New Report Reveals that At Majority of Ontarios School Boards, Each School Principal Is a Law Unto Themselves, With Arbitrary Power to Exclude a Student From School ? Real Risk of a Rash of Exclusion of Some Students with Disabilities When Schools Re-Open


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

July 23, 2020 Toronto: Parents of a third of a million Ontario K-12 students with disabilities have much to fear when schools re-open. A ground-breaking report by the non-partisan AODA Alliance (unveiled today, summary below) shows that for much of Ontario, each school principal is a law unto themselves, armed with a sweeping, arbitrary power to refuse to allow a student to come to school. If schools re-open this fall, there is a real risk of a rash of principals excluding some students with disabilities from school, because well-intentioned, overburdened principals wont know how to accommodate them during COVID-19.

The Education Act gives each school principal the drastic power to refuse to admit to school any person whose presence in the school or classroom would in the principals judgment be detrimental to the physical or mental well-being of the pupils”. A survey of Ontarios 72 school boards, unveiled today, shows that a majority of school boards have no policy reining in their principals sweeping power. Ontarios Ministry of Education gives principals precious little direction. Principals need not keep track of how many students they exclude, or for how long, or for what reason, nor need they report this information to anyone. School Boards are left largely free to do as little as they wish to monitor for and prevent abuse of this power.

This is especially worrisome for students with disabilities. Disproportionately, its students with disabilities who are at risk of being excluded from school.

Todays report details how the most vulnerable students can unjustifiably be treated very differently from one part of Ontario to the next. Of Ontarios 72 School Boards, only 33 Boards have been found to have any policy on this. Only 36 School Boards even responded to the AODA Alliance survey. Only 11 Boards gave the AODA Alliance a policy. A web search revealed that another 22 Boards have a policy on this.

As for the minority of 33 boards that have any policy on point, this report documented wild and arbitrary differences from Board to Board. Some Board policies have commendable and helpful ingredients that all boards should have. Some Board policies contain unfair and inappropriate ingredients that should be forbidden. For example, no Board should impose on a student or their family an arbitrary time limit for presenting an appeal from their exclusion to school.

Every student facing the trauma of an exclusion from school deserves full and equally fair procedures and safeguards, said AODA Alliance Chair David Lepofsky. The current arbitrary pattern of patchwork injustice cries out for new leadership now by the Ford Government.

COVID-19 escalates this issues urgency. The Ministry of Education should head off a rash of new exclusions from school this fall before it happens, by immediately directing School Boards to implement common sense restrictions on a principal, outlined in the report, on when and how a principal may exclude a student from school.

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

Download the entire AODA Alliance report on Refusals to Admit A Student to School by visiting https://www.aodaalliance.org/wp-content/uploads/2020/07/july-23-2020-AODA-Alliance-finalized-refusals-to-admit-brief.docx

The AODA Alliances COVID-19 web page details its efforts to ensure that the urgent needs of people with disabilities are met during the COVID-19 crisis.
The AODA Alliance’s Education web page details its ongoing efforts over the past decade to tear down the many barriers impeding students with disabilities in Ontarios education system.

Introduction and Summary of the AODA Alliances Report on the Power of Ontario School Principals to Refuse to Admit a Student to School

I. Introduction and Summary
(a) Whats the Problem?
For years, Ontarios Education Act has given every Ontario school principal the drastic power to refuse to admit to school any person whose presence in the school or classroom would in the principals judgment be detrimental to the physical or mental well-being of the pupils”. A student can be excluded from school for part or all of the school day. This report uses the terms refusal to admit and exclusion from school or simply exclusion to mean the same thing.

When a principal refuses to admit a student to school, that violates that students right to go to school to get an education. Under the Education Act as interpreted or applied by the Ontario Government and school boards, a student can be excluded from school for days, weeks or even months.

Ontarios Ministry of Education has given School Boards and principals very little direction on how this sweeping power may be used. School Boards are therefore left largely free to do as much or as little as they wish to ensure that this power is not abused by an individual school principal.

A School Board can develop a policy on how a principal can use the power to refuse to admit a student to school; however, a School Board does not have to do so. If it does adopt a policy, it does not have to be a good policy. (b) Taking Stock The AODA Alliance Surveys Ontario School Boards
The AODA Alliance therefore conducted a survey of Ontarios major School Boards to find out what their policies and practices are regarding the exclusion of students from school. The non-partisan grassroots AODA Alliance advocates for accessibility for people with disabilities, including for students with disabilities. See its websites Education page.

This report makes public the results of the AODA Alliance’s survey and investigation. It reveals an arbitrary patchwork of different policies around Ontario, unjustifiably treating the most vulnerable students differently from one part of Ontario to the next. There is a pressing need for the Ontario Government to step into the gap, to protect students, and especially students with disabilities.
In an error which the AODA Alliance regrets, the survey was inadvertently not earlier sent to one board, the Dufferin Peel Catholic District School Board, before this report was written. It has just done so, and will make public an addendum to this report if a response is received that alters the results expressed in this report. This error does not diminish this reports findings or recommendations.

School Boards were asked (i) if it has a policy on when-and-how its school principals can refuse to admit a student to school, (ii) whether the Board tracks its principals use of this power, and (iii) how many students have been excluded from school. The AODA Alliance sent its survey to School Boards twice, once in 2019, and once in 2020. The Council of Directors of Education retained private legal counsel to get legal advice before responding to this survey.
(c) The Survey Revealed an Arbitrary Patchwork of Wildly Varying Local Requirements
Of Ontarios 72 School Boards, only 33 Boards have been found to have a written policy or procedure on refusals to admit a student to school. Only 36 School Boards responded to the AODA Alliances survey. Of those, only 11 Boards gave the AODA Alliance their policy or procedure on refusals to admit.

Six School Boards told the AODA Alliance that they have no policy on refusals to admit. An extensive web search by the AODA Alliance revealed that another 22 School Boards have a written policy or procedure on this topic. In a number of cases, these were not easy to find. Taken together, a large number of Ontario School Boards revealed a troubling lack of openness and accountability on this subject.

This reports analysis of the 33 policies or procedures on refusals to admit, as obtained by the AODA Alliance, revealed that there are wild variations between the written policies of School Boards across Ontario on excluding a student from school. Some are very short and say very little. Others are far more extensive and detailed.

As for safeguards for vulnerable students and their parents in the face of an exclusion from school, there are arbitrary and unjustified differences from Board to Board. Some Board policies have commendable and helpful ingredients that should be required of all School Boards. Some Board policies contain unfair and inappropriate ingredients that should be forbidden. For example, no Board should use a refusal to admit to facilitate a police investigation, or set an arbitrary time limit in advance for an appeal hearing from a refusal to admit, or give a student or their family an arbitrary time limit for presenting such an appeal.

There is no justification for such wild variations from Board to Board, from no policy, to policies that say very little, to substantially better policies. Every student facing an exclusion from school deserves fair procedures and effective safeguards. Every School Board should meet basic requirements of transparency and accountability in their use of this drastic power. No compelling policy objective is served by leaving each School Board to reinvent the wheel here. (d) The Urgently Needed Solution: Action Now by the Ontario Government
This situation cries out for leadership on this issue by Ontarios Ministry of Education. The failure of so many School Boards to even have a policy in this area, the unwillingness of so many School Boards to even answer questions about their policy on this issue, and the fact that policies are so hard to find on line combine to create a disturbing picture. For too much of Ontario, well-intentioned school principals are left to be a law unto themselves. The AODA Alliance expects that these hard-working and dedicated principals neither asked for this nor would like this situation to remain as is.

This issue has serious implications for students with disabilities. Refusals to admit a student to school disproportionately burden some students with disabilities.

The COVID-19 crisis escalates the urgency of this issue. When schools re-open this fall, there is a real risk that there could be a rash of more refusals to admit some students with disabilities to school. This threatens to be the way some overwhelmed and overburdened principals will cope with the stressful uncertainties surrounding the COVID-19 pandemic.

The Ministry of Education should head off this problem before it happens, by immediately directing School Boards to implement some basic and overdue requirements for refusals to admit a student to school. The Ministry should then develop a comprehensive and broader set of mandatory requirements for all School Boards when exercising the power to refuse to admit a student to school.

Examples of helpful requirements that the Ministry of Education should require, and that this report documents as now in place in one or more School Boards include the following:
1. Refusals to admit should be recognized as an infringement of the students right to go to school to get an education, and as raising potential human rights issues, especially for students with disabilities. The Ontario Human Rights Code has primacy over the Education Act and the power to refuse to admit a student to school.
2. A refusal to admit should only be imposed for a proper safety purpose. A student cannot be refused admission to school for purposes of discipline.
3. Maximum time limits should be set for a refusal to admit, with a process for considering how to extend it if necessary and justified.
4. A refusal to admit a student to school should only be permitted in very rare, extreme cases, as a last resort, after considering or trying all less intrusive alternatives. A principal should be required to take a step-by-step tiered approach to deciding whether to refuse to admit a student to school, first exhausting all less restrictive alternatives, and first ensuring that the students disability-related needs have been accommodated as required under the Ontario Human Rights Code.
5. It should not be left to an individual principal to unilaterally decide on their own to refuse to admit a student to school. Prior approval of a higher authority with the School Board should be required, supported by sufficient documentation of the deliberations.
6. A principal should be required to work with a student and their family on issues well before it degenerates to the point of considering a refusal to admit. The School Board should be required to have a mandatory meeting with the family before a refusal to admit is imposed.
7. A principal should be required to immediately send a letter to the parents of a student whom they are refusing to admit to school, setting out the facts and specifics that are the reasons for the exclusion from school. A senior Board supervisor that approved the decision should be required to co-sign the letter. The letter should also be signed by the Director of Education if the student is to be excluded from all schools in the Board.
8. A School Board that excludes a student from school should be required to put in place a plan for delivering an effective educational program to that student while excluded from school, including the option of face-to-face engagement with a teacher off of school property. This plan should be monitored to ensure it is sufficient.
9. If a student is excluded from school, the School Board should be under a strong duty to work with the student and family to get them back to school as soon as possible.
10. A School Board that excludes a student from school should be required to hold a re-entry meeting with the student and family to transition to the return to school.
11. Any appeals to the Board of Trustees for the School Board from a refusal to admit should assure fair procedures to the student and their family. An excluded student should at least have all the safeguards in the appeal process as does a student who is subjected to discipline.
12. The appeal should be heard by the entire Board of Trustees, and not just a sub-committee of some trustees. An appeal hearing should be held and decided quickly, since the student is languishing at home.
13. A Board of Trustees, hearing an appeal from a refusal to admit, should consider whether the School Board has justified the students initial exclusion from school and its continuation. The burden should be on the School Board to justify the exclusion from school, and not on the student trying to go back to school. At an appeal hearing, the principal should first present why the exclusion from school is justified and should continue, before the student or parents are asked to show why the student should be allowed to return to school.
14. When an appeal is launched, the School Board should be required to first try to resolve the issue short of a full appeal hearing.
15. A students record of a refusal to admit to school should not stain the students official school record.
16. If a School Board directs that a student can only come to school for part of the school day), the same safeguards for the student should be required as for a student who is excluded for the entire day. 17. Any policy in this area should be periodically reviewed and updated.




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New Report Reveals that At Majority of Ontario’s School Boards, Each School Principal Is a Law Unto Themselves, With Arbitrary Power to Exclude a Student From School – Real Risk of a Rash of Exclusion of Some Students with Disabilities When Schools Re-Open


ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

NEWS RELEASE – FOR IMMEDIATE RELEASE

New Report Reveals that At Majority of Ontario’s School Boards, Each School Principal Is a Law Unto Themselves, With Arbitrary Power to Exclude a Student From School – Real Risk of a Rash of Exclusion of Some Students with Disabilities When Schools Re-Open

July 23, 2020 Toronto: Parents of a third of a million Ontario K-12 students with disabilities have much to fear when schools re-open. A ground-breaking report by the non-partisan AODA Alliance (unveiled today, summary below) shows that for much of Ontario, each school principal is a law unto themselves, armed with a sweeping, arbitrary power to refuse to allow a student to come to school. If schools re-open this fall, there is a real risk of a rash of principals excluding some students with disabilities from school, because well-intentioned, overburdened principals won’t know how to accommodate them during COVID-19.

The Education Act gives each school principal the drastic power to refuse to admit to school any “person whose presence in the school or classroom would in the principal’s judgment be detrimental to the physical or mental well-being of the pupils…”. A survey of Ontario’s 72 school boards, unveiled today, shows that a majority of school boards have no policy reining in their principals’ sweeping power. Ontario’s Ministry of Education gives principals precious little direction. Principals need not keep track of how many students they exclude, or for how long, or for what reason, nor need they report this information to anyone. School Boards are left largely free to do as little as they wish to monitor for and prevent abuse of this power.

This is especially worrisome for students with disabilities. Disproportionately, it’s students with disabilities who are at risk of being excluded from school.

Today’s report details how the most vulnerable students can unjustifiably be treated very differently from one part of Ontario to the next. Of Ontario’s 72 School Boards, only 33 Boards have been found to have any policy on this. Only 36 School Boards even responded to the AODA Alliance survey. Only 11 Boards gave the AODA Alliance a policy. A web search revealed that another 22 Boards have a policy on this.

As for the minority of 33 boards that have any policy on point, this report documented wild and arbitrary differences from Board to Board. Some Board policies have commendable and helpful ingredients that all boards should have. Some Board policies contain unfair and inappropriate ingredients that should be forbidden. For example, no Board should impose on a student or their family an arbitrary time limit for presenting an appeal from their exclusion to school.

“Every student facing the trauma of an exclusion from school deserves full and equally fair procedures and safeguards,” said AODA Alliance Chair David Lepofsky. “The current arbitrary pattern of patchwork injustice cries out for new leadership now by the Ford Government.”

COVID-19 escalates this issue’s urgency. The Ministry of Education should head off a rash of new exclusions from school this fall before it happens, by immediately directing School Boards to implement common sense restrictions on a principal, outlined in the report, on when and how a principal may exclude a student from school.

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

Download the entire AODA Alliance report on Refusals to Admit A Student to School by visiting https://www.aodaalliance.org/wp-content/uploads/2020/07/july-23-2020-AODA-Alliance-finalized-refusals-to-admit-brief.docx

The AODA Alliance’s COVID-19 web page details its efforts to ensure that the urgent needs of people with disabilities are met during the COVID-19 crisis.

The AODA Alliance‘s Education web page details its ongoing efforts over the past decade to tear down the many barriers impeding students with disabilities in Ontario’s education system.

Introduction and Summary of the AODA Alliance’s Report on the Power of Ontario School Principals to Refuse to Admit a Student to School

I. Introduction and Summary

(a) What’s the Problem?

For years, Ontario’s Education Act has given every Ontario school principal the drastic power to refuse to admit to school any “person whose presence in the school or classroom would in the principal’s judgment be detrimental to the physical or mental well-being of the pupils…”. A student can be excluded from school for part or all of the school day. This report uses the terms “refusal to admit” and “exclusion from school” or simply “exclusion” to mean the same thing.

When a principal refuses to admit a student to school, that violates that student’s right to go to school to get an education. Under the Education Act as interpreted or applied by the Ontario Government and school boards, a student can be excluded from school for days, weeks or even months.

