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Thomas to MacLeod: autism services should be like health care

OPSEU President Warren (Smokey) Thomas

Autism services should be no different from any other health care, says OPSEU President Warren (Smokey) Thomas in a letter to Minister of Children, Community and Social Services Lisa MacLeod. 

“In Ontario, if you need a heart transplant, you get a heart transplant,” Thomas wrote. “Autism services should be no different — if you need them, you should get them.”

“They should be effective, efficient, and holistic. They should be publicly provided, through a direct service organization, which is proven to provide better outcomes for children and saves your government money.”

Developed after consultation with parents of children with autism and OPSEU members who deliver autism services at health centres like CHEO, OPSEU’s recommendations will help families and the province save money.

Here’s the full text of the letter:

April 3, 2019
Lisa MacLeod
Minister of Children, Community and Social Services
Hepburn Block, 6th Floor, 80 Grosvenor St.
Toronto, ON, M7A 1E9

Dear Minister MacLeod,

On March 22, 2019, I met with staff at your constituency office in Nepean who said they would accept a written submission from my organization on what we think Ontario’s Autism Program should look like. Please accept this letter as a response to that commitment. We expect to be invited to fully participate in the formal consultation process you announced this week. I would also like to meet directly with you, along with a representative of the families and an OPSEU member who is a frontline autism service worker. My Legislative Assistant will be following up directly with your office.

In the meantime, please consider the following. 

As you make changes to Ontario’s Autism Program, I strongly suggest you consider investing in direct service programs. It’s cost-effective for both families and your government. OPSEU represents more than 800 frontline workers who deliver autism services. We draw the following recommendations from the experience of these frontline workers and from families we have met touring the province on this issue:

  1. Treat autism like any other health issue and fund the treatment
  2. Give parents the choice between direct funding and direct service programs
  3. Hire more people to provide direct service programming
  4. Work with the community colleges to train people to provide these services
  5. Create a governing body that certifies professional autism service workers
  6. Impose a moratorium on layoffs in the sector while consultations are taking place

Autism should be treated like any other health issue. In Ontario, if you need a heart transplant, you get a heart transplant. Autism services should be no different — if you need them, you should get them. They should be effective, efficient, and holistic. They should be publicly provided, through a direct service organization, which is proven to provide better outcomes for children and saves your government money. 

Direct service organizations, such as CHEO, provide evidence- and need-based treatment to all of its patients. Its frontline workers provide this treatment in the health centre, but also in the child’s home and school, which is what many children need. Direct service organizations design treatment plans based on a child’s unique needs, which means that only necessary services and therapy are recommended. That is good for the families, good for society, and good for your government.

The long- and short-term effect of giving appropriate autism therapies is a reduction in spending on our health care, social services, and corrections systems. Children with autism who don’t receive the services they need often require much more expensive services in adulthood. They spend more time in hospitals and mental health facilities. They are much more dependent on social services. And in the worst case-scenarios, they end up in our jails. The costs of these services are much greater than the costs of providing the autism services to children.

For example, it costs $55 to provide one hour of treatment at a direct service organization, such as CHEO. In contrast, it costs upwards of $120 per treatment hour through private service providers. If children do not receive the therapy they can end up hospitalized, which, at CHEO, costs $3,000 per day. There is no doubt that the public, direct service option, delivers the most value for money for families with children with autism and your government.

For the parents of children with autism, choice is crucial. Some parents want the ability to choose the frontline workers and the services their child needs. But for many parents, the tasks of finding services and acting as an employer are too much of a burden in an already overburdened life. For them, what they need is an accessible direct service option which can provide them all of the resources they need in one place. Despite the great need for autism services in Ontario, there are not enough people employed by direct service organizations to service the needs of children with autism. Instead, they end up in precarious private services providers that make their money based on number of treatment hours.

Lambton College in Sarnia suspended its Autism and Behavioural Science Program because of low enrolment despite the growing need for autism services in Ontario. There is a lack of jobs in direct service organizations that has resulted in a lack of skilled labour to meet the demand for autism services in Ontario. Your Ministry should work with the Ministry of Training, Colleges, and Universities to graduate autism service workers to get kids off the waitlist. Furthermore, you should provide workers who qualify a level of certification so that parents and kids can trust that the service is right and effective for them.

You should also ensure that direct service organizations such as CHEO are the diagnostic and referral hubs for all treatment and service plans, regardless of whether the treatment and service is provided by direct service or direct funding.

Families of children with autism deserve fair access to treatment, no matter where they live or how much money they make.

You have a big task ahead of you and you should not make any decisions on a whim. You should also impose a moratorium on layoffs in the sector until your decisions are made.

OPSEU has nearly 20 years of experience representing people who provide services to children with autism, educators of autism service workers, and people who work with people living with autism in our hospitals and public institutions.

I strongly suggest you consider these recommendations as you implement a right plan that will do justice for families of people living with autism. And I look forward to meeting with you directly.


Warren (Smokey) Thomas
President, Ontario Public Service Employees Union