked housing and accessibility in their platform.

ACCESSIBLE CANADA ACT STILL TOO WEAK: ADVOCATE

David Lepofsky, the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said people with disabilities were left out of decision-making throughout the pandemic, including when it came to recovery programs and vaccine prioritization.

“We’ve disproportionately suffered the consequences of the pandemic, and disproportionately been left out of the proper planning for urgent needs during the pandemic,” he told CTV’s Your Morning on Wednesday. He cited the federal government’s one-time payment took months to get to recipients.

Lepofsky also said that the Accessible Canada Act, which passed two years ago, is still far too weak because it doesn’t include enforceable regulations nor adequate compensation for victims of discrimination.

“We’ve written all the parties to ask them if they will strengthen and offered 12 ways to make things better,” said Lepofsky. Only the NDP responded and pledged to make many of the commitments, he said.

Lepofsky said Liberal Party Leader Justin Trudeau– who promised ambitious implementation of the act – and his government have been “dragging their feet.”

As for Conservative Party Leader Erin O’Toole, he hasn’t pledged to make any of the commitments put forth by Lepofsky’s advocacy group — despite the fact that during parliamentary debates in 2018, his party said it would strengthen the Accessible Canada Act, if the Liberals didn’t.

“We’re not partisan. We want all of the party leaders to make those commitments,” he said.

 Chat News Today September 13, 2021

Originally posted at https://chatnewstoday.ca/2021/09/13/blind-lawyer-says-lack-of-accessible-private-voting-options-violates-charter/

Blind lawyer says lack of accessible, private voting options violates Charter

 

Maan Alhmidi

The Canadian Press

SEPTEMBER 13, 2021

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta., Thursday, Sept. 2, 2021

David Lepofsky was not able to mark his choice independently on the mail-in ballot Elections Canada sent to him because he is blind.

He opted to not vote in person with his wife because she has a serious immune limitation and they don’t want to risk being infected with COVID-19.

Lepofsky, who is a lawyer advocating for accessibility for disabled people, said the voting options available for blind people don’t allow them to cast their ballots privately.

He said the lack of accessible voting options is a violation of section 15 of the Canadian Charter of Rights and Freedoms, which requires equal protection and benefit of the law to those living with mental or physical disabilities.

“This is just awful,” he said in an interview with The Canadian Press.

“The basic right we’re all supposed to enjoy is the right to mark our own ballot in private and to mark it independently, for ourselves, and to be able to verify this mark the way we want. And I currently don’t have that as a blind person at the federal level.”

Elections Canada responded to his complaint on Twitter on Sunday saying the agency recognizes “the special ballot process is not ideal for an elector who is unable to mark their ballot independently.”

Lepofsky said describing the situation as being “not ideal” is an “offensive understatement” because the mail-in ballots are not accessible.

He said the other option of voting in-person at a polling station also would not allow him to vote in private because an Elections Canada officer would have to read and verify his voting choice.

An Elections Canada spokesperson said those who provide assistance to voters must take oaths to protect the secrecy of those ballots.

“In the case of a poll worker, oaths are taken as part of the job when they provide assistance to an elector,” Matthew McKenna said in a statement.

According to Statistics Canada, about three per cent of Canadians aged 15 years and older, or about 750,000 people, have a seeing disability that limits their daily activities and 5.8 per cent of this group are legally blind.

Lepofsky, who is the chair of the Accessibility for Ontarians with Disabilities Act Alliance, said his group sent a letter last month to all main federal parties asking for 12 commitments on accessibility, including one on accessibility of the electoral process.

“Only one leader has answered us. And that is (NDP Leader) Jagmeet Singh,” he said.

“We don’t support anyone or oppose anyone. We try to get the strongest commitments we can, but we have not even gotten an answer from (Liberal Leader) Justin Trudeau or (Conservative Leader) Erin O’Toole.”

He said there should be voting options at the federal level for people with disabilities that allow them to vote without needing help from anyone. He said voting by phone through an automated system can be a good option.

“In New Zealand, they have a phone-in ballot which is not internet-connected. That’s available for voters with vision loss. There are different options around the world but we are lagging way behind,” he said.

“We’re in the dark ages.”

Last year, Elections BC provided a telephone voting option for voters who are unable to vote independently, including people who have vision loss, those who have a disability or an underlying health condition that prevents them from voting independently and those who were self-isolating during the last week of the campaign and unable to vote by mail.

McKenna said introducing other voting options requires a law change.

“Changes to the way Canadians vote, including telephone voting, would in almost all cases require authorization from Parliament, typically in the form of legislative change,” he said.

“When assessing new voting processes or services, we undertake significant planning and testing to ensure that the new option is accessible, and that the confidentiality, secrecy, reliability and integrity of the vote are preserved.”

 CTV News September 6, 2021

Originally posted at: https://www.ctvnews.ca/politics/federal-election-2021/mail-in-ballots-still-inaccessible-for-blind-voters-advocates-say-1.5575148

Mail-in ballots still inaccessible for blind voters, advocates say

Alexandra Mae Jones

CTVNews.ca

A mail-in voting package that voters will receive if requested is seen in Calgary, Alta., Thursday, Sept. 2, 2021.

TORONTO — The Council of Canadians with Disabilities (CCD) is calling on the government to do more for blind Canadians, pointing out that the Special Ballot to vote by mail is useless to blind voters unless they gain aid from a sighted person, impeding their right to vote in secret.

In a press release Friday, the organization said it was time to fix the discrimination that leaves out these voters, saying they expected more since this election follows the passage of the Accessible Canada Act, which aiming to introduce more legislation to aid those with disabilities.

“Due to the pandemic, there are voters who want to vote by mail,” the release stated. “For blind voters, for whom print is a barrier, the mail-in Special Ballot, which is a printed paper ballot, is proving problematic.”

Since ballots need to be filled out exactly in order to be counted, a blind voter would need the assistance of a sighted person to verify that they had filled out the ballot correctly.

“The inaccessible Special Ballot robs blind voters of the right to vote in secret, which is a key principle of democracy,” the release states.

The release added that the requirement to upload scanned identification to register for mail-in ballots online also requires a blind voter to seek help from a sighted person, and that there is no information about candidates in Braille at advance polls.

“We have been hearing that the mail-in ballot process is not one that can be negotiated independently by all blind voters,” Heather Walkus, CCD 1st vice chair, stated in the release. “As this election follows the passage of the Accessible Canada Act, which promised no new barriers, this is all very disappointing. Blind voters were expecting to finally exercise their franchise in secret this election the same as other voters.”

Elections Canada said in an email statement to CTVNews.ca that they are “committed to responding to the diverse needs of Canadians.”

They said that among the accessibility services they offer, they have sign language interpretation and have redesigned the ballot to improve readability for people who use screen readers.

Elections Canada added that they have a number of tools and services for voting in person, such as large-print candidates lists on advance polling and election days, and Braille lists of candidates on election day. There are also Braille voting templates available on advance polling and election days, they stated.

“We recognize that the special ballot process is not ideal for electors who are unable to mark their own ballot,” the statement continued. “Instead of voting by mail, electors who need help marking their ballot may contact their local Elections Canada office to make an appointment to vote with the assistance of an election officer, who will complete their registration and mark their ballot on their behalf.”

This does not address the issue of voters being entitled to a secret voting process, CCD pointed out. The CCD release stated that they have been calling for other methods to vote for years, such as adding the ability to vote through accessible voting machines and electronic voting.

“We are not seeking an end to the paper ballot, but the addition of accessible voting options so that all voters can exercise their franchise independently and in secret,” Walkus said.

The Accessible Canada Act, which came into effect in 2019, was intended to eliminate barriers and provide greater opportunities for disabled Canadians. It did not specifically include promises for making the voting process more accessible.



Source link

Another Media Report on Huge Problems with the Rick Hansen Foundation Private Accessibility “Certification” Program


RHF Concedes Its Training for Its Accessibility Assessors Does Not Make Them Experts in Accessibility

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

August 20, 2021

SUMMARY

An excellent, extensive article in the August 19, 2021 edition of the Burnaby Beacon, set out below, details many serious problems with the Rick Hansen Foundation (RHF) private accessibility “certification” program. For more than two years, this program has been the centrepiece of the Ford Government’s failing efforts to address the many substantial barriers that people with disabilities face in the built environment. What Ontarians with disabilities need instead is for the Ford Government to agree to develop a Built Environment Accessibility Standard under the Accessibility for Ontarians with Disabilities Act.

Over two years ago, the Ford Government announced that it would spend over 1.3 million public dollars on the RHF program over a two-year period. Two years later, there is no evidence that this has resulted in any improvement in the accessibility of the built environment in Ontario.

The AODA Alliance, quoted in this new article, as well as other credible voices, have together brought to public attention many serious failings in the RHF program. For example, the fact that the RHF calls a building “accessible” is no proof at all that it is accessible.

As another example, the very short training course that the RHF provides for those assessing a building’s accessibility is too short and riddled with problems. The RHF calls those who complete that inadequate course an “RHF accessibility professional”. This is an inaccurate and very misleading title. In this new news report, the RHF is quoted as in substance conceding this point. The article states in part:

we agree that the 2-week RHFAC training course is not sufficient to provide students with enough knowledge to consider themselves experts in the application of universal design, the foundation said.

This new article refers to a Toronto Star editorial that blasted the Ford Government for its strategy of using the RHF program. We set that editorial out below. It accords with criticisms of the RHF program that we have made public.

The AODA Alliance’s July 3, 2019 report on the RHF program, entitled “A Problematic Government Strategy on Accessibility for Ontarians with Disabilities and An Inappropriate Use of Public Money
The AODA Alliance Report on the Ontario Government’s Proposal to Spend Public Money on the Rick Hansen Foundation’s Private Accessibility Certification Process” made these findings which have not been disproven in the past two years:

“* Ford’s Government says this plan will remove barriers facing people with disabilities. Yet the report reveals that the plan need not result in any barriers ever being removed.

* Instead of using properly trained Government inspectors, Ford’s plan uses private individuals who may have no prior experience with the highly technical area of building accessibility, and who just took a two-week course and passed a multiple choice exam. To acquire the needed expertise, it takes much more training on accessibility than a 2-week course.

* There are serious concerns with RHF’s private standard or yardstick to assess a building’s accessibility. For example, there is a real risk of leaving out people whose disabilities are not related to mobility, vision or hearing.

* There is a risk of conflict of interest if the RHF inspects an organization that has given or may give the RHF a charitable donation. It would be inexcusable for an organization to give money to a Government inspector.

* These private free-lance accessibility assessors appear to have a troubling incentive to give higher accessibility ratings, in hopes of getting more work. An organization chooses the RHF-trained free-lance assessor who will inspect their building. Assessors are paid by the job.

*Even though the taxpayer will fund these inspections, the public will have no right to know the inspection’s results, unless an organization agrees to make its results public.”

The AODA Alliance’s August 15, 2019 supplemental report on the RHF program reached these 17 additional conclusions:

“1. It was wrong for the Ford Government not to hold an open competitive bidding process before deciding to give $1.3 million to the RHF.

2. There are no measures in place to address serious conflict of interest concerns with the RHFAC.

3. Key and basic aspects of this public funding program have still not yet been worked out months after it was announced.

4. It is troubling that the RHFAC tries to shift responsibility and risk for accessibility ratings and advice onto others.

5. The RHFAC accessibility ratings are clearly left in significant part to each free-lance assessor’s subjective discretion, despite the Government’s claims that these accessibility assessments are consistently applied.

6. It is problematic for the RHFAC to take averages of the accessibility of a building’s features like bathrooms.

7. The RHFAC program emphasizes the problematic idea of getting organizations to go “beyond code”, as if building code compliance is all that is required.

8. The RHFAC adjudication process has serious flaws.

9. There are insufficient safeguards to ensure that an RHF-certified building remains accessible after it is so-certified.

10. The mandatory RHFAC course is even shorter than the two weeks we earlier announced.

11. An instructor in the RHFAC course need not have demonstrated expertise in the accessibility of the built environment.

12. The RHF training course crams far too much curriculum into too short a time.

13. The RHFAC course appears to emphasize barriers facing people with physical disabilities such as people using wheelchairs.

14. It is misleading to suggest at points that building code compliance means that a building is accessible.

15. It is inappropriate and potentially harmful for the RHF to use blindness or vision loss simulations as part of the RHFAC course.

16. It is unhelpful for The RHFAC course to ask students to consider which disability they’d rather have or not have.

17. RHFAC testing of course participants is not shown to be sufficient.”

Fully 932 days ago, the Ford Government received the blistering final report of the David Onley AODA Independent Review. Among other things, that report called for substantial new regulatory action to make the built environment in Ontario accessible to people with disabilities. That report did not make any recommendation for the Ontario Government to use the RHF program. Over two and a half years later, Ontarians with disabilities are still waiting for meaningful provincial action on this front.

MORE DETAILS

Burnaby Beacon August 19, 2021

Originally posted at https://burnabybeacon.com/article/rick-hansen-foundation-parks-accessibility/

Who gets to decide what is accessibleand who does that leave behind?

The City of Burnaby is requiring all bidders on parks projects to have Rick Hansen Foundation certificationbut advocates say standards shouldn’t be put in the hands of private foundations.

By Dustin Godfrey

Disabilities advocates are decrying a move by the City of Burnaby to require architects and other contractors looking to work with the city to have certification with the Rick Hansen Foundation.

Earlier this summer, city staff noted in a report to the parks, recreation, and culture commission that the parks department is working to improve accessibility in parks and trails.

Following the principles of universal design, we strive to make our parks usable to the greatest extent possible, by everyone, director of parks, recreation, and cultural services Dave Ellenwood wrote in the report.

Standards for accessibility at parks facilities, according to the report, are sourced from a combination of provincial and national regulations, including the BC Housing Code and the Canadian Landscape Architecture Associations design standards for accessibility.

The report goes on to note that the city doesnt have a direct relationship with the Rick Hansen Foundation, but an access advisory committee in the city is in touch with the foundation semi-regularly.

Approximately 2 years ago, leadership from the Rick Hansen Foundation met with the mayor to inquire if the City would certify its corporate facilities; however, at the time there was substantial fee associated with the process, and it was not pursued, Ellenwood wrote.

Going forward, however, all new civic projects require Rick Hansen training/certification as criteria in its RFP [request for proposals] process for consultants/architects of new civic facilities, including the current recreation centre projects. This means that the Rick Hansen certification lens is applied to Burnaby civic projects.

But advocates say this wrongly forces architects to patronize a foundation they say relieves pressure on senior levels of government to develop their own stricter rules for accessibility.

It is exceedingly inappropriate and quite troubling, said David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, who described his organization as among the leading voices youll see being quoted publicly as raising concerns about the RHF certification process and certifier training.

And the issue draws questions about how accessibility should be regulatedby market forces, such as certifications drawn up by private foundations, or by public entities.

The City of Burnaby did not respond to requests for comment.

What is the Rick Hansen Foundation?

A statue of Rick Hansen at Rogers Arena in Vancouver before it was moved to the Vancouver General Hospital. (Flickr, Creative Commons)

The foundation was launched in the late 1980s as the Man in Motion World Tour Society by Rick Hansen, a paraplegic wheelchair user following a spinal cord injury at age 15 after he completed his famous 26-month Man in Motion World Tour.

The Paralympians 40,000-km wheelchair marathon, inspired by Terry Foxs Marathon of Hope, covered 34 countries and earned Hansen broad recognition, including the Order of Canada and the Order of BC.

And the momentum of that tour carried into the foundation, whose original aim, according to its website, was to raise money to improve the lives of people with disabilities and to support SCI research.

The Rick Hansen Foundation has been the vessel for a number of accessibility investments, doling out grants on behalf of governments, and in 2017, it launched a certification program to rate buildings for accessibility. Since then, the foundation has sent evaluators to over 1,300 sites to determine an accessibility ratingcertification requires 60% compliance, as well as full compliance with mandatory requirements, while a gold certification requires 80% compliance.

Of the 1,300-plus sites assessed, over 850 have received certification, while just over 70 have received gold certification.

Just last week, the federal governmentahead of an election callannounced a $7.5-million investment into the foundation to establish a new standardized profession of accessibility professionals, which will increase expertise and information on how to build accessible spaces in a way that includes people of all abilities.

Whats the problem?

In recent years, while the foundation has managed to elicit the praise of governments, it has also drawn the ire of many accessibility advocates.

Advocates say various governments have come to rely too heavily on RHFs certification program, effectively privatizing accessibility. And they say the program takes pressure off of governments to develop adequate accessibility legislation with teeth to enforce compliance.

Lepofsky pointed in particular to a move by the Ontario government to give Rick Hansen Foundation $1.3 million to do certification inspections on 250 buildings.

They pointed to this, in multiple statements, when points are made publicly that they are not making progress on accessibility in anywhere near the way we need it, Lepofsky said, adding the certification proves nothing other than a PR gesture.

Its a waste of money, but a lot of money for a photo op smokescreen to make it look like theyre doing something, so they can point to it and hope that that gets some good media.

Gabrielle Peters, a disabled writer and policy analyst in Vancouver, said she has been frustrated with the level of interest RHF has gotten from governments and the private sector, particularly around its certification program.

Accessibility is essentially, and should be, understood in terms of the built environment and the conditions of the built environment, she said. Its sort of akin to a fire code, [or] health policy. So if you dont follow the fire code, you can be shut down. Your business licence can be taken away. Thats my ideal situation.

Filling the gaps

Rick Hansen Foundation bills its certification program as something thats intended to fill the gaps not addressed by legislation, saying it agrees that the government also needs to take a role in the issue.

RHF does not disagree with the position that there should be government regulation, however we do not see this as being mutually exclusive to our program. Both can exist. Its important to have both enabling legislation and harmonized national codes and standards and a complementary national certification program that uses consistent methodology and recognizes industry leadership, the foundation wrote in a statement to Burnaby Beacon.

Legislation alone is not enough, according to a report from the Canadian Disability Policy Alliance (CDPA), public and private collaboration is essential.

The foundation also pointed to a study by HCMA Architecture + Design that showed building to the national and Ontario building codes would get a building 35% and 42% respectively on the RHF certification rating.

RHFAC was developed on national and international standards and research demonstrating best practices in accessibility. The program has been reviewed by a broad scope of stakeholders, the foundation said, listing major disabilities organizations, a technical committee of private and public officials, and an advisory committee made up of city planners and operators of commercial spaces.

“People are always ready to tell us if they disagree with usIve heard absolutely no one come to [RHF?s] defence.”
But Peters said accessibility should be defined by the public, through public institutions, comparing it to a fire code or food safety regulations.

If you could just imagine putting those things into a privatized situation, I think you can imagine the myriad of problems that could occur. You dont have to follow the fire code; you have to follow Dustins privately developed rules of fires, Peters said.

That would be a big problem, because it shouldnt be up to Dustin to decide. It should be up to the fire department and the fire marshal to decide. It should be up to a health authority, which is publicly accountable and publicly run. And the same with accessibility.

Legislation being implemented

BC and Canada have both recently passed accessibility legislation, including the Accessible Canada Act in 2019 and the Accessible BC Act signed in June this year.

The federal legislation only applies to federal agencies and federally regulated institutions in the private sector, such as banks, airlines, broadcasting and cross-provincial transportation.