Ontario’s Ministry of Education has given School Boards and principals very little direction on how this sweeping power may be used. School Boards are therefore left largely free to do as much or as little as they wish to ensure that this power is not abused by an individual school principal.

A School Board can develop a policy on how a principal can use the power to refuse to admit a student to school; however, a School Board does not have to do so. If it does adopt a policy, it does not have to be a good policy.

(b) Taking Stock – The AODA Alliance Surveys Ontario School Boards

The AODA Alliance therefore conducted a survey of Ontario’s major School Boards to find out what their policies and practices are regarding the exclusion of students from school. The non-partisan grassroots AODA Alliance advocates for accessibility for people with disabilities, including for students with disabilities. See its website’s Education page.

This report makes public the results of the AODA Alliance‘s survey and investigation. It reveals an arbitrary patchwork of different policies around Ontario, unjustifiably treating the most vulnerable students differently from one part of Ontario to the next. There is a pressing need for the Ontario Government to step into the gap, to protect students, and especially students with disabilities.

In an error which the AODA Alliance regrets, the survey was inadvertently not earlier sent to one board, the Dufferin Peel Catholic District School Board, before this report was written. It has just done so, and will make public an addendum to this report if a response is received that alters the results expressed in this report. This error does not diminish this report’s findings or recommendations.

School Boards were asked (i) if it has a policy on when-and-how its school principals can refuse to admit a student to school, (ii) whether the Board tracks its principal’s use of this power, and (iii) how many students have been excluded from school. The AODA Alliance sent its survey to School Boards twice, once in 2019, and once in 2020. The Council of Directors of Education retained private legal counsel to get legal advice before responding to this survey.

(c) The Survey Revealed an Arbitrary Patchwork of Wildly Varying Local Requirements

Of Ontario’s 72 School Boards, only 33 Boards have been found to have a written policy or procedure on refusals to admit a student to school. Only 36 School Boards responded to the AODA Alliance’s survey. Of those, only 11 Boards gave the AODA Alliance their policy or procedure on refusals to admit.

Six School Boards told the AODA Alliance that they have no policy on refusals to admit. An extensive web search by the AODA Alliance revealed that another 22 School Boards have a written policy or procedure on this topic. In a number of cases, these were not easy to find. Taken together, a large number of Ontario School Boards revealed a troubling lack of openness and accountability on this subject.

This report’s analysis of the 33 policies or procedures on refusals to admit, as obtained by the AODA Alliance, revealed that there are wild variations between the written policies of School Boards across Ontario on excluding a student from school. Some are very short and say very little. Others are far more extensive and detailed.

As for safeguards for vulnerable students and their parents in the face of an exclusion from school, there are arbitrary and unjustified differences from Board to Board. Some Board policies have commendable and helpful ingredients that should be required of all School Boards. Some Board policies contain unfair and inappropriate ingredients that should be forbidden. For example, no Board should use a refusal to admit to facilitate a police investigation, or set an arbitrary time limit in advance for an appeal hearing from a refusal to admit, or give a student or their family an arbitrary time limit for presenting such an appeal.

There is no justification for such wild variations from Board to Board, from no policy, to policies that say very little, to substantially better policies. Every student facing an exclusion from school deserves fair procedures and effective safeguards. Every School Board should meet basic requirements of transparency and accountability in their use of this drastic power. No compelling policy objective is served by leaving each School Board to reinvent the wheel here.

(d) The Urgently Needed Solution: Action Now by the Ontario Government

This situation cries out for leadership on this issue by Ontario’s Ministry of Education. The failure of so many School Boards to even have a policy in this area, the unwillingness of so many School Boards to even answer questions about their policy on this issue, and the fact that policies are so hard to find on line combine to create a disturbing picture. For too much of Ontario, well-intentioned school principals are left to be a law unto themselves. The AODA Alliance expects that these hard-working and dedicated principals neither asked for this nor would like this situation to remain as is.

This issue has serious implications for students with disabilities. Refusals to admit a student to school disproportionately burden some students with disabilities.

The COVID-19 crisis escalates the urgency of this issue. When schools re-open this fall, there is a real risk that there could be a rash of more refusals to admit some students with disabilities to school. This threatens to be the way some overwhelmed and overburdened principals will cope with the stressful uncertainties surrounding the COVID-19 pandemic.

The Ministry of Education should head off this problem before it happens, by immediately directing School Boards to implement some basic and overdue requirements for refusals to admit a student to school. The Ministry should then develop a comprehensive and broader set of mandatory requirements for all School Boards when exercising the power to refuse to admit a student to school.

Examples of helpful requirements that the Ministry of Education should require, and that this report documents as now in place in one or more School Boards include the following:

  1. Refusals to admit should be recognized as an infringement of the student’s right to go to school to get an education, and as raising potential human rights issues, especially for students with disabilities. The Ontario Human Rights Code has primacy over the Education Act and the power to refuse to admit a student to school.
  2. A refusal to admit should only be imposed for a proper safety purpose. A student cannot be refused admission to school for purposes of discipline.
  3. Maximum time limits should be set for a refusal to admit, with a process for considering how to extend it if necessary and justified.
  4. A refusal to admit a student to school should only be permitted in very rare, extreme cases, as a last resort, after considering or trying all less intrusive alternatives. A principal should be required to take a step-by-step tiered approach to deciding whether to refuse to admit a student to school, first exhausting all less restrictive alternatives, and first ensuring that the student’s disability-related needs have been accommodated as required under the Ontario Human Rights Code.
  5. It should not be left to an individual principal to unilaterally decide on their own to refuse to admit a student to school. Prior approval of a higher authority with the School Board should be required, supported by sufficient documentation of the deliberations.
  6. A principal should be required to work with a student and their family on issues well before it degenerates to the point of considering a refusal to admit. The School Board should be required to have a mandatory meeting with the family before a refusal to admit is imposed.
  7. A principal should be required to immediately send a letter to the parents of a student whom they are refusing to admit to school, setting out the facts and specifics that are the reasons for the exclusion from school. A senior Board supervisor that approved the decision should be required to co-sign the letter. The letter should also be signed by the Director of Education if the student is to be excluded from all schools in the Board.
  8. A School Board that excludes a student from school should be required to put in place a plan for delivering an effective educational program to that student while excluded from school, including the option of face-to-face engagement with a teacher off of school property. This plan should be monitored to ensure it is sufficient.
  9. If a student is excluded from school, the School Board should be under a strong duty to work with the student and family to get them back to school as soon as possible.
  10. A School Board that excludes a student from school should be required to hold a re-entry meeting with the student and family to transition to the return to school.
  11. Any appeals to the Board of Trustees for the School Board from a refusal to admit should assure fair procedures to the student and their family. An excluded student should at least have all the safeguards in the appeal process as does a student who is subjected to discipline.
  12. The appeal should be heard by the entire Board of Trustees, and not just a sub-committee of some trustees. An appeal hearing should be held and decided quickly, since the student is languishing at home.
  13. A Board of Trustees, hearing an appeal from a refusal to admit, should consider whether the School Board has justified the student’s initial exclusion from school and its continuation. The burden should be on the School Board to justify the exclusion from school, and not on the student trying to go back to school. At an appeal hearing, the principal should first present why the exclusion from school is justified and should continue, before the student or parents are asked to show why the student should be allowed to return to school.
  14. When an appeal is launched, the School Board should be required to first try to resolve the issue short of a full appeal hearing.
  15. A student’s record of a refusal to admit to school should not stain the student’s official school record.
  16. If a School Board directs that a student can only come to school for part of the school day), the same safeguards for the student should be required as for a student who is excluded for the entire day.
  17. Any policy in this area should be periodically reviewed and updated.



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On Global Accessibility Awareness Day, the AODA Alliance Again Writes Ontario’s Education Minister and TVO’s Vice President to Try to Get the Urgent Learning Needs of Students with Disabilities Met


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

May 21, 2020

SUMMARY

In our continuing campaign to get the Ford Government to address the urgent needs of a third of a million vulnerable students with disabilities during the COVID-19 crisis, the AODA Alliance today wrote two important letters, set out below. These are especially timely, because today is the internationally recognized Global Accessibility Awareness Day (GAAD).

First, we wrote Ontario Education Minister Stephen Lecce today to again press him to direct the establishment within his Ministry of a command table of experts on teaching students with disabilities. We need this command table created to lead and oversee the creation and implementation of an emergency plan to address the urgent needs of students with disabilities during the COVID-19 crisis. We were following up on our April 29, 2020 letter to the minister. In our new letter we point out three striking examples that show why there is a pressing need for the minister to direct his Ministry to immediately take the overdue actions we recommend.

Second, we today wrote the vice president for digital content at TVO, Ontarios public education TV network. We summarized a recent discussion that the vice president had with AODA Alliance Chair David Lepofsky. In that discussion, we gave TVO constructive recommendations for urgent action that TVO needs to take to fix the accessibility problems in its online education content.

Taken together, these letters show a recurring failure of leadership by the Ford Government when it comes to meeting the urgent needs of students with disabilities during the COVID-19 crisis. A striking illustration of this is the Education Ministers May 8, 2020 email to all school boards about distance learning during COVID-19. We also set out that memo below. The ministers detailed email to all school boards was missing the key directions to school boards on how to meet the urgent needs of students with disabilities during COVID-19.

Stay tuned for more AODA Alliance Updates. Keep us posted by sending us your feedback, at [email protected]

MORE DETAILS

May 21, 2020 Letter from the AODA Alliance to Ontario Education Minister Stephen Lecce

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE
[email protected] www.aodalliance.org Twitter: @aodaalliance

May 21, 2020

Via Email
To: The Hon Stephen Lecce, Minister of Education
[email protected]

Dear Minister,

Re: Ensuring that Students with Disabilities Fully Benefit from Education at Home During the COVID-19 Crisis

We write On Global Accessibility Awareness Day to follow up on our April 29, 2020 letter to you about the pressing need for the Ontario Government to create and swiftly implement a comprehensive plan to meet the urgent learning needs of a third of a million Ontario students with disabilities during the COVID-19 crisis.

Since we wrote you almost a month ago, we appreciate having had the chance to have conversations with your deputy minister, two of your assistant deputy ministers, and some other officials within the ministry. I also welcomed the chance to make a five-minute presentation to you during the May 6, 2020 virtual meeting of the K-12 Education Standards Development Committee of which I am a member.

It is good that during Premier Fords May 19, 2020 daily COVID-19 briefing, you recognized that more than ever, families of students with disabilities in Ontario need more support for their children to be able to learn at home. It is helpful that you said that the Government has great concern about these children and that the Government wants to ensure that these children get the support they need.

However, almost ten weeks into the school shutdown, and even after announcing that schools will remain closed for the rest of the school year, the Government has still announced no comprehensive plan to remove the troubling and recurring additional barriers facing students with disabilities that you have acknowledged. Your Government still leaves it to each school board to separately figure out what these barriers are and how to systematically overcome them. Your Government has still not set up and put in charge a much-needed command table with expertise in educating students with disabilities to steer and lead the provinces efforts in this area. This is especially wasteful and ineffective when school boards, like your Government, are trying to cope with an unexpected and unprecedented crisis. Front line educators and parents are struggling to do their best. They need more help from the Ontario Government.

Here are three illustrative and deeply disturbing examples of missing provincial leadership. We ask you to intervene with your Ministry officials to get them to act not only on these examples, but on a comprehensive plan of action.

First, with the rapid move to online classes, it is a bedrock necessity that the platform that schools use for online class meetings is accessible to students, teachers, and parents with disabilities. From our exchanges with Ministry staff, it is clear that the Ministry has not shown the required leadership on this issue. It does not appear to have directed school boards to ensure that they use accessible platforms, nor has it compared the options to direct which platform should be preferred.

Your detailed May 8, 2020 email to all school boards and other key players in the education system focuses primarily on the Ministrys directions to school boards to use synchronous learning (i.e. online classes in real time via web-based meeting platforms). That memo is stunningly silent on the need to ensure that the platform school boards use is accessible to students, teachers, and parents with disabilities. That memo gives school boards no directions on which platforms to use. That memo was sent two days after I briefed you and four of your caucus colleagues on this serious issue during the May 6, 2020 meeting of the K-12 Education Standards Development Committee in which you commendably participated.

The Ministry has told us that it has left it to each school board to decide for itself which meeting platform to use. That is a failed approach. It abdicates provincial leadership and oversight. Your Ministry is leaving it to each school board to itself decide whether or not it should investigate the relative accessibility of different online meeting platforms. A school board may not even know that this is an issue it needs to investigate.

Under your Ministrys approach a school board is free to simply overlook this issue altogether. Your Government is burdening each school board to duplicate the same investigation of the comparative accessibility of different online meeting platforms. It is not clear which school boards have any expertise to do this. There is no assurance that any school boards who do this will in fact get it right. Your Ministry is not tracking which online platforms are being used in Ontario schools, or to what extent accessible platforms are being used.

The Ministry told us it has not itself undertaken a comparison of the various virtual meeting platforms available to school boards in order to assess their comparative accessibility. We have called on your Ministry to do so and to direct school boards on the accessible platforms that may be used. Parents, students, and teachers with disabilities should not have to fight against such recurring barriers one class, one school, or one school board at a time.

Your Ministry told us that it leaves it to each school board to decide which synchronous meeting platform to use, based on the school boards assessment of its local needs. With respect, blindness, dyslexia, or other reading-related disabilities do not change when they occur in Cornwall or Kenora. The reason why the Government is now developing an Education Accessibility Standard under the Accessibility for Ontarians with Disabilities Act is so that people with disabilities will not have to fight the same battles time and again and so that school boards wont have to each reinvent the same accessibility wheel.

We have received troubling word that at least one school board has forbidden its teachers from using Zoom, which is at least as accessible as or more accessible than the other available online platforms. That flies in the face of the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act .

Your Ministry arranged a helpful May 13, 2020 demonstration of the specific online meeting platform that it has chosen to purchase for school boards, called Bongo. It is part of the Bright Space learning management system that your Ministry chose to procure from the D2L firm for use by school boards if they wish. During this demonstration, it became apparent that neither your Ministry nor D2L claimed that Bongo is the most accessible meeting platform available. Its accessibility features were helpfully demonstrated and described.

During this demonstration, we learned that your Government has no idea how many school boards, schools or teachers around Ontario are using the Bongo platform. Your Ministry has left them free to use whatever platform they wish. As far as your Ministry would know, there could be few if any teachers using Bongo or who even know about it.

This presentation included a comparison of Bongos accessibility features as compared to those of the Zoom platform. It was D2L that was comparing its product to Zoom. Your Ministry did not invite Zoom for a chance to showcase its own products accessibility features, leaving it to its competitor D2L to do this.

The D2L presentation made an unfair comparison. It compared the Bongo platform, for which the Ministry was directly or indirectly paying a fee, to the free version of Zoom. I pointed this out and asked how the Bongo platform compared to Zooms more robust pay version, as opposed to its free version, which has fewer features. D2L acknowledged that the pay version of Zoom is closer in comparison to Bongo.

During that May 13, 2020 presentation, my questions revealed that Bongo is missing an important accessibility feature that Zoom contains. With Zoom, a student can easily and instantly raise his or her virtual hand for the teachers attention, by simply typing a keyboard shortcut. Bongo has no such keyboard shortcut. For a student to reach Bongos accessible control for raising his or her hand, it takes more hunting around the program. Its location is not obvious. It is important for a student to be able to quickly raise ones hand without having to hunt around the program for the relevant control. D2L conceded that their accessibility tester had earlier asked Bongos provider to add this to their program. D2L did not include this important fact in its comparison of its product to Zoom.

