Ford Government Belatedly Extended to September 13, 2021 the Deadline for Sending Feedback on Recommendations to Remove Disability Barriers from Ontario’s Health Care System


Accessibility for Ontarians with Disabilities Act Alliance Update

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

Web: www.aodaalliance.org

Email: [email protected]

Twitter: @aodaalliance

Facebook: www.facebook.com/aodaalliance/

Ford Government Belatedly Extended to September 13, 2021 the Deadline for Sending Feedback on Recommendations to Remove Disability Barriers from Ontario’s Health Care System

August 18, 2021

        SUMMARY

1. Summary of All Deadlines for Sending Feedback to the Ford Government on What is Needed in New Education and Health Care Accessibility Standards

Last week, after the Ford Government’s deadline had already expired for submitting feedback on the barriers that people with disabilities face in the health care system, the Government extended that deadline. The Government never told us about that extension. After we heard a rumour about it, we asked the Government if there was an extension. The Government then put us on a list of people being notified about this extension. We do not know who else has been alerted to it.

You may understandably be very confused about when you can give the Ford Government this feedback, as well as your input on two other proposals that are out for public feedback, under the Accessibility for Ontarians with Disabilities Act. We here try to clarify things for you.

The bottom line is this: The Ford Government now has the initial reports of three different AODA Standards Development Committees publicly posted for your feedback and input. The Government has now extended two of the three deadlines it earlier announced for giving your feedback.

The AODA Alliance is taking part in all three consultations. We urge you to do so as well. We have submitted our detailed August 3, 2021 brief to the Health Care Standards Development Committee on its initial report. Please email that Committee to endorse the AODA Alliance brief. We know that the March of dimes of Canada and the Ontario Autism Coalition have already done so. Send them your endorsement of our brief by writing [email protected]

The deadlines for sending the Government your feedback are now as follows:

  1. You have up to September 13, 2021 to give feedback on the initial report of the Health Care Standards Development Committee. It recommends what should be included in the promised Health Care Accessibility Standard to tear down the disability barriers facing people with disabilities in Ontario’s health care system.
  1. You have up to September 29, 2021 to give the Government feedback on the initial report of the Post-Secondary Education Standards Development Committee. It recommends what should be included in the Education Accessibility Standard to tear down the disability barriers impeding students with disabilities in Ontario’s colleges and universities.
  1. You have up to September 30, 2021 to give feedback on the initial report of the K-12 Education Standards Development Committee. It recommends what should be included in the promised Education Accessibility Standard to tear down the disability barriers facing students with disabilities in Ontario’s education system.

Where do you send your feedback? Here are the email addresses to use:

 2. What Comes Next

What happens after all this feedback is gathered? After these feedback periods expire, three Government-appointed Standards Development Committees are to go back to work. They are supposed to review all the public feedback they received, and make any changes to their recommendations to the Government. They then submit their finalized report to the Ford Government on what they think the Government should include in the AODA accessibility standard on which they are working.

Section 10(2) of the AODA requires the Government to publicly post each final report from a Standards Development Committee upon receiving it. After the Government receives a Standards Development Committees final report, it can enact the accessibility standard that the Committee recommended as is, or with any changes it wishes. The Government can also do nothing at all.

At the very lethargic and sluggish rate that the Ford Government has been acting on implementing the AODA, it is extremely unlikely that it will enact a Health Care Accessibility Standard or Education Accessibility Standard before next June’s provincial election. It has enacted no accessibility standards and made no revisions to any accessibility standards since it took office over three years ago.

Making this worse, the Ford Government has not made any changes to strengthen the 2011 Transportation Accessibility Standard, even though the Government received a final report from the Transportation Accessibility Standard in the spring of 2018. It has not made any revisions to strengthen the Employment Accessibility Standard, even though it received the final report of the Employment Standards Development Committee over two years ago. It has not enacted any revisions to strengthen the Information and Communication Accessibility Standard, even though it received the Information and Communication Standards Development Committees final report almost one and a half years ago.

The AODA Alliance campaigned for over half a decade to get the Ontario Government to agree to develop and enact accessibility standards under the Accessibility for Ontarians with Disabilities Act in health care and education. The door is open for your input. These opportunities don’t often come along.

In next June’s provincial election, we plan to ask the major parties to commit to action to make Ontario’s education system and health care system fully accessible to people with disabilities. The current public consultations can help with that effort.

 3. Helpful Resources

a) On Disability Barriers in the K-12 Ontario School system

  1. The entire 185-page K-12 Education Standards Development Committee initial report and initial recommendations on what the promised Education Accessibility Standard should include to make education in Ontario schools barrier-free for all students with disabilities.
  1. The AODA Alliance’s 55-page condensed and annotated version of the K-12 Education Standards Development Committee initial report and recommendations.
  1. The AODA Alliance’s 15-page summary of the K-12 Education Standards Development Committee initial report and recommendations.
  1. The AODA Alliance‘s action kit on how to give public feedback on the K-12 Education Standards Development Committee initial report and recommendations.
  1. A captioned video by AODA Alliance Chair David Lepofsky explaining what is in the K-12 Education Standards Development Committee initial report.
  1. A captioned video of tips for parents of students with disabilities on how to advocate at school for their child’s needs.
  1. For general background, the AODA Alliance website Education page.

b) On Disability Barriers in Ontario Colleges and Universities

  1. The initial report of the Post-Secondary Education Standards Development Committee is available at https://www.aodaalliance.org/wp-content/uploads/2021/06/PSE-SDC-Initial-Recommendations-Report_June-25-2021.docx
  1. The draft framework for the Post-Secondary Education Accessibility Standard that the AODA Alliance sent to the Post-Secondary Education Standards Development Committee in March, 2020.
  1. You can learn more about our years of advocacy to make all parts of Ontario’s education system accessible for students with disabilities by visiting the AODA Alliance website’s education page.

c) On Disability Barriers in Ontario’s Health Care System

  1. The initial report of the Health Care Standards Development Committee is available at https://www.aodaalliance.org/wp-content/uploads/2021/05/Health-Care-SDC-Initial-Report-As-Submitted.doc
  1. The AODA Alliance’s August 3, 2021 brief to the Health Care Standards Development Committee giving feedback on its initial report is available at https://www.aodaalliance.org/wp-content/uploads/2021/08/August-3-2021-finalized-AODA-Alliance-Brief-to-Health-Care-Standards-Development-Committee.docx
  1. The AODA Alliance’s February 25, 2020 Framework that it submitted to the Health Care Standards Development Committee on what the promised Health Care Accessibility Standard should include.
  1. A comprehensive captioned video by AODA Alliance Chair David Lepofsky on the barriers facing people with disabilities in the health care system.
  1. A detailed captioned video by AODA Alliance Chair David Lepofsky on the dangers of disability discrimination in Ontario’s controversial critical care triage protocol during the COVID-19 pandemic.
  1. Background on the AODA Alliance’s campaign for barrier-free health care services for people with disabilities is available on the AODA Alliance website’s health care page.

 4. The Ford Government’s Confused and Confusing Handling of the current Public Consultations on AODA Accessibility Standards

So far, the Ford Government has shown poor leadership in how it has handled the current public consultations. For example:

  • It withheld publicly posting these three initial reports for a long time, even though the AODA s. 10(1) requires the Government to post each upon receiving the report. It delayed publicly posting the health Care Standards Development Committee initial report for over 5 months after receiving it. It delayed publicly posting the Post-Secondary Education Standards Development Committee’s initial report for 3.5 months after receiving it. It delayed publicly posting the K-12 Education Standards Development Committee initial report for 2.5 months after receiving it. In the case of the Health Care Standards Development Committee, that Committee voted to approve its initial report back in September 2020, almost a full year ago.
  • The Government’s delay in publicly posting the Health Care Standards Development Committee’s typifies how this governmental lethargy hurts people with disabilities. That initial report includes recommendations for action needed as a result of the COVID-19 pandemic. For example, it raises concerns about the Government’s critical care triage protocol that endangers some patients with disabilities in Ontario hospitals. The Government kept that report secret from the public over critical months when the danger to people with disabilities was especially high. During that same time, the Minister of Health refused to answer any of the AODA Alliance’s detailed letters raising serious human rights concerns about the Government’s critical care triage protocol and plans.
  • The Government did not announce the extension of the original August 11, 2021 deadline for submitting public feedback on the ‘Health Care Standards Development Committees initial report until August 13, 2021, after that feedback period had already expired. Organizations like the AODA Alliance therefore unnecessarily were forced to rush in the midst of the summer vacation period to submit their feedback before the August 11, 2021 period.
  • Rather than properly informing the entire public, the Ford Government appears to have only let some people know about the extension of the deadline for feedback on the Health Care Standards Development Committees initial report. As noted above, when we heard a rumour about this late last week, we wrote the Government to ask about it. It was only after that that the Government sent out an email to us announcing its extension.
  • The Government initially scheduled the public feedback period on the K-12 Education Standards Development Committee’s initial report to end on September 2, 2021, before the school year begins. This created hardships for giving feedback in connection with the school system. The Government only belatedly agreed to lengthen that feedback period.

 5. Will the Ford Government’s Delays on Accessibility for Ontarians with Disabilities Ever End?

For over three years, we have pressed the Ford Government to develop a detailed plan on accessibility, to lay out how it will get Ontario to the AODA’s mandatory goal of becoming accessible to people with disabilities by 2025. It has never done so.

On January 31, 2019, the Government received the blistering final report of the David Onley Independent Review of the AODA’s implementation. Minister for Accessibility Raymond Cho publicly said on April 10, 2019, that David Onley did a “marvelous job.”

The Onley report found that Ontario is full of “soul-crushing” barriers impeding people with disabilities. It concluded that progress on accessibility has taken place at a “glacial pace.” It determined that that the goal of accessibility by 2025 is nowhere in sight, and that specific new Government actions, spelled out in the report, are needed.

In the 931 days since receiving the Onley Report, the Ford Government has not made public a comprehensive plan to implement that report’s findings and recommendations. The Government has staged some media events with the Accessibility Minister to make announcements, but little if anything new was ever announced.

