FOR IMMEDIATE RELEASE
[La version française suit le texte anglais.]
WAITLIST FOR NEEDS-BASED AUTISM SERVICES REACHED 27,600 CHILDREN IN 2019-20
TORONTO, July 21, 2020 – The Financial Accountability Office (FAO) has released a new report providing an overview of the Province’s autism services and program design considerations for the new Ontario Autism Program (new OAP), which is scheduled to be in place by 2021.
The FAO estimates that there are about 42,000 children and youth living with autism spectrum disorder (autism) in Ontario. Families with children on the autism spectrum often seek behavioural therapy programs to improve language, communication and social skills, which can cost up to $95,000 per year, depending on the individual needs of the child.
Families can apply for support from the Government of Ontario (the Province), which provides a number of different autism services. In recent years, the Province has made material changes to its programs, including:
- In 2017, the Province introduced the Ontario Autism Program (OAP) which merged needs-based autism therapy services and increased funding to address the growing waitlist.
- In 2019, the Province announced that it would replace the OAP with age-based Childhood Budgets and committed to eliminate the waitlist entirely. However, the Province cancelled this reform later in 2019 and announced that it would introduce a new needs-based OAP by 2021.
As the Province made changes to its autism services, annual spending and the waitlist grew significantly.
- From 2015-16 to 2019-20, spending on autism services grew at an average annual rate of 34 per cent, reaching $608 million in 2019-20, due to the creation and expansion of the OAP, beginning in 2017, and then the introduction of Childhood Budgets in 2019.
- From 2011-12 to 2018-19, the waitlist for needs-based autism services grew at an average annual rate of 47.8 per cent, from 1,600 children in 2011-12 to 24,900 in 2018-19, as the Province expanded program eligibility. In 2019-20, the waitlist for needs-based services reached 27,600 as the Province stopped enrolling children into needs-based behavioural therapy programs and instead offered aged-based Childhood Budgets.
Looking forward, the Province has committed to introducing a new needs-based Ontario Autism Program (new OAP) with an annual budget of $600 million by 2021. The new OAP is currently under design, with a working group providing advice on the implementation of the new program, including service levels (length of service and intensity) for needs-based support. To support MPPs’ review of the new OAP, the FAO developed program design scenarios with the following variables: budget, service level, number of clients served and waitlist. The FAO made the following observations:
- With an annual $600 million budget, if the Province were to maintain needs-based service levels similar to the OAP in 2018 and 2019 (about $29,900 per child), then approximately 17,860 children would be able to access needs-based services, an increase of 8,700 children from 2019-20, and the waitlist would be 22,900 children.
- Lowering service levels would allow the Province to increase the number of children that receive needs-based support and reduce the waitlist. A reduction in average service levels by 56 per cent, to $13,100 per child, would completely eliminate the waitlist.
- In order to eliminate the waitlist but maintain service levels that average $29,900 per child, the Province would need to increase the new OAP’s annual budget to $1.4 billion.
- The FAO estimates that the average annual cost per client under the OAP (2018 and 2019) was $29,900 and the average annual cost per client for Childhood Budgets (2019 and 2020) was $8,100.
- In 2019-20, the Province recorded unaudited spending of $608 million for autism services, including $270 million for Childhood Budgets and interim one-time funding.
- The spending for Childhood Budgets and interim one-time funding includes $97 million for 8,100 children whose families received payments in the 2019-20 fiscal year and an accrued expense of $174 million for 25,100 children whose families did not receive payments by March 31, 2020, the end of the fiscal year.
- MPPs should confirm with the Auditor General of Ontario that the Province can record the full accrued expense of $174 million as spending in 2019-20.
- Given cost pressures from population growth and price inflation, the FAO estimates that to maintain the new OAP’s service levels and to ensure that the waitlist does not increase, the Province would need to increase the new OAP’s annual budget by $96 million to $696 million by 2025-26.
- There is a risk that the delivery of the new OAP could be constrained by the availability of qualified behavioural clinicians, speech language pathologists and occupational therapists required to provide needs-based services. In response to a question from the FAO, the Province noted that limited information was available on the autism services labour market and that the ministry was in the process of collecting information to confirm the availability of qualified clinicians needed to meet demand under the new OAP.
About the FAO
Established by the Financial Accountability Officer Act, 2013, the Financial Accountability Office (FAO) provides independent analysis on the state of the Province’s finances, trends in the provincial economy and related matters important to the Legislative Assembly of Ontario. Visit http://www.fao-on.org/en/ and follow us on Twitter at https://twitter.com/InfoFAO.