In the Ministrys PowerPoint prepared to demonstrate Bongos accessibility, a slide was included to suggest that the ARCH Disability Law Centre used Bongo. This was obviously done to convey or imply that it had ARCHs approval as accessible. The slides stated:

We have several clients who support people with disabilities: CNIB, CHS, Vision Australia, Thomas Pocklington Trust, ARCH Disability Law Centre.

ARCHs use of Virtual Classroom
Educating Canadians on Accessibility Rights using Brightspace and Virtual Classroom
ARCH is offering online courses to Community Champions and Disability Rights Lawyers on the Optional Protocol (OP) of the UN Convention on the Rights of Persons with Disabilities (CRPD) with Simultaneous French interpretation, English and French live captions, ASL, and LSQ.

Press Release ARCH launches OP Lab: Learning, Sharing, Actioning!

This was quite misleading. At this May 13, 2020 presentation, I responded that ARCHs executive director had advised me that while they had procured Bongo for certain upcoming events, they have not yet used it because it has several accessibility problems. ARCH has been trying to get these problems fixed. Neither D2L nor the Government disputed this.

Second, as a key part of its approach during the COVID-19 crisis, your Government has repeatedly pointed to key online learning resources for teachers and parents. We have alerted the Government that these have accessibility problems. This includes both the Governments own Learn at Home web page and the Government-owned TVOs online learning resources. It became evident from my May 14, 2020 phone call with TVOs Vice President for Digital Content that TVO is lacking a plan to retrofit its online educational resources to ensure that they become accessible to students, teachers, and parents with disabilities. TVO seemed to be unaware of the severity of this problem until we brought it to their and the publics attention. I encourage you to read our May 21, 2020 letter to TVOs Vice President of Digital Content, copied to you. It sets out our constructive advice to TVO advice which TVO found quite helpful.

We have seen no indication that your Ministry was aware of the problems with its own online resources or those of TVO until we raised these concerns. We have seen no plan from your Ministry to fix these problems.

This TVO situation reflects a double failure. TVO failed to properly ensure its online contents accessibility. After that, your Ministry failed to ensure the accessibility of TVOs online content before so heavily relying on it as part of its COVID-19 emergency planning.

Third, struggling with this COVID-19 crisis, it is great that teachers, parents, and others with expertise in the field in Ontario and elsewhere have been coming up with creative ways to help students with different disabilities learn while schools are closed. We have been urging your Government for weeks without success to devote staff to effectively gather from the front lines specific examples of effective strategies. We still need your Government to do so and to effectively share these with educators and parents as quickly as possible in a user-friendly way, not through a blizzard of links.

Let us illustrate how disturbing this situation is. On May 4, 2020, in the absence of effective Government action on this front, the AODA Alliance and the Ontario Autism Coalition joined together to hold a successful virtual town hall. It offered practical tips to parents and teachers for teaching students with disabilities at home during COVID-19. Your Ministrys Assistant Deputy Minister of Education responsible for special education Jeff Butler commendably took part in our virtual town hall and described its contents as valuable. In just over two weeks, it has been viewed over 1,400 times. We have no budget to publicize it.

We have repeatedly asked your Ministry to publicize this virtual town hall to school boards and frontline educators. So far, it has not agreed to do so. What could be a simpler and lower-cost way to help students with disabilities? We have also urged your Ministry for weeks without success to take over this idea and itself hold such events. We have offered to help with ideas. The Ministry, with its staff and resources, could do this more effectively than did our handful of volunteers who pulled together our successful May 4, 2020 virtual town hall in under a week.

Instead of taking us up on this, the Government has largely re-announced the same initiatives that have been underway for weeks. While helpful to a point, those measures have not effectively addressed the pressing concerns of vulnerable students with disabilities.

On May 19, 2020 you said at the Premiers daily COVID-19 briefing that you have directed school boards to unlock all their special education and mental health resources during the school shutdown to help students with disabilities. That of course has been their job from the outset. However, for them to succeed, they need far more provincial direction and support than this.

On May 19, 2020, in response to a question from the media at the Premiers COVID-19 briefing, you announced some sort of two-week summer program aimed at helping orient some students with disabilities, such as those with autism, to a return to school. That announcement gave no specifics, such as where this will be offered or which students or how many students will be eligible for this program. Depending on how this is carried out, it could be helpful.

However, here again, there is a similar pressing need for the Ontario Government to show leadership by setting specific detailed and effective standards and requirements for school re-openings to ensure that the added needs of students with disabilities are effectively met in this process. Your Ministrys approach to date to students with disabilities during this crisis will not ensure that this is properly handled.

Your May 8, 2020 memo to all school boards is quite illustrative of this entire problem. It commendably makes a few general references to accommodating students with special education needs and to mental health issues. However, it gives no specific directions for meeting the recurring needs of students with disabilities in circumstances where specificity and provincial leadership are required.

We remain eager to help with solutions. We need your active intervention to set things right. Please stay safe.

Sincerely,

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

CC: Premier Doug Ford
Via Email: [email protected]

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

Nancy Naylor, Deputy Minister of Education
[email protected]

Jeff Butler, Acting Assistant Deputy Minister of the Student Support and Field Services Division [email protected]

Yael Ginsler, Assistant Deputy Minister of Education (Acting) for the Student Achievement Division [email protected]

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

Susan Picarello, Assistant Deputy Minister, Accessibility Directorate of Ontario [email protected]

Claudine Munroe, Director of the Special Education/Success for All Branch [email protected]

Demetra Saldaris, Director of the Professionalism, Teaching Policy and Standards Branch [email protected]

Rashmi, Swarup TVO Vice President Digital Learning
[email protected]

May 21, 2020 Letter from the AODA Alliance to TVOs Vice President for Digital Content

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE
Email: [email protected]
Visit: www.aodalliance.org
Twitter: @aodaalliance

May 21, 2020

To: Rashmi Swarup
Vice President Digital Learning
Via email: [email protected]

Dear Ms. Swarup,

Re: Accessibility Problems with TVOs Online Educational Content

Thank you for speaking to me by phone on May 14, 2020 about the accessibility problems on TVOs website. It is especially timely that I am writing you on Global Accessibility Awareness Day.

Here are several key points that I shared with you during our discussion.

I explained that TVOs online learning content requires a major review as soon as possible for accessibility problems. Our preliminary look at them revealed significant and obvious problems. This strongly suggests that accessibility problems are likely more pervasive. The fact that they turned up so quickly suggests to us that TVO has not done effective accessibility user testing.

I explained that to rectify this, TVO needs to immediately put in place several new measures. It needs to now publicly commit to fix its online contents accessibility problems and to ensure that any new online content created in the future is accessible from the start.

You explained that you have been in your position for about one year as TVOs Vice President of Digital Content. Previously, you were a superintendent of schools at the York Region District School Board. You didnt claim to be a subject matter expert on digital content accessibility, though you have taken required basic AODA training training which we know to be quite introductory.

TVO needs to have a senior official with subject matter expertise in digital accessibility with lead responsibility and authority for ensuring the accessibility of TVOs digital content and online offerings. It seems clear from the presence of accessibility problems in TVOs online educational content that it is lacking that expertise in a leadership role.

I outlined for you that a number of major organizations have helpfully established a position of Chief Accessibility Officer to address their accessibility needs and duties. TVO could benefit from doing so. From what you explained, it appears that no one senior official at TVO has full responsibility for and authority over ensuring digital accessibility. Responsibility is spread over several members of the TVO senior management team. That is a far less effective way of addressing this important issue.

TVO needs to bring on board the subject matter expertise to fix this problem. I explained that there are digital accessibility experts TVO can retain to assist in this area.

TVO needs to establish and make public a detailed plan to fix the accessibility problems with its current digital learning content and to ensure that new digital content that TVO creates in the future is barrier-free. I explained that end-user testing is an important aspect of this. Automated checking tools cannot replace proper user testing by human beings. From our preliminary inspection of some of TVOs online educational content, it seemed that no proper user testing would have earlier occurred.

You said you appreciated our raising these concerns and the recommendations that I shared. Our raising these concerns had escalated TVOs attention. We appreciate your agreeing to write us to let us know what new action TVO will take to address these concerns.

We hope the Ontario Government will support TVOs taking swift action to correct these problems. We had raised our concerns about TVO at senior levels within the Ministry of Education. The Minister of Education Stephen Lecce has repeatedly said that the Government has partnered with TVO to help deliver online education to students during the COVID-19 crisis.

Finally, I emphasized that as a public broadcast, TVO should be a leader in this area. In contrast to TVOs accessibility deficiencies, WGBH, a US PBS station, is a key hub and, I believe, the birthplace for the important accessibility innovation of audio description for video content.

We look forward to hearing from you about the reforms TVO will adopt. It is important for corrective action to be taken quickly, given that schools remain closed for the rest of this school year due to the COVID-19 crisis and may have to close again should there be a second surge of COVID-19.

Please stay safe.

Sincerely,

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

CC
Premier Doug Ford
[email protected]

Stephen Lecce, Minister of Education,
[email protected]

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

Nancy Naylor, Deputy Minister of Education
[email protected]

Claudine Munroe, Director of the Special Education/Success for All Branch [email protected]

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

Susan Picarello, Assistant Deputy Minister, Accessibility Directorate of Ontario [email protected]

Renu Mandhane, Chief Commissioner, Ontario Human Rights Commission [email protected]

May 8, 2020 Email from Ontario Education Minister Stephen Lecce to Ontario School Boards

May 8 2020 Email from Minister of Education Stephen Lecce to Ontario School Boards From: Ministry of Education (EDU) <
[email protected]>

Sent: May 8, 2020 5:36 PM
To: Ministry of Education (EDU) <
[email protected]>
Subject: Updates on Continuity of Learning for the Extended School Closure Period | Mises à jour sur la continuité de lapprentissage pendant la période de fermeture prolongée des écoles

table with 2 columns and 2 rows
Memorandum To:
Chairs of District School Boards
Directors of Education
School Authorities

From:
Stephen Lecce
Minister of Education

Nancy Naylor
Deputy Minister
table end

Thank you for your continued commitment to supporting students during the school closure period. We have heard so many inspiring stories from across the province of students, parents, and educators doing extraordinary work to continue learning and build and maintain relationships at this time.

During this time, the mental health and well-being of students and the people working in the education system remains a priority. The government and school boards have moved rapidly to mobilize critical mental health resources and supports for students during these uncertain times.

As you know, the school closure period has been extended to at least May 31, 2020. To that end, we are writing to provide guidance on provincial standards for continuity of learning for the remainder of the closure period, as well as to provide updates on progress to date. GUIDANCE FOR CONTINUITY OF LEARNING

As we entered the school closure period, our transition to Learn at Home was aided by existing tools that were in place to support virtual learning. The ministry provides Ontarios Virtual Learning Environment (VLE) at no cost to educators in school boards and First Nation/federally operated schools to use for delivering online programming. As a learning management system, the VLE provides tools for both synchronous and asynchronous learning delivery. Boards may already have access to other synchronous learning management systems and tools, such as Google Classroom or Edsby.

While the expectation of the ministry was that educators would embrace the use of synchronous learning during the school closure period, there has been an inconsistent uptake of this mode of learning. As such, this memo is providing clarity on the ministry position.
Recognizing there are a wide range of modalities that are used in the continuum of learning between educators and their students, the ministrys expectation is that synchronous learning be used as part of whole class instruction, in smaller groups of students, and/or in a one-on-one context.

We know that parents and students are looking for ways to interact with their teachers – which can be addressed through multiple modalities – and that online synchronous learning experience with teachers and education workers is an effective and supportive method that will position students to succeed during the school closure period. Similarly, parents expect their childs educators to strive toward as normal a learning environment as possible during this period, of which synchronous learning is a key component.
Boards should take steps to ensure that privacy considerations are addressed and that students are aware of best practices, including not giving out passwords, ensuring that teachers are the last person to leave a synchronous meeting, and respecting other board policies on student conduct.

We recognize that there may be exceptional situations where synchronous online delivery may not be possible for all students. Exceptions could include, for example, where a parent has excused their child from instruction or this form of instruction, in which case a parents wishes should be respected.

If a student cannot participate due to a lack of devices or internet connectivity, or where students require accommodations for special education needs, alternate arrangements must be made, including personal outreach through phone calls. With that in mind, it is insufficient for educators to communicate with their students in one interaction per week, for example. We recognize that school boards have made extraordinary efforts to ensure that students have devices and connectivity wherever possible, and we once again reiterate our expectation that boards provide necessary technology to students as soon as possible, and appropriate accommodations for students with special education needs, where necessary. The ministry will continue to support school boards in these efforts.

If a teacher or education worker does not feel they can currently deliver education to their students in this manner, schools and boards are encouraged to provide support and professional development. However, in situations where teachers or education workers are not delivering synchronous learning, schools and boards are expected to immediately move to a team assignment approach to ensure that students are offered synchronous delivery of teacher led learning.

School boards should continue to follow the guidance provided on March 31, 2020 regarding the hours per student, per week, and the suggested areas of curriculum focus by grade groupings.

UPDATES ON PROGRESS TO DATE

Working Together

Between April 15 and 29, the ministry conducted a series of meetings beginning with Parent Involvement Committee Chairs and extending to include meetings with the following key roles responsible for supporting vulnerable students: Student Success and Student Effectiveness Leads, Indigenous Graduation Coaches, and Black Student Graduation Coaches. These meetings provided a venue for board leads to share successful practices and ongoing challenges to supporting vulnerable students and identify additional ways to offer support.

During these meetings, partners in school boards shared information on the many ways they are addressing the needs of vulnerable students, their wellbeing, and academic success. The ministry will continue to work with partners to determine ways to support student well-being, engagement in learning, and inclusive approaches to learning within a remote learning environment, as well as when students return to school.

Access to Technology

Access to internet connectivity and learning devices has been identified by school boards and other stakeholders as an urgent need during the school closure period. In response to this need, the ministry launched an education-related call for proposals on the Ontario Together web portal, focused on supporting equity of access to remote learning.

Through this initiative, the ministry will identify proposals that school boards may wish to consider to support student and educator access to internet connectivity and devices such as computers, tablets, and portable wi-fi hotspots. As well, school boards may also wish to consider consulting other partners and sources, such as OECM, to consider comparable services and goods.

As we prepare for the eventual return to the classroom, broadband modernization activities in schools continue. All Ontario students and educators in publicly funded schools will have access to reliable, fast, secure and affordable internet services at school, in all regions of the province including rural and northern communities. This work will be complete in secondary schools by September 2020 and in elementary schools by September 2021.

As of March 31, 2020, broadband modernization was complete at 1,983 schools (including 403 in northern communities and 686 in rural communities) and in progress at 2,953 schools (including 99 in northern communities and 408 in rural communities).

Ensuring protection of privacy and security of digital learning resources is of the utmost importance for the ministry to support a safe, inclusive and accepting learning environment for synchronous learning. While school boards remain independently accountable for establishing clear policies and approving appropriate use of collaboration tools to support students learning online, we will continue to work with boards and our government partners to provide guidance on cyber security and privacy best practices for sharing with educators in your schools.