        MORE DETAILS

August 13, 2021 Broadcast Email from the Accessibility Directorate of Ontario

Dear all,

We are pleased to share that the public feedback period for the Health Care SDC Initial Recommendations has been extended for an additional month, to September 13, 2021. The additional time is intended to recognize that organizations across the health sector and the disability community may require more time to review and respond given the ongoing COVID-19 pandemic.

As a reminder, the Initial Recommendations Report of the Health Care Standards Development Committee is available online here for public comment:

https://www.ontario.ca/page/consultation-initial-recommendations-development-health-care-accessibility-standards

 

As these recommendations may impact you or your community, we would encourage you to participate in this process. We would also encourage you to share this information broadly with your networks.

A survey has been developed to seek public feedback and is linked from the consultation page together with the report itself.

Written submissions can also be sent by email to [email protected]. Members of the public or interested organizations can also reach out to the Accessibility for Ontarians with Disabilities Division by email at [email protected] for any questions.

All feedback received will be considered by the Committee before finalizing their recommendations to the Minister. Identifying information will remain confidential as per the Government of Ontario’s Privacy Policy, and all survey responses will remain anonymous.

Sincerely,

Accessibility for Ontarians with Disabilities Division

Ministry for Seniors and Accessibility



Source link

Ford Government Belatedly Extended to September 13, 2021 the Deadline for Sending Feedback on Recommendations to Remove Disability Barriers from Ontario’s Health Care System


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 18, 2021

SUMMARY

1. Summary of All Deadlines for Sending Feedback to the Ford Government on What is Needed in New Education and Health Care Accessibility Standards

Last week, after the Ford Government’s deadline had already expired for submitting feedback on the barriers that people with disabilities face in the health care system, the Government extended that deadline. The Government never told us about that extension. After we heard a rumour about it, we asked the Government if there was an extension. The Government then put us on a list of people being notified about this extension. We do not know who else has been alerted to it.

You may understandably be very confused about when you can give the Ford Government this feedback, as well as your input on two other proposals that are out for public feedback, under the Accessibility for Ontarians with Disabilities Act. We here try to clarify things for you.

The bottom line is this: The Ford Government now has the initial reports of three different AODA Standards Development Committees publicly posted for your feedback and input. The Government has now extended two of the three deadlines it earlier announced for giving your feedback.

The AODA Alliance is taking part in all three consultations. We urge you to do so as well. We have submitted our detailed August 3, 2021 brief to the Health Care Standards Development Committee on its initial report. Please email that Committee to endorse the AODA Alliance brief. We know that the March of dimes of Canada and the Ontario Autism Coalition have already done so. Send them your endorsement of our brief by writing [email protected]

The deadlines for sending the Government your feedback are now as follows:

1. You have up to September 13, 2021 to give feedback on the initial report of the Health Care Standards Development Committee. It recommends what should be included in the promised Health Care Accessibility Standard to tear down the disability barriers facing people with disabilities in Ontario’s health care system.

2. You have up to September 29, 2021 to give the Government feedback on the initial report of the Post-Secondary Education Standards Development Committee. It recommends what should be included in the Education Accessibility Standard to tear down the disability barriers impeding students with disabilities in Ontario’s colleges and universities.

3. You have up to September 30, 2021 to give feedback on the initial report of the K-12 Education Standards Development Committee. It recommends what should be included in the promised Education Accessibility Standard to tear down the disability barriers facing students with disabilities in Ontario’s education system.

Where do you send your feedback? Here are the email addresses to use:

* Send your feedback on disability barriers in the health care system to [email protected]
* Send your feedback on disability barriers in the K-12 school system to: [email protected]
* Send your feedback on disability barriers in Ontario’s colleges and universities to: [email protected]

2. What Comes Next

What happens after all this feedback is gathered? After these feedback periods expire, three Government-appointed Standards Development Committees are to go back to work. They are supposed to review all the public feedback they received, and make any changes to their recommendations to the Government. They then submit their finalized report to the Ford Government on what they think the Government should include in the AODA accessibility standard on which they are working.

Section 10(2) of the AODA requires the Government to publicly post each final report from a Standards Development Committee upon receiving it. After the Government receives a Standards Development Committees final report, it can enact the accessibility standard that the Committee recommended as is, or with any changes it wishes. The Government can also do nothing at all.

At the very lethargic and sluggish rate that the Ford Government has been acting on implementing the AODA, it is extremely unlikely that it will enact a Health Care Accessibility Standard or Education Accessibility Standard before next June’s provincial election. It has enacted no accessibility standards and made no revisions to any accessibility standards since it took office over three years ago.

Making this worse, the Ford Government has not made any changes to strengthen the 2011 Transportation Accessibility Standard, even though the Government received a final report from the Transportation Accessibility Standard in the spring of 2018. It has not made any revisions to strengthen the Employment Accessibility Standard, even though it received the final report of the Employment Standards Development Committee over two years ago. It has not enacted any revisions to strengthen the Information and Communication Accessibility Standard, even though it received the Information and Communication Standards Development Committees final report almost one and a half years ago.

The AODA Alliance campaigned for over half a decade to get the Ontario Government to agree to develop and enact accessibility standards under the Accessibility for Ontarians with Disabilities Act in health care and education. The door is open for your input. These opportunities don’t often come along.

In next June’s provincial election, we plan to ask the major parties to commit to action to make Ontario’s education system and health care system fully accessible to people with disabilities. The current public consultations can help with that effort.

3. Helpful Resources

a) On Disability Barriers in the K-12 Ontario School system

1. The entire 185-page K-12 Education Standards Development Committee initial report and initial recommendations on what the promised Education Accessibility Standard should include to make education in Ontario schools barrier-free for all students with disabilities.

2. The AODA Alliance’s 55-page condensed and annotated version of the K-12 Education Standards Development Committee initial report and recommendations.

3. The AODA Alliance’s 15-page summary of the K-12 Education Standards Development Committee initial report and recommendations.

4. The AODA Alliance’s action kit on how to give public feedback on the K-12 Education Standards Development Committee initial report and recommendations.

5. A captioned video by AODA Alliance Chair David Lepofsky explaining what is in the K-12 Education Standards Development Committee initial report.

6. A captioned video of tips for parents of students with disabilities on how to advocate at school for their child’s needs.

7. For general background, the AODA Alliance website Education page.

b) On Disability Barriers in Ontario Colleges and Universities

1. The initial report of the Post-Secondary Education Standards Development Committee is available at https://www.aodaalliance.org/wp-content/uploads/2021/06/PSE-SDC-Initial-Recommendations-Report_June-25-2021.docx

2. The draft framework for the Post-Secondary Education Accessibility Standard that the AODA Alliance sent to the Post-Secondary Education Standards Development Committee in March, 2020.

3. You can learn more about our years of advocacy to make all parts of Ontario’s education system accessible for students with disabilities by visiting the AODA Alliance website’s education page.

c) On Disability Barriers in Ontario’s Health Care System

1. The initial report of the Health Care Standards Development Committee is available at https://www.aodaalliance.org/wp-content/uploads/2021/05/Health-Care-SDC-Initial-Report-As-Submitted.doc

2. The AODA Alliance’s August 3, 2021 brief to the Health Care Standards Development Committee giving feedback on its initial report is available at https://www.aodaalliance.org/wp-content/uploads/2021/08/August-3-2021-finalized-AODA-Alliance-Brief-to-Health-Care-Standards-Development-Committee.docx

3. The AODA Alliance’s February 25, 2020 Framework that it submitted to the Health Care Standards Development Committee on what the promised Health Care Accessibility Standard should include.

4. A comprehensive captioned video by AODA Alliance Chair David Lepofsky on the barriers facing people with disabilities in the health care system.

5. A detailed captioned video by AODA Alliance Chair David Lepofsky on the dangers of disability discrimination in Ontario’s controversial critical care triage protocol during the COVID-19 pandemic.

6. Background on the AODA Alliance’s campaign for barrier-free health care services for people with disabilities is available on the AODA Alliance website’s health care page.

4. The Ford Government’s Confused and Confusing Handling of the current Public Consultations on AODA Accessibility Standards

So far, the Ford Government has shown poor leadership in how it has handled the current public consultations. For example:

* It withheld publicly posting these three initial reports for a long time, even though the AODA s. 10(1) requires the Government to post each upon receiving the report. It delayed publicly posting the health Care Standards Development Committee initial report for over 5 months after receiving it. It delayed publicly posting the Post-Secondary Education Standards Development Committee’s initial report for 3.5 months after receiving it. It delayed publicly posting the K-12 Education Standards Development Committee initial report for 2.5 months after receiving it. In the case of the Health Care Standards Development Committee, that Committee voted to approve its initial report back in September 2020, almost a full year ago.
* The Government’s delay in publicly posting the Health Care Standards Development Committee’s typifies how this governmental lethargy hurts people with disabilities. That initial report includes recommendations for action needed as a result of the COVID-19 pandemic. For example, it raises concerns about the Government’s critical care triage protocol that endangers some patients with disabilities in Ontario hospitals. The Government kept that report secret from the public over critical months when the danger to people with disabilities was especially high. During that same time, the Minister of Health refused to answer any of the AODA Alliance’s detailed letters raising serious human rights concerns about the Government’s critical care triage protocol and plans.
* The Government did not announce the extension of the original August 11, 2021 deadline for submitting public feedback on the ‘Health Care Standards Development Committees initial report until August 13, 2021, after that feedback period had already expired. Organizations like the AODA Alliance therefore unnecessarily were forced to rush in the midst of the summer vacation period to submit their feedback before the August 11, 2021 period.
* Rather than properly informing the entire public, the Ford Government appears to have only let some people know about the extension of the deadline for feedback on the Health Care Standards Development Committees initial report. As noted above, when we heard a rumour about this late last week, we wrote the Government to ask about it. It was only after that that the Government sent out an email to us announcing its extension.
* The Government initially scheduled the public feedback period on the K-12 Education Standards Development Committee’s initial report to end on September 2, 2021, before the school year begins. This created hardships for giving feedback in connection with the school system. The Government only belatedly agreed to lengthen that feedback period.

5. Will the Ford Government’s Delays on Accessibility for Ontarians with Disabilities Ever End?

For over three years, we have pressed the Ford Government to develop a detailed plan on accessibility, to lay out how it will get Ontario to the AODA’s mandatory goal of becoming accessible to people with disabilities by 2025. It has never done so.