Meanwhile, its still unclear how BCs law will apply, with implementation taking place over 10 years. Its focuses over the next decade will include culture change, accountability requirements for BC government, monitoring and evaluation, and standards development.

As it stands, theres little recourse for anyone with a disability in BC who cant access services or even basics like curb cutsramps at the corners of sidewalks to allow wheelchairs and others to easily get onto the roadbeyond going to the BC Human Rights Tribunal.

But advocates issues with RHFs certification program arent just about who should be responsible for standardizing accessibilitythey have concerns about the methodology and scope of the program.

Weve been very public about this

Peters said Rick Hansen Foundation has gained a particularly strong foothold in BC, where its based, often acting as a vessel for government grant money.

But that hasnt been the case everywhereLepofsky said RHF doesnt have the same standing in Ontario.

When Doug Fords government gave $1.3 million to RHF, Lepofskys coalition listed 17 concerns they have with RHFAC and with the Ontario governments funding announcement. And his organization wasnt the only one that pushed back on the funding announcement.

The Toronto Stars editorial board penned a condemnation of the move, citing a number of similar qualms to Lepofskys concerns.

People are always ready to tell us if they disagree with usIve heard absolutely no one come to [RFH?s] defence, Lepofsky said.

Our positions are informed by feedback we get on an ongoing basis. Weve been very public about this, and Ive had nobody from within the disability community pushing back and saying, Youre wrong; this is a great thing.

Lepofskys concerns about RHF certification range from conflict of interest concerns to the short training period involved to the methodology around its ratings.

If the Hansen folks go in and say somethings accessible, all youve got to do is move a garbage can in the path of travel, and thats over. They get the label, they get the sign up [on the] front of their building, but it doesnt mean anything, Lepofsky said.

Lepofsky further took issue with the suggestion that RHF certification pushes building design beyond the bare minimum, with the implication that the building code is the minimum.

The minimum is the human rights code of the Charter of Rights. So what Mr. Hansen and the foundation talk about is encouraging people to go beyond the minimum, grossly understating what the minimum is, and then applauding people for doing better than that substandard requirement, Lepofsky said.

Human rights complaint

In fact, Lepofsky and Peters both pointed to a couple of notable shortcomings by Rick Hansen Foundation.

Last year, Pat Quinns Restaurant & Bar in Tsawwassen settled a human rights complaint filed against it by a wheelchair user, despite the buildingand restauranthaving accessibility certification from the Rick Hansen Foundation.

And in 2018, the foundation awarded YVR Airport a gold certification. The problem, they said, is where they held the photo opat a set of hangout steps or stepped seating, a feature that is loved by architects but derided by accessibility advocates.

The very picture where theyre portraying it had a barrier in the picture, Lepofsky said. This is a design, a thing that should never take place. And here, [RHF is] not only giving them a gold, but theyre giving them a gold [with hangout steps] in the picture. This is just proof positive of a complete bungle. So thats a huge problem.

RHF did not address a question about the YVR approval directly but said in an email statement that ratings provide a snapshot of the overall accessibility of their facilities.

Certification does not equal perfection. Using their scorecards, organizations are able to identify which areas have scored well and which areas require improvements in a simple and easily understood format, the foundation said.

Rick Hansen Foundation awards YVR Airport a gold certification, with a photo op at hangout stairs in the airport.
And that gets to another point of contention many within the disability community have with the RHF certification program: a sense that it may offer a photo op and a plaque for the sake of PR without actually being adequately accessible.

For Peters, a big part of the issue is transparency around how the certification process is done. The foundation has a public checklist on its website, indicating the different factors that are considered in its accessibility certification test, and how theyre weighted. But when a business says its RHF certified, its not clear what that means.

The word certification is a misnomer, according to Lepofsky.

They dont certify anything. Its not like you get a certificate that is now a defence to a human rights complaint. Its not, Lepofsky said.

Who certifies the certifiers?

Part of the issue, according to Thea Kurdi, an Ontario-based accessibility and universal design consultant with DesignAble who has been involved in writing accessibility standards, is how much training RHF certifiers getjust 10 days.

If youre doing an audit, none of my staff members are allowed to go out and do that independently for 2 years. We take 2 years to train people to make sure that they really understand what theyre doing, Kurdi said.

That can pose a problem when many parts of the checklist are discretionaryeach point is ranked on a scalerather than simple yes or no questions.

In its written statement, RHF noted that its certification process does have prerequisites for its training, including a diploma in architecture, engineering, or urban planning, or a minimum of 5 years experience related to accessibility in buildings.

Furthermore, RHFAC ratings are reviewed by an independent adjudication process, the foundation said. Despite this, we agree that the 2-week RHFAC training course is not sufficient to provide students with enough knowledge to consider themselves experts in the application of universal design, the foundation said.

However, it does change the way industry professionals see the built environment, help them to see barriers they didnt see before, and to challenge the assumption that meeting code is equal to providing real access for people with disabilities.

A focus on spinal cord injuries

One issue Kurdi, Lepofsky and Peters all noted were around where Rick Hansen Foundations focus has been for much of its existence. The foundation was originally created to raise money for spinal cord research, which is a really important endeavour, Kurdi said.

But all 3 said the foundations focus skews toward a specific type of disabilitywheelchair users.

While [the certification program] does talk about other types of disabilities, we have noticedbecause weve been asked to review it for several clients to see, does that make sense for them to useI find its still wheelchair-centric, Kurdi said.

Peters noted one particular RHF point that suggested facilities use aromatic plants as a form of wayfinding assistance for people who are blind or have low vision. This, she said, ignores the existence of winter and the fact that accessibility includes accommodating people with scent sensitivities and allergies.

RHFAC uses them as an example of an olfactory wayfinding clue for a building entrance but does not suggest their use in parks, the foundation said in response to a question about the suggestion.

We continue to value ongoing input from the community, and will discuss the feedback regarding aromatic plants with our Technical Advisory Committee during the development of RHFAC v4.0.

Kurdi said: I love it when people are trying to bring attention to accessibility and when theyre trying to move things going down the whole line. But I think people really need to understand the difference between a certification program and, for example, a building audit.

A certification program can be a fun way to celebrate accessibility and then raise awareness as a central improvement, Kurdi said, but she noted some limitations.

I dont think that this really captures whats required under the human rights code, and it certainly doesnt encompass what were recommending in the accessible built environment industry.

The foundation said its goal has, for 33 years, been to remove barriers for people with disabilities and to increase awareness of accessibility, along with its focus on spinal cord injury research.

One of the most fundamental barriers that people with disabilities face is the lack of physical accessibility in the places we live, work, learn, and play. A key priority for RHF is to improve accessibility for people with physical disabilities affecting their mobility, vision, and hearing, RHF said.

Laws with teeth

A person in a wheelchair uses a curb cut at a crosswalk.

Curb cuts are one basic area of accessibility that Gabrielle Peters says is woefully lacking in Metro Vancouver. (phaustov, Shutterstock)

Peters highlighted the Americans with Disabilities Act south of the border as an example of doing accessibility better than in Canada.

While Canadas and BCs laws have just been passed in the last couple of years, the ADA has been in place for 3 decades now. And while Peters said it isnt perfect by any means, its still much stronger than existing legislation in Canada.

And a key issue, she noted, is how effective it is as a lawif something isnt ADA compliant, a person can sue. This is what happened south of the border with curb cutsand that bears results.

The City of Portland recently settled a class-action lawsuit filed against it by committing to creating 1,500 curb cuts per year.

In Vancouver, Peters said the city has 8,000 corners without curb cuts, and when she sat on that citys transportation council, the projected completion date was 200 years out.

Here in Burnaby, meanwhile, many residential roads dont have sidewalks, and the city even cancelled a sidewalks project at the behest of local families.

Free resources

Peters said one of her main issues with the Rick Hansen Foundations certification program is the pricedescribed by the city in its own report as substantialand the barriers that adds.

This, she said, makes the process inaccessible to people who could consult on disabilities, drawing from lived experience and community consultations but who dont have RHF training.

It makes me very sad that this is being turned into a money-making opportunity that seems to be replicating some of the [existing] oppressions and hierarchy, Peters said.

All the while, she said, there are free resources the city could draw from for its parks facilities.

Because its publicly regulated, the ADAs guidelines are freely available, including standards specific to parks. Peters said the guidelines arent comprehensive but still are more so than those from RHF, also pointing to more guidelines freely available from the City of Malibu in California.

Watch for our companion piece to this article coming on Friday, August 20, where a local resident offers some challenges aroundand solutions foraccessibility in Burnabys parks facilities.

Dustin Godfrey
Reporter at Burnaby Beacon

The Toronto Star August 6, 2019

Originally posted at: https://www.thestar.com/opinion/editorials/2019/08/06/ontario-should-move-faster-on-tearing-down-barriers.html Ontario should move faster on tearing down barriers

Editorial

Buildings must be for everyone

As accessibility advocates constantly warn, we’re all just one illness or accident away from becoming disabled.

And with 1,000 Ontario baby boomers turning 65 every day, more of us will be dealing with aging vision, hearing, hips and knees that will affect our quality of life and make our physical environment more difficult to navigate.

So it’s disappointing that six months after former lieutenant governor David Onley delivered a scathing report on the “soul crushing” barriers that 2.6 million Ontarians with disabilities face on a daily basis, the Ford government has yet to develop a clear way forward.

In March, Raymond Cho, Ontario’s minister for seniors and accessibility, finally authorized work to resume on three committees developing accessibility standards in the education and health-care systems.

But, so far, none of the committees have met and no dates have been set.

When NDP MPP Joe Harden introduced a motion in the legislature in May urging the government to implement Onley’s report, starting with the development of new accessibility standards for the built environment, Cho dismissed the idea as “red tape.”

Instead, Cho and the Ford government are trumpeting a two-year $1.3-million investment in a new accessibility certification program developed by the Rick Hansen Foundation.

By certifying 250 public and private buildings, the government says it will raise awareness and encourage the development industry to make accessibility a priority.

We have no quarrel with the foundation’s quest to make the world more accessible for people with disabilities and to fund research into spinal cord injury and care.

But we are concerned about a program that relies on building professionals who have completed just two weeks of accessibility training to conduct the certifications.

And we question why certifications will be given to entire buildings at a time when most accessibility advocates and seasoned consultants say few buildings are fully accessible.

For example, the foundation was recently criticized for awarding a “gold” rating to the Vancouver airport in 2018, even though the building includes so-called “hangout steps” for socializing, which are inaccessible to people using wheelchairs and are difficult to navigate for those with vision loss or difficulty with balance.

Far better for the foundation to give its stamp of approval on accessible design elements that are truly remarkable and worth highlighting as examples for others to follow.

But, for the province to be financially backing such a scheme – particularly when it was not among Onley’s 15 recommendations – is questionable.

Shouldn’t scarce public funds be spent on implementing Onley’s detailed blueprint to ensure that Ontario meets its 2025 deadline for becoming fully accessible under the Accessibility for Ontarians with Disabilities Act?

As Onley rightly recommends, the province should be developing better provincial accessibility standards for public and private buildings and boosting enforcement of the few rules that currently exist.

And it should make accessibility courses mandatory in colleges and universities to ensure future architects and other design professionals get the training they need.

Just as physicians are trained to “do no harm,” architects and design professionals should be educated to create no barriers.

It’s hard to believe that during one of the biggest building booms in the history of Ontario, there are so few accessibility requirements in the Ontario Building Code.

Nothing prevents a developer from building acres of single family homes inaccessible to people with disabilities.

And just 15 per cent of units in multiresidential buildings – condominiums and apartments – are required to be accessible.

Ottawa’s national housing strategy aims to ensure 20 per cent of homes created under the plan are accessible. And yet, according to the latest 2017 federal statistics, 22 per cent of Canadians report having a disability, a percentage that will only grow as the population ages.

Clearly, we are not addressing current need, let alone future demand. The Ford government must do better.




Source link

Another Media Report on Huge Problems with the Rick Hansen Foundation Private Accessibility “Certification” Program – RHF Concedes Its Training for Its Accessibility Assessors Does Not Make Them Experts in Accessibility


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/

Another Media Report on Huge Problems with the Rick Hansen Foundation Private Accessibility “Certification” Program – RHF Concedes Its Training for Its Accessibility Assessors Does Not Make Them Experts in Accessibility

August 20, 2021

        SUMMARY

An excellent, extensive article in the August 19, 2021 edition of the Burnaby Beacon, set out below, details many serious problems with the Rick Hansen Foundation (RHF) private accessibility “certification” program. For more than two years, this program has been the centrepiece of the Ford Government’s failing efforts to address the many substantial barriers that people with disabilities face in the built environment. What Ontarians with disabilities need instead is for the Ford Government to agree to develop a Built Environment Accessibility Standard under the Accessibility for Ontarians with Disabilities Act.

Over two years ago, the Ford Government announced that it would spend over 1.3 million public dollars on the RHF program over a two-year period. Two years later, there is no evidence that this has resulted in any improvement in the accessibility of the built environment in Ontario.

The AODA Alliance, quoted in this new article, as well as other credible voices, have together brought to public attention many serious failings in the RHF program. For example, the fact that the RHF calls a building “accessible” is no proof at all that it is accessible.

As another example, the very short training course that the RHF provides for those assessing a building’s accessibility is too short and riddled with problems. The RHF calls those who complete that inadequate course an “RHF accessibility professional”. This is an inaccurate and very misleading title. In this new news report, the RHF is quoted as in substance conceding this point. The article states in part:

“‘we agree that the 2-week RHFAC training course is not sufficient to provide students with enough knowledge to consider themselves experts in the application of universal design,’ the foundation said.”

This new article refers to a Toronto Star editorial that blasted the Ford Government for its strategy of using the RHF program. We set that editorial out below. It accords with criticisms of the RHF program that we have made public.

The AODA Alliance’s July 3, 2019 report on the RHF program, entitled “A Problematic Government Strategy on Accessibility for Ontarians with Disabilities and An Inappropriate Use of Public Money

The AODA Alliance Report on the Ontario Government’s Proposal to Spend Public Money on the Rick Hansen Foundation’s Private Accessibility Certification Process” made these findings which have not been disproven in the past two years:

“* Ford’s Government says this plan will remove barriers facing people with disabilities. Yet the report reveals that the plan need not result in any barriers ever being removed.

* Instead of using properly trained Government inspectors, Ford’s plan uses private individuals who may have no prior experience with the highly technical area of building accessibility, and who just took a two-week course and passed a multiple choice exam. To acquire the needed expertise, it takes much more training on accessibility than a 2-week course.

* There are serious concerns with RHF’s private standard or yardstick to assess a building’s accessibility. For example, there is a real risk of leaving out people whose disabilities are not related to mobility, vision or hearing.

* There is a risk of conflict of interest if the RHF inspects an organization that has given or may give the RHF a charitable donation. It would be inexcusable for an organization to give money to a Government inspector.

* These private free-lance accessibility assessors appear to have a troubling incentive to give higher accessibility ratings, in hopes of getting more work. An organization chooses the RHF-trained free-lance assessor who will inspect their building. Assessors are paid by the job.

*Even though the taxpayer will fund these inspections, the public will have no right to know the inspection’s results, unless an organization agrees to make its results public.”

The AODA Alliance’s August 15, 2019 supplemental report on the RHF program reached these 17 additional conclusions:

“1. It was wrong for the Ford Government not to hold an open competitive bidding process before deciding to give $1.3 million to the RHF.

  1. There are no measures in place to address serious conflict of interest concerns with the RHFAC.
  1. Key and basic aspects of this public funding program have still not yet been worked out months after it was announced.
  1. It is troubling that the RHFAC tries to shift responsibility and risk for accessibility ratings and advice onto others.
  1. The RHFAC accessibility ratings are clearly left in significant part to each free-lance assessor’s subjective discretion, despite the Government’s claims that these accessibility assessments are consistently applied.
  1. It is problematic for the RHFAC to take averages of the accessibility of a building’s features like bathrooms.
  1. The RHFAC program emphasizes the problematic idea of getting organizations to go “beyond code”, as if building code compliance is all that is required.
  1. The RHFAC adjudication process has serious flaws.
  1. There are insufficient safeguards to ensure that an RHF-certified building remains accessible after it is so-certified.
  1. The mandatory RHFAC course is even shorter than the two weeks we earlier announced.
  1. An instructor in the RHFAC course need not have demonstrated expertise in the accessibility of the built environment.
  1. The RHF training course crams far too much curriculum into too short a time.
  1. The RHFAC course appears to emphasize barriers facing people with physical disabilities such as people using wheelchairs.
  1. It is misleading to suggest at points that building code compliance means that a building is accessible.
  1. It is inappropriate and potentially harmful for the RHF to use blindness or vision loss simulations as part of the RHFAC course.
  1. It is unhelpful for The RHFAC course to ask students to consider which disability they’d rather have or not have.
  1. RHFAC testing of course participants is not shown to be sufficient.”

Fully 932 days ago, the Ford Government received the blistering final report of the David Onley AODA Independent Review. Among other things, that report called for substantial new regulatory action to make the built environment in Ontario accessible to people with disabilities. That report did not make any recommendation for the Ontario Government to use the RHF program. Over two and a half years later, Ontarians with disabilities are still waiting for meaningful provincial action on this front.

        MORE DETAILS

Burnaby Beacon August 19, 2021

Originally posted at https://burnabybeacon.com/article/rick-hansen-foundation-parks-accessibility/

Who gets to decide what is accessible—and who does that leave behind?

The City of Burnaby is requiring all bidders on parks projects to have Rick Hansen Foundation certification—but advocates say standards shouldn’t be put in the hands of private foundations.

By Dustin Godfrey

Disabilities advocates are decrying a move by the City of Burnaby to require architects and other contractors looking to work with the city to have certification with the Rick Hansen Foundation.

Earlier this summer, city staff noted in a report to the parks, recreation, and culture commission that the parks department is working to improve accessibility in parks and trails.

“Following the principles of universal design, we strive to make our parks usable to the greatest extent possible, by everyone,” director of parks, recreation, and cultural services Dave Ellenwood wrote in the report.

Standards for accessibility at parks facilities, according to the report, are sourced from a combination of provincial and national regulations, including the BC Housing Code and the Canadian Landscape Architecture Association’s design standards for accessibility.

The report goes on to note that the city doesn’t have a direct relationship with the Rick Hansen Foundation, but an access advisory committee in the city is in touch with the foundation “semi-regularly.”

“Approximately 2 years ago, leadership from the Rick Hansen Foundation met with the mayor to inquire if the City would certify its corporate facilities; however, at the time there was substantial fee associated with the process, and it was not pursued,” Ellenwood wrote.

“Going forward, however, all new civic projects require Rick Hansen training/certification as criteria in its RFP [request for proposals] process for consultants/architects of new civic facilities, including the current recreation centre projects. This means that the Rick Hansen certification lens is applied to Burnaby civic projects.”

But advocates say this wrongly forces architects to patronize a foundation they say relieves pressure on senior levels of government to develop their own stricter rules for accessibility.

“It is exceedingly inappropriate and quite troubling,” said David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, who described his organization as “among the leading voices you’ll see being quoted publicly as raising concerns about the RHF certification process and certifier training.”

And the issue draws questions about how accessibility should be regulated—by market forces, such as certifications drawn up by private foundations, or by public entities.