School Construction

Schools are an essential part of supporting student achievement, as well as providing safe and healthy learning and work environments for students and staff. As we head into the spring and summer months, when school boards undertake critical capital construction and renewal projects, the province has revised the list of essential workplaces to support school infrastructure. Construction projects and services (e.g. new construction, maintenance and repair) that support the essential operation of, and provide new capacity in, schools and child care centres can proceed, provided that there is strict adherence to health and safety requirements.

As school boards are best situated to understand their own particular circumstances, the ministry is asking that school boards consider whether their construction projects are able to reopen in light of these changes. This may mean that boards will need to consult with their own legal counsel, as appropriate.

Learn at Home/
Apprendre à la maison

Learn at Home/
Apprendre à la maison
was launched on March 20, 2020. This website provides supplemental resources for parents and students to support independent learning at home while schools are closed.

Learn at Home/
Apprendre à la maison includes learning resources on a variety of subjects including math, science, technology, Indigenous history and ways of knowing, art, physical education, social sciences, and mental health. Supports for students with learning disabilities and special education needs, including autism, have also been included. Resources continue to be added to address a range of learning needs.

Over the past month, there have been over four million visits to Learn at Home/ Apprendre à la maison.
We encourage you to continue to share this website and promote the new resources available with parents and students in your board.

If there are additional high-quality online learning resources that you think would be particularly beneficial to students and parents at this time, we encourage you to share them with us by emailing [email protected]

School Mental Health Ontario

School Mental Health Ontario a provincial implementation support team that works alongside the ministry, school boards, and provincial education and health organizations to develop a systematic and comprehensive approach to school mental health has several resources available to support families during the school closure period (
https://smho-smso.ca/blog/how-to-support-student-mental-health-during-the-covid-19-pandemic/).

Professional development

Through webinars, the ministry is providing professional development to support educators in the use of the VLE and pedagogy for remote, synchronous and asynchronous learning. In addition, the ministry is providing professional learning webinars for educators on specialised topics such as supporting students with special education needs, kindergarten/primary education and meaningful assessments and evaluations.

To date, more than 23,000 teachers have participated in, or registered for future webinars, on 34 different topics. Completed webinars have been recorded and posted for teachers who were unable to attend the live session.

In addition to the webinar series, the ministry has created the Supports for Virtual Learning eCommunity. Over 9,000 educational staff have accessed this professional learning community, including resources for self-serve learning that are updated regularly.

First Nation and Indigenous partners

The ministry continues to support First Nation education partners during the school closure period. This has included providing access to online education resources, connecting First Nation partners to the supply chain to purchase Chromebooks and iPads, as well as encouraging local school boards to work closely with local First Nations and Indigenous partners, where possible.

In addition to supporting educators through teleconferences in areas/communities where bandwidth is limited or unavailable, the ministry has responded
to outreach from First Nation partners and has established a series of ongoing virtual meetings with First Nations Education Task Teams. The Task Teams were established to work collaboratively with First Nation education leadership, to identify gaps in services and develop options to address emerging priorities for First Nation students.

We are also ensuring that First Nation educators have access to Ontarios VLE and training for teachers provided by the ministry. There is no cost to the First Nation schools to access and use the VLE.

Summer learning

The ministry is working with boards and organizations to support an expanded offering of summer learning opportunities. This plan will focus on programs that support student learning through the summer such as summer school, course upgrading, and gap-closing programs for vulnerable students, students with special education needs, and Indigenous students. This plan will be flexible to accommodate both remote and face-to-face learning, pending emergency measures through the summer. While summer learning opportunities are voluntary for students, we hope that many students will take advantage of the opportunity to continue their learning throughout the summer.

The goal with these measures is to mitigate the impacts of the school closure period and the learning loss that may typically occur during the summer.

Further details will be provided in the coming weeks.

Communication with parents and families

We recognize that many boards are creating opportunities for parents to provide feedback on the current learning experience through surveys and other platforms, as well as continuing to seek the advice of their Parent Involvement Committee (PIC). Through a virtual meeting with PIC chairs at the end of April, the ministry heard that parents appreciate the efforts their boards are making to address a variety of diverse family challenges due to the pandemic. We encourage boards to continue to be open to feedback and to recognize where delivery of education under current circumstances can be challenging, and can be adjusted to better serve students and families.

Thank you once again for your flexibility and willingness to work together to support Ontarios students.

Sincerely,

Stephen Lecce Nancy Naylor
Minister of Education Deputy Minister

c: President, Association des conseils scolaires des écoles publiques de l’ontario (ACÉPO)
Executive Director, Association des conseils scolaires des écoles publiques de l’ontario (ACÉPO)
President, Association franco-ontarienne des conseils scolaires catholiques (AFOCSC)
Executive Director, Association franco-ontarienne des conseils scolaires catholiques (AFOCSC) President, Ontario Catholic School Trustees’ Association (OCSTA) Executive Director, Ontario Catholic School Trustees’ Association (OCSTA) President, Ontario Public School Boards’ Association (OPSBA) Executive Director, Ontario Public School Boards’ Association (OPSBA) Executive Director, Council of Ontario Directors of Education (CODE)
President, Association des enseignantes et des enseignants franco-ontariens (AEFO)
Executive Director and Secretary-Treasurer, Association des enseignantes et des enseignants franco-ontariens (AEFO) President, Ontario English Catholic Teachers Association (OECTA) General Secretary, Ontario English Catholic Teachers Association (OECTA) President, Elementary Teachers Federation of Ontario (ETFO) General Secretary, Elementary Teachers Federation of Ontario (ETFO) President, Ontario Secondary School Teachers Federation (OSSTF) General Secretary, Ontario Secondary School Teachers Federation (OSSTF) Chair, Ontario Council of Educational Workers (OCEW)
Chair, Education Workers Alliance of Ontario (EWAO)
President of OSBCU, Canadian Union of Public Employees Ontario (CUPE-ON) Co-ordinator, Canadian Union of Public Employees Ontario (CUPE-ON)




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On Global Accessibility Awareness Day, the AODA Alliance Again Writes Ontario’s Education Minister and TVO’s Vice President to Try to Get the Urgent Learning Needs of Students with Disabilities Met During the COVID-19 Crisis


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/

On Global Accessibility Awareness Day, the AODA Alliance Again Writes Ontario’s Education Minister and TVO’s Vice President to Try to Get the Urgent Learning Needs of Students with Disabilities Met During the COVID-19 Crisis

May 21, 2020

          SUMMARY

In our continuing campaign to get the Ford Government to address the urgent needs of a third of a million vulnerable students with disabilities during the COVID-19 crisis, the AODA Alliance today wrote two important letters, set out below. These are especially timely, because today is the internationally recognized Global Accessibility Awareness Day (GAAD).

First, we wrote Ontario Education Minister Stephen Lecce today to again press him to direct the establishment within his Ministry of a command table of experts on teaching students with disabilities. We need this command table created to lead and oversee the creation and implementation of an emergency plan to address the urgent needs of students with disabilities during the COVID-19 crisis. We were following up on our April 29, 2020 letter to the minister. In our new letter we point out three striking examples that show why there is a pressing need for the minister to direct his Ministry to immediately take the overdue actions we recommend.

Second, we today wrote the vice president for digital content at TVO, Ontario’s public education TV network. We summarized a recent discussion that the vice president had with AODA Alliance Chair David Lepofsky. In that discussion, we gave TVO constructive recommendations for urgent action that TVO needs to take to fix the accessibility problems in its online education content.

Taken together, these letters show a recurring failure of leadership by the Ford Government when it comes to meeting the urgent needs of students with disabilities during the COVID-19 crisis. A striking illustration of this is the Education Minister’s May 8, 2020 email to all school boards about distance learning during COVID-19. We also set out that memo below. The minister’s detailed email to all school boards was missing the key directions to school boards on how to meet the urgent needs of students with disabilities during COVID-19.

Stay tuned for more AODA Alliance Updates. Keep us posted by sending us your feedback, at [email protected]

          MORE DETAILS

May 21, 2020 Letter from the AODA Alliance to Ontario Education Minister Stephen Lecce

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

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

May 21, 2020

Via Email

To: The Hon Stephen Lecce, Minister of Education

[email protected]

Dear Minister,

Re: Ensuring that Students with Disabilities Fully Benefit from Education at Home During the COVID-19 Crisis

We write On Global Accessibility Awareness Day to follow up on our April 29, 2020 letter to you about the pressing need for the Ontario Government to create and swiftly implement a comprehensive plan to meet the urgent learning needs of a third of a million Ontario students with disabilities during the COVID-19 crisis.

Since we wrote you almost a month ago, we appreciate having had the chance to have conversations with your deputy minister, two of your assistant deputy ministers, and some other officials within the ministry. I also welcomed the chance to make a five-minute presentation to you during the May 6, 2020 virtual meeting of the K-12 Education Standards Development Committee of which I am a member.

It is good that during Premier Ford’s May 19, 2020 daily COVID-19 briefing, you recognized that more than ever, families of students with disabilities in Ontario need more support for their children to be able to learn at home. It is helpful that you said that the Government has great concern about these children and that the Government wants to ensure that these children get the support they need.

However, almost ten weeks into the school shutdown, and even after announcing that schools will remain closed for the rest of the school year, the Government has still announced no comprehensive plan to remove the troubling and recurring additional barriers facing students with disabilities that you have acknowledged. Your Government still leaves it to each school board to separately figure out what these barriers are and how to systematically overcome them. Your Government has still not set up and put in charge a much-needed command table with expertise in educating students with disabilities to steer and lead the province’s efforts in this area. This is especially wasteful and ineffective when school boards, like your Government, are trying to cope with an unexpected and unprecedented crisis. Front line educators and parents are struggling to do their best. They need more help from the Ontario Government.

Here are three illustrative and deeply disturbing examples of missing provincial leadership. We ask you to intervene with your Ministry officials to get them to act not only on these examples, but on a comprehensive plan of action.

First, with the rapid move to online classes, it is a bedrock necessity that the platform that schools use for online class meetings is accessible to students, teachers, and parents with disabilities. From our exchanges with Ministry staff, it is clear that the Ministry has not shown the required leadership on this issue. It does not appear to have directed school boards to ensure that they use accessible platforms, nor has it compared the options to direct which platform should be preferred.

Your detailed May 8, 2020 email to all school boards and other key players in the education system focuses primarily on the Ministry’s directions to school boards to use “synchronous learning” (i.e. online classes in real time via web-based meeting platforms). That memo is stunningly silent on the need to ensure that the platform school boards use is accessible to students, teachers, and parents with disabilities. That memo gives school boards no directions on which platforms to use. That memo was sent two days after I briefed you and four of your caucus colleagues on this serious issue during the May 6, 2020 meeting of the K-12 Education Standards Development Committee in which you commendably participated.

The Ministry has told us that it has left it to each school board to decide for itself which meeting platform to use. That is a failed approach. It abdicates provincial leadership and oversight. Your Ministry is leaving it to each school board to itself decide whether or not it should investigate the relative accessibility of different online meeting platforms. A school board may not even know that this is an issue it needs to investigate.

Under your Ministry’s approach a school board is free to simply overlook this issue altogether. Your Government is burdening each school board to duplicate the same investigation of the comparative accessibility of different online meeting platforms. It is not clear which school boards have any expertise to do this. There is no assurance that any school boards who do this will in fact get it right. Your Ministry is not tracking which online platforms are being used in Ontario schools, or to what extent accessible platforms are being used.

The Ministry told us it has not itself undertaken a comparison of the various virtual meeting platforms available to school boards in order to assess their comparative accessibility. We have called on your Ministry to do so and to direct school boards on the accessible platforms that may be used. Parents, students, and teachers with disabilities should not have to fight against such recurring barriers one class, one school, or one school board at a time.

Your Ministry told us that it leaves it to each school board to decide which synchronous meeting platform to use, based on the school board’s assessment of its local needs. With respect, blindness, dyslexia, or other reading-related disabilities do not change when they occur in Cornwall or Kenora. The reason why the Government is now developing an Education Accessibility Standard under the Accessibility for Ontarians with Disabilities Act is so that people with disabilities will not have to fight the same battles time and again and so that school boards won’t have to each reinvent the same accessibility wheel.

We have received troubling word that at least one school board has forbidden its teachers from using Zoom, which is at least as accessible as or more accessible than the other available online platforms. That flies in the face of the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act .

Your Ministry arranged a helpful May 13, 2020 demonstration of the specific online meeting platform that it has chosen to purchase for school boards, called “Bongo.” It is part of the Bright Space learning management system that your Ministry chose to procure from the D2L firm for use by school boards if they wish. During this demonstration, it became apparent that neither your Ministry nor D2L claimed that Bongo is the most accessible meeting platform available. Its accessibility features were helpfully demonstrated and described.

During this demonstration, we learned that your Government has no idea how many school boards, schools or teachers around Ontario are using the Bongo platform. Your Ministry has left them free to use whatever platform they wish. As far as your Ministry would know, there could be few if any teachers using Bongo or who even know about it.

This presentation included a comparison of Bongo’s accessibility features as compared to those of the Zoom platform. It was D2L that was comparing its product to Zoom. Your Ministry did not invite Zoom for a chance to showcase its own product’s accessibility features, leaving it to its competitor D2L to do this.

The D2L presentation made an unfair comparison. It compared the Bongo platform, for which the Ministry was directly or indirectly paying a fee, to the free version of Zoom. I pointed this out and asked how the Bongo platform compared to Zoom’s more robust pay version, as opposed to its free version, which has fewer features. D2L acknowledged that the pay version of Zoom is closer in comparison to Bongo.

During that May 13, 2020 presentation, my questions revealed that Bongo is missing an important accessibility feature that Zoom contains. With Zoom, a student can easily and instantly raise his or her virtual hand for the teacher’s attention, by simply typing a keyboard shortcut. Bongo has no such keyboard shortcut. For a student to reach Bongo’s accessible control for raising his or her hand, it takes more hunting around the program. Its location is not obvious. It is important for a student to be able to quickly raise one’s hand without having to hunt around the program for the relevant control. D2L conceded that their accessibility tester had earlier asked Bongo’s provider to add this to their program. D2L did not include this important fact in its comparison of its product to Zoom.

In the Ministry’s PowerPoint prepared to demonstrate Bongo’s accessibility, a slide was included to suggest that the ARCH Disability Law Centre used Bongo. This was obviously done to convey or imply that it had ARCH’s approval as accessible. The slides stated:

“•        We have several clients who support people with disabilities: CNIB, CHS, Vision Australia, Thomas Pocklington Trust, ARCH Disability Law Centre.

ARCH’s use of Virtual Classroom

  • Educating Canadians on Accessibility Rights using Brightspace and Virtual Classroom
  • ARCH is offering online courses to Community Champions and Disability Rights Lawyers on the Optional Protocol (OP) of the UN Convention on the Rights of Persons with Disabilities (CRPD) with Simultaneous French interpretation, English and French live captions, ASL, and LSQ.

Press Release – ARCH launches OP Lab: Learning, Sharing, Actioning!”

This was quite misleading. At this May 13, 2020 presentation, I responded that ARCH’s executive director had advised me that while they had procured Bongo for certain upcoming events, they have not yet used it because it has several accessibility problems. ARCH has been trying to get these problems fixed. Neither D2L nor the Government disputed this.

