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


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

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

August 20, 2021

SUMMARY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

8. The RHFAC adjudication process has serious flaws.

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

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

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

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

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

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

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

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

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

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

MORE DETAILS

Burnaby Beacon August 19, 2021

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

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

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

By Dustin Godfrey

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

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

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

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

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

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

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

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

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

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

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

What is the Rick Hansen Foundation?

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

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

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

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

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

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

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

Whats the problem?

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

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

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

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

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

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

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

Filling the gaps

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

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

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

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

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

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

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

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

Legislation being implemented

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

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

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

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

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

Weve been very public about this

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

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

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

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

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

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

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

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

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

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

Human rights complaint

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

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

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

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

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

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

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

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

The word certification is a misnomer, according to Lepofsky.

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

Who certifies the certifiers?

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

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

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

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

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

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

A focus on spinal cord injuries

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

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

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

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

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

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

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

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

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

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

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

Laws with teeth

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

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

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

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

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

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

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

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

Free resources

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

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

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

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

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

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

Dustin Godfrey
Reporter at Burnaby Beacon

The Toronto Star August 6, 2019

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

Editorial

Buildings must be for everyone

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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




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


Accessibility for Ontarians with Disabilities Act Alliance Update

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

Web: www.aodaalliance.org

Email: [email protected]

Twitter: @aodaalliance

Facebook: www.facebook.com/aodaalliance/

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

August 20, 2021

        SUMMARY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

        MORE DETAILS

Burnaby Beacon August 19, 2021

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

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

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

By Dustin Godfrey

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

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

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

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

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

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

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

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

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

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

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

What is the Rick Hansen Foundation?

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

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

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

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

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

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

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

What’s the problem?

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

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

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

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

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

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

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

Filling the gaps

 

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

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

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

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

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

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

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

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

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

 

Legislation being implemented

 

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

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

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

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

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

 

‘We’ve been very public about this’

 

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

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

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

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

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

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

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

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

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

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

Human rights complaint

 

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

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

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

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

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

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

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

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

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

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

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

 

Who certifies the certifiers?

 

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

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

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

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

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

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

A focus on spinal cord injuries

 

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

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

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

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

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

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

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

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

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

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

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

Laws with teeth

 

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

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

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

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

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

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

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

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

Free resources

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

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

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

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

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

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

Dustin Godfrey

Reporter at Burnaby Beacon

The Toronto Star August 6, 2019

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

Ontario should move faster on tearing down barriers

Editorial

Buildings must be for everyone

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

under the Accessibility for Ontarians with Disabilities Act?

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

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

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

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

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

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

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

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



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Check Out the New Video that Explains the K-12 Education Standards Development Committee’s 185-Page Initial Report and Gives Tips on How to Give Feedback


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/

Check Out the New Video that Explains the K-12 Education Standards Development Committee’s 185-Page Initial Report and Gives Tips on How to Give Feedback

June 24, 2021

            SUMMARY

We today unveil another new video! This video gives you helpful information on how and why to give feedback on the disability barriers that face students with disabilities in Ontario schools. The Ontario Government is conducting a public consultation this summer, ending on September 2, 2021. It is gathering feedback from the public on the initial recommendations in this area that have been prepared by the K-12 Education Standards Development Committee and posted for public comment. This new video is available at https://youtu.be/yjQgOjRTZJ8

This public consultation is the first time in a generation or longer that the Ontario Government has taken a good look at Ontario’s school system from the perspective of students with disabilities. The AODA Alliance wants to help you have your say. This video will be helpful for you if you are:

* a student with disabilities;

* a family member of students with disabilities;

* a teacher or other education staff;

* a school principal or vice principal, or school board administrator;

* a member of an Accessibility Advisory Committee or Special Education Advisory Committee;

* connected with a disability community organization;

* teaching in a Faculty of Education, or

* studying in a Faculty of Education or Early Childhood Education.

The video is recorded by AODA Alliance Chair David Lepofsky. He is also a Visiting Professor of Disability Rights and Legal Education at the Osgoode Hall Law School. He is a member of the K-12 Education Standards Development Committee, and a member and past chair of the Special Education Advisory Committee of the Toronto District School Board.

We hope this video helps you decide whether to give feedback to the K-12 Education Standards Development Committee, and helps you think about what feedback to give. You could use all or part of it as part of a public forum to gather input for the K-12 Education Standards Development Committee. If you are part of a committee or group that is going to collectively give feedback, such as a Special Education Advisory Committee, your members might find it helpful to watch this video before going to a meeting to discuss the feedback that you wish to give to the K-12 Education Standards Development Committee.

This video is 49 minutes long. Some might only want to watch part of it. To help with this, we set out below links to each major heading or topic in the video. You can just jump right to the part that you find most helpful to you.

In the video, Lepofsky refers to various helpful resources for you to read, if you want more information. Below is a list of these resources, with links to them.

Please encourage others to watch this video. Publicize it on social media.