The City of Burnaby did not respond to requests for comment.

What is the Rick Hansen Foundation?

A statue of Rick Hansen at Rogers Arena in Vancouver before it was moved to the Vancouver General Hospital. (Flickr, Creative Commons)

The foundation was launched in the late 1980s as the Man in Motion World Tour Society by Rick Hansen, a paraplegic wheelchair user following a spinal cord injury at age 15 after he completed his famous 26-month Man in Motion World Tour.

The Paralympian’s 40,000-km wheelchair marathon, inspired by Terry Fox’s Marathon of Hope, covered 34 countries and earned Hansen broad recognition, including the Order of Canada and the Order of BC.

And the momentum of that tour carried into the foundation, whose original aim, according to its website, was “to raise money to improve the lives of people with disabilities and to support SCI research.”

The Rick Hansen Foundation has been the vessel for a number of accessibility investments, doling out grants on behalf of governments, and in 2017, it launched a certification program to rate buildings for accessibility. Since then, the foundation has sent evaluators to over 1,300 sites to determine an accessibility rating—certification requires 60% compliance, as well as full compliance with mandatory requirements, while a gold certification requires 80% compliance.

Of the 1,300-plus sites assessed, over 850 have received certification, while just over 70 have received gold certification.

Just last week, the federal government—ahead of an election call—announced a $7.5-million investment into the foundation to “establish a new standardized profession of ‘accessibility professionals,’ which will increase expertise and information on how to build accessible spaces in a way that includes people of all abilities.”

What’s the problem?

In recent years, while the foundation has managed to elicit the praise of governments, it has also drawn the ire of many accessibility advocates.

Advocates say various governments have come to rely too heavily on RHF’s certification program, effectively privatizing accessibility. And they say the program takes pressure off of governments to develop adequate accessibility legislation with teeth to enforce compliance.

Lepofsky pointed in particular to a move by the Ontario government to give Rick Hansen Foundation $1.3 million to do certification inspections on 250 buildings.

“They pointed to this, in multiple statements, when points are made publicly that they are not making progress on accessibility in anywhere near the way we need it,” Lepofsky said, adding the certification “proves nothing other than a PR gesture.”

“It’s a waste of money, but a lot of money for a photo op smokescreen to make it look like they’re doing something, so they can point to it and hope that that gets some good media.”

Gabrielle Peters, a disabled writer and policy analyst in Vancouver, said she has been frustrated with the level of interest RHF has gotten from governments and the private sector, particularly around its certification program.

“Accessibility is essentially, and should be, understood in terms of the built environment and the conditions of the built environment,” she said. “It’s sort of akin to a fire code, [or] health policy. So if you don’t follow the fire code, you can be shut down. Your business licence can be taken away. That’s my ideal situation.”

Filling the gaps

 

Rick Hansen Foundation bills its certification program as something that’s intended to fill the gaps not addressed by legislation, saying it agrees that the government also needs to take a role in the issue.

“RHF does not disagree with the position that there should be government regulation, however we do not see this as being mutually exclusive to our program. Both can exist. It’s important to have both enabling legislation and harmonized national codes and standards and a complementary national certification program that uses consistent methodology and recognizes industry leadership,” the foundation wrote in a statement to Burnaby Beacon.

“Legislation alone is not enough, according to a report from the Canadian Disability Policy Alliance (CDPA), public and private collaboration is essential.”

The foundation also pointed to a study by HCMA Architecture + Design that showed building to the national and Ontario building codes would get a building 35% and 42% respectively on the RHF certification rating.

“RHFAC was developed on national and international standards and research demonstrating best practices in accessibility. The program has been reviewed by a broad scope of stakeholders,” the foundation said, listing major disabilities organizations, a technical committee of private and public officials, and an advisory committee made up of city planners and operators of commercial spaces.

“People are always ready to tell us if they disagree with us—I’ve heard absolutely no one come to [RHF’s] defence.”

But Peters said accessibility should be defined by the public, through public institutions, comparing it to a fire code or food safety regulations.

“If you could just imagine putting those things into a privatized situation, I think you can imagine the myriad of problems that could occur. You don’t have to follow the fire code; you have to follow Dustin’s privately developed rules of fires,” Peters said.

“That would be a big problem, because it shouldn’t be up to Dustin to decide. It should be up to the fire department and the fire marshal to decide. It should be up to a health authority, which is publicly accountable and publicly run. And the same with accessibility.”

 

Legislation being implemented

 

BC and Canada have both recently passed accessibility legislation, including the Accessible Canada Act in 2019 and the Accessible BC Act signed in June this year.

The federal legislation only applies to federal agencies and federally regulated institutions in the private sector, such as banks, airlines, broadcasting and cross-provincial transportation.

Meanwhile, it’s still unclear how BC’s law will apply, with implementation taking place over 10 years. Its focuses over the next decade will include culture change, accountability requirements for BC government, monitoring and evaluation, and standards development.

As it stands, there’s little recourse for anyone with a disability in BC who can’t access services or even basics like curb cuts—ramps at the corners of sidewalks to allow wheelchairs and others to easily get onto the road—beyond going to the BC Human Rights Tribunal.

But advocates’ issues with RHF’s certification program aren’t just about who should be responsible for standardizing accessibility—they have concerns about the methodology and scope of the program.

 

‘We’ve been very public about this’

 

Peters said Rick Hansen Foundation has gained a particularly strong foothold in BC, where it’s based, often acting as a vessel for government grant money.

But that hasn’t been the case everywhere—Lepofsky said RHF doesn’t have the same standing in Ontario.

When Doug Ford’s government gave $1.3 million to RHF, Lepofsky’s coalition listed 17 concerns they have with RHFAC and with the Ontario government’s funding announcement. And his organization wasn’t the only one that pushed back on the funding announcement.

The Toronto Star’s editorial board penned a condemnation of the move, citing a number of similar qualms to Lepofsky’s concerns.

“People are always ready to tell us if they disagree with us—I’ve heard absolutely no one come to [RFH’s] defence,” Lepofsky said.

“Our positions are informed by feedback we get on an ongoing basis. … We’ve been very public about this, and I’ve had nobody from within the disability community pushing back and saying, ‘You’re wrong; this is a great thing.’”

Lepofsky’s concerns about RHF certification range from conflict of interest concerns to the short training period involved to the methodology around its ratings.

“If the Hansen folks go in and say something’s accessible, all you’ve got to do is move a garbage can in the path of travel, and that’s over. They get the label, they get the sign up [on the] front of their building, but it doesn’t mean anything,” Lepofsky said.

Lepofsky further took issue with the suggestion that RHF certification pushes building design beyond the bare minimum, with the implication that the building code is the minimum.

“The minimum is the human rights code of the Charter of Rights. So what Mr. Hansen and the foundation talk about is encouraging people to go beyond the minimum, grossly understating what the minimum is, and then applauding people for doing better than that substandard requirement,” Lepofsky said.

Human rights complaint

 

In fact, Lepofsky and Peters both pointed to a couple of notable shortcomings by Rick Hansen Foundation.

Last year, Pat Quinn’s Restaurant & Bar in Tsawwassen settled a human rights complaint filed against it by a wheelchair user, despite the building—and restaurant—having accessibility certification from the Rick Hansen Foundation.

And in 2018, the foundation awarded YVR Airport a gold certification. The problem, they said, is where they held the photo op—at a set of “hangout steps” or stepped seating, a feature that is loved by architects but derided by accessibility advocates.

“The very picture where they’re portraying it had a barrier in the picture,” Lepofsky said. “This is a design, a thing that should never take place. And here, [RHF is] not only giving them a gold, … but they’re giving them a gold [with hangout steps] in the picture. This is just proof positive of a complete bungle. So that’s a huge problem.”

RHF did not address a question about the YVR approval directly but said in an email statement that ratings provide “a ‘snapshot’ of the overall accessibility of their facilities.”

“Certification does not equal perfection. Using their scorecards, organizations are able to identify which areas have scored well and which areas require improvements in a simple and easily understood format,” the foundation said.

Rick Hansen Foundation awards YVR Airport a gold certification, with a photo op at hangout stairs in the airport.

And that gets to another point of contention many within the disability community have with the RHF certification program: a sense that it may offer a photo op and a plaque for the sake of PR without actually being adequately accessible.

For Peters, a big part of the issue is transparency around how the certification process is done. The foundation has a public checklist on its website, indicating the different factors that are considered in its accessibility certification test, and how they’re weighted. But when a business says it’s RHF certified, it’s not clear what that means.

The word “certification” is a misnomer, according to Lepofsky.

“They don’t certify anything. It’s not like you get a certificate that is now a defence to a human rights complaint. It’s not,” Lepofsky said.

 

Who certifies the certifiers?

 

Part of the issue, according to Thea Kurdi, an Ontario-based accessibility and universal design consultant with DesignAble who has been involved in writing accessibility standards, is how much training RHF certifiers get—just 10 days.

“If you’re doing an audit, none of my staff members are allowed to go out and do that independently for 2 years. We take 2 years to train people to make sure that they really understand what they’re doing,” Kurdi said.

That can pose a problem when many parts of the checklist are discretionary—each point is ranked on a scale—rather than simple yes or no questions.

In its written statement, RHF noted that its certification process does have prerequisites for its training, including a diploma in architecture, engineering, or urban planning, or a minimum of 5 years’ experience related to accessibility in buildings.

“Furthermore, RHFAC ratings are reviewed by an independent adjudication process,” the foundation said. Despite this, we agree that the 2-week RHFAC training course is not sufficient to provide students with enough knowledge to consider themselves experts in the application of universal design,” the foundation said.

“However, it does change the way industry professionals see the built environment, help them to see barriers they didn’t see before, and to challenge the assumption that meeting code is equal to providing real access for people with disabilities.”

A focus on spinal cord injuries

 

One issue Kurdi, Lepofsky and Peters all noted were around where Rick Hansen Foundation’s focus has been for much of its existence. The foundation was originally created to raise money for spinal cord research, “which is a really important endeavour,” Kurdi said.

But all 3 said the foundation’s focus skews toward a specific type of disability—wheelchair users.

“While [the certification program] does talk about other types of disabilities, we have noticed—because we’ve been asked to review it for several clients to see, does that make sense for them to use—I find it’s still wheelchair-centric,” Kurdi said.

Peters noted one particular RHF point that suggested facilities use aromatic plants as a form of wayfinding assistance for people who are blind or have low vision. This, she said, ignores the existence of winter and the fact that accessibility includes accommodating people with scent sensitivities and allergies.

“RHFAC uses them as an example of an olfactory wayfinding clue for a building entrance but does not suggest their use in parks,” the foundation said in response to a question about the suggestion.

“We continue to value ongoing input from the community, and will discuss the feedback regarding aromatic plants with our Technical Advisory Committee during the development of RHFAC v4.0.”

Kurdi said: “I love it when people are trying to bring attention to accessibility and when they’re trying to move things going down the whole line. But I think people really need to understand the difference between a certification program and, for example, a building audit.”

A certification program can be a “fun way to celebrate accessibility and then raise awareness as a central improvement,” Kurdi said, but she noted some limitations.

“I don’t think that this really captures what’s required under the human rights code, and it certainly doesn’t encompass what we’re recommending in the accessible built environment industry.”

The foundation said its goal has, for 33 years, been to remove barriers for people with disabilities and to increase awareness of accessibility, along with its focus on spinal cord injury research.

“One of the most fundamental barriers that people with disabilities face is the lack of physical accessibility in the places we live, work, learn, and play. A key priority for RHF is to improve accessibility for people with physical disabilities affecting their mobility, vision, and hearing,” RHF said.

Laws with teeth

 

A person in a wheelchair uses a curb cut at a crosswalk.

Curb cuts are one basic area of accessibility that Gabrielle Peters says is woefully lacking in Metro Vancouver. (phaustov, Shutterstock)

Peters highlighted the Americans with Disabilities Act south of the border as an example of doing accessibility better than in Canada.

While Canada’s and BC’s laws have just been passed in the last couple of years, the ADA has been in place for 3 decades now. And while Peters said it isn’t perfect by any means, it’s still much stronger than existing legislation in Canada.

And a key issue, she noted, is how effective it is as a law—if something isn’t ADA compliant, a person can sue. This is what happened south of the border with curb cuts—and that bears results.

The City of Portland recently settled a class-action lawsuit filed against it by committing to creating 1,500 curb cuts per year.

In Vancouver, Peters said the city has 8,000 corners without curb cuts, and when she sat on that city’s transportation council, the projected completion date was 200 years out.

Here in Burnaby, meanwhile, many residential roads don’t have sidewalks, and the city even cancelled a sidewalks project at the behest of local families.

Free resources

Peters said one of her main issues with the Rick Hansen Foundation’s certification program is the price—described by the city in its own report as “substantial”—and the barriers that adds.

This, she said, makes the process inaccessible to people who could consult on disabilities, drawing from lived experience and community consultations but who don’t have RHF training.

“It makes me very sad that this is being turned into a money-making opportunity that seems to be replicating some of the [existing] oppressions and hierarchy,” Peters said.

All the while, she said, there are free resources the city could draw from for its parks facilities.

Because it’s publicly regulated, the ADA’s guidelines are freely available, including standards specific to parks. Peters said the guidelines aren’t comprehensive but still are more so than those from RHF, also pointing to more guidelines freely available from the City of Malibu in California.

Watch for our companion piece to this article coming on Friday, August 20, where a local resident offers some challenges around—and solutions for—accessibility in Burnaby’s parks facilities.

Dustin Godfrey

Reporter at Burnaby Beacon

The Toronto Star August 6, 2019

Originally posted at: https://www.thestar.com/opinion/editorials/2019/08/06/ontario-should-move-faster-on-tearing-down-barriers.html

Ontario should move faster on tearing down barriers

Editorial

Buildings must be for everyone

As accessibility advocates constantly warn, we’re all just one illness or accident away from becoming disabled.

And with 1,000 Ontario baby boomers turning 65 every day, more of us will be dealing with aging vision, hearing, hips and knees that will affect our quality of life and make our physical environment more difficult to navigate.

So it’s disappointing that six months after former lieutenant governor David Onley delivered a scathing report on the “soul crushing” barriers that 2.6 million Ontarians with disabilities face on a daily basis, the Ford government has yet to develop a clear way forward.

In March, Raymond Cho, Ontario’s minister for seniors and accessibility, finally authorized work to resume on three committees developing accessibility standards in the education and health-care systems.

But, so far, none of the committees have met and no dates have been set.

When NDP MPP Joe Harden introduced a motion in the legislature in May urging the government to implement Onley’s report, starting with the development of new accessibility standards for the built environment, Cho dismissed the idea as “red tape.”

Instead, Cho and the Ford government are trumpeting a two-year $1.3-million investment in a new accessibility certification program developed by the Rick Hansen Foundation.

By certifying 250 public and private buildings, the government says it will raise awareness and encourage the development industry to make accessibility a priority.

We have no quarrel with the foundation’s quest to make the world more accessible for people with disabilities and to fund research into spinal cord injury and care.

But we are concerned about a program that relies on building professionals who have completed just two weeks of accessibility training to conduct the certifications.

And we question why certifications will be given to entire buildings at a time when most accessibility advocates and seasoned consultants say few buildings are fully accessible.

For example, the foundation was recently criticized for awarding a “gold” rating to the Vancouver airport in 2018, even though the building includes so-called “hangout steps” for socializing, which are inaccessible to people using wheelchairs and are difficult to navigate for those with vision loss or difficulty with balance.

Far better for the foundation to give its stamp of approval on accessible design elements that are truly remarkable and worth highlighting as examples for others to follow.

But, for the province to be financially backing such a scheme – particularly when it was not among Onley’s 15 recommendations – is questionable.

Shouldn’t scarce public funds be spent on implementing Onley’s detailed blueprint to ensure that Ontario meets its 2025 deadline for becoming fully accessible

under the Accessibility for Ontarians with Disabilities Act?

As Onley rightly recommends, the province should be developing better provincial accessibility standards for public and private buildings and boosting enforcement of the few rules that currently exist.

And it should make accessibility courses mandatory in colleges and universities to ensure future architects and other design professionals get the training they need.

Just as physicians are trained to “do no harm,” architects and design professionals should be educated to create no barriers.

It’s hard to believe that during one of the biggest building booms in the history of Ontario, there are so few accessibility requirements in the Ontario Building Code.

Nothing prevents a developer from building acres of single family homes inaccessible to people with disabilities.

And just 15 per cent of units in multiresidential buildings – condominiums and apartments – are required to be accessible.

Ottawa’s national housing strategy aims to ensure 20 per cent of homes created under the plan are accessible. And yet, according to the latest 2017 federal statistics, 22 per cent of Canadians report having a disability, a percentage that will only grow as the population ages.

Clearly, we are not addressing current need, let alone future demand. The Ford government must do better.



Source link

New Captioned Video Tells the Whole Disability Discrimination Story in Ontario’s Critical Care Triage Plan – and – More Media Reports Reveal More Cause for Worry


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/

New Captioned Video Tells the Whole Disability Discrimination Story in Ontario’s Critical Care Triage Plan – and – More Media Reports Reveal More Cause for Worry

May 6, 2021

            SUMMARY

Here are six more important developments in our campaign to protect people with disabilities from disability discrimination in Ontario’s critical care triage protocol.

 1. New Captioned Video — Learn About the Disability Issues in Ontario’s Critical Care Triage Protocol

Day after day, you are getting so much information from us and others about the critical care triage issue for people with disabilities. That includes all the new information we report in this AODA Alliance Update.

Are you eager for a video that will explain what this is all about, from beginning to end? Check out the new captioned video by AODA Alliance Chair David Lepofsky where the whole story is explained. The video brings you up to date as of now. It explains the disability objections to the Ontario critical care triage, the troubling way the Ontario Government his dealing with this issue, and the bogus defences that the Government’s defenders have been giving the media, in their attempt to justify what the Government is doing.

We invite you to watch the video and share it with others. If you are teaching a course where this might be helpful, feel free to use this video. It is available at https://youtu.be/Ju8cyH7TbQo

Let us know what you think. Email your feedback to us at [email protected]

 2. Where is the Public Accountability for Critical Care Triage Now Being Conducted by Ambulance Crews?

We have been warning for months about the danger of “trickle down triage”. For example, an ambulance crew, called to a medical emergency at your home, could decide whether or not to give a patient life-saving care, before they even get to hospital. We expect ambulance crews to do all they can to save lives, and not to decide whether or not to even try to save a life.

The Ford Government has refused to answer questions about this, whether from the AODA Alliance in writing or from the opposition in Question Period in the Legislature. In a very upsetting article in the April 28, 2021 Toronto Sun, set out below, it is evident that this triage is already going on.

This is a life and death issue. The public should daily be told how many lives are lost due to any form of triage, including this roadside triage. The Ford Government should now make public any directions to ambulance and emergency crews on this kind of triage. Protections need to be put in place to avert the danger of disability discrimination. We know that there is clear disability discrimination in the directions already sent to Ontario doctors, should they have to triage critical care services. There is no reason to be confident that there is no such danger if triage is done by ambulance crews before even reaching a hospital.