Second, as a key part of its approach during the COVID-19 crisis, your Government has repeatedly pointed to key online learning resources for teachers and parents. We have alerted the Government that these have accessibility problems. This includes both the Government’s own “Learn at Home” web page and the Government-owned TVO’s online learning resources. It became evident from my May 14, 2020 phone call with TVO’s Vice President for Digital Content that TVO is lacking a plan to retrofit its online educational resources to ensure that they become accessible to students, teachers, and parents with disabilities. TVO seemed to be unaware of the severity of this problem until we brought it to their and the public’s attention. I encourage you to read our May 21, 2020 letter to TVO’s Vice President of Digital Content, copied to you. It sets out our constructive advice to TVO – advice which TVO found quite helpful.

We have seen no indication that your Ministry was aware of the problems with its own online resources or those of TVO until we raised these concerns. We have seen no plan from your Ministry to fix these problems.

This TVO situation reflects a double failure. TVO failed to properly ensure its online content’s accessibility. After that, your Ministry failed to ensure the accessibility of TVO’s online content before so heavily relying on it as part of its COVID-19 emergency planning.

Third, struggling with this COVID-19 crisis, it is great that teachers, parents, and others with expertise in the field in Ontario and elsewhere have been coming up with creative ways to help students with different disabilities learn while schools are closed. We have been urging your Government for weeks without success to devote staff to effectively gather from the front lines specific examples of effective strategies. We still need your Government to do so and to effectively share these with educators and parents as quickly as possible in a user-friendly way, not through a blizzard of links.

Let us illustrate how disturbing this situation is. On May 4, 2020, in the absence of effective Government action on this front, the AODA Alliance and the Ontario Autism Coalition joined together to hold a successful virtual town hall. It offered practical tips to parents and teachers for teaching students with disabilities at home during COVID-19. Your Ministry’s Assistant Deputy Minister of Education responsible for special education Jeff Butler commendably took part in our virtual town hall and described its contents as valuable. In just over two weeks, it has been viewed over 1,400 times. We have no budget to publicize it.

We have repeatedly asked your Ministry to publicize this virtual town hall to school boards and frontline educators. So far, it has not agreed to do so. What could be a simpler and lower-cost way to help students with disabilities? We have also urged your Ministry for weeks without success to take over this idea and itself hold such events. We have offered to help with ideas. The Ministry, with its staff and resources, could do this more effectively than did our handful of volunteers who pulled together our successful May 4, 2020 virtual town hall in under a week.

Instead of taking us up on this, the Government has largely re-announced the same initiatives that have been underway for weeks. While helpful to a point, those measures have not effectively addressed the pressing concerns of vulnerable students with disabilities.

On May 19, 2020 you said at the Premier’s daily COVID-19 briefing that you have directed school boards to unlock all their special education and mental health resources during the school shutdown to help students with disabilities. That of course has been their job from the outset. However, for them to succeed, they need far more provincial direction and support than this.

On May 19, 2020, in response to a question from the media at the Premier’s COVID-19 briefing, you announced some sort of two-week summer program aimed at helping orient some students with disabilities, such as those with autism, to a return to school. That announcement gave no specifics, such as where this will be offered or which students or how many students will be eligible for this program. Depending on how this is carried out, it could be helpful.

However, here again, there is a similar pressing need for the Ontario Government to show leadership by setting specific detailed and effective standards and requirements for school re-openings to ensure that the added needs of students with disabilities are effectively met in this process. Your Ministry’s approach to date to students with disabilities during this crisis will not ensure that this is properly handled.

Your May 8, 2020 memo to all school boards is quite illustrative of this entire problem. It commendably makes a few general references to accommodating students with special education needs and to mental health issues. However, it gives no specific directions for meeting the recurring needs of students with disabilities in circumstances where specificity and provincial leadership are required.

We remain eager to help with solutions. We need your active intervention to set things right. Please stay safe.

Sincerely,

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

CC: Premier Doug Ford

Via Email: [email protected]

Raymond Cho, Minister of Seniors and Accessibility

[email protected]

Nancy Naylor, Deputy Minister of Education

[email protected]

Jeff Butler, Acting Assistant Deputy Minister of the Student Support and Field Services Division

[email protected]

Yael Ginsler, Assistant Deputy Minister of Education (Acting) for the Student Achievement Division

[email protected]

Denise Cole, Deputy Minister for Seniors and Accessibility

[email protected]

Susan Picarello, Assistant Deputy Minister, Accessibility Directorate of Ontario

[email protected]

Claudine Munroe, Director of the Special Education/Success for All Branch

[email protected]

Demetra Saldaris, Director of the Professionalism, Teaching Policy and Standards Branch

[email protected]

Rashmi, Swarup TVO Vice President Digital Learning

[email protected]

May 21, 2020 Letter from the  AODA Alliance to TVO’s Vice President for Digital Content

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT ALLIANCE

Email: [email protected]

Visit: www.aodalliance.org

Twitter: @aodaalliance

May 21, 2020

To: Rashmi Swarup

Vice President Digital Learning

Via email: [email protected]

Dear Ms. Swarup,

Re: Accessibility Problems with TVO’s Online Educational Content

Thank you for speaking to me by phone on May 14, 2020 about the accessibility problems on TVO’s website. It is especially timely that I am writing you on Global Accessibility Awareness Day.

Here are several key points that I shared with you during our discussion.

I explained that TVO’s online learning content requires a major review as soon as possible for accessibility problems. Our preliminary look at them revealed significant and obvious problems. This strongly suggests that accessibility problems are likely more pervasive. The fact that they turned up so quickly suggests to us that TVO has not done effective accessibility user testing.

I explained that to rectify this, TVO needs to immediately put in place several new measures. It needs to now publicly commit to fix its online content’s accessibility problems and to ensure that any new online content created in the future is accessible from the start.

You explained that you have been in your position for about one year as TVO’s Vice President of Digital Content. Previously, you were a superintendent of schools at the York Region District School Board. You didn’t claim to be a subject matter expert on digital content accessibility, though you have taken required basic AODA training – training which we know to be quite introductory.

TVO needs to have a senior official with subject matter expertise in digital accessibility with lead responsibility and authority for ensuring the accessibility of TVO’s digital content and online offerings. It seems clear from the presence of accessibility problems in TVO’s online educational content that it is lacking that expertise in a leadership role.

I outlined for you that a number of major organizations have helpfully established a position of Chief Accessibility Officer to address their accessibility needs and duties. TVO could benefit from doing so. From what you explained, it appears that no one senior official at TVO has full responsibility for and authority over ensuring digital accessibility. Responsibility is spread over several members of the TVO senior management team. That is a far less effective way of addressing this important issue.

TVO needs to bring on board the subject matter expertise to fix this problem. I explained that there are digital accessibility experts TVO can retain to assist in this area.

TVO needs to establish and make public a detailed plan to fix the accessibility problems with its current digital learning content and to ensure that new digital content that TVO creates in the future is barrier-free. I explained that end-user testing is an important aspect of this. Automated checking tools cannot replace proper user testing by human beings. From our preliminary inspection of some of TVO’s online educational content, it seemed that no proper user testing would have earlier occurred.

You said you appreciated our raising these concerns and the recommendations that I shared. Our raising these concerns had escalated TVO’s attention. We appreciate your agreeing to write us to let us know what new action TVO will take to address these concerns.

We hope the Ontario Government will support TVO’s taking swift action to correct these problems. We had raised our concerns about TVO at senior levels within the Ministry of Education. The Minister of Education Stephen Lecce has repeatedly said that the Government has partnered with TVO to help deliver online education to students during the COVID-19 crisis.

Finally, I emphasized that as a public broadcast, TVO should be a leader in this area. In contrast to TVO’s accessibility deficiencies, WGBH, a US PBS station, is a key hub and, I believe, the birthplace for the important accessibility innovation of audio description for video content.

We look forward to hearing from you about the reforms TVO will adopt. It is important for corrective action to be taken quickly, given that schools remain closed for the rest of this school year due to the COVID-19 crisis and may have to close again should there be a second surge of COVID-19.

Please stay safe.

Sincerely,

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

CC

Premier Doug Ford

[email protected]

Stephen Lecce, Minister of Education,

[email protected]

Raymond Cho, Minister of Seniors and Accessibility

[email protected]

Nancy Naylor, Deputy Minister of Education

[email protected]

Claudine Munroe, Director of the Special Education/Success for All Branch

[email protected]

Denise Cole, Deputy Minister for Seniors and Accessibility

[email protected]

Susan Picarello, Assistant Deputy Minister, Accessibility Directorate of Ontario

[email protected]

Renu Mandhane, Chief Commissioner, Ontario Human Rights Commission

[email protected]

May 8, 2020 Email from Ontario Education Minister Stephen Lecce to Ontario School Boards

May 8 2020 Email from Minister of Education Stephen Lecce to Ontario School Boards

From: Ministry of Education (EDU) <

[email protected]>

Sent: May 8, 2020 5:36 PM

To: Ministry of Education (EDU) <

[email protected]>

Subject: Updates on Continuity of Learning for the Extended School Closure Period | Mises à jour sur la continuité de l’apprentissage pendant la période

de fermeture prolongée des écoles

table with 2 columns and 2 rows

Memorandum To:

Chairs of District School Boards

Directors of Education

School Authorities

From:

Stephen Lecce

Minister of Education

Nancy Naylor

Deputy Minister

table end

Thank you for your continued commitment to supporting students during the school closure period. We have heard so many inspiring stories from across the province of students, parents, and educators doing extraordinary work to continue learning and build and maintain relationships at this time.

During this time, the mental health and well-being of students and the people working in the education system remains a priority. The government and school boards have moved rapidly to mobilize critical mental health resources and supports for students during these uncertain times.

As you know, the school closure period has been extended to at least May 31, 2020. To that end, we are writing to provide guidance on provincial standards for continuity of learning for the remainder of the closure period, as well as to provide updates on progress to date.

GUIDANCE FOR CONTINUITY OF LEARNING

As we entered the school closure period, our transition to Learn at Home was aided by existing tools that were in place to support virtual learning.  The ministry provides Ontario’s Virtual Learning Environment (VLE) at no cost to educators in school boards and First Nation/federally operated schools to use for delivering online programming. As a learning management system, the VLE provides tools for both synchronous and asynchronous learning delivery.  Boards may already have access to other synchronous learning management systems and tools, such as Google Classroom or Edsby.

While the expectation of the ministry was that educators would embrace the use of synchronous learning during the school closure period, there has been an inconsistent uptake of this mode of learning. As such, this memo is providing clarity on the ministry position.

Recognizing there are a wide range of modalities that are used in the continuum of learning between educators and their students, the ministry’s expectation is that synchronous learning be used as part of whole class instruction, in smaller groups of students, and/or in a one-on-one context.

We know that parents and students are looking for ways to interact with their teachers – which can be addressed through multiple modalities – and that online synchronous learning experience with teachers and education workers is an effective and supportive method that will position students to succeed during the school closure period. Similarly, parents expect their child’s educators to strive toward as normal a learning environment as possible during this period, of which synchronous learning is a key component.

Boards should take steps to ensure that privacy considerations are addressed and that students are aware of best practices, including not giving out passwords, ensuring that teachers are the last person to leave a synchronous meeting, and respecting other board policies on student conduct.

We recognize that there may be exceptional situations where synchronous online delivery may not be possible for all students. Exceptions could include, for example, where a parent has excused their child from instruction or this form of instruction, in which case a parent’s wishes should be respected.

If a student cannot participate due to a lack of devices or internet connectivity, or where students require accommodations for special education needs, alternate arrangements must be made, including personal outreach through phone calls. With that in mind, it is insufficient for educators to communicate with their students in one interaction per week, for example. We recognize that school boards have made extraordinary efforts to ensure that students have devices and connectivity wherever possible, and we once again reiterate our expectation that boards provide necessary technology to students as soon as possible, and appropriate accommodations for students with special education needs, where necessary.  The ministry will continue to support school boards in these efforts.

If a teacher or education worker does not feel they can currently deliver education to their students in this manner, schools and boards are encouraged to provide support and professional development.  However, in situations where teachers or education workers are not delivering synchronous learning, schools and boards are expected to immediately move to a team assignment approach to ensure that students are offered synchronous delivery of teacher led learning.

School boards should continue to follow the guidance provided on March 31, 2020 regarding the hours per student, per week, and the suggested areas of curriculum focus by grade groupings.

UPDATES ON PROGRESS TO DATE

Working Together

Between April 15 and 29, the ministry conducted a series of meetings beginning with Parent Involvement Committee Chairs and extending to include meetings with the following key roles responsible for supporting vulnerable students: Student Success and Student Effectiveness Leads, Indigenous Graduation Coaches, and Black Student Graduation Coaches. These meetings provided a venue for board leads to share successful practices and ongoing challenges to supporting vulnerable students and identify additional ways to offer support.

During these meetings, partners in school boards shared information on the many ways they are addressing the needs of vulnerable students, their wellbeing, and academic success. The ministry will continue to work with partners to determine ways to support student well-being, engagement in learning, and inclusive approaches to learning within a remote learning environment, as well as when students return to school.

Access to Technology

Access to internet connectivity and learning devices has been identified by school boards and other stakeholders as an urgent need during the school closure period. In response to this need, the ministry launched an education-related call for proposals on the Ontario Together web portal, focused on supporting

equity of access to remote learning.

Through this initiative, the ministry will identify proposals that school boards may wish to consider to support student and educator access to internet connectivity and devices such as computers, tablets, and portable wi-fi hotspots. As well, school boards may also wish to consider consulting other partners and sources, such as OECM, to consider comparable services and goods.

As we prepare for the eventual return to the classroom, broadband modernization activities in schools continue.  All Ontario students and educators in publicly funded schools will have access to reliable, fast, secure and affordable internet services at school, in all regions of the province including rural and northern communities.  This work will be complete in secondary schools by September 2020 and in elementary schools by September 2021.

As of March 31, 2020, broadband modernization was complete at 1,983 schools (including 403 in northern communities and 686 in rural communities) and in progress at 2,953 schools (including 99 in northern communities and 408 in rural communities).

Ensuring protection of privacy and security of digital learning resources is of the utmost importance for the ministry to support a safe, inclusive and accepting learning environment for synchronous learning.  While school boards remain independently accountable for establishing clear policies and approving appropriate use of collaboration tools to support students’ learning online, we will continue to work with boards and our government partners to provide guidance on cyber security and privacy best practices for sharing with educators in your schools.

School Construction

Schools are an essential part of supporting student achievement, as well as providing safe and healthy learning and work environments for students and staff. As we head into the spring and summer months, when school boards undertake critical capital construction and renewal projects, the province has revised the list of essential workplaces to support school infrastructure.  Construction projects and services (e.g. new construction, maintenance and repair) that support the essential operation of, and provide new capacity in, schools and child care centres can proceed, provided that there is strict adherence to health and safety requirements.

As school boards are best situated to understand their own particular circumstances, the ministry is asking that school boards consider whether their construction projects are able to reopen in light of these changes. This may mean that boards will need to consult with their own legal counsel, as appropriate.

Learn at Home/

Apprendre à la maison

Learn at Home/

Apprendre à la maison

was launched on March 20, 2020. This website provides supplemental resources for parents and students to support independent learning at home while schools are closed.