This video is now in the process of being captioned. This captioning (and not just Youtube’s automated captions) should be available in the next few days.

As this video makes clear, it was not produced by the K-12 Education Standards Development Committee.

Did you find this video helpful? Write us at [email protected]

            MORE DETAILS

1. How to Jump Directly to Each Topic in This New Video

  1. Start of the video: https://youtu.be/yjQgOjRTZJ8
  1. 2. What is the Accessibility for Ontarians with Disabilities Act? What is an accessibility standard? (3:30: minutes) https://youtu.be/yjQgOjRTZJ8?t=210
  1. What is the K-12 Education Standards Development Committee? (5 minutes): https://youtu.be/yjQgOjRTZJ8?t=285
  1. What is the current public consultation? (6:50 minutes): https://youtu.be/yjQgOjRTZJ8?t=405
  1. What can an accessibility standard include? (7:35 minutes): https://youtu.be/yjQgOjRTZJ8?t=455
  1. Why do we need an Education Accessibility Standard? (8 minutes): https://youtu.be/yjQgOjRTZJ8?t=490
  1. How to have your say. Different ways you can give your feedback to the K-12 Education Standards Development Committee up to September 2, 2021 (11 minutes): https://youtu.be/yjQgOjRTZJ8?t=660
  1. What did the K-12 Education Standards Development Committee recommend in its initial report? Review of the 20 major themes in the K-12 Education Standards Development Committee initial recommendations (13:20 minutes): https://youtu.be/yjQgOjRTZJ8?t=800
  1. Tips on what you can do right now to use the K-12 Education Standards Development Committee’s initial report, to get action to help students with disabilities (43 minutes): https://youtu.be/yjQgOjRTZJ8?t=2580
  1. Conclusion and Further resources for more information and to help you give feedback (46:50): https://youtu.be/yjQgOjRTZJ8?t=2810

2. Key Background Resources

  1. The entire 185-page K-12 Education Standards Development Committee initial report and initial recommendations on what the promised Education Accessibility Standard should include to make education in Ontario schools barrier-free for all students with disabilities.
  2. The AODA Alliance’s 55-page condensed and annotated version of the K-12 Education Standards Development Committee initial report and recommendations.
  3. The AODA Alliance’s 15-page summary of the K-12 Education Standards Development Committee initial report and recommendations.
  4. The AODA Alliance‘s action kit on how to give public feedback on the K-12 Education Standards Development Committee initial report and recommendations.
  5. The June 16, 2021 AODA Alliance Update, setting out the K-12 Education Standards Development Committee‘s recommendations for designing a barrier-free school building.
  6. A captioned video of tips for parents of students with disabilities on how to advocate at school for their child’s needs.
  7. For general background, the AODA Alliance website Education page.



Source link

Check Out the New Video that Explains the K-12 Education Standards Development Committee’s 185-Page Initial Report and Gives Tips on How to Give Feedback


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

June 24, 2021

SUMMARY
We today unveil another new video! This video gives you helpful information on how and why to give feedback on the disability barriers that face students with disabilities in Ontario schools. The Ontario Government is conducting a public consultation this summer, ending on September 2, 2021. It is gathering feedback from the public on the initial recommendations in this area that have been prepared by the K-12 Education Standards Development Committee and posted for public comment. This new video is available at https://youtu.be/yjQgOjRTZJ8

This public consultation is the first time in a generation or longer that the Ontario Government has taken a good look at Ontario’s school system from the perspective of students with disabilities. The AODA Alliance wants to help you have your say. This video will be helpful for you if you are: * a student with disabilities;
* a family member of students with disabilities;
* a teacher or other education staff;
* a school principal or vice principal, or school board administrator;
* a member of an Accessibility Advisory Committee or Special Education Advisory Committee; * connected with a disability community organization;
* teaching in a Faculty of Education, or
* studying in a Faculty of Education or Early Childhood Education.

The video is recorded by AODA Alliance Chair David Lepofsky. He is also a Visiting Professor of Disability Rights and Legal Education at the Osgoode Hall Law School. He is a member of the K-12 Education Standards Development Committee, and a member and past chair of the Special Education Advisory Committee of the Toronto District School Board.

We hope this video helps you decide whether to give feedback to the K-12 Education Standards Development Committee, and helps you think about what feedback to give. You could use all or part of it as part of a public forum to gather input for the K-12 Education Standards Development Committee. If you are part of a committee or group that is going to collectively give feedback, such as a Special Education Advisory Committee, your members might find it helpful to watch this video before going to a meeting to discuss the feedback that you wish to give to the K-12 Education Standards Development Committee.

This video is 49 minutes long. Some might only want to watch part of it. To help with this, we set out below links to each major heading or topic in the video. You can just jump right to the part that you find most helpful to you.

In the video, Lepofsky refers to various helpful resources for you to read, if you want more information. Below is a list of these resources, with links to them.

