Autism help on way but will take some time
After missteps, Ontario finally getting it right
Another delay, another disappointment for parents of autistic children in Ontario. This week’s news that the provincial government’s new- andimproved autism plan won’t be fully in place for more than a year wasn’t what parents wanted to hear.
Their frustration is understandable. This is the fifth reinvention of the program in less than four years. Families are facing enormous emotional and financial pressure. The clock is ticking for children awaiting autism treatment, which is most effective when delivered at a young age. Lacking timely support from the government, many parents are putting themselves into debt to help their children.
That said, it isn’t surprising that the government can’t double the size of the system in just a few months. Deciding to increase funding from $ 300 million to $ 600 million was the easy part, although it’s a big commitment. Creating the capacity to help far more children won’t be nearly so simple.
Todd Smith, minister of Children, Community and Social Services, has taken a huge step forward by accepting the recommendations of a provincial advisory panel that called for a needs- based autism program. That’s a far better approach than the first one the PCS took, which would have given all families some money, but didn’t take needs into account.
When they took office, the PCS inherited a Liberal plan that provided a high level of service to a minority of the children that needed help and nothing at all to most. Without a clinically determined end point for service, the waiting lists barely moved.
Instead, the PCS offered $ 20,000 a year for parents with children under six and $ 5,000 for those with older children. The PC alternative was certainly fairer, but it was universally unpopular. Parents whose children were getting a high level of service could see their kids would get less. Those who had been waiting for service realized they’d only get a fraction of what was required. To make it worse, this new free- market model relied on parents to seek out quality service providers in an unregulated system.
The PC government did it right the second time, appointing a broad- based panel and accepting their recommendations. The advisory panel itself suggested an implementation group with clinical expertise to work out the details. That will take time.
Building up capacity to handle demand is clearly a challenge. During the period of uncertainty between the two PC approaches, some autism service providers laid off staff or didn’t fill vacant positions. The government says it is assuring them that money is coming to expand their services. The new approach also calls for clinical care co- ordinators to guide parents through the system. That will be a big improvement, but it’s a position that doesn’t exist now.
One of the most difficult and controversial issues is establishing guidelines for how much care will be provided. Clinical experts and the government will work that out, but the new system will not provide everything that every family needs. The expert panel was asked to design the best system it could within a $ 600 million annual budget. Like every other kind of health service, autism treatment will be subject to triage and rationing. That’s almost certain to disappoint some parents, but it shouldn’t shock them.
This new system will have to operate for at least a couple of years before the government really has a grip on the gap between legitimate demand and the substantial but arbitrary budget it has established.
To help the parents a bit until the new system is ready, the government is
Parents of children with autism face another tough year.
issuing one- time payments of either $ 5,000 or $ 20,000 depending on the age of the child. That’s a rather unfortunate echo of the money available in the failed plan and it certainly won’t go far for families with substantial bills.
The government’s immediate spending priority should be putting more money into the public sector service providers that deliver 70 per cent of the province’s autism care now. That’s the fastest way to deliver more service and cut waiting lists while the new plan is fleshed out.
Parents of children with autism face another tough year of struggling to get what services they can. That’s understandably difficult to accept, but it’s hard to see how the government can do more. At least there is now the realistic hope of a fair and functional system, something that Ontarians have never had.
The autism file has been an important learning experience for the PC government. In its initial enthusiasm to fix problems immediately, it didn’t spend enough time listening to the people it was trying to help. When it comes to autism, this government’s heart has always been in the right place. Now, its head is finally following.