Learn at Home/

Apprendre à la maison  includes learning resources on a variety of subjects including math, science, technology, Indigenous history and ways of knowing, art, physical education,  social sciences, and mental health. Supports for students with learning disabilities and special education needs, including autism, have also been included.

Resources continue to be added to address a range of learning needs.

Over the past month, there have been over four million visits to  Learn at Home/

Apprendre à la maison.

We encourage you to continue to share this website and promote the new resources available with parents and students in your board.

If there are additional high-quality online learning resources that you think would be particularly beneficial to students and parents at this time, we encourage you to share them with us by emailing  [email protected]

School Mental Health Ontario

School Mental Health Ontario – a provincial implementation support team that works alongside the ministry, school boards, and provincial education and health organizations to develop a systematic and comprehensive approach to school mental health – has several resources available to support families during the school closure period (

https://smho-smso.ca/blog/how-to-support-student-mental-health-during-the-covid-19-pandemic/).

Professional development

Through webinars, the ministry is providing professional development to support educators in the use of the VLE and pedagogy for remote, synchronous and asynchronous learning. In addition, the ministry is providing professional learning webinars for educators on specialised topics such as supporting students with special education needs, kindergarten/primary education and meaningful assessments and evaluations.

To date, more than 23,000 teachers have participated in, or registered for future webinars, on 34 different topics.  Completed webinars have been recorded and posted for teachers who were unable to attend the live session.

In addition to the webinar series, the ministry has created the Supports for Virtual Learning eCommunity.  Over 9,000 educational staff have accessed this professional learning community, including resources for self-serve learning that are updated regularly.

First Nation and Indigenous partners

The ministry continues to support First Nation education partners during the school closure period. This has included providing access to online education resources, connecting First Nation partners to the supply chain to purchase Chromebooks and iPads, as well as encouraging local school boards to work closely with local First Nations and Indigenous partners, where possible.

In addition to supporting educators through teleconferences in areas/communities where bandwidth is limited or unavailable, the ministry has responded

to outreach from First Nation partners and has established a series of ongoing virtual meetings with First Nations Education Task Teams. The Task Teams were established to work collaboratively with First Nation education leadership, to identify gaps in services and develop options to address emerging priorities for First Nation students.

We are also ensuring that First Nation educators have access to Ontario’s VLE and training for teachers provided by the ministry.

There is no cost to the First Nation schools to access and use the VLE.

Summer learning

The ministry is working with boards and organizations to support an expanded offering of summer learning opportunities. This plan will focus on programs that support student learning through the summer such as summer school, course upgrading, and gap-closing programs for vulnerable students, students with special education needs, and Indigenous students.  This plan will be flexible to accommodate both remote and face-to-face learning, pending emergency measures through the summer. While summer learning opportunities are voluntary for students, we hope that many students will take advantage of the opportunity to continue their learning throughout the summer.

The goal with these measures is to mitigate the impacts of the school closure period and the learning loss that may typically occur during the summer.

Further details will be provided in the coming weeks.

Communication with parents and families

We recognize that many boards are creating opportunities for parents to provide feedback on the current learning experience through surveys and other platforms, as well as continuing to seek the advice of their Parent Involvement Committee (PIC). Through a virtual meeting with PIC chairs at the end of April, the ministry heard that parents appreciate the efforts their boards are making to address a variety of diverse family challenges due to the pandemic.  We encourage boards to continue to be open to feedback and to recognize where delivery of education under current circumstances can be challenging, and can be adjusted to better serve students and families.

Thank you once again for your flexibility and willingness to work together to support Ontario’s students.

Sincerely,

Stephen Lecce                        Nancy Naylor

Minister of Education            Deputy Minister

c:    President, Association des conseils scolaires des écoles publiques de l’ontario (ACÉPO)

Executive Director, Association des conseils scolaires des écoles publiques de l’ontario (ACÉPO)

President, Association franco-ontarienne des conseils scolaires catholiques (AFOCSC)

Executive Director, Association franco-ontarienne des conseils scolaires catholiques (AFOCSC)

President, Ontario Catholic School Trustees’ Association (OCSTA)

Executive Director, Ontario Catholic School Trustees’ Association (OCSTA)

President, Ontario Public School Boards’ Association (OPSBA)

Executive Director, Ontario Public School Boards’ Association (OPSBA)

Executive Director, Council of Ontario Directors of Education (CODE)

President, Association des enseignantes et des enseignants franco-ontariens (AEFO)

Executive Director and Secretary-Treasurer, Association des enseignantes et des enseignants franco-ontariens (AEFO)

President, Ontario English Catholic Teachers’ Association (OECTA)

General Secretary, Ontario English Catholic Teachers’ Association (OECTA)

President, Elementary Teachers’ Federation of Ontario (ETFO)

General Secretary, Elementary Teachers’ Federation of Ontario (ETFO)

President, Ontario Secondary School Teachers’ Federation (OSSTF)

General Secretary, Ontario Secondary School Teachers’ Federation (OSSTF)

Chair, Ontario Council of Educational Workers (OCEW)

Chair, Education Workers’ Alliance of Ontario (EWAO)

President of OSBCU, Canadian Union of Public Employees – Ontario (CUPE-ON)

Co-ordinator, Canadian Union of Public Employees – Ontario (CUPE-ON)



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Ontario’s Ministry of Education Must Now Meet the Urgent Needs of A Third of a Million Students with Disabilities During the COVID-19 Crisis


A Captioned Online Virtual Town Hall Today at 3 PM Lets Experts Give Practical Action Tips for Teachers and Parents While Schools Remain Closed.

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

May 4, 2020

Some hardships of COVID-19 fall disproportionately on students with disabilities. What can teachers, principals, parents, schools and the Ontario Government do to make sure Ontario’s students with disabilities can effectively continue their education at home while schools are closed? What can teachers and parents of students with disabilities do right now to break through the barriers that distance and online learning can create for students with disabilities?

We’ll tackle these questions today from 3 to 4 pm Eastern at a captioned Virtual Town Hall on meeting the urgent learning needs of students with disabilities during the COVID-19 crisis. Log in to https://www.youtube.com/c/OntarioAutismCoalition

Nothing will stream at that link until the moment we start our Virtual Town Hall. If you click that link just before we start streaming, you may get our stream automatically coming to you we start, or you may have to monitor for a new link to click when we start. That will depend on your settings. Just keep at it till you start receiving our event. Within hours after this event, we will circulate a new link to this event once it is archived on Youtube and permanently available for all to revisit.

The rapid move to online learning for 2 million students in schools created enormous challenges for all students, teachers and parents. Much bigger hardships face a third of a million Ontario students with disabilities, if not more, and for their parents and teaching staff. These are at least one out of every six students in Ontario-funded schools.

Before COVID, Ontario’s education system had far too many disability barriers, impeding many students with disabilities. The move to online learning created even more hardships for them, and their teachers.

Our virtual Town Hall will help you, whether you are in Ontario, elsewhere in Canada, or anywhere around the world. It will be helpful for teachers, principals, parents, students, school boards and Government officials. This is the second such virtual town hall organized by the grassroots AODA Alliance together with the Ontario Autism Coalition. Our widely-viewed earlier April 7, 2020 virtual public forum looked at the full spectrum of COVID-19 crisis problems facing people with disabilities from health care to long-term care. At today’s event, we’re zeroing in on education for students with disabilities. Co-anchors for this event are AODA Alliance Chair David Lepofsky, a visiting professor at the Osgoode Hall Law School, and Laura Kirby-McIntosh, president of the OAC. Both have strong track records in tenacious disability advocacy for students with disabilities in Ontario’s education system. Their discussion will be fueled by feedback accumulating over the past days via email and social media. The hashtag #DisabilityUrgent was created for disability issues in the COVID-19 crisis. Feedback can also be sent to [email protected]

The media is free to broadcast any clips from this town hall. We hope this virtual town hall will help pressure the Ford Government to take new action. We are delighted that its lead public official responsible for special education, Assistant Deputy Minister of Education Jeff Butler, has agreed to speak at this event. Five other experts will offer practical tips for teachers and parents of students with disabilities, for just some of the barriers they are now facing. We regret that in this one event, we cannot address every disability and every barrier. We call on the Ford Government to take up this idea and run with it, using our virtual Town Hall as an illustration of what is needed.

For more background:

The April 30, 2020 letter from the AODA Alliance to Ontario Education Minister Stephen Lecce, which sets out a list of concrete and constructive requests for action that the AODA Alliance presented to Ontario’s Ministry of Education.

* The AODA Alliance’s education web page, that documents its efforts over the past decade to advocate for Ontario’s education system to become fully accessible to students with disabilities

* The AODA Alliance’s COVID-19 web page, setting out our efforts to advocate for governments to meet the urgent needs of people with disabilities during the COVID-19 crisis.

* The Ontario Autism Coalition’s web site, to learn about its ongoing advocacy efforts.




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Ontario’s Ministry of Education Must Now Meet the Urgent Needs of A Third of a Million Students with Disabilities During the COVID-19 Crisis – A Captioned Online Virtual Town Hall Today at 3 PM Lets Experts Give Practical Action Tips for Teachers and Parents While Schools Remain Closed


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/

Ontario’s Ministry of Education Must Now Meet the Urgent Needs of A Third of a Million Students with Disabilities During the COVID-19 Crisis – A Captioned Online Virtual Town Hall Today at 3 PM Lets Experts Give Practical Action Tips for Teachers and Parents While Schools Remain Closed

May 4, 2020

Some hardships of COVID-19 fall disproportionately on students with disabilities. What can teachers, principals, parents, schools and the Ontario Government do to make sure Ontario’s students with disabilities can effectively continue their education at home while schools are closed? What can teachers and parents of students with disabilities do right now to break through the barriers that distance and online learning can create for students with disabilities?

We’ll tackle these questions today from 3 to 4 pm Eastern at a captioned Virtual Town Hall on meeting the urgent learning needs of students with disabilities during the COVID-19 crisis. Log in to https://www.youtube.com/c/OntarioAutismCoalition

Nothing will stream at that link until the moment we start our Virtual Town Hall. If you click that link just before we start streaming, you may get our stream automatically coming to you we start, or you may have to monitor for a new link to click when we start. That will depend on your settings. Just keep at it till you start receiving our event. Within hours after this event, we will circulate a new link to this event once it is archived on Youtube and permanently available for all to revisit.

The rapid move to online learning for 2 million students in schools created enormous challenges for all students, teachers and parents. Much bigger hardships face a third of a million Ontario students with disabilities, if not more, and for their parents and teaching staff. These are at least one out of every six students in Ontario-funded schools.

Before COVID, Ontario’s education system had far too many disability barriers, impeding many students with disabilities. The move to online learning created even more hardships for them, and their teachers.

Our virtual Town Hall will help you, whether you are in Ontario, elsewhere in Canada, or anywhere around the world. It will be helpful for teachers, principals, parents, students, school boards and Government officials. This is the second such virtual town hall organized by the grassroots AODA Alliance together with the Ontario Autism Coalition. Our widely-viewed earlier April 7, 2020 virtual public forum looked at the full spectrum of COVID-19 crisis problems facing people with disabilities from health care to long-term care. At today’s event, we’re zeroing in on education for students with disabilities. Co-anchors for this event are AODA Alliance Chair David Lepofsky, a visiting professor at the Osgoode Hall Law School, and Laura Kirby-McIntosh, president of the OAC. Both have strong track records in tenacious disability advocacy for students with disabilities in Ontario’s education system. Their discussion will be fueled by feedback accumulating over the past days via email and social media. The hashtag #DisabilityUrgent was created for disability issues in the COVID-19 crisis. Feedback can also be sent to [email protected]

The media is free to broadcast any clips from this town hall. We hope this virtual town hall will help pressure the Ford Government to take new action. We are delighted that its lead public official responsible for special education, Assistant Deputy Minister of Education Jeff Butler, has agreed to speak at this event. Five other experts will offer practical tips for teachers and parents of students with disabilities, for just some of the barriers they are now facing. We regret that in this one event, we cannot address every disability and every barrier. We call on the Ford Government to take up this idea and run with it, using our virtual Town Hall as an illustration of what is needed.

For more background:

The April 30, 2020 letter from the AODA Alliance to Ontario Education Minister Stephen Lecce, which sets out a list of concrete and constructive requests for action that the AODA Alliance presented to Ontario’s Ministry of Education.

* The AODA Alliance’s education web page, that documents its efforts over the past decade to advocate for Ontario’s education system to become fully accessible to students with disabilities

* The AODA Alliance’s COVID-19 web page, setting out our efforts to advocate for governments to meet the urgent needs of people with disabilities during the COVID-19 crisis.

* The Ontario Autism Coalition‘s web site, to learn about its ongoing advocacy efforts.



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Ontario’s New Democratic Party and the Ontario Human Rights Commission Press the Ford Government to Take Substantially More Action to Address Ontarians with Disabilities’ Urgent Needs During the COVID-19 Crisis


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

April 22, 2020

SUMMARY

Here are even more calls for the Ford Government to take substantially more action to address the urgent needs of Ontarians with disabilities during the COVID-19 crisis. Below we set out four important recent documents showing this crisis. The first three are from the Ontario New Democratic Party, and the fourth is from the Ontario Human Rights Commission:

1. On April 22, 2020, an NDP news release called on the Ford Government to include in a long-overdue emergency plan for people with disabilities a number of important measures, including mobile testing for people with disabilities who need to be tested for COVID-19.

2. On April 17, 2020, NDP leader Andrea Horwath and NDP disabilities critic Joel Harden wrote to the Ford Government, combining to echo the AODA Alliance’s call for the Ford Government to create a focused plan to address the urgent needs of Ontarians with disabilities as part of its COVID-19 emergency planning. The NDP also echoed our call for the Government to consult the grassroots disability community on this. As their letter shows, the NDP was inspired to take this action by the April 7, 2020 online Virtual Public Forum on the impact of COVID-19 on people with disabilities that was jointly organized by the AODA Alliance and the Ontario Autism Coalition. In the two weeks since that virtual public forum, it has been viewed over 2,000 times. It remains available to be viewed online, with captions and American Sign Language interpretation.

3. In the April 6, 2020 letter from NDP health critic France Gelinas to Ontario’s Health Minister Christine Elliott, the NDP urged the Government to re-open the shuttered Assistive Devices Program (ADP) and to treat it as an essential service for people with disabilities. The Government’s failure to do so is symptomatic of its larger and recurring failure to effectively address the urgent needs of Ontarians with disabilities during this crisis.

4. In the April 6, 2020 letter from Ontario Human Rights Commissioner Renu Mandhane to Health Minister Christine Elliott, the Commission raised important human rights concerns with the Government’s controversial and secret March 28, 2020 medical triage protocol. Yesterday, as detailed in the AODA Alliance’s April 21, 2020 news release, the Government has walked back that protocol and agreed to consult human rights and community experts on it. We have not yet heard whether the Ford Government will include the AODA Alliance among those it will consult.

We thank and commend the NDP and the Ontario Human Rights Commission for these efforts. For more background, check out and widely share:

* The guest column by AODA Alliance Chair David Lepofsky in the April 20, 2020 online Toronto Star, which summarizes our major COVID disability issues in one place.

* The widely viewed April 7, 2020 online Virtual Public Forum on what Government Must Do to Meet the Urgent Needs of People with Disabilities During the COVID crisis.

* The AODA Alliance’s April 14, 2020 Discussion Paper on Ensuring that Medical Triage or Rationing of Health Care Services During the COVID-19 Crisis Does Not Discriminate Against Patients with Disabilities.