On January 31, 2019, the Government received the blistering final report of the David Onley Independent Review of the AODA’s implementation. Minister for Accessibility Raymond Cho publicly said on April 10, 2019, that David Onley did a “marvelous job.”

The Onley report found that Ontario is full of “soul-crushing” barriers impeding people with disabilities. It concluded that progress on accessibility has taken place at a “glacial pace.” It determined that that the goal of accessibility by 2025 is nowhere in sight, and that specific new Government actions, spelled out in the report, are needed.

In the 931 days since receiving the Onley Report, the Ford Government has not made public a comprehensive plan to implement that report’s findings and recommendations. The Government has staged some media events with the Accessibility Minister to make announcements, but little if anything new was ever announced.

MORE DETAILS

August 13, 2021 Broadcast Email from the Accessibility Directorate of Ontario

Dear all,

We are pleased to share that the public feedback period for the Health Care SDC Initial Recommendations has been extended for an additional month, to September 13, 2021. The additional time is intended to recognize that organizations across the health sector and the disability community may require more time to review and respond given the ongoing COVID-19 pandemic.

As a reminder, the Initial Recommendations Report of the Health Care Standards Development Committee is available online here for public comment:
https://www.ontario.ca/page/consultation-initial-recommendations-development-health-care-accessibility-standards

As these recommendations may impact you or your community, we would encourage you to participate in this process. We would also encourage you to share this information broadly with your networks.

A survey has been developed to seek public feedback and is linked from the consultation page together with the report itself.

Written submissions can also be sent by email to [email protected] Members of the public or interested organizations can also reach out to the Accessibility for Ontarians with Disabilities Division by email at [email protected] for any questions.

All feedback received will be considered by the Committee before finalizing their recommendations to the Minister. Identifying information will remain confidential as per the Government of Ontario’sPrivacy Policy, and all survey responses will remain anonymous.

Sincerely,

Accessibility for Ontarians with Disabilities Division
Ministry for Seniors and Accessibility




Source link

CBC Reports on Troubling Disability Barrier at Canada’s Wonderland – and – Ford Government Extends Deadline to September 30, 2021 to Send in Public Feedback on Disability Barriers in Ontario’s School system


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/

CBC Reports on Troubling Disability Barrier at Canada’s Wonderland – and – Ford Government Extends Deadline to September 30, 2021 to Send in Public Feedback on Disability Barriers in Ontario’s School system

August 6, 2021

SUMMARY

1. More Proof that the Ontario Government’s Implementation and Enforcement of the Accessibility for Ontarians with Disabilities Act is Ineffectual

The AODA was passed in 2005 so that disability barriers in Ontario would be removed and prevented, without people with disabilities having to battle those barriers one at a time. Here is another inexcusable illustration of how still we must continue to battle those barriers, one at a time, even more than 16 years after the AODA was enacted.

CBC Radio Toronto reported yesterday on a recent incident where Canada’s Wonderland, a well-established amusement park north of Toronto, refused to allow a person with a disability to go on any rides whatsoever. We set out below the online report on CBC’s website. If Ontario had a strong, effective Customer Service Accessibility Standard under the AODA, and if the Ford Government enforced it effectively, such incidents would not continue to occur.

Even 918 days after the Ford Government received a strong call to beef up the AODA’s implementation and enforcement by the Independent Review Report prepared by former Lieutenant Governor David Onley, The Government still has no comprehensive plan to ensure that Ontario becomes accessible to people with disabilities by 2025, under 3.5 years from now.

2. The Ford Government Has Extended to September 30, 2021 the Deadline for Submitting Public Feedback on the Initial Report of the K-12 Education Standards Development Committee

The Ford Government has given you more time to send in your feedback on the disability barriers that impede students with disabilities in Ontario schools. You now have up to September 30, rather than September 2, 2021, to send in your feedback.

This is a once-in-a-generation opportunity. We encourage one and all to let that Standards Development Committee know what you think.

The Government’s original September 2, 2021 deadline was exceedingly unrealistic, since schools are closed for the summer. However, the Government earlier unfairly delayed the entire feedback process, because it withheld the K-12 Education Standards Development Committee’s initial report for 2.5 months before publicly posting it. We are eager for all Standards Development Committees to have their final reports submitted to the Government by the end of this year, if possible, and to have them made public upon the Government receiving them, not months later.

We especially call on each school board’s Special Education Advisory Committee to take this extended opportunity to have their say by sending their feedback to The Government, and by urging their school board to now start implementing the recommendations that the K-12 Education Standards Development Committee prepared.

The AODA Alliance website has helpful resources to make it easier to give your feedback:

  1. A 50 minute captioned video that explains what the K-12 Education Standards Development Committee initial report recommends.
  1. The entire 185-page K-12 Education Standards Development Committee initial report and initial recommendations on what the promised Education Accessibility Standard should include to make education in Ontario schools barrier-free for all students with disabilities.
  1. The AODA Alliance’s 55-page condensed and annotated version of the K-12 Education Standards Development Committee initial report and recommendations.
  1. The AODA Alliance’s 15-page summary of the K-12 Education Standards Development Committee initial report and recommendations.
  1. The AODA Alliance‘s action kit on how to give public feedback on the K-12 Education Standards Development Committee initial report and recommendations.
  1. A captioned video of tips for parents of students with disabilities on how to advocate at school for their child’s needs.
  1. For general background, the AODA Alliance website Education page.

^MORE DETAILS

CBC News Online August 5, 2021

Originally posted at https://www.cbc.ca/news/canada/toronto/paraplegic-man-denied-access-to-rides-1.6129624

Man with disability feels ‘belittled’ after Canada’s Wonderland denies him access to all its rides |

By Jessica Cheung, CBC News

Ahmad El Nasser was looking forward to a visit to Canada’s Wonderland with his niece, but when they got there, he found out he wouldn’t be able to go on any of the rides due to his disability.

“When I was denied access. I kind of felt belittled. I felt a little bit humiliated,” El Nasser, who is paralyzed from the waist down due to a spinal cord injury, told CBC News.

“Being able to ride on these rides is not the big deal; the big deal is seeing my niece upset.”

When El Nasser arrived at the park on July 19 he was given a “boarding pass,” which allows guests with mobility restrictions or cognitive impairment to get on attractions at specified times via the alternate access entrance without having to be in lineups.

Then, El Nasser said he was asked a series of questions, such as “Can you transfer?” That means moving from a wheelchair to other locations — something he is able to do.

Ahmad El Nasser is paralyzed from the waist down after a motorcycle accident 10 years ago. He uses a wheelchair but says he is still very active and outgoing.

“I have full, complete upper body control … I can transfer. I can get on beds. I can get in my car. I can get in rides, no problem,” he said.

“I answered all of them as best I could.”

But the rider access form El Nasser received said he would not be allowed to go on any rides in the park and when he asked why, staff said it was due to manufacturers’ liability.

“I couldn’t even get on little kiddy rides,” he said.

“So it pretty much had nothing to do with my physical capabilities, whether I can transfer, whether I can do this or that. It was, ‘Hey, we don’t want to get sued, so you can’t go on.’”

In a statement, Canada’s Wonderland said it is committed to giving all guests with disabilities the same opportunity to enjoy and benefit from their services and attractions in a similar way as other guests.

“The ride admission policy at Canada’s Wonderland is developed in consultation with industry experts and based on the safety recommendations of the ride manufacturers,” the amusement park’s management said in a statement.

“The safety of our guests and associates is our first priority and we reserve the right to make the final decision regarding the eligibility of a rider to endure the dynamics of a ride without risk of injury to themselves or other riders.”

The company said it is equally committed to providing accommodations to people with disabilities.

El Nasser, whose injury is the result of a motorcycle accident about a decade ago, was refunded the money for his park pass. He said the experience felt discriminatory.

“Nobody really took the time on their end to understand each [of our] individual needs … I felt it was easier for them to just put us all in one bag and say, ‘This is the no section.’”

Laverne Jacobs, a faculty of law professor at the University of Windsor, said when El Nasser paid his admission fee for the park, he entered into a contract that gives him the right to be accommodated to the point of undue hardship under Ontario’s Accessibility Standards for Customer Service.

“What that means is that the park not only should be asking questions about what he can do, but should be trying to use that information in order to accommodate him to make sure that they can help to support and enable him to participate in the activities,” Jacobs said.

Jacobs says safety is a factor in this incident but believes the park created a blanket exclusion to “contract out their obligation to accommodate people with disabilities.”

“It seems that [the park] wanted to enter into a contract that says we don’t want to take on any risk of an accident whatsoever … the very problematic piece of this, though, is that in order to avoid all risk, they’ve essentially categorically excluded individuals with particular disabilities.”

David Lepofsky, the chair of the Accessibility for Ontarians with Disabilities Act Alliance, says service providers like Canada’s Wonderland have a duty to accommodate customers with disabilities.

“If the individual can make an informed decision for themselves that they want to assume that risk, then it’s not for Canada’s Wonderland to unilaterally make that decision for them,” he said.

Canada’s Wonderland does have a guest assistance guide, but Lepofsky says individuals with disabilities need to be dealt with case-by-case.

“Canada’s Wonderland has a duty to investigate solutions,” he said.

“Including investigating it with the individual and find out if other amusement parks have allowed something similar before they could just slam the door on this individual.”

A petition launched by El Nasser’s sister is calling for an end to the exclusion of paraplegics and quadriplegics from rides at the park. It has since garnered hundreds of signatures. El Nasser said he hopes shedding light on this will spark some action.

“What I would like to see changed is for people with disabilities to have that confidence to know that [the park is] doing more and they’re treating us with respect individually, that they want to let us ride.”



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Please Send Us Your Feedback on the AODA Alliance’s Draft Brief to the Health Care Standards Development Committee on the Disability Barriers in Ontario’s Health Care System


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

Please Send Us Your Feedback on the AODA Alliance’s Draft Brief to the Health Care Standards Development Committee on the Disability Barriers in Ontario’s Health Care System

July 23, 2021

            SUMMARY

Did we get it right? Let us know!