 3. Who Exactly Will Live and Who Will Die if There is Critical care Triage in Hospitals? Behind Closed Doors, Practice Drills Have Been Going on For Months with No Public Accountability

The April 27, 2021 report by Global News, set out below, confirms that hospitals have been training for months on how to conduct critical care triage, in case it becomes necessary. This is all happening behind closed doors. We have no idea who ends up living and who ends up dying, according to these practice drills or simulations. We have no idea how differently the same case is decided from one hospital to the next, or from one doctor to the next. We have no word that anyone with human rights expertise is part of this, to alert doctors when they are running afoul of the Charter of Rights and the Ontario Human Rights Code. We have no idea if the Ford Government is monitoring any of this, to find out where its disability discriminatory Ontario critical care triage protocol needs to be fixed.

 4. Pulling Back the Curtain on A Troubling and Misleading Media Strategy Now In Place, Seemingly Led by Those Behind Ontario’s Disability-Discriminatory Critical Care Triage Protocol

Those who are behind the creation and implementation of Ontario’s disability-discriminatory critical care triage protocol appear now to be conducting some sort of media public relations strategy to get out their version of this controversial issue. This appears to be underway to manage public expectations about critical care triage and to respond to some bad press that The Government has gotten on this issue. In the January 23, 2021 online webinar for doctors on the critical care triage protocol, those evidently at the centre of this indicated that they were planning such a communications strategy, to be later rolled out close to the time that critical care triage may become necessary.

Among the key people quoted in these stories include Dr. James Downar, co-author of the disability-discriminatory Ontario critical care triage protocol, and Dr. David Neilipovitz, a lead at the Ford Government’s secretive Critical Care COVID-19 Command Centre. We have asked the Ford Government who are the members of that command centre, and what its mandate includes. As with all our other inquiries, the Ford Government has refused to answer.

Part of this communication strategy seems to be the repetition of bogus arguments to defend the critical care triage protocols disability discrimination. In the April 20, 2021 AODA Alliance Update, we listed some of those bogus arguments.

In the April 26, 2021 Metroland report set out below, yet another bogus defence is offered, as follows, quoting Dr. Downar:

“Regarding disability concerns, he added that the protocol will also ensure patients are being compared across different conditions the same way.

“There’s cancer guidance that applies only to people with cancer, heart failure guidance that only applies to people with heart failure, the frailty scale is only applied to people with frailty,” he explained. “It’s not applied to everybody who has a disability.””

As in other contexts which we document in the April 20, 2021 AODA Alliance Update, this absurd argument presupposes that disability discrimination only exists if you discriminate against all people with disabilities at the same time. By that bankrupt approach, Nazi Germany’s viciously anti-Semitic Nuremberg laws did not discriminate because of religion. That is because they only applied to Jews and equally applied to all Jews. It would similarly justify separate schools for black children, as was the case in the US for decades, under the widely denounced 1896 U.S. Supreme Court ruling in Plessy v. Ferguson.

The Supreme Court of Canada wisely rejected such an impoverished approach to equality decades ago, in Andrews v. Law Society of BC, where the Court stated:

“The test as stated, however, is seriously deficient in that it excludes any consideration of the nature of the law. If it were to be applied literally, it could be used to justify the Nuremberg laws of Adolf Hitler. Similar treatment was contemplated for all Jews. The similarly situated test would have justified the formalistic separate but equal doctrine of Plessy v. Ferguson, 163 U.S. 637 (1896), …”

We encourage the Ford Government to get their human rights legal advice from the Ontario Human Rights Commission and human rights experts, and not from physicians.

Another bogus and misleading part of this communication strategy is to try to misleadingly water down what critical care triage is. If a patient is refused critical care triage, they are bound to die. Yet part of the communication strategy on which we pull back the curtain is to claim that no one will be refused care. The April 26, 2021 Metroland article, set out below, includes this:

“What would triaging look like in Ontario?

“It’s really important to note that with emergency standards of care, no patient is not going to get care,” said Dr. Randy Wax, a critical care doctor who is also a lead at the Ontario Critical Care COVID-19 Command Centre.”

Let’s decode this. If you are refused critical care you need, you won’t be kicked right out of the hospital. You will be offered some lesser form of care, like palliative care. However, that is not the care you need to have any hope o of surviving.

This would be like someone who gets a gunshot wound who is told that they can’t have surgery they need to survive, and then being told: “But we are not refusing you care. Here’s an aspirin.”

Later in this Update, a May 5, 2021 article from CBC news online includes some of the same dubious defences. It gives no attention to voices from the disability community. This appears to be another story that could well be part of the communication strategy being conducted on behalf of the Ford Government’s Critical Care COVID Command Centre, to manage public expectations.

 5. Due to Protracted and Harmful Government Secrecy, Media Must Continue to Rely on Leaks to Report on Ontario’s Critical Care Triage situation

In a May 4, 2021 news report set out below, The Globe and Mail reported that Ontario’s ICU overload may be levelling off. This could avoid the need for The Government to green light rationing or triage of critical care, even though, as noted above, this appears to be going on already in our health care system in one form or another.

It is worrisome that the Globe and Mail report is based on a leaked internal memo. Those making these decisions are still cloistered behind closed doors.

That leak could have come from an aggrieved doctor working in the system. On the other hand, it could well have come from an official at the Ministry of Health, the Premier’s office or Ontario Health. They are taking heat for the critical care triage issue. Such a leak would help deflect some of that pressure. It could lead some reporters to think (wrongly, if so) that there is no longer a story here to cover, when it comes to disability discrimination in critical care triage. However, Ontario is certainly not out of the woods by any means.

 6. Disability Accessibility, the Ford Government and the Big Picture

The Ford Government’s delays on disability accessibility just carry on. There have now been 826 days, or over 2 and a quarter years, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no effective plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis. The Ontario Government only has 1,336 days left until 2025, the deadline by which the Government must have led Ontario to become fully accessible to people with disabilities.

            MORE DETAILS

 Toronto Sun April 28, 2021

Originally posted at https://torontosun.com/news/local-news/to-live-or-die-waves-of-covid-reality-hit-torontos-paramedics

TO LIVE OR DIE: Waves of COVID reality hit Toronto’s paramedics

Struggling to keep up with Toronto’s third wave, city paramedics say they’re having to ‘triage’ cardiac arrest patients

Author of the article: Bryan Passifiume

Paramedics wheel a patient into the emergency department at Mount Sinai Hospital in Toronto, Wednesday, Jan. 13, 2021. PHOTO BY COLE BURSTON /The Canadian Press

As soon as the call clears, another one’s loaded and ready.

And these days, it’ll most likely be another COVID patient.

That’s the reality for Toronto’s paramedics, who say nobody among their ranks thought COVID-19’s third wave would be this bad.

“You just don’t believe the news, the news says hospitals are overwhelmed, but are they?” said a veteran Toronto advanced-care paramedic, whom the Toronto Sun agreed not to identify.

“From the horse’s mouth: we’re seeing it — that’s something we’re all now realizing.”

While Toronto’s professional lifesavers have indeed been busy this past year, he told the Sun things really started to get bad earlier this month.

In fact, he remembers the exact call.

“Honestly, it was three weeks ago,” he said, describing the short-of-breath 30-something male he and his partner were dispatched to assist.

“This guy had a fever and couldn’t get up, and we’re like, ‘Oh, damn,’” he recalled.

“He had a room-air sat of 50%.”

Patients with blood-oxygen levels that low are almost always unconscious. In fact, anything below 90% is cause for concern.

Called “silent hypoxia,” it’s one of this pandemic’s biggest medical mysteries: how patients with such dangerously low oxygen levels show little outward evidence of their dire condition.

“They don’t even look tired,” he said.

“Then you check them and realize … ‘Dude, really?! You don’t feel this?! We need to go to the hospital.’”

It’s this deceptive pathology that makes COVID such a challenge.

“It causes moments where the patient looks OK, but they’re actually really, really bad,” he said, adding those patients often crash quickly and catastrophically.

What sticks out the most are the ages — and a lack of comorbidities — of those going into the back of his ambulance.

“Waves one and two were elderly people,” he said.

“Now we’re averaging late 40s.”

What irks him and his co-workers most are those who dismiss COVID as a bad flu.

“Influenza doesn’t make your O2 (oxygen) saturation drop below your age,” he said.

“We’re seeing patients with oxygen levels not seen without opioids in play, and neither Narcan nor oxygen are going to fix it.”

Emergency rooms and ICUs are full, he said — with many receiving care in the ER normally seen in intensive care.

“That’s what overcapacity means,” he said.

“It means that there’s people in emerge receiving ICU treatment — and that’s not the place for it.”

A paramedic transports a patient to Mount Sinai Hospital in Toronto, April 17, 2020.

City Council orders check-up on Toronto paramedics

Erik Sande is the president of Medavie Health Services.

SANDE: Paramedics answer the call — across Ontario’s health system

A Region of Durham Paramedic Services ambulance.

Gravely-ill patients more likely to be pronounced dead at scene

As city hospitals steel themselves for worst-case triage protocols, paramedics say it’s a reality they’re already experiencing.

Overrun emergency rooms and intensive-care units put paramedics in the position — as well as the base physic

ians overseeing them — of having to pronounce gravely ill patients, particularly in cases of cardiac arrest, deceased on scene rather than going through the usually hopeless motions of seeking hospital treatment.

“I haven’t actively run a cardiac arrest in the past five I’ve done,” said the Toronto advanced-care paramedic.

“We just said to the family, ‘Do you want anything done?’”

Cardiac arrest, particularly in older patients, is a dire medical emergency with less than 10% survival rates, according to the Heart and Stroke Foundation.

The COVID emergency, the paramedic said, means they’re more likely to pronounce such patients dead over pursuing lifesaving efforts that only serve to prolong the inevitable.

Except in cases of obvious and catastrophic trauma, paramedics seek guidance on pronouncing death from physicians over the phone.

“I got a pronouncement in 20 seconds the other day,” the paramedic said.

The alternative, he said, is often worse.

“If you get them back, where are they going to go, into the ICU to live for a day on a vent and die?” he said.

“The family’s able to see them now, be with them — there’s no closure bringing (the patient) to the hospital where, oh by the way, they can’t come.”

This leads to paramedics forced into end-of-life discussions with grieving family members.

“You know who does those? Doctors. Doctors have those conversations,” he said.

“Now, it’s us.”

Experts, including outspoken critical care physician Dr. Michael Warner, are warning Toronto’s hospitals are just days away from ICU triage, where decisions are made on who is and isn’t entitled to lifesaving care.

“The way Dr. Warner’s talking about how we don’t want to have to triage ICU patients, we are now triaging cardiac arrest patients,” the paramedic said. “If bringing this person back or giving them hope means only living for one more day on a ventilator … man, no. Let them go.”

Families forced to make this decision, he said, are almost always grateful.

“They say ‘Thank you for not working on them, thank you for letting them pass as peacefully as possible,” he said.

“Then you walk out, do your paperwork, grab a coffee, then go on to the next one.”

[email protected]

On Twitter: @bryanpassifiume

 Global News April 27, 2021

Originally posted at https://fm96.com/news/7812658/covid-ontario-icu-emergency-triage/

Pushing Ontario’s ICUs to the brink: How some hospitals are preparing for the worst FM96 London

Rachael D’Amore GlobalNews.ca

More than a year into the COVID-19 pandemic, Ontario doctors and nurses may have more experience treating the disease but are increasingly staring life-or-death decisions in the face.

The spike in cases has strained intensive care capacity across the province. There are about 875 COVID-19 patients in Ontario hospital ICUs as of Tuesday — an all-time high — and 589 people in intensive care units (ICUs) on a ventilator. With staffing shortages — particularly the lack of ICU-trained nurses — and beds rapidly filling up, discussions about the possible need to triage life-saving care are mounting.

A “critical care triage protocol,” something that was not done during earlier waves of the virus, could be enacted, meaning health-care providers may have to decide who gets potentially life-saving care and who doesn’t.

“If you’ve ever participated in a fire drill, you understand what we’re talking about here,” said Dr. James Downar, a palliative and critical care physician in Ottawa who co-wrote Ontario’s ICU protocol.

“The purpose of training is to be prepared because if a crisis arrives and you run out of your resources and you don’t have a plan and you’re not prepared to institute your plan, things will get very, very bad.”

Ontario hospitals received a document in January laying out guidelines on how to deal with critical care triage. In other words, what to do if there aren’t enough ICU beds.

Under those guidelines, patients are essentially ranked on their likelihood to survive one year after the onset of a critical illness. The process came under criticism from human rights advocates, saying it is discriminatory, particularly toward people with disabilities and seniors.

At this point, the province has not finalized the protocol nor has it officially been published, but a widely circulating draft titled “Adult Critical Care Clinical Emergency Standard of Care for Major Surge” – said patients could be scored by doctors on a “short-term mortality risk assessment.”

The aim would be to “prioritize those patients who are most likely to survive their critical illness,” the document reads.

“Patients who have a high likelihood of dying within twelve months from the onset of their episode of critical illness (based on an evaluation of their clinical presentation at the point of triage) would have a lower priority for critical care resources,” it said.

The lists three levels of critical care triage:

  • Level 1 triage deprioritizes critical care resources for patients with a predicted mortality greater than 80 per cent.
  • Level 2 triage deprioritizes critical care resources for patients with a predicted mortality greater than 50 per cent.
  • At Level 3 triage, patients with predicted mortality of 30 per cent — or a 70 per cent chance of surviving beyond a year — will not receive critical care.

At this level, clinicians may abandon the short-term mortality predictions in favour of randomization, which the document noted is to be used “as a last resort” and should be conducted by an administrator, not by bedside clinicians.

The leaked document was prepared by the province’s critical care COVID-19 command centre, which would ultimately declare when to use it.

Hundreds of COVID-19 ICU patient transfers planned as Ontario braces for ‘horrific’ 2 weeks

The College of Physicians and Surgeons of Ontario told doctors on April 8 that the province was considering “enacting the critical care triage protocol,” and that it would support such a tool once it is “initiated by the command tables of the province” and “even when doing so requires departing from our policy expectations.”

Downar emphasized that the protocol has not been instituted, echoing Ontario Health Minister Christine Elliott who on April 7 said “there are some emergency protocols out there” but they “have not finalized any of that yet.”

“None of us want to be in this position, none of us want to be doing this,” said Downar. “We are prepared for it if it comes to that, but we are focused on not letting it come to that.”

While a standard provincial protocol has not been formally established, some Ontario hospitals have been preparing anyway.

The University Health Network (UHN), which includes Toronto General, Toronto Western and Princess Margaret hospitals, have started virtual training sessions for staff on what to do if the virus’ growth gets the better of all other efforts to expand and accommodate the ICU system.

Dr. Niall Ferguson, the head of critical care at UHN, said while preparations for worst-case scenarios are happening, it doesn’t necessarily mean they’ll be enacted.

“We’re not expecting to be implementing them anytime in the near future… I think the likelihood is probably low,” he told Global News.

“COVID is more like a controlled train crash as opposed to an actual train crash where you’ve got a thousand critically ill people all on the same day — then triage is inevitable. When you’re getting a thousand critical care patients over the course of weeks, which we are here, then there is an opportunity to adapt the system and grow capacity and do things differently.”

Ontario’s latest modelling predictions cast doubt on short-term improvements. Even as cases slow or plateau, hospitalizations and ICU numbers are so-called “lagging indicators” of the severity of the virus in a certain jurisdiction. The provincial data predicts a peak of at least 1,500 virus cases in ICUs by the first week of May — that’s next week — and it could be higher, pushing Ontario’s total 2,000-ICU-bed capacity over the edge.

Downar said some training around emergency care standards has been “going on for months.”

He said avoiding the worst-case scenario depends on a lot of things and is not as simple as “staring at the number of COVID cases.”

“It’s tough. Everybody wants to know a number and everybody wants to know where that line is, but it’s just not something that is easily put into numbers at the moment.”

What’s unfolded over the past few weeks exemplifies just how bad it’s gotten — but also how the system has been forced to adapt, as Ferguson said. Hundreds of patients from already over-capacity hospitals in the Greater Toronto Area are being transferred to other hospitals hours away. The province has directed hospitals to “ramp down” all elective and non-emergency surgeries to help alleviate pressure on the health-care system.

“Transfers are not completely benign. There is a risk when we transfer people from one place to another,” Downar said. “It’s important for everybody to recognize that there already consequences to what we’ve been doing.”

 Metroland DurhamRegion.com April 26, 2021

Originally posted at https://www.durhamregion.com/news-story/10381003-what-would-triaging-patients-look-like-in-ontario-s-hospitals-if-invoked-/

What would triaging patients look like in Ontario’s hospitals if invoked?

Protocol created to ‘counteract implicit biases and subjectivity’

Veronica Appia

OurWindsor.Ca

Monday, April 26, 2021

This story is Part Two of a two-part explainer about the current surge of patients in Ontario’s intensive care units amid the third wave of COVID-19, and the possibility of the province invoking the Emergency Standard of Care protocol. Read Part One here.

Amid a rise in ICU admissions across the province, medical experts have been discussing the possibility of invoking the Emergency Standard of Care protocol, released by the Ontario Critical Care COVID-19 Command Centre earlier this year, which includes three triaging scenarios.

Dr. David Neilipovitz, the department head of critical care at the Ottawa Hospital and a lead at the Ontario Critical Care COVID-19 Command Centre, said it’s important to note that the Emergency Standard of Care protocol has different aspects to it and “not everything is triage.”

“Triage has a different connotation,” he said, adding that this would typically mean withdrawing care from patients without their family’s consent.

Neilipovitz said that while the Emergency Standard of Care protocol has similar aspects, there is no withdrawal of care.

What would triaging look like in Ontario?

“It’s really important to note that with emergency standards of care, no patient is not going to get care,” said Dr. Randy Wax, a critical care doctor who is also a lead at the Ontario Critical Care COVID-19 Command Centre.

Rather, he said, it would be a matter of determining other appropriate ways to support the patients that would not have access to critical care.

“The whole principle of triage is to try to maximize the number of lives saved with the resources that you have and so, in general, the concept is we want to be able to identify patients who are most likely to benefit from receiving IC services,” Wax noted.

Dr. James Downar, a palliative and critical care specialist who was responsible for creating the protocol, added that the decision as to who would have access, under the protocol, would solely be determined by mortality risk.

Is triaging patients a likely reality for Ontario’s hospitals?

“Everybody who would be considered for critical care would have two separate assessments performed by qualified physicians to assess what would be felt to be their short-term mortality risk and they would use their clinical judgment, aided by the guidance provided,” he said, adding that in cases where there is insufficient data or disagreement between physicians, the hospital would take the most optimistic approach.

What are the human rights implications?

The concept of triaging has been cause for concern for human rights advocates and disability groups.

In an April 22 statement to Metroland, Ena Chadha, chief commissioner of the Ontario Human Rights Commission (OHRC), said the Emergency Standard of Care protocol “includes potentially discriminatory triage criteria, should doctors be forced to decide who gets access to critical care and who does not.”

She stated that since December 2020, human rights groups and vulnerable populations have not been consulted on the protocol.

On April 9, the OHRC issued a public statement asking the government to provide the status of the Emergency Standard of Care protocol, confirm that the Health Care Consent Act prevails to protect the rights of patients and families, consult human rights stakeholders and require hospitals to collect data about the populations most affected by COVID-19.

In response to these concerns, Downar said that the reason the protocol was created in the first place was to ensure there wouldn’t be any human rights concerns in these scenarios.

