CONTENTS
Wednesday 26 November 1997
Election of Chair
Subcommittee membership
Case of Mr S
STANDING COMMITTEE ON THE OMBUDSMAN
Chair / Président
Mr Marcel Beaubien (Lambton PC)
Vice-Chair / Vice-Président
Mr Trevor Pettit (Hamilton Mountain PC)
Mr Dominic Agostino (Hamilton East / -Est L)
Mr Marcel Beaubien (Lambton PC)
Mr Douglas B. Ford (Etobicoke-Humber PC)
Mr Allan K. McLean (Simcoe East / -Est PC)
Mr John L. Parker (York East / -Est PC)
Mr Trevor Pettit (Hamilton Mountain PC)
Mrs Sandra Pupatello (Windsor-Sandwich L)
Mr Bill Vankoughnet (Frontenac-Addington PC)
Mr Len Wood (Cochrane North / -Nord ND)
Substitutions / Membres remplaçants
Mr John Gerretsen (Kingston and The Islands / Kingston et Les Îles L)
Clerk / Greffière
Ms Tonia Grannum
Staff / Personnel
Mr Philip Kaye, research officer, Legislative Research Service
The committee met at 1011 in room 151.
ELECTION OF CHAIR
Clerk of the Committee (Ms Tonia Grannum): Honourable members, it is my duty to call on you to elect a Chair. Are there any nominations?
Mr Trevor Pettit (Hamilton Mountain): I nominate Mr Marcel Beaubien for Chair of the Ombudsman committee.
Clerk of the Committee: Any further nominations?
Mr John Gerretsen (Kingston and The Islands): May I nominate someone else? I'll nominate Mr Pettit, unless he declines.
Mr Pettit: While I appreciate the nomination by Mr Gerretsen, I will in fact decline.
Mr Gerretsen: I'll nominate Mr Vankoughnet.
Clerk of the Committee: Do you accept?
Mr Bill Vankoughnet (Frontenac-Addington): I thank my colleague from Kingston and The Islands but I've already committed myself to the nominee here, who I think can do the job. Thank you very much, Mr Gerretsen.
Mr Gerretsen: There being no further nominations --
Clerk of the Committee: Seeing no further nominations, I declare the nominations closed and Mr Marcel Beaubien elected as Chair.
The Chair (Mr Marcel Beaubien): Good morning, everyone, and thank you very much for your overwhelming support, and Mr Gerretsen, it certainly applies to you. I'm certainly happy to be here this morning.
The first order of business this morning is that we'll need a motion that the membership of the subcommittee on committee business be amended by substituting the Chair for Mr O'Toole.
SUBCOMMITTEE MEMBERSHIP
Mr Pettit: I move that the membership in the subcommittee on committee business be amended by substituting Mr Marcel Beaubien for Mr O'Toole.
The Chair: You've heard the motion. Is there any discussion on the motion? If not, all those in favour? The motion is carried.
Mr Gerretsen: On a point of order, Mr Chair: I want you to clearly understand that just because I moved two other members to chair this illustrious committee, that doesn't take anything away from the fact that I have the highest regard for you and I know you will chair this committee in a very good fashion and I have full confidence in you as Chair of this committee.
The Chair: Thank you very much.
The next order of business for the committee's information is that the subcommittee will be made up of Mr John Parker, Dominic Agostino, Mr Len Wood and Marcel Beaubien.
CASE OF MR S
The Chair: The next order of business will be the consideration of the draft report by Mr Kaye.
Mr Philip Kaye: The Ombudsman's case report in the matter of Mr S and the Ministry of Health is the second case report or so-called recommendation-denied case to be examined by this committee since September.
In drafting the report on Mr S's case for the committee's consideration, I have adhered to the format adopted by the committee when reporting on recommendation-denied cases. The draft begins with an outline of the context of Mr S's complaint, which is the Ministry of Health's assistive devices program. That context also includes to a lesser degree northern health travel grants, which were referred to by both the Ombudsman and the ministry.
The paper next explains the nature of Mr S's complaint to the Ombudsman, followed by the positions of the Ombudsman and the Ministry of Health regarding his case.
The conclusion contains the committee's decision reached on October 1 whether or not to support the Ombudsman.
Beginning on page 1 of the draft report, it's noted that Mr S's complaint related to the operation of the assistive devices program, or ADP, which is administered by the Ministry of Health.
In February of this year the Deputy Minister of Health defined the objectives of the program. The statement by the deputy minister appears towards the bottom of page 1. It reads:
"...to financially assist Ontario residents with long-term physical disabilities to obtain basic, personalized assistive devices appropriate for the individual's needs and essential for independent living. Devices covered by the programs are intended to give people increased independence and control over their lives. The devices allow them to avoid costly institutional settings and remain in a community living arrangement."
Any Ontario resident who has a physical disability of six months or longer and a valid health card is eligible to participate in the program. Residents are eligible whatever their incomes.
Assistance can assume various forms. In some cases the program pays up to 75% of the cost of devices. In other cases it contributes a fixed amount. With respect to yet other items, ADP pays an annual grant directly to the person involved.