We’ve been busy as can be, writing a brief that we plan to submit by August 11, 2021 to the Health Care Standards Development Committee. The Ontario Government appointed that Committee back in 2017 to come up with recommendations on what the promised Health Care Accessibility Standard should include. The Health Care Accessibility Standard is a law that is to be enacted under the Accessibility for Ontarians with Disabilities Act to tear down the barriers that obstruct people with disabilities in Ontario’s health care system.

We’ve come up with a draft brief. We want your feedback on it to help us finalize it.

Back on May 7, 2021, the Ford Government made public the initial report of the Health Care Standards Development Committee. That initial report makes a series of recommendations on what the promised Health Care Accessibility Standard should include. The Government is inviting public feedback on that initial report up to August 11, 2021. The Health Care Standards Development Committee will be given all that public feedback. It can use that feedback to finalize its recommendations to the Government. We want our brief to give as much help as possible to the Health Care Standards Development Committee.

Below we set out a summary of what our draft brief to the Health Care Standards Development Committee recommends. We applaud and agree with most of what the Health Care Standards Development Committee wrote. However, we make a number of recommendations on how it can improve its report.

Our draft brief builds upon all the feedback we have received over the years about disability barriers in the health care system. You can download our draft brief by visiting https://www.aodaalliance.org/wp-content/uploads/2021/07/July-23-2021-Draft-AODA-Alliance-brief-on-health-Care-Standards-Development-Committee-initial-report.docx

Please send us your suggestions on our draft brief by August 1, 2021. We will then have to rush to turn our draft brief into a finished product.

Here are resources that you might find helpful:

  1. The Health Care Standards Development Committee’s initial report, recommending what the promise Health Care Accessibility Standard should include.
  1. A captioned talk by AODA Alliance Chair David Lepofsky two years ago about disability barriers in the health care system.
  1. A captioned talk earlier this year by AODA Alliance Chair David Lepofsky about the disability discrimination in Ontario’s critical care triage protocol that is now embedded in Ontario hospitals.
  1. The AODA Alliance website’s health care page, which documents our advocacy efforts over the past decade to make health care services accessible to people with disabilities.

A long 904 days ago, the Ford Government received the blistering final report of the Independent Review of the AODA’s implementation by former Lieutenant Governor David Onley. It called for urgent action to speed up and strengthen the AODA’s implementation and enforcement. Since then, the Ford Government has announced no comprehensive plan of action to implement that report.

            MORE DETAILS

Summary of the July 23, 2021 Draft AODA Alliance Brief to the Health Care Standards Development Committee

  1. a) The Health Care Standards Development Committee should recommend more concrete actions to ensure that disability barriers are removed and prevented, rather than instead giving primary emphasis to individually accommodating patients with disabilities and having hospitals plan for accessibility.
  1. b) The Health Care Standards Development Committee should more forcefully address all barriers in the hospital sector and the broader health care system.
  1. c) The Health Care Accessibility Standard should ensure that all disability barriers are removed and prevented in hospitals, not just those the Accessibility Minister asked the Standards Development Committee to focus on.
  1. d) The Health Care Accessibility Standard should not assume that smaller hospitals always need more time to comply.
  1. e) The initial report incorrectly understates the role of the Health Care Standards Development Committee.
  1. f) The proposed long-term objective of the Health Care Accessibility Standard should be strengthened.
  1. g) The initial report’s vision of a barrier-free health care system should be strengthened.
  1. h) Additional recommendations are needed to ensure accountability for accessibility within a hospital or other health care provider’s organization.
  1. i) Specific requirements for accessibility of health care facilities’ built environment are needed.
  1. j) Specific actions should be recommended to ensure that diagnostic and treatment equipment are accessible.
  1. k) Specific actions are needed to ensure the accessibility of health records.
  1. l) The initial report’s recommendations on training of health care providers should be strengthened.
  1. m) Detailed recommendations are needed to protect the right of patients with disabilities and of any patients’ support people with disabilities to physically get to health care services.
  1. n) Action is needed to guarantee the right of patients with disabilities to the privacy of their health care information.
  1. o) Additional recommendations are needed to help ensure the rights of patients with disabilities and of patients’ support people with disabilities to accessible information and communication in connection with health care.
  1. p) The initial report’s recommendations should be strengthened to effectively protect the right of patients with disabilities to the support services they need to access health care services.
  1. q) Additional measures should be recommended to ensure right of patients with disabilities to identify their disability-related accessibility needs in advance and to request accessibility/accommodation from a health care provider or facility.
  1. r) Patients with disabilities and support people with disabilities should be assured accessible complaint processes at health care providers’ self-governing colleges, and to have those colleges ensure that the profession they regulate are trained to meet the needs of patients with disabilities.
  1. s) Systemic accessibility safeguards should be built into the health care system from top to bottom.
  1. t) The experience and expertise of people with disabilities working in the health care system should be harnessed to expedite the removal and prevention of barriers facing patients, and those facing their support people with disabilities.
  1. u) The Health Care Standards Development Committee should endorse the K-12 Education Standards Development Committee initial report’s health care recommendations.
  1. v) Further steps should be recommended to supplement the initial report’s recommendations arising from the covid-19 pandemic.
  1. w) The initial report’s recommendations on strengthening AODA enforcement are heartily applauded.t



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Please Send Us Your Feedback on the AODA Alliance’s Draft Brief to the Health Care Standards Development Committee on the Disability Barriers in Ontario’s Health Care System


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/

July 23, 2021

SUMMARY

Did we get it right? Let us know!

We’ve been busy as can be, writing a brief that we plan to submit by August 11, 2021 to the Health Care Standards Development Committee. The Ontario Government appointed that Committee back in 2017 to come up with recommendations on what the promised Health Care Accessibility Standard should include. The Health Care Accessibility Standard is a law that is to be enacted under the Accessibility for Ontarians with Disabilities Act to tear down the barriers that obstruct people with disabilities in Ontario’s health care system.

We’ve come up with a draft brief. We want your feedback on it to help us finalize it.

Back on May 7, 2021, the Ford Government made public the initial report of the Health Care Standards Development Committee. That initial report makes a series of recommendations on what the promised Health Care Accessibility Standard should include. The Government is inviting public feedback on that initial report up to August 11, 2021. The Health Care Standards Development Committee will be given all that public feedback. It can use that feedback to finalize its recommendations to the Government. We want our brief to give as much help as possible to the Health Care Standards Development Committee.

Below we set out a summary of what our draft brief to the Health Care Standards Development Committee recommends. We applaud and agree with most of what the Health Care Standards Development Committee wrote. However, we make a number of recommendations on how it can improve its report.

Our draft brief builds upon all the feedback we have received over the years about disability barriers in the health care system. You can download our draft brief by visiting https://www.aodaalliance.org/wp-content/uploads/2021/07/July-23-2021-Draft-AODA-Alliance-brief-on-health-Care-Standards-Development-Committee-initial-report.docx

Please send us your suggestions on our draft brief by August 1, 2021. We will then have to rush to turn our draft brief into a finished product.

Here are resources that you might find helpful:

1. The Health Care Standards Development Committee’s initial report, recommending what the promise Health Care Accessibility Standard should include.

2. A captioned talk by AODA Alliance Chair David Lepofsky two years ago about disability barriers in the health care system.

3. A captioned talk earlier this year by AODA Alliance Chair David Lepofsky about the disability discrimination in Ontario’s critical care triage protocol that is now embedded in Ontario hospitals.

4. The AODA Alliance website’s health care page, which documents our advocacy efforts over the past decade to make health care services accessible to people with disabilities.

A long 904 days ago, the Ford Government received the blistering final report of the Independent Review of the AODA’s implementation by former Lieutenant Governor David Onley. It called for urgent action to speed up and strengthen the AODA’s implementation and enforcement. Since then, the Ford Government has announced no comprehensive plan of action to implement that report.

MORE DETAILS

Summary of the July 23, 2021 Draft AODA Alliance Brief to the Health Care Standards Development Committee

a) The Health Care Standards Development Committee should recommend more concrete actions to ensure that disability barriers are removed and prevented, rather than instead giving primary emphasis to individually accommodating patients with disabilities and having hospitals plan for accessibility.

b) The Health Care Standards Development Committee should more forcefully address all barriers in the hospital sector and the broader health care system.

c) The Health Care Accessibility Standard should ensure that all disability barriers are removed and prevented in hospitals, not just those the Accessibility Minister asked the Standards Development Committee to focus on.

d) The Health Care Accessibility Standard should not assume that smaller hospitals always need more time to comply.

e) The initial report incorrectly understates the role of the Health Care Standards Development Committee.

f) The proposed long-term objective of the Health Care Accessibility Standard should be strengthened.

g) The initial report’s vision of a barrier-free health care system should be strengthened.

h) Additional recommendations are needed to ensure accountability for accessibility within a hospital or other health care provider’s organization.

i) Specific requirements for accessibility of health care facilities’ built environment are needed.

j) Specific actions should be recommended to ensure that diagnostic and treatment equipment are accessible.

k) Specific actions are needed to ensure the accessibility of health records.

l) The initial report’s recommendations on training of health care providers should be strengthened.

m) Detailed recommendations are needed to protect the right of patients with disabilities and of any patients’ support people with disabilities to physically get to health care services.

n) Action is needed to guarantee the right of patients with disabilities to the privacy of their health care information.

o) Additional recommendations are needed to help ensure the rights of patients with disabilities and of patients’ support people with disabilities to accessible information and communication in connection with health care.

p) The initial report’s recommendations should be strengthened to effectively protect the right of patients with disabilities to the support services they need to access health care services.

q) Additional measures should be recommended to ensure right of patients with disabilities to identify their disability-related accessibility needs in advance and to request accessibility/accommodation from a health care provider or facility.

r) Patients with disabilities and support people with disabilities should be assured accessible complaint processes at health care providers’ self-governing colleges, and to have those colleges ensure that the profession they regulate are trained to meet the needs of patients with disabilities.

s) Systemic accessibility safeguards should be built into the health care system from top to bottom.

t) The experience and expertise of people with disabilities working in the health care system should be harnessed to expedite the removal and prevention of barriers facing patients, and those facing their support people with disabilities.

u) The Health Care Standards Development Committee should endorse the K-12 Education Standards Development Committee initial report’s health care recommendations.

v) Further steps should be recommended to supplement the initial report’s recommendations arising from the covid-19 pandemic.

w) The initial report’s recommendations on strengthening AODA enforcement are heartily applauded.t




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Attend CNIB’s July 27, 2021 Virtual Town Hall on Dangers that Electric Scooters Pose for People with Disabilities if London Ontario Allows Them – and— Please Fill Out an Important Online Survey About Disability Barriers in Ontario’s Courts


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/

Attend CNIB’s July 27, 2021 Virtual Town Hall on Dangers that Electric Scooters Pose for People with Disabilities if London Ontario Allows Them – and— Please Fill Out an Important Online Survey About Disability Barriers in Ontario’s Courts

July 22, 2021

            SUMMARY

Here’s a buffet of recent news from the trenches of the battle for accessibility for people with disabilities:

  1. Please come to CNIB’s July 27, 2021 Virtual Town Hall between 5 and 7 pm local time to discuss the dangers that e-scooters pose if the City of London Ontario allows them. Read on for details on how to register to take part.
  1. Please complete an important online survey before September 30, 2021 about disability barriers you have experienced in Ontario’s Courts. See below for more information on this.
  1. What do you think of the initial reports of the K-12 Education Standards Development Committee or the Post-Secondary Education Standards Development Committee on what needs to be done to tear down the many disability barriers that impede students with disabilities in Ontario? Let us know! Once again, read on for more about this.