“When human beings are overwhelmed and confronted by difficult decisions in emotional situations, that’s where implicit biases and subjectivity become major factors and undermine decision-making,” he said.

“You counteract that with explicit guidance and consistent rules.”

Regarding disability concerns, he added that the protocol will also ensure patients are being compared across different conditions the same way.

“There’s cancer guidance that applies only to people with cancer, heart failure guidance that only applies to people with heart failure, the frailty scale is only applied to people with frailty,” he explained. “It’s not applied to to everybody who has a disability.”

Veronica Appia is a reporter with Torstar Corporation Community Brands, covering COVID-19 news across Ontario.

 The Globe and Mail May 4, 2021

Memo says Ontario hospitals may avoid triage protocol

By JEFF GRAY

Staff

Ontario’s hospitals, despite facing an unprecedented strain from COVID-19, will likely escape the pandemic’s third wave without resorting to a triage protocol that would have forced doctors to decide who lives and who dies, according to a memo obtained by The Globe and Mail.

Doctors and hospital officials warn that weeks of tough public-health restrictions are still needed to keep slowing the virus’s spread. Hospitals will also need to keep increasing their already ballooned intensive-care capacity, postponing non-emergency operations and helicoptering patients from jammed facilities in hot spots to other beds across the province.

As of Monday, Ontario had 881 COVID-19 patients in its ICUs, more than double the total from just a month ago.

But the rate of increase appeared to be slowing. (In all, there were just over 2,000 patients of all kinds in the province’s ICUs.)

In a message to hospital chief executives dated May 2, Andrew Baker, the incident commander of the province’s critical-care COVID-19 command centre, says recent provincial modelling is still “concerning,” even as it shows a lower estimated number of COVID-19 ICU admissions than it did two weeks ago.

The memo asks hospitals to put 284 more ICU beds, already identified as ready to go at short notice, into operation and to prepare to receive more transferred patients. And it says the command centre will monitor staffing levels, and the effects of recent moves to transfer more elderly patients into long-term care homes, to determine whether hospitals should try to create even more critical-care capacity.

But the memo adds that it now looks as though the worst can be avoided: “I also wanted to share with you and your teams that we are increasingly confident that we will not need to activate the Emergency Standard of Care or recommend the use of the triage protocol.”

Requests for comment from Dr. Baker, who is chair of the critical-care department at St. Michael’s Hospital in Toronto, were referred to Ontario Health, the government agency that oversees health care in the province.

Ontario Health executive vice-president Chris Simpson, also a Kingston cardiologist, said the worst-case scenario from the most recent modelling by the province’s external COVID-19 Science Table – which projected the potential for more than 1,400 COVID-19 patients in the province’s ICUs by month’s end – would mean triage could be necessary.

But the province appears to be tracking the modelling’s mid-range scenario, in which ICU admissions crest around 1,000 before descending gradually.

“I think that scenario, if that were to unfold, does keep us out of triage-tool territory,” Dr. Simpson said. “But only because of the extra capacity that we have been able to bring online.”

He cautioned that the stresses on the system were already having effects on the quality of care for patients. He also raised concerns there could be “tremendous pressure” to reopen the province too quickly if cases continue to plateau or fall.

Doing so, he warned, could plunge the province into a fourth wave.

Kevin Smith, president and CEO of University Health Network, which includes Toronto General, Toronto Western and Princess Margaret hospitals, said even as numbers appear to be levelling off, hospitals and their staff are stretched past their normal limits. To avoid the worst, he said Ontarians need to keep following strict public-health rules, get vaccinated as quickly as possible and not let their guard down over the May long weekend.

“I would certainly hate for anyone to think that this is a time to relax,” he said.

“Absolutely that is not the case.”

Anthony Dale, president and CEO of the Ontario Hospital Association, said the science table predictions are cause for hope, noting that daily new infection numbers have been moderating. (Ontario recorded 3,436 new cases on Monday, down from a peak of more than 4,800 in mid-April.)

But he said nothing about COVID-19 can be taken for granted. Even if these encouraging trends continue, he said, the health care system will still be in a state of massive disruption for months, noting that more than 250,000 operations have been postponed in the pandemic.

“There’s nothing natural or normal about any of this,” Mr. Dale said.

Ontario’s triage protocol has been clouded by secrecy. A draft was only made public after a leaked copy was obtained by a disability rights group. Under the plans, incoming patients would be assessed for their likelihood of survival after 12 months. Those with the best chances would be prioritized for ICU beds.

 CBC Online News May 5, 2021

Originally posted at: https://www.cbc.ca/news/canada/toronto/doctors-describe-critical-care-triage-training-as-surreal-emotional-1.6013411

Doctors express relief, cautious optimism at news Ontario will likely avoid triage protocol

Province says no triage model has been activated in Ontario at this time

Talia Ricci CBC News

Dr. Shajan Ahmed says most of his colleagues had never done any kind of triage training before. He was part of a group of physicians at UHN who participated in mock scenarios during the second wave. (Submitted/Shajan Ahmed)

Dr. Shajan Ahmed says he always thought of triage training as something needed in other countries or in war zones, where doctors must decide who gets potentially life-saving care and who doesn’t.

So when the emergency room physician with Toronto’s University Health Network found himself watching a webinar about it to help prepare doctors for the third wave of COVID-19, he says he was in a bit of shock.

“To come to grips with this being right at our [doorsteps] here in Toronto, a place where we have all kinds of resources, it was really bizarre, it was surreal,” he told CBC Toronto.

“None of us had trained for it before and none of us really signed up for this, to be honest with you.”

Ahmed was among a group of around 60 physicians who received the training earlier this year. It included running through mock cases, reading material and referencing online resources. The virtual sessions were conducted over Zoom with experts in simulation, ethics and palliative care.

The province says no triage model has been activated in Ontario at this time, and although the overall number of ICU admissions climbed to 900 for the first time last Saturday, the rate of increase appears to have started to slow down. In a memo obtained by CBC News directed to hospital CEOs, Andrew Baker, the incident commander of the province’s critical-care COVID-19 command centre, says projections remained “very concerning.” But the memo also adds they are “increasingly confident” that they will not need to recommend the use of the triage protocol.

But the prospect still weighs on the minds of some doctors, and for Ahmed, the training made the situation feel “very real.”

Hospitals in Ontario may not have to use triage protocol, memo says

“You read about it and you think it may come, but until you are actually doing the training it doesn’t feel real until that point,” he said, adding the sessions were more challenging than he anticipated.

“We would debrief after the sessions to talk about how it felt, and what was going through our minds and collectively everyone had to take a deep breath and, I guess, also a bit of a sigh of relief because we aren’t actually in this situation.”

Despite describing the current situation in GTA hospitals as “bursting at the seams,” Ahmed wants people to know if the triage model is activated, patients will still be cared for. The decision is not whether someone lives or dies but whether the person would be offered ICU level care.

“It’s very complex and there’s a lot of logistics involved but I don’t want the public to think we’re making decisions as to booting people to the street without providing care,” he said.

“We absolutely will provide care.”

Compassionate conversations part of the training

Dr. Erin O’ Connor, the deputy medical director of the University Health Network’s emergency departments, was part of the team that led the training.

“There’s a lot of emotion around this and this isn’t something any physician or any health-care provider wants to do, but when we were getting ever closer to it we realized we needed to prepare ourselves,” she said.

She adds that conversations with patients and their families were a big part of it.

“It helped people find the right way to say this kindly and empathetically and to also recognize and process their own emotions around it.”

Dr. Erin O’Connor is the deputy medical director of emergency departments at Toronto’s University

Health Network. O’Connor describes the process as an application of tools to help determine how likely someone is to survive and their likelihood of survival after a year of any acute illness, not just COVID-19. She says the team looked at five cases that represented typical situations in the emergency department and had participants evaluate the patients’ chances of survival.

“It was a little bit of how you would apply the tools to different cases, so it wasn’t so abstract,” she explained. She says the whole point of developing the short term mortality risk tools was to remove any bias from the system.

Canadian Armed Forces sending teams to Ontario as COVID-19 cases strain critical care capacity

“It was very clearly laid out that decisions cannot be made based on race, gender, economic status, disability, or age. This is really looking at as much as possible the medical factors that contribute to whether someone has a high chance of survival at a year,” she said.

Resources have been expanded through bringing health-care workers from other parts of the country, redeploying and retraining health-care workers, cancelling surgeries, bringing in more ventilators and transferring patients from hot-spot areas, among other measures. The Ministry of Health says the province continues to create additional hospital beds in the province, including the creation of two mobile health units.

“The logistics have been massive. But all of these things are being done to prevent us from getting into a position where we have to triage resources,” O’Connor said.

She says she’s feeling cautiously optimistic given the recent trends.

“We’re not out of the woods yet because we know patients stay in the ICU for a long time but we are slightly backing away from the need to use this.”

But Ahmed still thinks about it, and is still concerned about the current state of ICUs. He’s encouraging people to have conversations with loved ones about their goals of care.

“A lot of us lose sleep over it.”

ABOUT THE AUTHOR

Talia Ricci

Talia Ricci is a CBC reporter based in Toronto. She has travelled around the globe with her camera documenting people and places as well as volunteering. Talia enjoys covering offbeat human interest stories and exposing social justice issues. When she’s not reporting, you can find her reading or strolling the city with a film camera.



Source link

New Captioned Video Tells the Whole Disability Discrimination Story in Ontario’s Critical Care Triage Plan and More Media Reports Reveal More Cause for Worry


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

May 6, 2021

SUMMARY

Here are six more important developments in our campaign to protect people with disabilities from disability discrimination in Ontario’s critical care triage protocol.

1. New Captioned Video — Learn About the Disability Issues in Ontario’s Critical Care Triage Protocol

Day after day, you are getting so much information from us and others about the critical care triage issue for people with disabilities. That includes all the new information we report in this AODA Alliance Update.

Are you eager for a video that will explain what this is all about, from beginning to end? Check out the new captioned video by AODA Alliance Chair David Lepofsky where the whole story is explained. The video brings you up to date as of now. It explains the disability objections to the Ontario critical care triage, the troubling way the Ontario Government his dealing with this issue, and the bogus defences that the Government’s defenders have been giving the media, in their attempt to justify what the Government is doing.

We invite you to watch the video and share it with others. If you are teaching a course where this might be helpful, feel free to use this video. It is available at https://youtu.be/Ju8cyH7TbQo

Let us know what you think. Email your feedback to us at [email protected]

2. Where is the Public Accountability for Critical Care Triage Now Being Conducted by Ambulance Crews?

We have been warning for months about the danger of trickle down triage. For example, an ambulance crew, called to a medical emergency at your home, could decide whether or not to give a patient life-saving care, before they even get to hospital. We expect ambulance crews to do all they can to save lives, and not to decide whether or not to even try to save a life.

The Ford Government has refused to answer questions about this, whether from the AODA Alliance in writing or from the opposition in Question Period in the Legislature. In a very upsetting article in the April 28, 2021 Toronto Sun, set out below, it is evident that this triage is already going on.

This is a life and death issue. The public should daily be told how many lives are lost due to any form of triage, including this roadside triage. The Ford Government should now make public any directions to ambulance and emergency crews on this kind of triage. Protections need to be put in place to avert the danger of disability discrimination. We know that there is clear disability discrimination in the directions already sent to Ontario doctors, should they have to triage critical care services. There is no reason to be confident that there is no such danger if triage is done by ambulance crews before even reaching a hospital.

3. Who Exactly Will Live and Who Will Die if There is Critical care Triage in Hospitals? Behind Closed Doors, Practice Drills Have Been Going on For Months with No Public Accountability

The April 27, 2021 report by Global News, set out below, confirms that hospitals have been training for months on how to conduct critical care triage, in case it becomes necessary. This is all happening behind closed doors. We have no idea who ends up living and who ends up dying, according to these practice drills or simulations. We have no idea how differently the same case is decided from one hospital to the next, or from one doctor to the next. We have no word that anyone with human rights expertise is part of this, to alert doctors when they are running afoul of the Charter of Rights and the Ontario Human Rights Code. We have no idea if the Ford Government is monitoring any of this, to find out where its disability discriminatory Ontario critical care triage protocol needs to be fixed.

4. Pulling Back the Curtain on A Troubling and Misleading Media Strategy Now In Place, Seemingly Led by Those Behind Ontario’s Disability-Discriminatory Critical Care Triage Protocol

Those who are behind the creation and implementation of Ontario’s disability-discriminatory critical care triage protocol appear now to be conducting some sort of media public relations strategy to get out their version of this controversial issue. This appears to be underway to manage public expectations about critical care triage and to respond to some bad press that The Government has gotten on this issue. In the January 23, 2021 online webinar for doctors on the critical care triage protocol, those evidently at the centre of this indicated that they were planning such a communications strategy, to be later rolled out close to the time that critical care triage may become necessary.

Among the key people quoted in these stories include Dr. James Downar, co-author of the disability-discriminatory Ontario critical care triage protocol, and Dr. David Neilipovitz, a lead at the Ford Government’s secretive Critical Care COVID-19 Command Centre. We have asked the Ford Government who are the members of that command centre, and what its mandate includes. As with all our other inquiries, the Ford Government has refused to answer.

Part of this communication strategy seems to be the repetition of bogus arguments to defend the critical care triage protocols disability discrimination. In the April 20, 2021 AODA Alliance Update, we listed some of those bogus arguments.

In the April 26, 2021 Metroland report set out below, yet another bogus defence is offered, as follows, quoting Dr. Downar:

Regarding disability concerns, he added that the protocol will also ensure patients are being compared across different conditions the same way.

“There’s cancer guidance that applies only to people with cancer, heart failure guidance that only applies to people with heart failure, the frailty scale is only applied to people with frailty,” he explained. It’s not applied to everybody who has a disability.”

As in other contexts which we document in the April 20, 2021 AODA Alliance Update, this absurd argument presupposes that disability discrimination only exists if you discriminate against all people with disabilities at the same time. By that bankrupt approach, Nazi Germany’s viciously anti-Semitic Nuremberg laws did not discriminate because of religion. That is because they only applied to Jews and equally applied to all Jews. It would similarly justify separate schools for black children, as was the case in the US for decades, under the widely denounced 1896 U.S. Supreme Court ruling in Plessy v. Ferguson.

The Supreme Court of Canada wisely rejected such an impoverished approach to equality decades ago, in Andrews v. Law Society of BC, where the Court stated:

The test as stated, however, is seriously deficient in that it excludes any consideration of the nature of the law. If it were to be applied literally, it could be used to justify the Nuremberg laws of Adolf Hitler. Similar treatment was contemplated for all Jews. The similarly situated test would have justified the formalistic separate but equal doctrine of Plessy v. Ferguson, 163 U.S. 637 (1896),

We encourage the Ford Government to get their human rights legal advice from the Ontario Human Rights Commission and human rights experts, and not from physicians.

Another bogus and misleading part of this communication strategy is to try to misleadingly water down what critical care triage is. If a patient is refused critical care triage, they are bound to die. Yet part of the communication strategy on which we pull back the curtain is to claim that no one will be refused care. The April 26, 2021 Metroland article, set out below, includes this:

What would triaging look like in Ontario?
“It’s really important to note that with emergency standards of care, no patient is not going to get care,” said Dr. Randy Wax, a critical care doctor who is also a lead at the Ontario Critical Care COVID-19 Command Centre.

Let’s decode this. If you are refused critical care you need, you won’t be kicked right out of the hospital. You will be offered some lesser form of care, like palliative care. However, that is not the care you need to have any hope o of surviving.

This would be like someone who gets a gunshot wound who is told that they can’t have surgery they need to survive, and then being told: But we are not refusing you care. Here’s an aspirin.

Later in this Update, a May 5, 2021 article from CBC news online includes some of the same dubious defences. It gives no attention to voices from the disability community. This appears to be another story that could well be part of the communication strategy being conducted on behalf of the Ford Government’s Critical Care COVID Command Centre, to manage public expectations.

5. Due to Protracted and Harmful Government Secrecy, Media Must Continue to Rely on Leaks to Report on Ontario’s Critical Care Triage situation

In a May 4, 2021 news report set out below, The Globe and Mail reported that Ontario’s ICU overload may be levelling off. This could avoid the need for The Government to green light rationing or triage of critical care, even though, as noted above, this appears to be going on already in our health care system in one form or another.

It is worrisome that the Globe and Mail report is based on a leaked internal memo. Those making these decisions are still cloistered behind closed doors.

That leak could have come from an aggrieved doctor working in the system. On the other hand, it could well have come from an official at the Ministry of Health, the Premier’s office or Ontario Health. They are taking heat for the critical care triage issue. Such a leak would help deflect some of that pressure. It could lead some reporters to think (wrongly, if so) that there is no longer a story here to cover, when it comes to disability discrimination in critical care triage. However, Ontario is certainly not out of the woods by any means.

6. Disability Accessibility, the Ford Government and the Big Picture

The Ford Government’s delays on disability accessibility just carry on. There have now been 826 days, or over 2 and a quarter years, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no effective plan of new action to implement that report. That makes even worse the serious problems facing Ontarians with disabilities during the COVID-19 crisis. The Ontario Government only has 1,336 days left until 2025, the deadline by which the Government must have led Ontario to become fully accessible to people with disabilities.

MORE DETAILS
Toronto Sun April 28, 2021

Originally posted at https://torontosun.com/news/local-news/to-live-or-die-waves-of-covid-reality-hit-torontos-paramedics

TO LIVE OR DIE: Waves of COVID reality hit Toronto’s paramedics
Struggling to keep up with Toronto’s third wave, city paramedics say they’re having to ‘triage’ cardiac arrest patients

Author of the article: Bryan Passifiume
Paramedics wheel a patient into the emergency department at Mount Sinai Hospital in Toronto, Wednesday, Jan. 13, 2021. PHOTO BY COLE BURSTON /The Canadian Press As soon as the call clears, another one’s loaded and ready.

And these days, it’ll most likely be another COVID patient.

That’s the reality for Toronto’s paramedics, who say nobody among their ranks thought COVID-19’s third wave would be this bad.

You just don’t believe the news, the news says hospitals are overwhelmed, but are they? said a veteran Toronto advanced-care paramedic, whom the Toronto Sun agreed not to identify.

From the horse’s mouth: we’re seeing it that’s something we’re all now realizing.

While Toronto’s professional lifesavers have indeed been busy this past year, he told the Sun things really started to get bad earlier this month.

In fact, he remembers the exact call.

Honestly, it was three weeks ago, he said, describing the short-of-breath 30-something male he and his partner were dispatched to assist.

This guy had a fever and couldn’t get up, and we’re like, Oh, damn,’ he recalled.

He had a room-air sat of 50%.

Patients with blood-oxygen levels that low are almost always unconscious. In fact, anything below 90% is cause for concern.

Called silent hypoxia, it’s one of this pandemic’s biggest medical mysteries: how patients with such dangerously low oxygen levels show little outward evidence of their dire condition.

They don’t even look tired, he said.

Then you check them and realize Dude, really?! You don’t feel this?! We need to go to the hospital.’

It’s this deceptive pathology that makes COVID such a challenge.

It causes moments where the patient looks OK, but they’re actually really, really bad, he said, adding those patients often crash quickly and catastrophically.

What sticks out the most are the ages and a lack of comorbidities of those going into the back of his ambulance.