* Action tips on how to help ensure that patients with disabilities don’t face discrimination in access to critical health care.

* The April 8, 2020 open letter to Premier Ford, organized by the ARCH Disability Law Centre, voicing concerns about the Ontario Government’s protocol for rationing medical care during the COVID crisis.

* The AODA Alliance’s March 25, 2020 letter to Premier Ford, which has gone unanswered.

There have now been 447 days since the Ford Government received the groundbreaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has still announced no comprehensive plan of new action to implement that report. That is making worse the problems facing Ontarians with disabilities during the COVID-19 crisis.

There have been 28 days since we wrote Ontario Premier Doug Ford on March 25, 2020 to urge specific action to address the urgent needs of Ontarians with disabilities during the COVID-19 crisis. He has not answered. The ordeal facing Ontarians with disabilities during the COVID-19 crisis is made even worse by that delay.

MORE DETAILS

April 22, 2020 News Release from the Ontario New Democratic Party

Government must make in-home testing available for people with disabilities: NDP
Province needs a plan to meet the needs of 2.6 million Ontarians with disabilities

QUEEN’S PARK The Official Opposition is calling for the Ford government to make COVID-19 testing available at home for people with disabilities who face barriers trying to travel to testing sites.

“There are 2.6 million Ontarians living with disabilities, yet Doug Ford has not announced any plans to support them during the pandemic despite the fact that many people with disabilities are among the most susceptible to COVID-19, and often face barriers in accessing testing and treatment,” said Andrea Horwath, Leader of the Official Opposition.

“Access to testing must not discriminate based on ability,” said Joel Harden, NDP critic for Accessibility and People with Disabilities. “If we are truly all in this together, that means making sure every Ontarian who should get a test can get one.”

Harden said that for people like John Mossa, the testing system simply excludes them. Mossa has a mobility disability, and fragile health with limited lung function. When he came down with cold-like symptoms, including a cough, he felt he needed a test but would have needed a PSW to go along with him to a hospital or assessment centre, and worried about exposing his weak system to transit staff and others along the way. Ultimately, medical professionals advised him not to get a test, because the risks were too great and supports too few.

“People with disabilities, their families, and their caregivers cannot be an afterthought in the government’s response to COVID-19,” said Harden. “We need urgent action to ensure that their needs are met during this pandemic.”

Home-based tests for people with disabilities should be delivered by workers wearing full personal protective equipment, noted Harden.

Horwath and Harden wrote to Doug Ford calling for his government to adopt a plan in consultation with experts and grassroots disability community leaders. The plan should include, but not be limited to:

* Adopting a clinical triage protocol that respects the human rights of people with disabilities
* Ensuring that attendant care workers who help people with disabilities in their own homes have access to personal protective equipment
* Resources and clear guidelines to support 330,000 special education students with e-learning
* Provide remote and distance supports to assist the families of people with developmental or intellectual disabilities living with them, to provide respite for family members during mandatory periods of isolation at home
* Declaring the Assistive Devices Program an essential service so that no one is deprived of critical mobility or medical aides

Media contact: Jodie Shupac, 416-806-9147
Quotes

John Mossa,Toronto:
“There should be COVID testing in the home of people with disabilities, especially if they are symptomatic, to prevent community spread and properly treat their illness. It is an accessibility accommodation the government should provide to vulnerable Ontarians – in keeping with the AODA.”

April 17, 2020 Letter to Premier Doug Ford from the Ontario New Democratic Party April 17, 2020

Premier Doug Ford
Room 281
Legislative Building, Queen’s Park
Toronto, ON M7A 1A1

Dear Premier,

We write to you having convened an urgent discussion with disability rights groups and leaders within this important sector. We are urging your government to adopt a comprehensive plan in consultation with them that ensures people with disabilities’ needs are met during this pandemic.

There are 2.6 million people with disabilities in Ontario, and their concerns are not being properly addressed in our province’s response to COVID-19. The same is true for their paid and unpaid caregivers. These are among the most vulnerable people to the spread of the virus.

Ontario has not announced a disability strategy for COVID-19, and the government has not responded to repeated appeals by grassroots disability rights groups. These groups have identified a number of concerns with respect to the government’s response, including but not limited to:

* According to Ontario Health’s Clinical Triage Protocol for Major Surge in COVID pandemic, dated March 28, some people will not get critical care because of their disability. Over 200 organizations have signed an open letter calling on the government to adopt a triage protocol that respects the human rights and needs of people with disabilities.
* Attendant care for Ontarians with disabilities is also precarious given the lack of access to personal protective equipment. Social distancing is impossible between care workers and their disabled clients, so the lack of access to PPE presents a real threat to the spread of COVID-19.
* Over 330,000 children with disabilities are currently attempting to learn from home with little or no strategy or support from the Ministry of Education. We cannot assume that all families and students can easily adjust to online learning, particularly when the format itself can be a barrier.
* Ontario’s Assistive Devices Program was not declared an essential service under COVID-19, and has effectively ceased functioning. This has left thousands of disabled Ontarians without access to the crucial supports they need.

Last week, the AODA Alliance and the Ontario Autism Coalition convened a virtual town hall that brought together a variety of experts and disability rights organizations. They presented a number of recommendations that would help key departments, including health and education, in the fight against the virus. We urge your office to reach out to them without delay so these ministries get the best advice possible.

Ontario has a legal obligation to ensure no new barriers are created for people with disabilities, and that requires ensuring their voices are heard as our COVID-19 response continues.

In the end, Ontario will be judged by how we care for the most vulnerable among us during COVID-19. We urge you to consult experts and grassroots leaders from the disability community, and take immediate action given what you hear.

Sincerely,

Andrea Horwath Joel Harden
Leader of the Official Opposition MPP for Ottawa-Centre

Cc: Minister Raymond Cho, Minister for Seniors and Accessibility

April 6, 2020 Letter from Ontario NDP to the Ontario Health Minister

Hon. Christine Elliott April 6, 2020
Ministry of Health and Long-Term Care
5th Floor, 777 Bay Street
Toronto, Ontario M7A 2J3

Minister Elliott,

I understand the need to keep employees safe and take the advice of Public Health during this pandemic. Your office has shared with me that the ADP is closed. I am concerned with the impact the closure of the Assistive Devices Program office is having on families across Ontario. I would like to share a few examples with you.

In London, a palliative cancer care patient was taken home by her husband in order to decrease the occupancy rate and free up a bed at the hospital. Dave Houghton tried to re-apply to ADP to restore his wife’s grant for ostomy supplies and possibly rent/purchase a chair lift. The LHIN agreed to provide the ostomy supplies this month but supplies for next month are in limbo. Approval of funding for the needed chair lift, remains in limbo too as the ADP is closed.

In Windsor, a family needed an enteral feeding pump for the first time. They rented this from an ADP vendor. They tried to apply to ADP for funding to purchase a pump outright but the Office is closed. The LHIN paid to rent the pump for April but no one knows where funding will come from for May, since the ADP is closed.

In Barrie, 16-year old Ten Morgan needs a power wheelchair. She has an undiagnosed muscular condition that leaves her flat in bed most of the time. She is unable to hold herself upright. Her second-hand wheelchair was sized for a 7-year old so she cannot attend school as a result. Her family applied for a power wheelchair to ADP over one year ago, but a response was not received before the Office closed.

These situations create hardship for families in this stressful time. The services of the Assistive Devices Program are needed now, during the pandemic, as hospitals try to free up as many beds as possible. I know ADP has made financial arrangements so vendors are not too affected. Similar arrangements are needed for patients. Families with loved ones living with serious medical conditions have enough to deal with and they should not be left scrambling to find funding for medically necessary supplies and mobility devices because the ADP is closed.

Minister, I hope you will find a way to make the services of the ADP accessible to the families who need them.

Regards,

France Gelinas
Official Opposition Health Critic
MPP, Nickel Belt

April 9 2020 Letter to the Ontario Minister of Health from the Ontario Human Rights Commission

April 9, 2020

The Honourable Christine Elliott
Minister of Health
College Park, 5th Floor
777 Bay Street
Toronto, Ontario
M7A 2J3
[email protected]

Dear Minister Elliott:

RE: Potential human rights issues in the Ministry of Health’s COVID-19 response

I hope this finds you and your team safe and healthy. On behalf of the Ontario Human Rights Commission (OHRC), thank you for your ongoing efforts to address the COVID-19 pandemic.

The OHRC is ready and willing to assist the government to proactively consider, assess and address human rights concerns related to the COVID-19 pandemic. As you may know, last week, the OHRC released policy guidance to help Ontario adopt a human rights-based approach to pandemic management.

I am writing today to encourage the Ministry of Health (MOH) to engage with the OHRC on COVID-19 responses that raise potential human rights issues, including but not limited to: 1. MOH’s development of a “clinical triage protocol”
2. Collection and public reporting of human rights-based data related to COVID-19.

1. Clinical triage protocol

The media has recently reported that Ontario is developing a clinical triage protocol to address limited critical care capacity in anticipation of a potential major surge in COVID-19 cases. Disability rights groups have contacted the OHRC because they are concerned that such a protocol could have a disproportionate and discriminatory effect on Ontarians with disabilities.

Development of such protocols is obviously complex, raising many difficult ethical and moral questions. However, it is vitally important that any process to develop clinical triage protocols include, not only medical professionals and ethicists, but also human rights experts and representatives from vulnerable groups that may be disproportionately affected by its operation, including people with disabilities, older persons, Indigenous and racialized people, etc.

Consistent with the its Actions consistent with a human rights-based approach to managing the COVID-19 pandemic, the OHRC strongly recommends that MOH establish a mechanism to ensure human rights oversight and accountability before finalizing any clinical triage protocol.

To this end, the OHRC would be pleased to support MOH by providing input on the protocol, either informally or as part of the ethics table established for the government’s coordinated COVID-19 response.

2. Human rights-based pandemic data
The OHRC is also concerned that the COVID-19 pandemic may have a disproportionate and potentially discriminatory effect on Code-protected groups. As such, MOH must collect and publicly report on human rights data to properly assess and address these impacts.

It is clear that some vulnerable groups may have a more difficult time following public health guidance around isolation and physical distancing, which may increase their risk of contracting COVID-19. These vulnerable groups include people with disabilities and addictions, Indigenous and racialized people, women and children facing domestic violence, people who do not have access to stable housing, amongst others. At the same time, people from vulnerable groups may be over-represented in essential service professions (cleaners, cashiers, construction workers etc.) and tend to be recipients of essential services themselves.

The immediate risk to vulnerable groups is amplified when one considers pre-existing health inequalities and poor health outcomes within these communities, especially and including Indigenous communities. In the United States, for example, media reports indicate that Black Americans comprise 70% of reported COVID-19 deaths in Chicago while making up only 29% of the population. In Louisiana, where Black Americans make up one-third of the population, the media reports that they represent 70% of COVID-19-related deaths.

Unfortunately, unlike many jurisdictions outside Canada, MOH’s public data on COVID-19 is not disaggregated on human rights grounds and cannot be used to identify any disparate impacts on vulnerable groups. This is a serious problem and should be immediately remedied to ensure that Ontario’s short-term and long-term response to the pandemic is effective and equitable.

The OHRC has extensive experience advising governments and other public bodies on the collective and reporting of human rights-based data, and would be pleased to assist MOH in developing the necessary protocols in the context of COVID-19.

Please do not hesitate to contact me to discuss these issues further. Sincerely,

Original Signed by

Renu Mandhane, B.A., J.D., LL.M.
Chief Commissioner

cc: Hon. Doug Downey, Attorney General
Roberto Lattanzio, Executive Director, ARCH Disability Law Centre David Lepofsky, Chair, AODA Alliance
OHRC Commissioners




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Ontario’s New Democratic Party and the Ontario Human Rights Commission Press the Ford Government to Take Substantially More Action to Address Ontarians with Disabilities’ Urgent Needs During the COVID-19 Crisis


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/

Ontario’s New Democratic Party and the Ontario Human Rights Commission Press the Ford Government to Take Substantially More Action to Address Ontarians with Disabilities’ Urgent Needs During the COVID-19 Crisis

April 22, 2020

          SUMMARY

Here are even more calls for the Ford Government to take substantially more action to address the urgent needs of Ontarians with disabilities during the COVID-19 crisis. Below we set out four important recent documents showing this crisis. The first three are from the Ontario New Democratic Party, and the fourth is from the Ontario Human Rights Commission:

  1. On April 22, 2020, an NDP news release called on the Ford Government to include in a long-overdue emergency plan for people with disabilities a number of important measures, including mobile testing for people with disabilities who need to be tested for COVID-19.
  1. On April 17, 2020, NDP leader Andrea Horwath and NDP disabilities critic Joel Harden wrote to the Ford Government, combining to echo the AODA Alliance’s call for the Ford Government to create a focused plan to address the urgent needs of Ontarians with disabilities as part of its COVID-19 emergency planning. The NDP also echoed our call for the Government to consult the grassroots disability community on this. As their letter shows, the NDP was inspired to take this action by the April 7, 2020 online Virtual Public Forum on the impact of COVID-19 on people with disabilities that was jointly organized by the AODA Alliance and the Ontario Autism Coalition. In the two weeks since that virtual public forum, it has been viewed over 2,000 times. It remains available to be viewed online, with captions and American Sign Language interpretation.
  1. In the April 6, 2020 letter from NDP health critic France Gelinas to Ontario’s Health Minister Christine Elliott, the NDP urged the Government to re-open the shuttered Assistive Devices Program (ADP) and to treat it as an essential service for people with disabilities. The Government’s failure to do so is symptomatic of its larger and recurring failure to effectively address the urgent needs of Ontarians with disabilities during this crisis.
  1. In the April 6, 2020 letter from Ontario Human Rights Commissioner Renu Mandhane to Health Minister Christine Elliott, the Commission raised important human rights concerns with the Government’s controversial and secret March 28, 2020 medical triage protocol. Yesterday, as detailed in the AODA Alliance’s April 21, 2020 news release, the Government has walked back that protocol and agreed to consult human rights and community experts on it. We have not yet heard whether the Ford Government will include the AODA Alliance among those it will consult.

We thank and commend the NDP and the Ontario Human Rights Commission for these efforts. For more background, check out and widely share:

* The guest column by AODA Alliance Chair David Lepofsky in the April 20, 2020 online Toronto Star, which summarizes our major COVID disability issues in one place.

* The widely viewed April 7, 2020 online Virtual Public Forum on what Government Must Do to Meet the Urgent Needs of People with Disabilities During the COVID crisis.

* The AODA Alliance’s April 14, 2020 Discussion Paper on Ensuring that Medical Triage or Rationing of Health Care Services During the COVID-19 Crisis Does Not Discriminate Against Patients with Disabilities.

* Action tips on how to help ensure that patients with disabilities don’t face discrimination in access to critical health care.

* The April 8, 2020 open letter to Premier Ford, organized by the ARCH Disability Law Centre, voicing concerns about the Ontario Government’s protocol for rationing medical care during the COVID crisis.

* The AODA Alliance’s March 25, 2020 letter to Premier Ford, which has gone unanswered.