Believe it or not, 903 days ago, the Ford Government received the blistering final report of the Independent Review of the AODA’s implementation by former Lieutenant Governor David Onley. It called for urgent action to speed up and strengthen the AODA’s implementation and enforcement. Since then, the Ford Government has still announced no comprehensive plan of action to implement that report. Numbering at least 2.6 million, Ontarians with disabilities deserve better.

            MORE DETAILS

1. Come to CNIB’s July 27, 2021 Virtual Town Hall on Dangers to People with Disabilities if London, Ontario Allows E-Scooters

It is very troubling that London, Ontario is considering allowing e-scooters. After an incredibly tenacious effort, people with disabilities managed to convince the City of Toronto not to allow e-scooters because they endanger people with disabilities, seniors, children and others. Now it is time to mount a similar campaign in other cities in Ontario that are thinking of creating the same danger for people with disabilities.

London, Ontario is now actively considering the possibility of conducting a “pilot project” with e-scooters. The corporate lobbyists for the e-scooter rental companies are unquestionably behind this, as they were in Toronto, Ottawa, Windsor and elsewhere.

We are thrilled that on Tuesday, July 27, 2021 from 5 to 7 pm local time, CNIB will be hosting an on-line Virtual Town Hall for people with disabilities to discuss concerns about the possibility of London allowing e-scooters and to explore what you can do about this danger. Please plan to take part! To register for this event, contact Larissa Proctor [email protected] and let her know if you have any accommodation needs.

For background you can check out our short, widely viewed, captioned online video by AODA Alliance Chair David Lepofsky about the dangers that e-scooters pose for people with disabilities. It formed part of our successful campaign against allowing e-scooters in Toronto.

Toronto City staff did a comprehensive job of documenting the dangers that e-scooters pose for people with disabilities, seniors, children and others. That research led Toronto City Council to unanimously defeat a proposal to allow e-scooters, which was heavily backed by the e-scooters corporate lobbyists. We call on all other Ontario cities to show the same wisdom and concern for the safety of people with disabilities and others.

To learn all about our campaign over the past two years to protect Ontarians with disabilities from the dangers that e-scooters pose, visit the AODA Alliance website’s e-scooters page.

Why are we having to fight this battle one city at a time? Sadly, this is all due to Premier Doug Ford refusing to listen to us about this while listening instead only to the e-scooter corporate lobbyists. Two years ago, e-scooters were not allowed in public places in Ontario, thanks to Ontario law. As the AODA Alliance website’s e-scooters page amply documents, the Ford Government decided to change all that in 2019. It passed a harmful regulation that let each municipality conduct a pilot project if they wished with e-scooters over a 5-year period. We tried to convince the Ford Government not to do this, because of the dangers posed to people with disabilities and others. The Ford Government decided, however, to give in to the corporate lobbyists and to entirely reject our concerns.

People with disabilities won this uphill battle against the corporate lobbyists in Toronto. We can do the same in London and elsewhere, with your help. Please register to take part in the July 27, 2021 Virtual Town Hall to get involved.

2. Please Take Part In an On-Line Survey About Disability Barriers in Ontario’s Court System

Have you had experience encountering any disability barriers in any court proceedings in Ontario? Here is an amazing chance for you to anonymously share your experience and help with an ongoing effort to make Ontario’s courts barrier-free for people with disabilities by 2025, as the Accessibility for Ontarians with Disabilities Act requires.

In 2007, a major official report, the Weiler Report, mapped out actions needed to make Ontario’s courts fully accessible for court participants with disabilities. It was prepared by a group including representation from the courts, the Government, the legal profession and the disability community. That group was appointed by Ontario’s then Chief Justice Roy McMurtry. It was chaired by then Court of Appeal Justice Karen Weiler. AODA Alliance Chair David Lepofsky was a member of that group.

Among other things, the Weiler Report recommended that a permanent committee be established to monitor and oversee progress in this area. This led to the creation of the Ontario Courts Accessibility Committee (OCAC), which has been in action since then. A successor to the Weiler group, OCAC also includes representatives from the courts, the Government, the legal profession and the disability community. AODA Alliance Chair David Lepofsky has also been a member of that committee since it began.

To help OCAC with its ongoing work, an online survey is underway until September 30, 2021. It gives you a chance to give your input without sharing your identity. Please take part in the survey. Please publicize it to others, and urge them to take part as well.

The online survey about disability barriers in Ontario’s courts is available in English at https://www.surveymonkey.com/r/OCACSurveyEN and in French at https://www.surveymonkey.com/r/OCACSondageFR

To learn more about the AODA Alliance’s advocacy for accessibility in Ontario’s courts, visit the AODA Alliance website’s courts accessibility page.

3. Reminder to Send Us Input to Help Us Give Feedback on Barriers in Ontario Schools, Colleges and Universities Facing Students with Disabilities

As we earlier announced, we are preparing briefs to submit to the K-12 Education Standards Development Committee on its initial report and to the Post-Secondary Education Standards Development Committee on its initial report. These reports address barriers facing students with disabilities in schools, colleges and universities respectively. Send your input to us at [email protected] to help us with the preparation of our briefs.

We will also very shortly be sharing with you a draft of the brief on disability barriers in the health care system facing patients with disabilities, to see how you like it. That brief, once finalized will be shared with the Health Care Standards Development Committee.

It is extremely rare that people with disabilities get a chance to have input into such important issues. They are all happening at the same time. Let’s take advantage and be sure we all have our say.

To help you, we have made available a captioned online education video that summarizes the K-12 Education Standards Development Committee’s initial report. Check it out. We have also made available for you an Action Kit on how to take part, as well as a 15-page summary and a 55-page summary of the K-12 Education Standards Development Committee initial report. Choose which of these offerings is the most helpful for you.

Learn more about our advocacy efforts in the area of education for students with disabilities by visiting the AODA Alliance website’s education page.



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At the AODA Alliance’s Request, CTV Commendably Corrects an Inaccurate Online News Report About Ontario’s Critical Care Triage 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/

June 8, 2021

SUMMARY

Who watches the watchers? Once again, the AODA Alliance has had to do so, when it comes to monitoring media coverage or lack of coverage of the danger since the start of the COVID-19 pandemic of disability discrimination in access to life-saving critical care in Ontario hospitals.

This is Part 2 of our own coverage on this important question. The June 7, 2021 AODA Alliance Update described how CBC’s flagship national daytime current affairs radio program The Current has failed to cover the dangers of disability discrimination in critical care triage during the COVID-19 pandemic. Today, we look to another network and another storyone with an eventual happy ending.

Back on April 28, 2021, CTV’s nightly national TV news program commendably covered the danger of critical care triage in Ontario. It is good that its report included a reference to disability concerns.

However, CTV’s online news report on this issue (unlike its shorter broadcast TV news item) inaccurately stated as a fact that under Ontario’s critical care triage protocol, people with disabilities are to be treated no differently than others. It stated:

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population

That statement of fact was absolutely and provably incorrect. We were not contacted by CTV before that story ran.

This story appeared to the AODA Alliance to possibly be one that the physicians at the centre of planning the Ontario critical care triage protocol may have brought to the media. It has the focus and sound of the message that they espoused.

On April 30, 2021, the AODA Alliance reached out by email to CTV news. We showed how that statement was factually wrong. To its credit, after some back-and-forth exchanges, at our request CTV news removed that harmfully inaccurate statement from its online report. We very much appreciate that this story was corrected.

Around May 6, 2021, CTV updated this online story in response to our concerns. However, the change was not an effective solution. The line, quoted above, was revised to read as follows, which was also factually inaccurate:

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population

As well, the following was commendably added later in the story:

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

On May 18 and 19, 2021, AODA Alliance Chair David Lepofsky again wrote CTV about this story. While appreciating CTV’s effort to correct it, CTV was told that it was still inaccurate for the story to state as a fact that people with pre-existing disabilities are not to be treated any differently than the rest of the population under Ontario’s critical care triage protocol. Shortly after that, CTV again revised the online story to remove the entire unfactual statement. The following words were removed from it:

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population

As well the online CTV story now includes a link to the AODA Alliance’s detailed February 25, 2021 report on disability discrimination in Ontario’s critical care triage protocol.

Below you can read the following:

a) the original version of this CTV story as posted online on April 28, 2021.

b) the AODA Alliance’s April 30, 2021 email to CTV news.

c) The revised CTV online story as of May 6, 2021.

d) The May 18 and 19, 2021 emails from the AODA Alliance to CTV, and

e) The final version of the story as it now appears online.

We applaud CTV for correcting this story, and for being open to our feedback on it. We have urged CTV’s national news to do a story specifically focusing on the disability discrimination problems with Ontario’s critical care triage protocol. They have not yet done so. It remains an immediate and important story. Things are better in Ontario, but there has been no public accounting for the disability discrimination now embedded in hospital training across Ontario. As well, Manitoba is facing an immediate danger of possible critical care triage.