Waves one and two were elderly people, he said.

Now we’re averaging late 40s.

What irks him and his co-workers most are those who dismiss COVID as a bad flu.

Influenza doesn’t make your O2 (oxygen) saturation drop below your age, he said.

We’re seeing patients with oxygen levels not seen without opioids in play, and neither Narcan nor oxygen are going to fix it.

Emergency rooms and ICUs are full, he said with many receiving care in the ER normally seen in intensive care.

That’s what overcapacity means, he said.

It means that there’s people in emerge receiving ICU treatment and that’s not the place for it.

A paramedic transports a patient to Mount Sinai Hospital in Toronto, April 17, 2020. City Council orders check-up on Toronto paramedics
Erik Sande is the president of Medavie Health Services.
SANDE: Paramedics answer the call — across Ontario’s health system A Region of Durham Paramedic Services ambulance.

Gravely-ill patients more likely to be pronounced dead at scene
As city hospitals steel themselves for worst-case triage protocols, paramedics say it’s a reality they’re already experiencing.

Overrun emergency rooms and intensive-care units put paramedics in the position as well as the base physic
ians overseeing them of having to pronounce gravely ill patients, particularly in cases of cardiac arrest, deceased on scene rather than going through the usually hopeless motions of seeking hospital treatment.

I haven’t actively run a cardiac arrest in the past five I’ve done, said the Toronto advanced-care paramedic.

We just said to the family, Do you want anything done?’

Cardiac arrest, particularly in older patients, is a dire medical emergency with less than 10% survival rates, according to the Heart and Stroke Foundation.

The COVID emergency, the paramedic said, means they’re more likely to pronounce such patients dead over pursuing lifesaving efforts that only serve to prolong the inevitable.

Except in cases of obvious and catastrophic trauma, paramedics seek guidance on pronouncing death from physicians over the phone.

I got a pronouncement in 20 seconds the other day, the paramedic said.

The alternative, he said, is often worse.

If you get them back, where are they going to go, into the ICU to live for a day on a vent and die? he said.

The family’s able to see them now, be with them there’s no closure bringing (the patient) to the hospital where, oh by the way, they can’t come.

This leads to paramedics forced into end-of-life discussions with grieving family members.

You know who does those? Doctors. Doctors have those conversations, he said.

Now, it’s us.

Experts, including outspoken critical care physician Dr. Michael Warner, are warning Toronto’s hospitals are just days away from ICU triage, where decisions are made on who is and isn’t entitled to lifesaving care.

The way Dr. Warner’s talking about how we don’t want to have to triage ICU patients, we are now triaging cardiac arrest patients, the paramedic said. If bringing this person back or giving them hope means only living for one more day on a ventilator man, no. Let them go.

Families forced to make this decision, he said, are almost always grateful.

They say Thank you for not working on them, thank you for letting them pass as peacefully as possible, he said.

Then you walk out, do your paperwork, grab a coffee, then go on to the next one.

[email protected]
On Twitter: @bryanpassifiume

Global News April 27, 2021

Originally posted at https://fm96.com/news/7812658/covid-ontario-icu-emergency-triage/

Pushing Ontario’s ICUs to the brink: How some hospitals are preparing for the worst FM96 London

Rachael D’Amore GlobalNews.ca

More than a year into the COVID-19 pandemic, Ontario doctors and nurses may have more experience treating the disease but are increasingly staring life-or-death decisions in the face.

The spike in cases has strained intensive care capacity across the province. There are about 875 COVID-19 patients in Ontario hospital ICUs as of Tuesday an all-time high and 589 people in intensive care units (ICUs) on a ventilator. With staffing shortages particularly the lack of ICU-trained nurses and beds rapidly filling up, discussions about the possible need to triage life-saving care are mounting.

A critical care triage protocol, something that was not done during earlier waves of the virus, could be enacted, meaning health-care providers may have to decide who gets potentially life-saving care and who doesn’t.

If you’ve ever participated in a fire drill, you understand what we’re talking about here, said Dr. James Downar, a palliative and critical care physician in Ottawa who co-wrote Ontario’s ICU protocol.

The purpose of training is to be prepared because if a crisis arrives and you run out of your resources and you don’t have a plan and you’re not prepared to institute your plan, things will get very, very bad.

Ontario hospitals received a document in January laying out guidelines on how to deal with critical care triage. In other words, what to do if there aren’t enough ICU beds.

Under those guidelines, patients are essentially ranked on their likelihood to survive one year after the onset of a critical illness. The process came under criticism from human rights advocates, saying it is discriminatory, particularly toward people with disabilities and seniors.

At this point, the province has not finalized the protocol nor has it officially been published, but a widely circulating draft titled Adult Critical Care Clinical Emergency Standard of Care for Major Surge said patients could be scored by doctors on a short-term mortality risk assessment.

The aim would be to prioritize those patients who are most likely to survive their critical illness, the document reads.

Patients who have a high likelihood of dying within twelve months from the onset of their episode of critical illness (based on an evaluation of their clinical presentation at the point of triage) would have a lower priority for critical care resources, it said.

The lists three levels of critical care triage:

Level 1 triage deprioritizes critical care resources for patients with a predicted mortality greater than 80 per cent.
Level 2 triage deprioritizes critical care resources for patients with a predicted mortality greater than 50 per cent.
At Level 3 triage, patients with predicted mortality of 30 per cent or a 70 per cent chance of surviving beyond a year will not receive critical care.

At this level, clinicians may abandon the short-term mortality predictions in favour of randomization, which the document noted is to be used as a last resort and should be conducted by an administrator, not by bedside clinicians.

The leaked document was prepared by the province’s critical care COVID-19 command centre, which would ultimately declare when to use it.

Hundreds of COVID-19 ICU patient transfers planned as Ontario braces for horrific’ 2 weeks

The College of Physicians and Surgeons of Ontario told doctors on April 8 that the province was considering enacting the critical care triage protocol, and that it would support such a tool once it is initiated by the command tables of the province and even when doing so requires departing from our policy expectations.

Downar emphasized that the protocol has not been instituted, echoing Ontario Health Minister Christine Elliott who on April 7 said there are some emergency protocols out there but they have not finalized any of that yet.

None of us want to be in this position, none of us want to be doing this, said Downar.We are prepared for it if it comes to that, but we are focused on not letting it come to that.

While a standard provincial protocol has not been formally established, some Ontario hospitals have been preparing anyway.

The University Health Network (UHN), which includes Toronto General, Toronto Western and Princess Margaret hospitals, have started virtual training sessions for staff on what to do if the virus’ growth gets the better of all other efforts to expand and accommodate the ICU system.

Dr. Niall Ferguson, the head of critical care at UHN, said while preparations for worst-case scenarios are happening, it doesn’t necessarily mean they’ll be enacted.
We’re not expecting to be implementing them anytime in the near future I think the likelihood is probably low, he told Global News.
COVID is more like a controlled train crash as opposed to an actual train crash where you’ve got a thousand critically ill people all on the same day then triage is inevitable. When you’re getting a thousand critical care patients over the course of weeks, which we are here, then there is an opportunity to adapt the system and grow capacity and do things differently.

Ontario’s latest modelling predictions cast doubt on short-term improvements. Even as cases slow or plateau, hospitalizations and ICU numbers are so-called lagging indicators of the severity of the virus in a certain jurisdiction. The provincial data predicts a peak of at least 1,500 virus cases in ICUs by the first week of May that’s next week and it could be higher, pushing Ontario’s total 2,000-ICU-bed capacity over the edge.

Downar said some training around emergency care standards has been going on for months.

He said avoiding the worst-case scenario depends on a lot of things and is not as simple as staring at the number of COVID cases.

It’s tough. Everybody wants to know a number and everybody wants to know where that line is, but it’s just not something that is easily put into numbers at the moment.

What’s unfolded over the past few weeks exemplifies just how bad it’s gotten but also how the system has been forced to adapt, as Ferguson said. Hundreds of patients from already over-capacity hospitals in the Greater Toronto Area are being transferred to other hospitals hours away. The province has directed hospitals to ramp down all elective and non-emergency surgeries to help alleviate pressure on the health-care system.

Transfers are not completely benign. There is a risk when we transfer people from one place to another, Downar said. It’s important for everybody to recognize that there already consequences to what we’ve been doing.

Metroland DurhamRegion.com April 26, 2021

Originally posted at https://www.durhamregion.com/news-story/10381003-what-would-triaging-patients-look-like-in-ontario-s-hospitals-if-invoked-/

What would triaging patients look like in Ontario’s hospitals if invoked? Protocol created to ‘counteract implicit biases and subjectivity’ Veronica Appia
OurWindsor.Ca
Monday, April 26, 2021
This story is Part Two of a two-part explainer about the current surge of patients in Ontario’s intensive care units amid the third wave of COVID-19, and the possibility of the province invoking the Emergency Standard of Care protocol. Read Part One here.

Amid a rise in ICU admissions across the province, medical experts have been discussing the possibility of invoking the Emergency Standard of Care protocol, released by the Ontario Critical Care COVID-19 Command Centre earlier this year, which includes three triaging scenarios.

Dr. David Neilipovitz, the department head of critical care at the Ottawa Hospital and a lead at the Ontario Critical Care COVID-19 Command Centre, said it’s important to note that the Emergency Standard of Care protocol has different aspects to it and “not everything is triage.”

“Triage has a different connotation,” he said, adding that this would typically mean withdrawing care from patients without their family’s consent.

Neilipovitz said that while the Emergency Standard of Care protocol has similar aspects, there is no withdrawal of care.

What would triaging look like in Ontario?
“It’s really important to note that with emergency standards of care, no patient is not going to get care,” said Dr. Randy Wax, a critical care doctor who is also a lead at the Ontario Critical Care COVID-19 Command Centre.

Rather, he said, it would be a matter of determining other appropriate ways to support the patients that would not have access to critical care.

“The whole principle of triage is to try to maximize the number of lives saved with the resources that you have and so, in general, the concept is we want to be able to identify patients who are most likely to benefit from receiving IC services,” Wax noted.

Dr. James Downar, a palliative and critical care specialist who was responsible for creating the protocol, added that the decision as to who would have access, under the protocol, would solely be determined by mortality risk.

Is triaging patients a likely reality for Ontario’s hospitals?

“Everybody who would be considered for critical care would have two separate assessments performed by qualified physicians to assess what would be felt to be their short-term mortality risk and they would use their clinical judgment, aided by the guidance provided,” he said, adding that in cases where there is insufficient data or disagreement between physicians, the hospital would take the most optimistic approach.

What are the human rights implications?
The concept of triaging has been cause for concern for human rights advocates and disability groups.

In an April 22 statement to Metroland, Ena Chadha, chief commissioner of the Ontario Human Rights Commission (OHRC), said the Emergency Standard of Care protocol “includes potentially discriminatory triage criteria, should doctors be forced to decide who gets access to critical care and who does not.”

She stated that since December 2020, human rights groups and vulnerable populations have not been consulted on the protocol.

On April 9, the OHRC issued a public statement asking the government to provide the status of the Emergency Standard of Care protocol, confirm that the Health Care Consent Act prevails to protect the rights of patients and families, consult human rights stakeholders and require hospitals to collect data about the populations most affected by COVID-19.

In response to these concerns, Downar said that the reason the protocol was created in the first place was to ensure there wouldn’t be any human rights concerns in these scenarios.

“When human beings are overwhelmed and confronted by difficult decisions in emotional situations, that’s where implicit biases and subjectivity become major factors and undermine decision-making,” he said.

“You counteract that with explicit guidance and consistent rules.”

Regarding disability concerns, he added that the protocol will also ensure patients are being compared across different conditions the same way.

“There’s cancer guidance that applies only to people with cancer, heart failure guidance that only applies to people with heart failure, the frailty scale is only applied to people with frailty,” he explained. “It’s not applied to to everybody who has a disability.”

Veronica Appia is a reporter with Torstar Corporation Community Brands, covering COVID-19 news across Ontario.

The Globe and Mail May 4, 2021

Memo says Ontario hospitals may avoid triage protocol

By JEFF GRAY
Staff
Ontario’s hospitals, despite facing an unprecedented strain from COVID-19, will likely escape the pandemic’s third wave without resorting to a triage protocol that would have forced doctors to decide who lives and who dies, according to a memo obtained by The Globe and Mail.

Doctors and hospital officials warn that weeks of tough public-health restrictions are still needed to keep slowing the virus’s spread. Hospitals will also need to keep increasing their already ballooned intensive-care capacity, postponing non-emergency operations and helicoptering patients from jammed facilities in hot spots to other beds across the province.

As of Monday, Ontario had 881 COVID-19 patients in its ICUs, more than double the total from just a month ago.

But the rate of increase appeared to be slowing. (In all, there were just over 2,000 patients of all kinds in the province’s ICUs.)

In a message to hospital chief executives dated May 2, Andrew Baker, the incident commander of the province’s critical-care COVID-19 command centre, says recent provincial modelling is still “concerning,” even as it shows a lower estimated number of COVID-19 ICU admissions than it did two weeks ago.

The memo asks hospitals to put 284 more ICU beds, already identified as ready to go at short notice, into operation and to prepare to receive more transferred patients. And it says the command centre will monitor staffing levels, and the effects of recent moves to transfer more elderly patients into long-term care homes, to determine whether hospitals should try to create even more critical-care capacity.

But the memo adds that it now looks as though the worst can be avoided: “I also wanted to share with you and your teams that we are increasingly confident that we will not need to activate the Emergency Standard of Care or recommend the use of the triage protocol.”

Requests for comment from Dr. Baker, who is chair of the critical-care department at St. Michael’s Hospital in Toronto, were referred to Ontario Health, the government agency that oversees health care in the province.

Ontario Health executive vice-president Chris Simpson, also a Kingston cardiologist, said the worst-case scenario from the most recent modelling by the province’s external COVID-19 Science Table – which projected the potential for more than 1,400 COVID-19 patients in the province’s ICUs by month’s end – would mean triage could be necessary.

But the province appears to be tracking the modelling’s mid-range scenario, in which ICU admissions crest around 1,000 before descending gradually.

“I think that scenario, if that were to unfold, does keep us out of triage-tool territory,” Dr. Simpson said. “But only because of the extra capacity that we have been able to bring online.”

He cautioned that the stresses on the system were already having effects on the quality of care for patients. He also raised concerns there could be “tremendous pressure” to reopen the province too quickly if cases continue to plateau or fall.

Doing so, he warned, could plunge the province into a fourth wave.

Kevin Smith, president and CEO of University Health Network, which includes Toronto General, Toronto Western and Princess Margaret hospitals, said even as numbers appear to be levelling off, hospitals and their staff are stretched past their normal limits. To avoid the worst, he said Ontarians need to keep following strict public-health rules, get vaccinated as quickly as possible and not let their guard down over the May long weekend.

“I would certainly hate for anyone to think that this is a time to relax,” he said.

“Absolutely that is not the case.”

Anthony Dale, president and CEO of the Ontario Hospital Association, said the science table predictions are cause for hope, noting that daily new infection numbers have been moderating. (Ontario recorded 3,436 new cases on Monday, down from a peak of more than 4,800 in mid-April.)

But he said nothing about COVID-19 can be taken for granted. Even if these encouraging trends continue, he said, the health care system will still be in a state of massive disruption for months, noting that more than 250,000 operations have been postponed in the pandemic.

“There’s nothing natural or normal about any of this,” Mr. Dale said.

Ontario’s triage protocol has been clouded by secrecy. A draft was only made public after a leaked copy was obtained by a disability rights group. Under the plans, incoming patients would be assessed for their likelihood of survival after 12 months. Those with the best chances would be prioritized for ICU beds. CBC Online News May 5, 2021

Originally posted at: https://www.cbc.ca/news/canada/toronto/doctors-describe-critical-care-triage-training-as-surreal-emotional-1.6013411 Doctors express relief, cautious optimism at news Ontario will likely avoid triage protocol Province says no triage model has been activated in Ontario at this time

Talia Ricci CBC News

Dr. Shajan Ahmed says most of his colleagues had never done any kind of triage training before. He was part of a group of physicians at UHN who participated in mock scenarios during the second wave. (Submitted/Shajan Ahmed)

Dr. Shajan Ahmed says he always thought of triage training as something needed in other countries or in war zones, where doctors must decide who gets potentially life-saving care and who doesn’t.

So when the emergency room physician with Toronto’s University Health Network found himself watching a webinar about it to help prepare doctors for the third wave of COVID-19, he says he was in a bit of shock.

“To come to grips with this being right at our [doorsteps] here in Toronto, a place where we have all kinds of resources, it was really bizarre, it was surreal,” he told CBC Toronto.

“None of us had trained for it before and none of us really signed up for this, to be honest with you.”

Ahmed was among a group of around 60 physicians who received the training earlier this year. It included running through mock cases, reading material and referencing online resources. The virtual sessions were conducted over Zoom with experts in simulation, ethics and palliative care.

The province says no triage model has been activated in Ontario at this time, and although the overall number of ICU admissions climbed to 900 for the first time last Saturday, the rate of increase appears to have started to slow down. In a memo obtained by CBC News directed to hospital CEOs, Andrew Baker, the incident commander of the province’s critical-care COVID-19 command centre, says projections remained “very concerning.” But the memo also adds they are “increasingly confident” that they will not need to recommend the use of the triage protocol.

But the prospect still weighs on the minds of some doctors, and for Ahmed, the training made the situation feel “very real.”

Hospitals in Ontario may not have to use triage protocol, memo says
“You read about it and you think it may come, but until you are actually doing the training it doesn’t feel real until that point,” he said, adding the sessions were more challenging than he anticipated.

“We would debrief after the sessions to talk about how it felt, and what was going through our minds and collectively everyone had to take a deep breath and, I guess, also a bit of a sigh of relief because we aren’t actually in this situation.”

Despite describing the current situation in GTA hospitals as “bursting at the seams,” Ahmed wants people to know if the triage model is activated, patients will still be cared for. The decision is not whether someone lives or dies but whether the person would be offered ICU level care.

“It’s very complex and there’s a lot of logistics involved but I don’t want the public to think we’re making decisions as to booting people to the street without providing care,” he said.

“We absolutely will provide care.”

Compassionate conversations part of the training
Dr. Erin O’ Connor, the deputy medical director of the University Health Network’s emergency departments, was part of the team that led the training.

“There’s a lot of emotion around this and this isn’t something any physician or any health-care provider wants to do, but when we were getting ever closer to it we realized we needed to prepare ourselves,” she said.

She adds that conversations with patients and their families were a big part of it.

“It helped people find the right way to say this kindly and empathetically and to also recognize and process their own emotions around it.”

Dr. Erin O’Connor is the deputy medical director of emergency departments at Toronto’s University
Health Network. O’Connor describes the process as an application of tools to help determine how likely someone is to survive and their likelihood of survival after a year of any acute illness, not just COVID-19. She says the team looked at five cases that represented typical situations in the emergency department and had participants evaluate the patients’ chances of survival.

“It was a little bit of how you would apply the tools to different cases, so it wasn’t so abstract,” she explained. She says the whole point of developing the short term mortality risk tools was to remove any bias from the system.

Canadian Armed Forces sending teams to Ontario as COVID-19 cases strain critical care capacity

“It was very clearly laid out that decisions cannot be made based on race, gender, economic status, disability, or age. This is really looking at as much as possible the medical factors that contribute to whether someone has a high chance of survival at a year,” she said.