Please encourage others to watch this video. Publicize it on social media.
This video is now in the process of being captioned. This captioning (and not just Youtube’s automated captions) should be available in the next few days.
As this video makes clear, it was not produced by the K-12 Education Standards Development Committee. Did you find this video helpful? Write us at [email protected]

MORE DETAILS

1. How to Jump Directly to Each Topic in This New Video

1. Start of the video: https://youtu.be/yjQgOjRTZJ8

2. What is the Accessibility for Ontarians with Disabilities Act? What is an accessibility standard? (3:30: minutes) https://youtu.be/yjQgOjRTZJ8?t=210

3. What is the K-12 Education Standards Development Committee? (5 minutes): https://youtu.be/yjQgOjRTZJ8?t=285

4. What is the current public consultation? (6:50 minutes): https://youtu.be/yjQgOjRTZJ8?t=405

5. What can an accessibility standard include? (7:35 minutes): https://youtu.be/yjQgOjRTZJ8?t=455

6. Why do we need an Education Accessibility Standard? (8 minutes): https://youtu.be/yjQgOjRTZJ8?t=490

7. How to have your say. Different ways you can give your feedback to the K-12 Education Standards Development Committee up to September 2, 2021 (11 minutes): https://youtu.be/yjQgOjRTZJ8?t=660

8. What did the K-12 Education Standards Development Committee recommend in its initial report? Review of the 20 major themes in the K-12 Education Standards Development Committee initial recommendations (13:20 minutes): https://youtu.be/yjQgOjRTZJ8?t=800

9. Tips on what you can do right now to use the K-12 Education Standards Development Committee’s initial report, to get action to help students with disabilities (43 minutes): https://youtu.be/yjQgOjRTZJ8?t=2580

10. Conclusion and Further resources for more information and to help you give feedback (46:50): https://youtu.be/yjQgOjRTZJ8?t=2810

2. Key Background Resources

1. The entire 185-page K-12 Education Standards Development Committee initial report and initial recommendations on what the promised Education Accessibility Standard should include to make education in Ontario schools barrier-free for all students with disabilities.
2. The AODA Alliance’s 55-page condensed and annotated version of the K-12 Education Standards Development Committee initial report and recommendations.
3. The AODA Alliance’s 15-page summary of the K-12 Education Standards Development Committee initial report and recommendations.
4. The AODA Alliance’s action kit on how to give public feedback on the K-12 Education Standards Development Committee initial report and recommendations.
5. The June 16, 2021 AODA Alliance Update, setting out the K-12 Education Standards Development Committee’s recommendations for designing a barrier-free school building.
6. A captioned video of tips for parents of students with disabilities on how to advocate at school for their child’s needs. 7. For general background, the AODA Alliance website Education page.




Source link

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


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

June 8, 2021

SUMMARY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Below you can read the following:

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

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

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

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

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

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

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

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

For more background on this issue, check out:

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

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

1 MORE DETAILS

CTV News April 28, 2021

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CTV News Online Report Updated by May 6, 2021

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

QUEBEC FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

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

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

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

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

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

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

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

intensive care admissions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CTV News

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

Elizabeth St. Philip, CTV News
Contact @LizTV

Ben Cousins , CTVNews.ca Writer
Contact @cousins_ben

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Correction:
A previous version of this story suggested triage guidelines




Source link

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


Accessibility for Ontarians with Disabilities Act Alliance Update

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

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

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

June 8, 2021

            SUMMARY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Below you can read the following:

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

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

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

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

For more background on this issue, check out:

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

1          MORE DETAILS

 CTV News April 28, 2021

Originally posted at

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

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

Avis Favaro

Medical Correspondent, CTV National News

@ctv_avisfavaro

Elizabeth St. Philip

CTV News

@LizTV

Ben Cousins

CTVNews.ca Writer

@cousins_ben

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

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

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

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

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

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

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

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

intensive care admissions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

CTV News Online Report Updated by May 6, 2021

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

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

Medical Correspondent, CTV National News

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins, CTVNews.ca Writer

Contact @cousins_ben

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

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

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

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

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

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

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

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

intensive care admissions

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

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

To: CTVNews

From: David Lepofsky

Date: May 18, 2021

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

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

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

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

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

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

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

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

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

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

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

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

David Lepofsky CM, O. Ont

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

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

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

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

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

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

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

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

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

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

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

David Lepofsky CM, O. Ont

Chair Accessibility for Ontarians with Disabilities Act Alliance

Twitter: @davidlepofsky

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

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

CTV News

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

Avis Favaro, Medical Correspondent

Contact @ctv_avisfavaro

Elizabeth St. Philip, CTV News

Contact @LizTV

Ben Cousins , CTVNews.ca Writer

Contact @cousins_ben

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

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

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

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

Related Links

Accessibility for Ontarians with Disabilities Act Alliance on triage protocols

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

QUEBEC ‘FAR FROM TRIGGERING’ TRIAGE PROTOCOLS

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

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

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

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

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

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

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

Correction:

A previous version of this story suggested triage guidelines



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