In contrast, CBC TV’s The National commendably ran a 7-minute story on that topic on 18, 2021. That was a very lengthy story for a national TV news program.

Who watches the watchers? The AODA Alliance and people with disabilities must do so!

For more background on this issue, check out:

1. The online captioned video talk on this issue by AODA Alliance Chair David Lepofsky, seen over 1,000 times, and

2. The AODA Alliance website’s health care page.

1 MORE DETAILS

CTV News April 28, 2021

Originally posted at
https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols Avis Favaro
Medical Correspondent, CTV National News
@ctv_avisfavaro

Elizabeth St. Philip
CTV News
@LizTV
Ben Cousins
CTVNews.ca Writer
@cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT
TORONTO As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground, Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past, said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

There is a wall that’s going to be hit at some point, Simpson said. We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

That doesn’t mean we’re not going to care for people, O’Connor said. We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator —
people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

The hardest part really is going to be making these decisions, she said. This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.

This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving, said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years, he said. They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.

QUEBEC FAR FROM TRIGGERING’ TRIAGE PROTOCOLS
Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context, according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is far from triggering the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

This scenario is one of last resort that we want to avoid at all costs, the statement read. That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

These assessments must be based on the best available scientific evidence, the Saskatchewan Health Authority wrote in a statement.

Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.

intensive care admissions
As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

April 30, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

CTV’s online April 28, 2021 online news report on the issue of critical care triage in Ontario, entitled Ontario hospitals on the verge of enacting ‘last resort’ triage protocols, includes a seriously inaccurate and deeply disturbing statement that needs to be rectified. It states:

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population

In fact, and contrary to what CTV reports, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports.

For example, if a cancer patient needs critical care, they will be deprioritized if a patient is Completely disabled and cannot carry out any self-care; totally confined to bed or chair. As another example, if a patient needing critical care is over 65 and has a progressive disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. In both examples, this is disability discrimination, pure and simple.

This is not open to factual debate. The secret January 13, 2021 Critical Care Triage Protocol has been posted on the AODA Alliance website for over three months. No one has disputed that those two features are in the protocol. They can also be found in the terrifying online calculator that we made public, and that critical care doctors are being told to use if critical care triage takes place.

The presence of disability discrimination in the January 13, 2021 Critical Care Triage Protocol has led leading disability organizations to publicly demand that this disability discrimination be removed from it. See our efforts on this at www.aodaalliance.org/healthcare It has led the Ontario Human Rights Commission to raise serious concerns. As well, fully six members of the Ontario Government’s own advisory Bioethics Table have been publicly critical of the January 13, 2021 Critical Care Triage Protocol. This is all documented in detail at www.aodaalliance.org/healthcare

It is good that your story quotes Prof. Jeff Preston as being concerned about the triage protocol. The entire passage, excerpted above, states:

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving, said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years, he said. They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.

It is good that the CTV report notes that people with disabilities are terrified. However, the substantial misstatement of fact to which we here point is not corrected by that aspect of the CTV report. The reader is left with the uncontradicted categorical statement that

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population

At best, the triage protocol says that people with certain stable disabilities are not thereby to be assessed by the Clinical Frailty Scale that measures their ability to perform the eleven tasks of daily living, listed above, without assistance. However, the protocol goes on to apply that disability-discriminatory Scale to people with progressive disabilities (e.g. MS or arthritis, to name a few).

Especially in a national online news story dealing with a life-and-death issue, and its dangerous implications for society’s most vulnerable, it is essential for CTV to get its facts right. This is all the more so since people with disabilities disproportionately have born the brunt of COVID-19 and disproportionately died from it. It is also especially so since it has been so hard to get the media to cover this story. We’ve been trying for over a year, with success for the most part taking place only very recently.

It would be one thing for your report to include our position and then any defence the Ford Government wishes to offer. CTV did not do so. Instead, it categorically states as objective fact something which is 100% incorrect, and which your reporters on this story did not reach out to us to discuss. Our position on these issues has been widely publicized to the media, including to CTV, via news releases and Twitter.
In marked contrast to the April 28, 2021 CTV online report, on the same day, Global TV News Toronto aired a story commendably bearing the accurate headline: Ontario’s COVID-19 triage protocol discriminates because of disability,’ advocates say.

We know from the January 23, 2021 online webinar that Critical care Services Ontario conducted for hospitals that the Government or its proxies planned to do some sort of public media strategy on the critical care triage protocol. Your story corresponds in large part to the core messages of that strategy. That could very well be a coincidence, and CTV may well have not known about those media relations strategic plans.

We urgently ask you to do a national report on the disability discrimination that is explicitly included in the Ontario critical care triage protocol, the bogus arguments that have been made on the Ontario Government’s behalf to defend it, and the objections to it from the disability community, the Ontario Human Rights Commission and some members of the Government’s own advisory Bioethics Table. We would be please to assist you in any way in such a story.

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

CTV News Online Report Updated by May 6, 2021

Originally posted at https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746 Ontario hospitals on the verge of enacting ‘last resort’ triage protocols Medical Correspondent, CTV National News
Contact @ctv_avisfavaro
Elizabeth St. Philip, CTV News
Contact @LizTV
Ben Cousins, CTVNews.ca Writer
Contact @cousins_ben
Published Wednesday, April 28, 2021 10:00PM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground, Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past, said Dr. Erin O’Connor, the deputy medical director of the University Health Networkemergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per dayby the end of May, even under strong public health restrictions.

There is a wall that’s going to be hit at some point, Simpson said. We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

That doesn’t mean we’re not going to care for people, O’Connor said. We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator —
people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

The hardest part really is going to be making these decisions, she said. This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.

This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving, said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years, he said. They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context, according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is far from triggering the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

This scenario is one of last resort that we want to avoid at all costs, the statement read. That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

These assessments must be based on the best available scientific evidence, the Saskatchewan Health Authority wrote in a statement.

Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.

intensive care admissions

As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

May 18, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

To: CTVNews
From: David Lepofsky
Date: May 18, 2021

I regret that I must write to again raised concerns about the factual inaccuracy of CTV News’ online April 28, 2021 news report regarding Ontario’s critical care triage protocol. On April 30, 2021, I wrote to alert you to the fact that there was a serious factual error in that report, where it stated the following:

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

In my April 30, 2021 email to CTV news, I explained that contrary to what CTV reported, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports. That is disability discrimination.

I very much appreciate that as a result, CTV reporter Avis Favaro spoke to me about this issue and that CTV news looked into our objection.

As a result, CTV News made two changes to the online CTV News report, on or around May 6, 2021. I regret that the first of those changes included a serious factual inaccuracy. The first change was simply to add the word pre-existing before the word disabilities in the inaccurate statement in the original April 28, 2021 CTV news report. Report’s The revised statement now reads:

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

Second, the May 6, 2021 version later adds this accurate sentence:

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

It is good that CTV attempted to correct it’s inaccurate April 28, 2021 news report. However, CTV has replaced one serious inaccuracy with another serious inaccuracy. The January 13, 2021 Critical Care Triage Protocol does not specify that people with disabilities are not treated any differently than the rest of the population (as the inaccurate April 28, 2021 report originally claimed) or that people with pre-existing disabilities are not treated any differently than others (as the May 6, 2021 revision to that article claims. To the contrary, under that critical care triage protocol, if a cancer patient with pre-existing cancer needs critical care, they will be deprioritized if a patient is Completely disabled and cannot carry out any self-care; totally confined to bed or chair. That is disability discrimination, up front. Under that protocol, if a patient needing critical care is over 65 and has a progressive pre-existing disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. That too is disability discrimination, pure and simple, including disability discrimination based on a pre-existing disability. CTV’s insertion of the word pre-existing into the inaccurate statement did not reduce or correct its complete and demonstrable inaccuracy.

I would add that unless I am mistaken or missed something, nothing on the CTV web page displaying this report acknowledges that there previously was a factual inaccuracy in it. In contrast, newspapers regularly print corrections to earlier stories, that are entitled correction, to ensure that the reader is aware that an earlier report had been inaccurate. No one reading the original April 28, 2021 story would know that it was erroneous. No one reading the same report, as revised on or around May 6, 2021, would know that CTV had attempted to correct it. Of course, no one would know from that report that it is inaccurate where it states as a fact that under the protocol, people with pre-existing disabilities are to be treated like everyone else.

We would very much appreciate this story being corrected so that it is accurate. We also would again encourage CTV to run a story that reports specifically on this disability discrimination issue that is anchored in the very wording of the January 13, 2021 Critical Care Triage Protocol. Ontario is not out of the woods, even though ICU cases and overall new COVID-19 cases are reducing. This remains a live issue for your viewers and readers, including the many with disabilities. The newsworthiness of this disability discrimination standing alone is important. The inaccuracy on the CTV website makes the case for a further report even more compelling.

We would be delighted to assist in any way we can. Please stay safe.

David Lepofsky CM, O. Ont
Chair Accessibility for Ontarians with Disabilities Act Alliance Twitter: @davidlepofsky May 19, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

Thank you for asking what correction or clarification to the April 28, 2021 CTV News story we would recommend. We respectfully propose that the sentence that requires a change is this:

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

May we propose two alternatives. The first and preferable alternative would read:

The triage guidelines do not ensure that people with pre-existing disabilities are not treated any differently than the rest of the population. Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

The second and less desirable alternative would be to simply delete the inaccurate words The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but. The paragraph would therefore read

Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

You asked for a link to the AODA Alliance website. We again offer two alternatives. The more specific link to our report that exhaustively details the disability discrimination in the Ontario critical care triage protocol is https://www.aodaalliance.org/whats-new/a-deeply-troubling-issue-of-life-and-death-an-independent-report-on-ontarios-seriously-flawed-plans-for-rationing-or-triage-of-critical-medical-care-if-covid-19-overwhelms-ontario-hospitals/ The more general link to all our posts on this issue is www.aodaalliance.org/healthcare

We Hope this helps. If a phone call would assist, let me know.