Resources have been expanded through bringing health-care workers from other parts of the country, redeploying and retraining health-care workers, cancelling surgeries, bringing in more ventilators and transferring patients from hot-spot areas, among other measures. The Ministry of Health says the province continues to create additional hospital beds in the province, including the creation of two mobile health units.

“The logistics have been massive. But all of these things are being done to prevent us from getting into a position where we have to triage resources,” O’Connor said.

She says she’s feeling cautiously optimistic given the recent trends.

“We’re not out of the woods yet because we know patients stay in the ICU for a long time but we are slightly backing away from the need to use this.”

But Ahmed still thinks about it, and is still concerned about the current state of ICUs. He’s encouraging people to have conversations with loved ones about their goals of care.

“A lot of us lose sleep over it.”

ABOUT THE AUTHOR

Talia Ricci
Talia Ricci is a CBC reporter based in Toronto. She has travelled around the globe with her camera documenting people and places as well as volunteering. Talia enjoys covering offbeat human interest stories and exposing social justice issues. When she’s not reporting, you can find her reading or strolling the city with a film camera.




Source link

More Advocacy Action, More Media, and More Ford Government Secrecy on Ontario’s Disability-Discriminatory Plans for Critical Care Triage If Hospital ICUs Run Out of Space for All Patients Needing Life-Saving Care


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

April 14, 2021

SUMMARY

Disability advocacy keeps up the pressure on the critical care triage issue while the Ford Government keeps up the secrecy.

a) On April 13, 2021, the ARCH Disability Law Centre wrote the College of Physicians and Surgeons of Ontario. Its excellent letter is set out below. CPSO regulates Ontario physicians. ARCH echoed the AODA Alliance’s serious objections to the position on critical care triage that the CPSO sent to all Ontario doctors last week. The AODA Alliance s objections are set out in our April 9, 2021 letter and our April 13, 2021 letter to the CPSO, all of which we have made public.

ARCH’s letter amplified our disability concerns. We thank ARCH for its letter, and for working so closely together with the AODA Alliance and other disability advocates on this issue.

b) On April 13, 2021 Andrea Horwath, Ontario’s Leader of the Official Opposition, and Joel Harden, the Ontario NDP disability critic, released a strong statement on the critical care triage issue, also set out below. It blasts the Ford Government for its secret critical care triage protocol that wrongly discriminates based on disability. We thank the NDP for this action, and urge it to give this urgent issue as much public attention as possible.

c) On April 12, 2021, the Thunder Bay Family Network held a Zoom public forum to rally disability rights organizers and advocates in northern Ontario on the disability discrimination concerns with the Ontario critical care triage protocol and plan. AODA Alliance Chair David Lepofsky spoke at that event. A video of that event is posted on TBFN’s Facebook page. We congratulate TBFN and all those who attended and who made this such a success. We urge other organizations to hold similar events. We’d be delighted to help. Email the AODA Alliance at [email protected]

d) There continues to be some media attention on the critical care triage issue, but we need more of it!

We congratulate the fiery Dahlia Kurtz for her new national program on Sirius-XM Radio Channel 167, and applaud her for including AODA Alliance Chair David Lepofsky on that show’s third day on the air on April 14, 2021. That should be available later today at https://soundcloud.com/canadatalks

Below we set out the April 8, 2021 Toronto Star report on where the Ford Government stands on the idea of it agreeing in advance to pay all doctors’ claims for deaths due to critical care triage under the disability-discriminatory Ontario critical care triage protocol. We regret that the Toronto Star did not identify or address the disability issues here, as the Star last did several months ago.

We also set out below a column in the April 2, 2021 London Free Press. It identified AODA Alliance concerns with the Ford Government’s mishandling of the critical care triage issue.

e) The Ford Government’s delays on disability accessibility seem interminable. There have now been 804 days, or over 2 and a quarter years, since the Ford Government received the ground-breaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no 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. The Ontario Government only has 1,358 days left until 2025, the deadline by which the Government must have led Ontario to become fully accessible to people with disabilities.

For More on these issues, check out

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

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

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

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

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

6. You can also visit the AODA Alliance’s COVID-19 web page to see what we have been up to, trying to ensure that the needs of people with disabilities during the COVID-19 crisis are properly addressed. Send us your feedback! Write us at [email protected] Please stay safe!

MORE DETAILS

April 13, 2021 ARCH Disability Law Centre Letter to the College of Physicians and Surgeons of Ontario

55 University Avenue, 15th Floor
Toronto, Ontario M5J 2H7
www.archdisabilitylaw.ca
(416) 482-8255 (Main) 1 (866) 482-ARCH (2724) (Toll Free)
(416) 482-1254 (TTY) 1 (866) 482-ARCT (2728) (Toll Free)
(416) 482-2981 (FAX) 1 (866) 881-ARCF (2723) (Toll Free)

Sent via email at [email protected] and [email protected] April 13, 2021
Dr. Nancy Whitmore, Registrar and CEO
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, Ontario M5G 2E2

Dear Dr. Whitmore:

Re: Triaging of Critical Care in Ontario

I am writing on behalf of ARCH Disability Law Centre in response to your email correspondence to members of the College of Physicians and Surgeons of Ontario on April 8, 2021, and the College’s subsequent response to the AODA Alliance dated April 12, 2021. ARCH shares the concerns raised by the AODA Alliance in its April 9th and April 13th letters.

We understand and appreciate the context of your correspondence, and the need to respond to the challenging circumstances that this pandemic continues to thrust on our health care service providers including physicians and surgeons. We also understand the need for a plan as this third wave of the pandemic overwhelms hospitals and critical care resources.

Your email correspondence addresses physicians’ obligations regarding the withholding and withdrawing of critical care. You state that the College supports deviation from its policies in following triage frameworks as developed by the command table.

Respectfully, your stated intention to ensure public trust in decision-making is eroded by supporting a critical care triage protocol that has been kept secret, on which there has been no proper public consultation, and which has been subject to serious disability discrimination objections. Disability advocates, and other marginalized communities, have been outspoken for over a year since the first Triage Protocol draft was leaked, identifying serious unlawful discriminatory implications that have persisted and have not yet been remedied. In addition, your correspondence does not clarify that all actions by your members must be taken free from any discrimination. Human rights protections under Ontario’s Human Rights Code and the Canadian Charter of Rights and Freedoms continue to fully apply during a pandemic. It is precisely during times such as these that our human rights protections are most critical. We are concerned that the College’s messaging disregards and dispenses entirely with such human rights concerns, to the serious detriment of Ontario physicians and patients.

Moreover, in considering public interest and protecting the rights of our most vulnerable patients, any messaging by the College that supports a potentially discriminatory framework and contemplates limitations on patients’ rights such as the making of complaints to the College is troubling and inappropriate.

The public looks to the College to objectively and impartially decide any individual complaints against member physicians. It must not pre-decide issues on which it will have to rule. The public must be given confidence that its complaints process is a fair one. The College’s April 8, 2021 email to its members is inconsistent with that obligation, on a topic where the public needs a strong assurance, rather than a cause for concern.

We urge the College to rescind and clarify its message and ensure that its members understand their paramount human rights obligations during this pandemic, and their continued human rights obligations regardless of what triage frameworks are ultimately approved.

Sincerely,
ARCH Disability Law Centre
Robert Lattanzio
Executive Director

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

April 13, 2021 Statement by New Democratic Party on Critical Care Triage

April 13, 2021

Ford’s triage protocol needs public consultation and must respect disability rights

QUEEN’S PARK NDP Leader Andrea Horwath and MPP Joel Harden (Ottawa Centre), the NDP’s critic for Accessibility and Persons with Disabilities, said that as ICUs struggle to provide care for a rising number of people in critical condition, the provincial government must hold open consultations on the triage protocol and remove disability discrimination from it.

We all desperately hope the triage protocol will never have to be triggered, and there is more the provincial government can do to prevent that horrific scenario from playing out in Ontario. But preparing for life-and-death decisions about the lives of people, including people with disabilities, should not be done by the Ford government in secret, said Horwath. It’s time for this government to do the work it should have done months ago, and consult with disability and human rights groups, as well as Ontario families who will bear the consequences of these decisions.

Horwath and Harden said Doug Ford must stop ignoring human rights leaders and over 200 community organizations that wrote to the Ford government over a year ago exposing and denouncing its directions to Ontario hospitals on life-saving critical care that discriminates against people with disabilities. According to the Toronto Star, the Ford government is considering indemnifying critical care physicians from lawsuits which means the government is planning for doctors to have to make life-and-death decisions about allocating care, but is doing so behind closed doors.

“People with disabilities face a higher risk of getting and being severely impacted by COVID-19,” said Harden. “The Ford government must immediately remove disability discrimination from its clinical triage protocol, and respect the human rights of patients with disabilities.”

Toronto Star April 8, 2021

News

Originally posted at https://www.thestar.com/politics/provincial/2021/04/07/premier-doug-ford-instituting-province-wide-stay-at-home-order-expected-to-begin-thursday-sources-say.html

[Premier Doug Ford is vowing to have…]

Rob Ferguson, Robert Benzie and Kristin Rushowy Queen’s Park Bureau
Premier Doug Ford is vowing to have 40 per cent of adults vaccinated against COVID-19 – including essential workers over age 18 in Toronto and Peel Region hot spots – during Ontario’s 28-day stay-at-home order that begins Thursday.

Declaring a third state of emergency in a year, Ford said special education workers across the province and “all education workers in high-risk neighbourhoods in Toronto and Peel” would also begin getting shots during next week’s spring break, with dangerous variants of the virus spreading by the day.

The stay-at-home order, which could be extended, goes to May 6. The premier’s office said Ford’s 40 per cent vaccination target should get enough first doses to hot zones and quell transmission levels there.

“We need to get the vaccines where they will have the greatest impact as quickly as possible,” a sombre Ford said Wednesday, bowing to pressure from health experts and educators for targeted shots in trouble spots where outbreaks have resulted in younger adults being hospitalized at higher rates.

Vaccines will be sent to more hot zones in other municipalities as supplies allow.

“I am pleased with the pivot,” said Dr. Michael Warner, medical director of critical care at Michael Garron Hospital, formerly Toronto East General Hospital. He warned that adults under age 50 in ICUs are now dying at twice the speed of the first and second waves, with one fatality every 2.8 days.

For Toronto and Peel hot spots, Ford said mobile teams and pop-up clinics are being organized to give jabs to anyone over 18 living in highly impacted neighbourhoods.

The trigger for the second stay-at-home order since January was a sudden increase in admissions of critically ill Ontarians to hospital intensive care units above levels that had been predicted in the “worst-case” modelling scenarios, threatening the health-care system, Ford added.

“How we handle the next four weeks, what we do until we start achieving mass immunization, will be the difference between life and death for thousands of people,” he said, brushing aside criticisms that he should have acted sooner on the stay-at-home order given repeated warnings from his science advisers.

“Ford walked us right into this lockdown with eyes wide open,” New Democrat Leader Andrea Horwath told reporters.

“Experts made it clear every step of the way – he was reopening too quickly, taking away public health protections too soon, and implementing half-measures that would not stop the spread.”

With ICU admissions increasing, Health Minister Christine Elliott said the government is trying to boost hospital capacity. It has not yet prepared a cabinet order indemnifying intensive care physicians from liability in making difficult triage decisions as to which patients will get the resources needed to have the best chance to survive, she said.

“We haven’t finalized any of that.”

The province’s science advisers have cautioned the scenario seen last year in New York City and northern Italy, where ICUs were overwhelmed, would become reality in Ontario once patient levels of about 800 are reached in critical care.

The province is at 504 – a record in the pandemic – after a one-third rise in the last week and more admissions expected with the province averaging almost 3,000 new infections a day.

Elliott said many hospitals are at capacity, meaning there is no way for Ontario to vaccinate its way out of the situation and a four-week stay-at-home order is crucial to containing the virus and its highly contagious variants.

“The variants have won this round of the race,” Peel medical officer Dr. Lawrence Loh told a news conference in Brampton. “Close down, vaccinate, and get out of this.”

There were 3,215 new infections reported Wednesday – including 1,095 in Toronto and 596 in Peel – with 17 more deaths bringing the pandemic total to 7,475 fatalities.

The government limited retailers open for in-person shopping mainly to supermarkets, pharmacies, LCBO outlets, and takeout restaurants. Non-essential retailers go back to online sales and curbside pickup. Malls can designate one indoor location for customer pickup of items by appointment.

In a change from a similar order issued to quell the second wave in January, big box stores like Walmart and Costco will be limited to selling essential food, pharmacy, personal and pet care items.

Employees who can are asked to work from home and trips outside the home should be for essential reasons only, such as food shopping, medical appointments and exercise.

Close contact with anyone from another household is discouraged.

The changes came six days after the premier announced an Ontario-wide “lockdown” widely panned as inadequate since it just closed restaurant patios, indoor dining and personal services such as hair salons and barber shops that were open in areas outside Toronto and Peel, and not already in lockdown.

Toronto’s public and Catholic schools closed to in-person learning Wednesday, following in the footsteps of Peel Region schools the day before.

Ford rejected pressure from health experts and opposition parties to introduce a sick pay policy so that people with COVID-19 symptoms and without benefits can stay home if ill. Ford said a federal program is available.

The stay-at-home order is a dramatic turnaround from recent weeks, in which Ford allowed non-essential retailers in lockdown zones to open to 25 per cent customer capacity, raised indoor dining capacity limits in bars and restaurants outside lockdown areas and permitted sidewalk patios in Toronto and Peel.

There was also the promise that barber shops, hair and nail salons could open April 12 in Toronto, Peel and other regions elevated to lockdowns, but as infection levels grew across the province those hopes were dashed.

Cases of COVID-19 are up more than 70 per cent in the last two weeks.

London Free Press April 2, 2021

Originally posted at https://lfpress.com/opinion/columnists/baranyai-triage-framework-should-be-debated-if-public-is-to-have-confidence-as-third-wave-rises Baranyai: Triage framework should be debated as COVID’s third wave rises Author of the article: Robin Baranyai Special to Postmedia News A triage nurse waits for patients in the Emergency Department. (File photo)
Under normal circumstances, patient triage is about identifying who should be treated first: who needs resuscitation, and who can wait to have their broken wrist set. It is not a question of whether the patient receives the care they need, but when.

Last March, that assumption was turned on its head. The world watched in horror as Italy’s well-regarded health-care system, with 3.2 hospital beds per 1,000 people (compared to 2.5 in Canada), was overwhelmed.

The case for delaying the second vaccine dose
Faced with too many patients and too few ventilators, doctors were forced to decide on the fly where scant resources should be allocated. All too often, it came down to the patient’s age.

Canadians hope to avoid these unthinkable choices. As they say: Hope for the best, but plan for the worst.

Concerns again were raised this week about Ontario’s emergency standard of care, designed to provide consistent medical guidance on decisions should they become necessary about who receives care, by prioritizing resources for the patients most likely to survive. The protocol includes an online risk calculator for short-term mortality.

The protocol has been shared with Ontario hospitals, though not approved by the Ministry of Health, nor officially made public. The ministry has deflected queries to Jennifer Gibson, director of the University of Toronto’s joint centre for bioethics, and co-chair of the government’s bioethics table, which developed the triage framework.

It’s not shocking there is a protocol for making life-or-death care decisions, should hospital resources be overwhelmed. It would be shocking if there were not.

It is concerning, however, that an updated version of the protocol was brought to light by a disability advocacy group, and not by an open process of consultation, as recommended by both the bioethics table and the Ontario Human Rights Commission.

Under the protocol, two physicians would be involved in treatment decisions. The online tool allows doctors to input data on the severity of comorbid conditions, such as cancer, to help estimate patients’ odds of survival. Those with the best chance of surviving 12 months would be given priority for ICU beds.

The use of a clinical frailty scale (CFS) in risk calculations was flagged by the Accessibility for Ontarians with Disabilities Act (AODA) Alliance. It measures the ability to perform everyday tasks in patients older than 65. While a CFS may reduce the subjectivity of assessments, the AODA Alliance rightly points out, difficulty people with disabilities have with everyday tasks may have nothing to do with their odds of survival.

Similar concerns were raised by disability advocates in Quebec. An expert working group developed an emergency protocol last March, and the province held open consultations. The emergency protocol was revised after hearing from advocacy groups, including the Quebec Intellectual Disability Society.

Quebec’s protocol goes further than Ontario’s, establishing criteria by which patients could be removed from life support, if needed, without their consent. As yet, there is no mechanism in Ontario to prioritize treatment of patients with a higher likelihood of survival over those on life support.

This is deeply uncomfortable territory. It forces us to think about choices we’d rather not make, or have made for us. But if we want continued confidence in our health-care system, people need to know how these decisions could be made.

The hard choices of battlefield medicine may not be theoretical for long. At the height of the second wave in January, the number of COVID-19 patients in Ontario ICUs peaked at 420. As of Monday, there were 390.

The battle here is not only between patient care and system capacity. It is between communication and opacity; transparency and uncertainty. Transparency builds confidence.

[email protected]




Source link

As the COVID-19 Pandemic Again Worsens, Here’s Additional Media Coverage of the Ford Government’s Unwarranted Secrecy Over Ontario’s Seriously Flawed Critical Care Triage Protocol and Plans


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

April 1, 2021

SUMMARY

1. The News

The new and much more contagious COVID-19 variants are rapidly spreading. The media reports that Ontario hospital Intensive Care Units have more COVID-19 patients than ever. The Ford Government is understandably imposing more lock-down measures to stem the spread of the pandemic.

This all means that the risk of Ontario having to resort to rationing critical care, also called critical care triage, grows ever more imminent. Yet in contrast to regular public reports by the Ford Government on its plans for distributing the COVID-19 vaccine, the Government’s inexcusable secrecy over its dangerous critical care triage plans and protocol remains omnipresent. Below we set out two new media reports on this issue. We offer more reflections on this life-and-death story, one that deserves far more attention from other news organizations.

1. A CTV News online story that was posted on March 30, 2021 on the critical care triage issue. It also ran on the CTV Toronto 6 pm news on March 31, 2021.

2. A guest column on the critical care triage issue that ran in the March 4, 2021 Globe and Mail.

2. Some Reflections on the News

1. Amidst the recent coverage, and not-so-recent coverage, which media organizations are strikingly absent from the scene? Prominent among them is the CBC. CBC’s Ontario-based radio and TV local news programs have included NOTHING on the disability concerns with Ontario’s critical care triage plans in months. Yet Canada’s public broadcaster claims to have a strong commitment to inclusiveness and diversity in its coverage. We will later have more to say about this.

2. In the CTV news report set out below, attention focuses on the controversial online calculator which the AODA Alliance revealed to the public earlier this year. It was secretly created to help doctors and hospitals decide who will be refused life-saving critical care, if critical care triage becomes necessary.

The AODA Alliance’s February 25, 2021 report on Ontario’s seriously-problematic critical care triage plans made public the existence of this online life-and-death calculator that has been provided to Ontario hospitals and doctors. In the following excerpt from that report, the AODA Alliance also identified the very serious problems with this calculator. The AODA Alliances February 25, 2021 report states

Ontario Has Created a Seriously Flawed Online Calculator to Compute Who Will Be Refused Needed Life-Saving Critical Care During Triage

We were deeply troubled to discover from the January 23, 2021 webinar that Ontario has created an online Short Term Mortality Risk Calculator. It is supposed to calculate whether a patient will be refused needed life-saving critical care, if critical care triage is directed. It is at the website www.STMRCalculator.ca.