There have now been 447 days since the Ford Government received the groundbreaking final report of the Independent Review of the implementation of the Accessibility for Ontarians with Disabilities Act by former Ontario Lieutenant Governor David Onley. The Government has still announced no comprehensive plan of new action to implement that report. That is making worse the problems facing Ontarians with disabilities during the COVID-19 crisis.

There have been 28 days since we wrote Ontario Premier Doug Ford on March 25, 2020 to urge specific action to address the urgent needs of Ontarians with disabilities during the COVID-19 crisis. He has not answered. The ordeal facing Ontarians with disabilities during the COVID-19 crisis is made even worse by that delay.

          MORE DETAILS

April 22, 2020 News Release from the Ontario New Democratic Party

Government must make in-home testing available for people with disabilities: NDP

Province needs a plan to meet the needs of 2.6 million Ontarians with disabilities

QUEEN’S PARK — The Official Opposition is calling for the Ford government to make COVID-19 testing available at home for people with disabilities who face barriers trying to travel to testing sites.

“There are 2.6 million Ontarians living with disabilities, yet Doug Ford has not announced any plans to support them during the pandemic — despite the fact that many people with disabilities are among the most susceptible to COVID-19, and often face barriers in accessing testing and treatment,” said Andrea Horwath, Leader of the Official Opposition.

“Access to testing must not discriminate based on ability,” said Joel Harden, NDP critic for Accessibility and People with Disabilities. “If we are truly all in this together, that means making sure every Ontarian who should get a test can get one.”

Harden said that for people like John Mossa, the testing system simply excludes them. Mossa has a mobility disability, and fragile health with limited lung function. When he came down with cold-like symptoms, including a cough, he felt he needed a test — but would have needed a PSW to go along with him to a hospital or assessment centre, and worried about exposing his weak system to transit staff and others along the way. Ultimately, medical professionals advised him not to get a test, because the risks were too great and supports too few.

“People with disabilities, their families, and their caregivers cannot be an afterthought in the government’s response to COVID-19,” said Harden. “We need urgent action to ensure that their needs are met during this pandemic.”

Home-based tests for people with disabilities should be delivered by workers wearing full personal protective equipment, noted Harden.

Horwath and Harden wrote to Doug Ford calling for his government to adopt a plan in consultation with experts and grassroots disability community leaders. The plan should include, but not be limited to:

  • Adopting a clinical triage protocol that respects the human rights of people with disabilities
  • Ensuring that attendant care workers who help people with disabilities in their own homes have access to personal protective equipment
  • Resources and clear guidelines to support 330,000 special education students with e-learning
  • Provide remote and distance supports to assist the families of people with developmental or intellectual disabilities living with them, to provide respite for family members during mandatory periods of isolation at home
  • Declaring the Assistive Devices Program an essential service so that no one is deprived of critical mobility or medical aides

Media contact: Jodie Shupac, 416-806-9147

Quotes

 

John Mossa, Toronto:

“There should be COVID testing in the home of people with disabilities, especially if they are symptomatic, to prevent community spread and properly treat their illness. It is an accessibility accommodation the government should provide to vulnerable Ontarians – in keeping with the AODA.”

April 17, 2020 Letter to Premier Doug Ford from the Ontario New Democratic Party

April 17, 2020

Premier Doug Ford

Room 281

Legislative Building, Queen’s Park

Toronto, ON M7A 1A1

Dear Premier,

We write to you having convened an urgent discussion with disability rights groups and leaders within this important sector. We are urging your government to adopt a comprehensive plan in consultation with them that ensures people with disabilities’ needs are met during this pandemic.

There are 2.6 million people with disabilities in Ontario, and their concerns are not being properly addressed in our province’s response to COVID-19. The same is true for their paid and unpaid caregivers. These are among the most vulnerable people to the spread of the virus.

Ontario has not announced a disability strategy for COVID-19, and the government has not responded to repeated appeals by grassroots disability rights groups. These groups have identified a number of concerns with respect to the government’s response, including but not limited to:

  • Attendant care for Ontarians with disabilities is also precarious given the lack of access to personal protective equipment. Social distancing is impossible between care workers and their disabled clients, so the lack of access to PPE presents a real threat to the spread of COVID-19.
  • Over 330,000 children with disabilities are currently attempting to learn from home with little or no strategy or support from the Ministry of Education. We cannot assume that all families and students can easily adjust to online learning, particularly when the format itself can be a barrier.
  • Ontario’s Assistive Devices Program was not declared an essential service under COVID-19, and has effectively ceased functioning. This has left thousands of disabled Ontarians without access to the crucial supports they need.

Last week, the AODA Alliance and the Ontario Autism Coalition convened a virtual town hall that brought together a variety of experts and disability rights organizations. They presented a number of recommendations that would help key departments, including health and education, in the fight against the virus. We urge your office to reach out to them without delay so these ministries get the best advice possible.

Ontario has a legal obligation to ensure no new barriers are created for people with disabilities, and that requires ensuring their voices are heard as our COVID-19 response continues.

In the end, Ontario will be judged by how we care for the most vulnerable among us during COVID-19. We urge you to consult experts and grassroots leaders from the disability community, and take immediate action given what you hear.

Sincerely,

Andrea Horwath                                                        Joel Harden

Leader of the Official Opposition                              MPP for Ottawa-Centre

Cc: Minister Raymond Cho, Minister for Seniors and Accessibility

April 6, 2020 Letter from Ontario NDP to the Ontario Health Minister

Hon. Christine Elliott                                                             April 6, 2020

Ministry of Health and Long-Term Care

5th Floor, 777 Bay Street

Toronto, Ontario M7A 2J3

Minister Elliott,

I understand the need to keep employees safe and take the advice of Public Health during this pandemic. Your office has shared with me that the ADP is closed. I am concerned with the impact the closure of the Assistive Devices Program office is having on families across Ontario. I would like to share a few examples with you.

In London, a palliative cancer care patient was taken home by her husband in order to decrease the occupancy rate and free up a bed at the hospital. Dave Houghton tried to re-apply to ADP to restore his wife’s grant for ostomy supplies and possibly rent/purchase a chair lift. The LHIN agreed to provide the ostomy supplies this month but supplies for next month are in limbo. Approval of funding for the needed chair lift, remains in limbo too as the ADP is closed.

In Windsor, a family needed an enteral feeding pump for the first time. They rented this from an ADP vendor. They tried to apply to ADP for funding to purchase a pump outright – but the Office is closed. The LHIN paid to rent the pump for April but no one knows where funding will come from for May, since the ADP is closed.

In Barrie, 16-year old Ten Morgan needs a power wheelchair. She has an undiagnosed muscular condition that leaves her flat in bed most of the time. She is unable to hold herself upright. Her second-hand wheelchair was sized for a 7-year old so she cannot attend school as a result. Her family applied for a power wheelchair to ADP over one year ago, but a response was not received before the Office closed.

These situations create hardship for families in this stressful time. The services of the Assistive Devices Program are needed now, during the pandemic, as hospitals try to free up as many beds as possible. I know ADP has made financial arrangements so vendors are not too affected. Similar arrangements are needed for patients. Families with loved ones living with serious medical conditions have enough to deal with and they should not be left scrambling to find funding for medically necessary supplies and mobility devices because the ADP is closed.

Minister, I hope you will find a way to make the services of the ADP accessible to the families who need them.

Regards,

France Gelinas

Official Opposition Health Critic

MPP, Nickel Belt

April 9 2020 Letter to the Ontario Minister of Health from the Ontario Human Rights Commission

April 9, 2020

The Honourable Christine Elliott

Minister of Health

College Park, 5th Floor

777 Bay Street

Toronto, Ontario

M7A 2J3

[email protected]

Dear Minister Elliott:

RE: Potential human rights issues in the Ministry of Health’s COVID-19 response

I hope this finds you and your team safe and healthy. On behalf of the Ontario Human Rights Commission (OHRC), thank you for your ongoing efforts to address the COVID-19 pandemic.

The OHRC is ready and willing to assist the government to proactively consider, assess and address human rights concerns related to the COVID-19 pandemic. As you may know, last week, the OHRC released policy guidance to help Ontario adopt a human rights-based approach to pandemic management.

I am writing today to encourage the Ministry of Health (MOH) to engage with the OHRC on COVID-19 responses that raise potential human rights issues, including but not limited to:

  1. MOH’s development of a “clinical triage protocol”
  2. Collection and public reporting of human rights-based data related to COVID-19.
  1. Clinical triage protocol

The media has recently reported that Ontario is developing a clinical triage protocol to address limited critical care capacity in anticipation of a potential major surge in COVID-19 cases. Disability rights groups have contacted the OHRC because they are concerned that such a protocol could have a disproportionate and discriminatory effect on Ontarians with disabilities.

Development of such protocols is obviously complex, raising many difficult ethical and moral questions. However, it is vitally important that any process to develop clinical triage protocols include, not only medical professionals and ethicists, but also human rights experts and representatives from vulnerable groups that may be disproportionately affected by its operation, including people with disabilities, older persons, Indigenous and racialized people, etc.

 

Consistent with the its Actions consistent with a human rights-based approach to managing the COVID-19 pandemic, the OHRC strongly recommends that MOH establish a mechanism to ensure human rights oversight and accountability before finalizing any clinical triage protocol.

To this end, the OHRC would be pleased to support MOH by providing input on the protocol, either informally or as part of the ethics table established for the government’s coordinated COVID-19 response.

  1. Human rights-based pandemic data

The OHRC is also concerned that the COVID-19 pandemic may have a disproportionate and potentially discriminatory effect on Code-protected groups. As such, MOH must collect and publicly report on human rights data to properly assess and address these impacts.

It is clear that some vulnerable groups may have a more difficult time following public health guidance around isolation and physical distancing, which may increase their risk of contracting COVID-19. These vulnerable groups include people with disabilities and addictions, Indigenous and racialized people, women and children facing domestic violence, people who do not have access to stable housing, amongst others. At the same time, people from vulnerable groups may be over-represented in essential service professions (cleaners, cashiers, construction workers etc.) and tend to be recipients of essential services themselves.

The immediate risk to vulnerable groups is amplified when one considers pre-existing health inequalities and poor health outcomes within these communities, especially and including Indigenous communities. In the United States, for example, media reports indicate that Black Americans comprise 70% of reported COVID-19 deaths in Chicago while making up only 29% of the population. In Louisiana, where Black Americans make up one-third of the population, the media reports that they represent 70% of COVID-19-related deaths.

Unfortunately, unlike many jurisdictions outside Canada, MOH’s public data on COVID-19 is not disaggregated on human rights grounds and cannot be used to identify any disparate impacts on vulnerable groups. This is a serious problem and should be immediately remedied to ensure that Ontario’s short-term and long-term response to the pandemic is effective and equitable.

The OHRC has extensive experience advising governments and other public bodies on the collective and reporting of human rights-based data, and would be pleased to assist MOH in developing the necessary protocols in the context of COVID-19.

Please do not hesitate to contact me to discuss these issues further.

Sincerely,

Original Signed by

Renu Mandhane, B.A., J.D., LL.M.

Chief Commissioner

cc:        Hon. Doug Downey, Attorney General

Roberto Lattanzio, Executive Director, ARCH Disability Law Centre

David Lepofsky, Chair, AODA Alliance

OHRC Commissioners



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


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

February 25, 2020

SUMMARY

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

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

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

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

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

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

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

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

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

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

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

A Framework for the Health Care Accessibility Standard

February 25, 2020

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

Introduction — What is This Framework?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following are the headings in this Framework:

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

2. A Vision of An Accessible Health Care System

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2. A Vision of An Accessible Health Care System

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

a) guides on accessible procurement including procurement of accessible furniture

b) lists of venders of accessible furniture

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

c) A health care facility’s discharge instructions.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Barrier: Healthcare providers:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

a) Attendant care.

b) Assistance with meals.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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




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


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

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

February 25, 2020

          SUMMARY

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

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

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

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

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

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

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

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

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

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

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

          A Framework for the Health Care Accessibility Standard

February 25, 2020

Proposed by the Accessibility for Ontarians with Disabilities Act Alliance

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

Introduction — What is This Framework?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following are the headings in this Framework:

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

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

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

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

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

2. A Vision of An Accessible Health Care System

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  1. a) All advertisements for health care promotion should have captioning and audio description.
  1. b) All mail-out, printed and online materials focusing on health promotion should be required to be in accessible formats, regardless of any exemptions in the Information and Communication Accessibility Standard.

Barrier: Healthcare providers:

  1. a) may not recognize a patient who has an invisible communication disability;
  1. b) may not know how to communicate with a patient if the patient uses ways other than speech to communicate;
  1. c) may overestimate or underestimate a patient’s comprehension and ability to give informed consent;
  1. d) may erroneously assume the patient’s incapacity based on their communication disability;
  1. e) may not know how and/or when to provide communication accommodations and supports for effective communication.

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

#11-13. The Healthcare Accessibility Standards should require:

  1. a) Intake procedures that identify, document and share a patient’s communication profile with their healthcare team. For example, the patient’s preferred communication method, home language and authorized communication assistant.
  1. b) Procedures to ensure privacy and confidentiality of information if third parties are present to assist with communication.
  1. c) Provision of required communication accommodations and supports. Accommodations include items that patients need to communicate, such as pen, paper, boogie board, picture, letter board and communication devices. Supports include strategies that healthcare providers can use to facilitate communication with a patient as well as assistance from people who know the patient well, a sign language interpreter, a language translator, a speech language pathologist.
  1. d) Engagement when needed of Speech-Language Pathology services to provide appropriate accommodations and supports, in situations where a patient has no means to communicate or to ensure authenticity of communication in high stake consent situations.
  1. e) Access to generic, commercial picture/word displays for emergency, ICU and inpatient use.

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

  1. a) Ensure in any education program for health care providers or professionals (including first responders and emergency care staff), training on core competencies on communicating with patients who may have unclear speech, reduced comprehension of spoken language or who may use sign language, writing, picture, letter boards, communication devices and/or someone else to assist a patient with communication.
  1. b) Establish and fund a central hub for rapid provision of communication supports referred to here, which health care facilities and providers can use.
  1. c) Create, widely distribute and publicize readily available and easy-to-use kits and guides for health care facilities and providers, including first responders, on how to arrange for effective communication with a patient with communication disabilities.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  1. a) Review its public complaints process to identify any barriers at any stage in that process that could adversely affect people with disabilities filing a complaint, or about whom a complaint is filed.
  1. b) Develop a plan for removing and preventing any accessibility barriers identified whether or not those barriers are specified in any current AODA accessibility standards.
  1. c) Publicly report to its governing board of directors and the public on these barriers and the college’s plans to remove and prevent such barriers, in order to achieve a barrier-free complaints process.
  1. d) Establish and maintain a standing committee of its governing board of directors responsible for the accessibility of the services that the college offers the public, including, but not limited to its public complaints process.
  1. e) Regularly consult with the public, including people with disabilities, on barriers that people with disabilities experience when seeking the services of the health care professionals that that profession regulates, to be shared with the board’s Accessibility Committee.
  1. f) As provided in Recommendation #13-1 above, set specific curriculum requirements that a person must complete on providing accessible services to patients with disabilities, in order to qualify to get a license to practice in the profession they regulate.
  1. g) As required by Recommendation #13-1 above, for those already licensed to practice in the profession they regulate, set continuing professional development training requirements on providing accessible services to patients with disabilities that a licensed professional must complete.

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

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

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

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

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

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

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

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

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

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

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

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

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



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