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

CTV News Online Report As Revised Again on May 19, 2021

Originally posted at: jhttps://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

CTV News

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols Avis Favaro, Medical Correspondent
Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News
Contact @LizTV

Ben Cousins , CTVNews.ca Writer
Contact @cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT
Last Updated Wednesday, May 19, 2021 9:14AM EDT
TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

Related Links
Accessibility for Ontarians with Disabilities Act Alliance on triage protocols
The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground, Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past, said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

There is a wall that’s going to be hit at some point, Simpson said. We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

That doesn’t mean we’re not going to care for people, O’Connor said. We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator —
people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

The hardest part really is going to be making these decisions, she said. This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.

This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving, said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.

Preston is skeptical of the triage guidelines in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years, he said. They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC FAR FROM TRIGGERING’ TRIAGE PROTOCOLS
Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context, according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is far from triggering the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

This scenario is one of last resort that we want to avoid at all costs, the statement read. That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

These assessments must be based on the best available scientific evidence, the Saskatchewan Health Authority wrote in a statement.

Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.

Correction:
A previous version of this story suggested triage guidelines




Source link

At the AODA Alliance’s Request, CTV Commendably Corrects an Inaccurate Online News Report About Ontario’s Critical Care Triage Plans


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/

At the AODA Alliance’s Request, CTV Commendably Corrects an Inaccurate Online News Report About Ontario’s Critical Care Triage Plans

June 8, 2021

            SUMMARY

Who watches the watchers? Once again, the AODA Alliance has had to do so, when it comes to monitoring media coverage or lack of coverage of the danger since the start of the COVID-19 pandemic of disability discrimination in access to life-saving critical care in Ontario hospitals.

This is Part 2 of our own coverage on this important question. The June 7, 2021 AODA Alliance Update described how CBC’s flagship national daytime current affairs radio program “The Current” has failed to cover the dangers of disability discrimination in critical care triage during the COVID-19 pandemic. Today, we look to another network and another story—one with an eventual  happy ending.

Back on April 28, 2021, CTV’s nightly national TV news program commendably covered the danger of critical care triage in Ontario. It is good that its report included a reference to disability concerns.

However, CTV’s online news report on this issue (unlike its shorter broadcast TV news item) inaccurately stated as a fact that under Ontario’s critical care triage protocol, people with disabilities are to be treated no differently than others. It stated:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

That statement of fact was absolutely and provably incorrect. We were not contacted by CTV before that story ran.

This story appeared to the AODA Alliance to possibly be one that the physicians at the centre of planning the Ontario critical care triage protocol may have brought to the media. It has the focus and sound of the message that they espoused.

On April 30, 2021, the AODA Alliance reached out by email to CTV news. We showed how that statement was factually wrong. To its credit, after some back-and-forth exchanges, at our request CTV news removed that harmfully inaccurate statement from its online report. We very much appreciate that this story was corrected.

Around May 6, 2021, CTV updated this online story in response to our concerns. However, the change was not an effective solution. The line, quoted above, was revised to read as follows, which was also factually inaccurate:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population…”

As well, the following was commendably added later in the story:

“Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.”

On May 18 and 19, 2021, AODA Alliance Chair David Lepofsky again wrote CTV about this story. While appreciating CTV’s effort to correct it, CTV was told that it was still inaccurate for the story to state as a fact that people with pre-existing disabilities are not to be treated any differently than the rest of the population under Ontario’s critical care triage protocol. Shortly after that, CTV again revised the online story to remove the entire unfactual statement. The following words were removed from it:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

As well the online CTV story now includes a link to the AODA Alliance’s detailed February 25, 2021 report on disability discrimination in Ontario’s critical care triage protocol.

Below you can read the following:

  1. a) the original version of this CTV story as posted online on April 28, 2021.
  1. b) the AODA Alliance’s April 30, 2021 email to CTV news.
  1. c) The revised CTV online story as of May 6, 2021.
  1. d) The May 18 and 19, 2021 emails from the AODA Alliance to CTV, and
  1. e) The final version of the story as it now appears online.

We applaud CTV for correcting this story, and for being open to our feedback on it. We have urged CTV’s national news to do a story specifically focusing on the disability discrimination problems with Ontario’s critical care triage protocol. They have not yet done so. It remains an immediate and important story. Things are better in Ontario, but there has been no public accounting for the disability discrimination now embedded in hospital training across Ontario. As well, Manitoba is facing an immediate danger of possible critical care triage.

In contrast, CBC TV’s The National commendably ran a 7-minute story on that topic on 18, 2021. That was a very lengthy story for a national TV news program.

Who watches the watchers? The AODA Alliance and people with disabilities must do so!

For more background on this issue, check out:

  1. The online captioned video talk on this issue by AODA Alliance Chair David Lepofsky, seen over 1,000 times, and
  1. The AODA Alliance website’s health care page.

1          MORE DETAILS

 CTV News April 28, 2021

Originally posted at

https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Avis Favaro

Medical Correspondent, CTV National News

@ctv_avisfavaro

Elizabeth St. Philip

CTV News

@LizTV

Ben Cousins

CTVNews.ca Writer

@cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

intensive care admissions

As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

April 30, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

CTV’s online April 28, 2021 online news report on the issue of critical care triage in Ontario, entitled “Ontario hospitals on the verge of enacting ‘last resort’ triage protocols”, includes a seriously inaccurate and deeply disturbing statement that needs to be rectified. It states:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

In fact, and contrary to what CTV reports, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports.

For example, if a cancer patient needs critical care, they will be deprioritized if a patient is “Completely disabled and cannot carry out any self-care; totally confined to bed or chair”. As another example, if a patient needing critical care is over 65 and has a progressive disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. In both examples, this is disability discrimination, pure and simple.

This is not open to factual debate. The secret January 13, 2021 Critical Care Triage Protocol has been posted on the AODA Alliance website for over three months. No one has disputed that those two features are in the protocol. They can also be found in the terrifying online calculator that we made public, and that critical care doctors are being told to use if critical care triage takes place.

The presence of disability discrimination in the January 13, 2021 Critical Care Triage Protocol has led leading disability organizations to publicly demand that this disability discrimination be removed from it. See our efforts on this at www.aodaalliance.org/healthcare It has led the Ontario Human Rights Commission to raise serious concerns. As well, fully six members of the Ontario Government’s own advisory Bioethics Table have been publicly critical of the January 13, 2021 Critical Care Triage Protocol. This is all documented in detail at www.aodaalliance.org/healthcare

It is good that your story quotes Prof. Jeff Preston as being concerned about the triage protocol. The entire passage, excerpted above, states:

“The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

It is good that the CTV report notes that people with disabilities are terrified. However, the substantial misstatement of fact to which we here point is not corrected by that aspect of the CTV report. The reader is left with the uncontradicted categorical statement that

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population…”

At best, the triage protocol says that people with certain stable disabilities are not thereby to be assessed by the Clinical Frailty Scale that measures their ability to perform the eleven tasks of daily living, listed above, without assistance. However, the protocol goes on to apply that disability-discriminatory Scale to people with progressive disabilities (e.g. MS or arthritis, to name a few).

Especially in a national online news story dealing with a life-and-death issue, and its dangerous implications for society’s most vulnerable, it is essential for CTV to get its facts right. This is all the more so since people with disabilities disproportionately have born the brunt of COVID-19 and disproportionately died from it. It is also especially so since it has been so hard to get the media to cover this story. We’ve been trying for over a year, with success for the most part taking place only very recently.

It would be one thing for your report to include our position and then any defence the Ford Government wishes to offer. CTV did not do so. Instead, it categorically states as objective fact something which is 100% incorrect, and which your reporters on this story did not reach out to us to discuss. Our position on these issues has been widely publicized to the media, including to CTV, via news releases and Twitter.

In marked contrast to the April 28, 2021 CTV online report, on the same day, Global TV News Toronto aired a story commendably bearing the accurate headline: “Ontario’s COVID-19 triage protocol ‘discriminates because of disability,’ advocates say”.

We know from the January 23, 2021 online webinar that Critical care Services Ontario conducted for hospitals that the Government or its proxies planned to do some sort of public media strategy on the critical care triage protocol. Your story corresponds in large part to the core messages of that strategy. That could very well be a coincidence, and CTV may well have not known about those media relations strategic plans.

We urgently ask you to do a national report on the disability discrimination that is explicitly included in the Ontario critical care triage protocol, the bogus arguments that have been made on the Ontario Government’s behalf to defend it, and the objections to it from the disability community, the Ontario Human Rights Commission and some members of the Government’s own advisory Bioethics Table. We would be please to assist you in any way in such a story.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

CTV News Online Report Updated by May 6, 2021

Originally posted at https://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Medical Correspondent, CTV National News

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins, CTVNews.ca Writer

Contact @cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Networkemergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per dayby the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

intensive care admissions

As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

May 18, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

To: CTVNews

From: David Lepofsky

Date: May 18, 2021

I regret that I must write to again raised concerns about the factual inaccuracy of CTV News’ online April 28, 2021 news report regarding Ontario’s critical care triage protocol. On April 30, 2021, I wrote to alert you to the fact that there was a serious factual error in that report, where it stated the following:

“The triage guidelines specify that people with disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.“

In my April 30, 2021 email to CTV news, I explained that contrary to what CTV reported, the January 13, 2021 Critical Care Triage Protocol explicitly directs that a patient’s disability IS a factor that in some cases is to be weighed AGAINST their getting access to the life-saving critical care they need, if Ontario has more patients needing critical care than it has critical care beds and supports. That is disability discrimination.

I very much appreciate that as a result, CTV reporter Avis Favaro spoke to me about this issue and that CTV news looked into our objection.

As a result, CTV News made two changes to the online CTV News report, on or around May 6, 2021. I regret that the first of those changes included a serious factual inaccuracy. The first change was simply to add the word “pre-existing” before the word “disabilities” in the inaccurate statement in the original April 28, 2021 CTV news report. Report’s The revised statement now reads:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

Second, the May 6, 2021 version later adds this accurate sentence:

“Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.”