A triage physician can input information about a patient who needs critical care into this short term mortality risk calculator. The calculator then coldly spits out a number that gives the patient’s triage priority score. That number will determine whether a patient is eligible for critical care they need, or whether they will be refused critical care, depending on the level of critical care triage that has been directed. During the January 23, 2021 webinar, Dr. James Downar, reportedly the author of the January 13, 2021 Critical Care Triage Protocol and a member of the Bioethics Table, stated:

We’ve actually also got a calculator now that’s online that helps calculate these and gives the sort of you can punch in some clinical information. It will give you the answer.

The Government and its Ontario Critical Care COVID Command Centre and other related health bodies have never announced to the public the existence of this online calculator, to our knowledge. We have seen no indication that it has been successfully field-tested and/or peer-reviewed.

This short term mortality risk calculator is seriously objectionable. First, it wrongly and disrespectfully reduces a life-and-death decision about a seriously ill human being to a cold, digitized computation.

It risks giving triage doctors a false sense that it is the calculator that decides who lives and who dies. That wrongly diminishes a triage doctor’s needed alertness to their responsibility for their action. It is vital for triage doctors to own the triage decisions they make and feel fully responsible and accountable for them. This report later shows further concerns in that regard.

Second, this calculator creates the dangerous false impression that such a life-and-death assessment can in fact accurately and safely become an objective mathematical calculation. Medical science is far from that precise, when it comes to predicting whether a critically ill patient will die within the next year. On the January 22, 2021 edition of CBC Radio’s White Coat Black Art program, Dr. Michael Warner, head of the Michael Garron Hospital’s Intensive Care Unit, stated in part:

What’s different now is we have to essentially guesstimate what would happen a year from now.

He explained that this is not how treatment decisions are now made, and that doing this would be very difficult to do because doctors will be very busy caring for patients, and not all patients will have this protocol. This head of a Toronto hospital’s ICU said candidly that he is not sure how they would action this in real life because it’s a policy on paper Dr. Warner was asked how confident he is that emergency doctors can use these new rules accurately in a chaotic and stressful environment like an emergency room. Dr. Warner responded in part:

so it’s hard to know how we would be able to effectively use a tool that’s written on a piece of paper, where two doctors have to verify someone’s mortality risk and then decide on what to do, if there are patients everywhere, you know, potentially dying. You know, I think we need something written down on paper, so that all these stakeholders can review it and provide their input, but at the end of the day, if we ever have to use it, we may have to improvise.

Further supporting the serious concern that that this is not a precise mathematical calculation, Dr. James Downar, reportedly the January 13, 2021 Critical Care Triage Protocol’s author, conceded during the January 23, 2021 webinar that triage physicians will be estimating a triage patient’s likelihood of surviving for a year after receiving critical care. Dr. Downar said:

Ultimately this boils down to an individualized assessment for each person. This is not a checklist that applies to everybody, but simply an approach to estimating short term mortality risk, and using tools as appropriate to do that. The clinical criteria the prioritization criteria are based on published data where possible, and in some cases, based on expert opinion, based on the peer review that Andrea referenced.

Dr. Downar also earlier said during that webinar:

The focus of this is on the mortality risk at twelve months, not the estimated survival duration for an individual, right? So we know that it can be challenging to predict survival for individuals, but when we are looking at populations based on published data, we can I think be reasonably more sure about risks and certainly within the ranges, the broad ranges that we are talking about here.

Third, this online calculator uses criteria that are transparently disability discriminatory, contrary to the Ontario Human Rights Code and the Canadian Charter of Rights and Freedoms. Under the heading Frailty, for patients over 65 with a terminal illness and expected mortality of more than six months, the calculator uses the disability-discriminatory Clinical Frailty Scale, described earlier in this report. As noted earlier, that Scale inquires about the number of activities of daily living that a patient can do without assistance, including dressing, bathing, eating, walking, getting in/out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, and handling their own finances. The calculator increases the patient’s frailty rating accordingly.

The AODA Alliance and the ARCH Disability Law Centre have amply shown the Government and the Government’s external advisory Bioethics Table that the Clinical Frailty Scale is replete with unjustifiable disability discrimination. See e.g. the AODA Alliances August 30, 2020 written submission to the Bioethics Table, the AODA Alliance’s August 31, 2020 oral presentation to the Bioethics Table and the ARCH Disability Law Centre’s September 1, 2020 written submission to the Bioethics Table. Neither the Bioethics Table nor the Ministry of Health, nor Ontario Health nor the Ontario Critical Care COVID Command Centre have presented any convincing arguments to disprove that the Clinical Frailty Scale is disability discriminatory, contrary to the Ontario Human Rights Code and the Charter of Rights.

That alone would be fatal to this online calculator. However, making this worse, the AODA Alliance has discovered that the online calculator also uses other disability discriminatory criteria. We have not had a full opportunity to investigate the entire calculator from this perspective. However, as an example, for Cancer, the calculator rates the following physical ability criteria all of which can be tied directly to a person’s disability:

Whether a patient is Fully active and able to carry on all pre-disease performance without restriction
Whether a patient is Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light housework, office work
Whether a patient is Ambulatory and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours
Whether a patient is Capable of only limited selfcare; confided to bed or chair more than 50% of waking hours
Whether a patient is Completely disabled and cannot carry out any self-care; totally confined to bed or chair persons in this category receive the worst rating, for getting access to critical care.

The online Calculator does not alert doctors to these as serious human rights concerns. A physician using this online calculator could commit flagrant disability discrimination, without being alerted to this, and thinking it is totally appropriate conduct.

The foregoing examples of disability discrimination contradict the clear statement of the Government’s Bioethics Table in its September 11, 2020 report to the Ford Government as follows:

To emphasize: the existence of disability must not be used as a criterion on which to deny critical care.

That important sentence is strikingly missing from the later January 13, 2021 Critical Care Triage Protocol. It is not known whether the Bioethics Table later retreated from that important sentence in its later secret January 12, 2021 report to the Government, which the AODA Alliance and the public have not seen.

Fourth, the Bioethics Table and the Ontario Government including its Ontario Critical Care COVID Command Centre, never consulted the AODA Alliance or, to our knowledge, other disability advocates and experts, on this online calculator. The AODA Alliance has no knowledge whether the Government or its Bioethics Table or its Critical Care COVID Command Centre ever consulted the Ontario Human Rights Commission on this online calculator.

CTV’s March 30, 2021 report quotes Dr. Andrea Frolic (a bioethicist, not a physician) as defending the calculator. She has been quoted more than once in the role of defending the Ford Government’s critical care triage plans. The CTV report states:

The calculator, to be very clear, is not driving the clinical decision. The calculator simply helps the physician at the bedside to check the accuracy of the clinical judgment, said Dr. Andrea Frolic of Hamilton Health Sciences.

That claim is contradicted by the calculator itself and the information about it, set out above, that the AODA Alliance’s February 25, 2021 report provides.

The CTV report later quotes Dr. Frolic again as defending the disability-discriminatory content of the online life-and-death calculator. The news report states:

All of those criteria were pulled from global medical literature designed to determine the chance that someone would survive a year, Dr. Frolic said.

Great pains have been taken to ensure that equality, that any patient with any diagnosis gets the same assessment applied, to mitigate any potential bias, she said.

Frolic’s remarks are riddled with fatal flaws.

First, even if it were assumed that some studies purportedly point to using disability-discriminatory criteria (a proposition needing much further public inquiry) this would not mean that it thereby justifies disability discrimination that is contrary to the Ontario Human Rights Code and the Charter of Rights. By analogy, had there been a study that showed that a patient’s race or sex made them more likely to die within a year, that would not justify using a patient’s race or sex in the online life-and-death calculator. To be clear, that calculator does not include race or sex, nor are we saying that anyone has claimed that medical literature would support that or that racist or sexist criteria should be used. However, the point remains the same. Such racial, gender or disability discrimination is simply not permitted.

Second, Dr. Frolic says that the aim of this calculator is to treat all the patients the same. In order to achieve equality. Yet, the Supreme Court of Canada has made it clear for decades that same treatment can itself create discrimination. For people with disabilities, it often does. It would be same treatment to tell all job applicants that they must climb a flight of stairs to get into a building to attend a job interview. Yet for people using a wheelchair, that same treatment is clear disability discrimination.

Dr. Frolic has been told this. She served on the Ontario Government’s advisory Bioethics Table. Last summer, she took active part in meetings with disability advocates including AODA Alliance Chair David Lepofsky. Those advocates explained more than once that same treatment can constitute a denial of equality.

We emphasize that Dr. Frolic is not the issue. The Ford Government’s approach to critical care triage is the issue. However, Dr. Frolic is one of the few people who have served in the role of defending the Government on this issue, as the Government remains in hiding.

3. As noted earlier, below is also set out a guest column in the March 4, 2021 Globe and Mail by bioethicist ARTHUR SCHAFER. He makes a compelling argument why it is exceedingly harmful and dangerous for the Ford Government to keep Ontario’s plans for critical care triage shrouded in secrecy. We repeat here that if a member of the public wants to read those plans, it is the AODA Alliance website and not the Government’s website to which they must turn.

We take decisive exception to one comment in this Globe and Mail column. It argues:

Quebec, whose triage plan is public, allows doctors to remove patients from life support if their prognosis is poor, thereby freeing up resources for those more likely to benefit. If the goal is to save as many lives as possible, then Quebec’s plan seems ethically preferable to Ontario’s.

Some doctors are pressing the Ford Government to suspend the Health Care Consent Act, so that a doctor would have the power to unilaterally withdraw critical care from a patient already receiving it, even if that patient objects. We have repeatedly pointed out that this raises massive legal and constitutional concerns. As but one consideration, the column’s author might think that to do so could be ethical a view with which we strongly disagree. There is a real risk that it would implicate Canada’s Criminal Code’s homicide provisions.

As of now, there have been an inexcusable 791 days, well over two years, since the Ford Government received the final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has announced no comprehensive plan of new action to implement that ground-breaking report. This worsens the festering problems facing patients with disabilities during the COVID-19 pandemic, such as those threatened by the possibility of critical care triage . There are only 3 and ¾ years left for the Ontario Government to lead Ontario to become fully accessible to 2.6 million people with disabilities, as the Accessibility for Ontarians with Disabilities Act requires.

For more background on this issue, check out:

1. The AODA Alliance’s comprehensive February 25, 2021 report on the serious problems with Ontario’s critical care triage and plan.

2. The AODA Alliance’s December 21, 2020 news release on the critical care triage issue.

3. The Government’s external advisory Bioethics Table’s September 11, 2020 draft critical care triage protocol, finally revealed days ago.
4. The AODA Alliance’s unanswered September 25, 2020 letter, its November 2, 2020 letter, its November 9, 2020 letter, its December 7, 2020 letter, its December 15, 2020 letter, its December 17, 2020 letter, its January 18, 2021 letter and its February 25, 2021 letter to Health Minister Christine Elliott.

5. The August 30, 2020 AODA Alliance submission to the Ford Government’s Bioethics Table, and a captioned online video of the AODA Alliance’s August 31, 2020 oral presentation to the Bioethics Table on disability discrimination concerns in critical care triage.

6. The September 1, 2020 submission and July 20, 2020 submission by the ARCH Disability Law Centre to the Bioethics Table.

7. The November 5, 2020 captioned online speech by AODA Alliance Chair David Lepofsky on the disability rights concerns with Ontario’s critical care triage protocol.

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

MORE DETAILS

CTV Online News March 30, 2021

Originally posted at https://toronto.ctvnews.ca/would-you-be-admitted-to-hospital-amid-a-covid-19-surge-ontario-doctors-have-an-online-calculator-to-help-check-1.5367752 Would you be admitted to hospital amid a COVID-19 surge? Ontario doctors have an online calculator to help check Jon Woodward
Videojournalist, CTV News Toronto
@CTV_Jon
Published Tuesday, March 30, 2021 8:02AM EDT
A health-care worker wearing PPE transports a patient in the dialysis unit at the Humber River Hospital during the COVID-19 pandemic in Toronto on Wednesday, December 9, 2020. THE CANADIAN PRESS/Nathan Denette

TORONTO — An online calculator that would help Ontario doctors decide which patients should be treated and which should be turned away COVID-19 cases overwhelm hospitals is meant to be used as a last resort, says an ethics consultant involved in its design.

The Short-term mortality risk calculation tool takes in age and medical conditions, and outputs scores that can help a doctor determine the likelihood that a patient will survive for a year if treated.

If that threshold is low the bed that could have gone to that patient can be given to someone more likely to survive.

The calculator, to be very clear, is not driving the clinical decision. The calculator simply helps the physician at the bedside to check the accuracy of the clinical judgment, said Dr. Andrea Frolic of Hamilton Health Sciences.

But that hasn’t quelled worries of advocates for people with disabilities, who say that ingrained in the assessment tools it digitizes are biases against people in wheelchairs or people whose life span may not be clear.

The calculator dehumanizes it and makes it falsely seem like it’s a mathematical calculation. It is not, said David Lepofsky of the AODA Alliance, an Ontario disability advocacy group.

He pointed to elements of the ECOG Grade that included a score for Completely disabled; cannot carry on any self-care; totally confined to bed or chair.

People with disabilities are disproportionately exposed to getting COVID, and dying of COVID. It would be a cruel irony if they then faced the risk of being deprioritized in getting access to critical care, Lepofsky said.

The STMR Calculation Tool is a digital expression of the Short Term Mortality Risk Assessment for Critical Illness form that doctors may have to fill out if they are overwhelmed. That form was obtained by CTV News Toronto.

In a Level 1 Triage Scenario, patients with a greater than 80 per cent chance of dying in the next year are turned away. In Level 2, that drops to 50 per cent. In Level 3, patients with just a 30 per cent chance of dying could be turned away.

Among the list of conditions that could meet that criteria are severe trauma, burns, cardiac arrests, metastatic cancers, strokes, and liver failure.

The form includes a line of age greater than 65, and Clinical Frailty Score of greater than seven on a nine-point scale. It cautions doctors that this frailty must be part of a progressive illness, and not an ongoing condition.

All of those criteria were pulled from global medical literature designed to determine the chance that someone would survive a year, Dr. Frolic said.

Great pains have been taken to ensure that equality, that any patient with any diagnosis gets the same assessment applied, to mitigate any potential bias, she said.

It’s not immediately clear who is behind the online calculator. There’s no logo on the website, and a check of its domain registration shows redacted for privacy on many identifying details.

However in the site’s end user license agreement, the site mentions the Hamilton Health Sciences Corporation an agency of Hamilton Health Sciences. That was where the programming was done for the tool, which was commissioned as part of Ontario’s COVID-19 response, said Dr. Frolic.

Ottawa Centre MPP Joel Harden, who is the NDP Critic for accessibility and persons with disabilities, said there had been little public discussion of what end of care life should be.

We have a government operating in secrecy on critical life or death decisions. If the hospitals get overwhelmed the government will not debate out in the open what the criteria should be in rationing lifesaving care, Harden said.

The Ontario Ministry of Health did not return messages left by CTV News Toronto.

Globe and Mail March 4, 2021 / News
OPINION

Keeping Ontario’s triage plan secret is fostering mistrust
By ARTHUR SCHAFER
Founding director of the Centre for Professional and Applied Ethics at the University of Manitoba

The government of Ontario has a secret triage plan for the rationing of essential medical care. If a third wave of COVID-19 overwhelms Ontario’s hospital system, provincial protocols instruct doctors which patients should get priority life-saving treatments.

Although the guidelines have not been published, they reportedly mandate hospital intensivecare units to withhold life support from patients unlikely to survive at least 12 months. Patients already on life support will not have that support withdrawn, no matter how poor their prognosis.

The cabinet hasn’t yet given formal approval to these triage guidelines. Indeed, the Ministry of Health prefers to describe the plan as merely a “framework document” – with the implication that we need not pay too close attention. Nevertheless, the document has been distributed to the province’s hospitals.

Whether we label it a “plan” or something else, is it ethically defensible? Quebec, whose triage plan is public, allows doctors to remove patients from life support if their prognosis is poor, thereby freeing up resources for those more likely to benefit. If the goal is to save as many lives as possible, then Quebec’s plan seems ethically preferable to Ontario’s.

Most people understand that governments must plan in advance how to allocate resources in a public-health emergency. Absent such planning, decisions would have to be made by individual doctors at their patients’ bedside. Doctors would in effect become gatekeepers for life-support technology; however, this role fits uneasily with the principles they imbibed at medical school. “Every life is valuable. Every patient is entitled to appropriate treatment.”

Instead of asking, “Would my patient benefit from admission to the ICU?” the doctor would be required to ask, “Which of my eligible patients will be most likely to benefit? Or which will benefit most?” For doctors to make this kind of life-and-death choice among their eligible patients seems inconsistent with the fundamental principle of the Hippocratic Oath: The life and health of my patient will be my first consideration.

In situations where some patients will likely benefit greatly from an ICU bed, while others will benefit only marginally, traditional physician ethics come under pressure. “First come, first served” doesn’t seem like an ethically defensible moral rule when the patient who came first is unlikely to survive long while the patient who came second has a more favourable prognosis.

Nor does the “first come” principle help when a decision has to be made concerning the withdrawal of life support once it has begun. For these reasons, giving doctors sole discretionary power to withhold or withdraw life support would impose on them a heavy moral and emotional burden. Equally or more important, it would lead to arbitrary and unfair differences in the way patients are treated.

Thus, a consensus has developed. In times of runaway pandemic, every province should have in place a triage plan for the distribution of scarce health care resources. But who should be responsible for establishing the provincial plan? The government of Ontario quietly established an advisory “bioethics table” to recommend guidelines. Unfortunately, the composition of this expert panel is secret, as are its detailed recommendations. The alternatives considered by the panel and its reasoning are also concealed. Media questioning of the government has elicited a promise that there will be future consultations with “stakeholder groups.” The general public is apparently to have no input in the decisionmaking process.

Understandably, all this secrecy has generated public suspicion. People are wondering what is being covered up, or if the plan discriminates against the elderly, people with disabilities or racialized groups. It’s critically important that governments be held accountable. This means that even those who trust in the bona fides of the government should insist that, in a liberal democracy, the public has the right to be fully informed, hear expert discussions and weigh in with its own views.

Sadly, the Ontario government is not alone in its persistent refusal to recognize that secrecy promotes cynicism and distrust. Governments everywhere could learn a lesson from the “death panel” myth about Barack Obama’s Medicare plan. There was nothing in Mr. Obama’s legislation that would have led to individuals being judged as “unworthy of health care,” but millions of Americans were nevertheless misled. Similar myths about the Ford government’s intentions are already circulating.

Openness and transparency promote trust. When exposed to critical scrutiny by an informed public, the Ontario triage plan may come to be seen as reasonable and fair; but continued secrecy will inevitably feed suspicion that the government is concealing something nefarious.

In a time of pandemic, trust is the most precious resource possessed by public-health officials. Once lost, it can be difficult or impossible to regain.




Source link