It is good that CTV attempted to correct it’s inaccurate April 28, 2021 news report. However, CTV has replaced one serious inaccuracy with another serious inaccuracy. The January 13, 2021 Critical Care Triage Protocol does not specify that “people with disabilities” are not treated any differently than the rest of the population (as the inaccurate April 28, 2021 report originally claimed) or that people with pre-existing disabilities are not treated any differently than others (as the May 6, 2021 revision to that article claims. To the contrary, under that critical care triage protocol, if a cancer patient with pre-existing cancer needs critical care, they will be deprioritized if a patient is “Completely disabled and cannot carry out any self-care; totally confined to bed or chair”. That is disability discrimination, up front. Under that protocol, if a patient needing critical care is over 65 and has a progressive pre-existing disease (like MS, arthritis or Parkinson’s), their access to critical care is reduced depending on how few of eleven activities of daily living they can perform without assistance. This includes dressing, bathing, eating, walking, getting in and out of bed, using the telephone, going shopping, preparing meals, doing housework, taking medication, or handling their finances. That too is disability discrimination, pure and simple, including disability discrimination based on a pre-existing disability. CTV’s insertion of the word “pre-existing” into the inaccurate statement did not reduce or correct its complete and demonstrable inaccuracy.

I would add that unless I am mistaken or missed something, nothing on the CTV web page displaying this report acknowledges that there previously was a factual inaccuracy in it. In contrast, newspapers regularly print corrections to earlier stories, that are entitled “correction”, to ensure that the reader is aware that an earlier report had been inaccurate. No one reading the original April 28, 2021 story would know that it was erroneous. No one reading the same report, as revised on or around May 6, 2021, would know that CTV had attempted to correct it. Of course, no one would know from that report that it is inaccurate where it states as a fact that under the protocol, people with pre-existing disabilities are to be treated like everyone else.

We would very much appreciate this story being corrected so that it is accurate. We also would again encourage CTV to run a story that reports specifically on this disability discrimination issue that is anchored in the very wording of the January 13, 2021 Critical Care Triage Protocol. Ontario is not out of the woods, even though ICU cases and overall new COVID-19 cases are reducing. This remains a live issue for your viewers and readers, including the many with disabilities. The newsworthiness of this disability discrimination standing alone is important. The inaccuracy on the CTV website makes the case for a further report even more compelling.

We would be delighted to assist in any way we can. Please stay safe.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance Twitter: @davidlepofsky

May 19, 2021 Email from AODA Alliance Chair David Lepofsky to CTV News

Thank you for asking what correction or clarification to the April 28, 2021 CTV News story we would recommend. We respectfully propose that the sentence that requires a change is this:

“The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

May we propose two alternatives. The first and preferable alternative would read:

“The triage guidelines do not ensure that people with pre-existing disabilities are not treated any differently than the rest of the population. Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

The second and less desirable alternative would be to simply delete the inaccurate words “The triage guidelines specify that people with pre-existing disabilities are not treated any differently than the rest of the population, but”. The paragraph would therefore read

“Preston is skeptical in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.”

You asked for a link to the AODA Alliance website. We again offer two alternatives. The more specific link to our report that exhaustively details the disability discrimination in the Ontario critical care triage protocol is https://www.aodaalliance.org/whats-new/a-deeply-troubling-issue-of-life-and-death-an-independent-report-on-ontarios-seriously-flawed-plans-for-rationing-or-triage-of-critical-medical-care-if-covid-19-overwhelms-ontario-hospitals/

The more general link to all our posts on this issue is www.aodaalliance.org/healthcare

We Hope this helps. If a phone call would assist, let me know.

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

CTV News Online Report As Revised Again on May 19, 2021

Originally posted at: jhttps://www.ctvnews.ca/health/coronavirus/ontario-hospitals-on-the-verge-of-enacting-last-resort-triage-protocols-1.5406746

CTV News

Ontario hospitals on the verge of enacting ‘last resort’ triage protocols

Avis Favaro, Medical Correspondent

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins , CTVNews.ca Writer

Contact @cousins_ben

Published Wednesday, April 28, 2021 10:00PM EDT

Last Updated Wednesday, May 19, 2021 9:14AM EDT

TORONTO — As intensive care admissions climb to dangerously high levels in Ontario, health-care workers in the province worry they might soon be forced into the worst-case scenario of choosing who gets the best care and who doesn’t.

On Wednesday, Ontario reported 3,480 new COVID-19 cases. Although a third wave in the province appears to be levelling off, the number of COVID-19 patients in the intensive care units (ICUs) is steadily climbing, to the point where the province is getting assistance from Newfoundland and Labrador and the Canadian military.

Related Links

Accessibility for Ontarians with Disabilities Act Alliance on triage protocols

The province also reported on Wednesday that 2,281 patients are currently hospitalized, with 877 patients in intensive care.

It’s believed the province could be forced to enact triage protocols if ICU admissions related to COVID-19 exceed 900.

“I just can’t say strongly enough just what a horrible position we’re in the health-care sector right now and why it’s so important that we really drive these numbers to the ground,” Dr. Chris Simpson, a cardiologist and executive vice-president of Ontario Health, told CTV News.

“We simply have to get COVID under control if we’re going to have our health-care system back in a functional state again.”

Ontario’s triage protocols, developed in January, are meant as a last resort to determine who should be given intensive care when the demand for critical care exceeds the supply.

“It’s going to be extremely emotionally difficult for staff to have to make these decisions to tell family members that we’re not able to offer ICU-level treatments that we would have been able to offer in the past,” said Dr. Erin O’Connor, the deputy medical director of the University Health Network emergency departments.

The situation is already dire in the Toronto area, where health officials have been forced to transport patients to other districts as ICU beds in the city fill up. Ontario’s COVID-19 modelling numbers from April 16 suggest the province could see nearly 10,000 new COVID-19 cases per day by the end of May, even under strong public health restrictions.

“There is a wall that’s going to be hit at some point,” Simpson said. “We don’t know where that is yet. We do believe we can build about 200 new ICU beds per week for the next three weeks or so. It gets increasingly tougher, but we think that that will take us into mid-May and we can only hope that things will be cresting by that point.”

Under the triage protocols, all patients are assigned four colours — red, purple, yellow and green — depending on how doctors perceive a patient’s likelihood of surviving for another 12 months. Patients deemed red are predicted to have a 20-per-cent chance of surviving for the year, while patients deemed in the green have more than a 70-per-cent chance of surviving.

Under this system, ICU beds would be given to the green patients first, followed by yellow, purple and red.

“That doesn’t mean we’re not going to care for people,” O’Connor said. “We’re going to offer as much medical care as we possibly can, but some people won’t be able to be on a ventilator — people that we would have put on a ventilator in the past — simply because we’re in a situation where we’re dealing with scarce resources.”

The triage system puts doctors and other health-care workers in the unenviable position of deciding who does not receive the best possible care. It would even require doctors to decide who to withdraw from ICU care if they’re unlikely to survive for another year.

For O’Connor, the prospect having to tell a patient and their family that the province cannot provide them with the best care could have long-term consequences on the entire health-care system in Ontario.

“The hardest part really is going to be making these decisions,” she said. “This is going to take a really large emotional toll and I worry about my staff and I worry about people — after this — leaving medicine because they’re not going to be able to recover.”

“This is not what we’re trained to do. It’s not what we thought we would ever have to do in our careers.”

The triage guidelines are also terrifying for people with disabilities, advanced age or pre-existing conditions.

“There’s also this very real concern that I may be denied care based on protocols that say that I have a less likely chance of surviving,” said Jeff Preston, who has a neuromuscular disorder and works as an assistant professor of disability studies at King’s University College, an affiliate of Western University in London, Ont.

“It’s one thing to get COVID and die, it’s a whole other thing to say, as a Canadian citizen, I might not actually have the same access to health care that other Canadians are going to receive and that hurts in a different way.”

Preston is skeptical of the triage guidelines in part because doctors sometimes incorrectly estimate life expectancy of people with these conditions.

“When I was first diagnosed as a baby, they did not believe I was going to survive more than a couple of years,” he said. “They predicted that I would probably die before four or five years old. Now here I am, almost 40 years old, many years later and that prognosis didn’t turn out to be true.”

Disability advocates, backed by the Ontario Human Rights Commission, have raised human rights and discriminatory concerns about the protocol in letters to the provincial government.

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

Other provinces have also developed similar triage protocols in the event ICU admissions exceed the available beds.

In Quebec for example, prioritization protocols are similar to Ontario’s and those who do not receive ICU admission “will not be abandoned; they will continue to receive other care, the most appropriate for their condition and possible in the context,” according to a statement from Quebec’s Ministry of Health and Social Services.

The department added that it is “far from triggering” the prioritization protocols and has not done so since the start of the pandemic. It has also expanded ICU capacity for COVID-19 patients to hopefully make sure it doesn’t happen.

“This scenario is one of last resort that we want to avoid at all costs,” the statement read. “That is why we are asking Quebecers for their contribution by reducing their contact as much as possible and by rigorously applying the recommended health measures.”

In Saskatchewan, triage protocols will consider a patient’s chance at survival, but also the length of time a patient may require the most care.

“These assessments must be based on the best available scientific evidence,” the Saskatchewan Health Authority wrote in a statement.

“Patients who are not going to receive ICU level of care will receive compassionate care. The sick and dying would not be abandoned. If a patient is not expected to survive, palliative or comfort care would be provided to reduce pain and suffering.”

Correction:

A previous version of this story suggested triage guidelines



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Companies under pressure to comply with Ontario’s new website accessibility standards


Companies with at least 50 employees that do business in Ontario face a June 30 deadline to confirm they are complying with new standards for making websites accessible for people with disabilities.

All private-sector and not-for-profit organizations with more than 50 employees could be fined for failing to ensure their website complies with rules that took effect in January.

The Ford government has given until the end of this month for organizations to self-report on their compliance with the accessibility law.

Read more:
Save-On-Foods apologizes to B.C. man after accessibility features removed from shopping app

The Accessibility for Ontarians with Disabilities Act provides for enforcing compliance with an escalating range of fines that can reach $100,000 per day.

The law originally focused on physical barriers but more recently adopted an international standard for accessible websites and digital communications.

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Ontario’s law has been described as the toughest in Canada when it comes to digital communications but years behind what’s in place in the United States.




© 2021 The Canadian Press






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