The program has 127,000 clients and an annual budget of $80 million. During 1996-97 close to one third of all applicants were required to undergo an assessment at an assistive devices assessment centre.
As mentioned earlier, both the submissions of the Ombudsman and the Ministry of Health made reference to northern health travel grants. These grants help to pay the transportation costs of northern Ontario residents who must travel long distances for medical care. Grants total 30.5 cents per kilometre based on the one-way travelling distance between the patient's home and the nearest appropriate specialist or health care facility.
Mr John L. Parker (York East): Excuse me. I wonder if I might just intervene. We've all received a copy of the report. Some of us are a little slower than others at reviewing it. I've just reviewed it myself. Frankly, I don't need the benefit of Mr Kaye's review of the report. I'm open to comments from my colleagues whether they need it, but I'm wondering whether we can just dispense with the reading of the report and vote on it.
The Chair: Go to the discussion and question period: Is that what you're suggesting?
Mr Parker: Just go straight to a vote. I'm satisfied to proceed without any further discussion.
Mr Gerretsen: Maybe Mr Kaye can shorten the summary of the report to some extent, but I think there may be people out there, particularly the ones who are watching on television, who may want to get a better idea of what's going on here. The only way they can do so, since they don't have the benefit of reading the report beforehand, is to have the matter explained to them. I don't think it should take all that long.
The Chair: Any other comments from the committee members?
Mr Allan K. McLean (Simcoe East): If he could just summarize it, that would be appropriate. I think Mr Gerretsen is right. There are viewers who are wondering what this report is. I sit sometimes and watch and I'm wondering what they're talking about and I haven't a clue. I think the viewers have a right to have an overview. I think just an overview and the conclusion of it would be appropriate.
The Chair: I'll ask Mr Kaye to continue with his report, but I'll leave it up to him if he feels he can summarize it or condense it a little bit. I'll leave it up to you, Mr Kaye.
Mr Kaye: Thank you very much. What I will do is summarize the nature of the complaint and then highlight the key argument of the Ombudsman and the key argument raised by the ministry.
With respect to the complaint itself, Mr S sought funding from the ADP for the cost of a high-technology, sight-enhancement device. He was first required to attend at an ADP-approved assessment centre to determine which device would best meet his needs. Mr S, however, lived in Ottawa and the nearest centre which performed this kind of assessment was in Toronto. He complained to the Ombudsman's office that by denying him financial assistance to cover the cost of travel to Toronto, the ministry was denying him access to the program.
Mr S subsequently did receive assistance for a low-technology device, although the Ombudsman reported that he still preferred high-technology vision assistance.
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The Ombudsman's principal concern in the case held that the financial assistance provided by the program was not universally available if the funding could not be accessed because of economic and geographic considerations. Such considerations related to the affordability of the costs of travel and the capacity to travel that were particularly acute for persons with disabilities. For instance, the Ombudsman pointed out that in 1990 the average income for Ontario residents with disabilities was 28% less than for those without disabilities.
From the perspective of the Ministry of Health a key argument dealt with the issue of precedent and costs. The ministry was especially concerned about the possible precedent which would be set by a departure from its policy not to pay travel costs with the exception of northern health travel grants. One of its comments in this regard said that Ontario residents currently know they have to travel to centres of excellence such as the Princess Margaret Hospital for cancer treatment or the Hospital for Sick Children for specialized paediatric care. Such services raise the following issue: If the ministry pays for travel for high-technology vision aids, why should it not then pay for travel for other health services?
The ministry concluded that if it were required to pay for travel for specialized health care services, the costs would be high and an unreasonable burden would be placed on the existing health care budget.
The committee's conclusion is found at the bottom of page 8. There is a typo. The reference to "Ministry of Finance" should state "Ministry of Health." The committee's decision reads: After considering the submissions of the Ombudsman and the Ministry of Health, the committee has decided not to support the Ombudsman's recommendation.
The Chair: Thank you, Mr Kaye. I'll entertain comments and questions. Mr Gerretsen, I'll give you the floor if you want to start.
Mr Gerretsen: It so happens I was here on that particular day. I can remember this being discussed quite extensively and the representations that were made by the Ombudsman at that time. What it basically boils down to is whether we feel that, in order for this program to be accessible to all people, it would include --
Mr Parker: Mr Chair, excuse me, we're not here to debate the merits of the case. We've done that. We've heard the case. We've debated the case and we've ruled on the case. We are here to consider the report that has been submitted by Philip as a summary of the case, and to satisfy ourselves that it accurately reflects the issues of the case and the decision that was made.
We're not here to rehash the issues of the case. I'd like to keep this discussion focused to the task that's in front of us here today, which is to discuss the report, not to discuss the case.
The Chair: Mr Parker, I would tend to agree with you, but I am a new Chairperson here today and I have not had the opportunity -- I don't say that we should rehash the whole case, but I don't think Mr Gerretsen's opening statements are unreasonable. I think I will hear what he has to say at this point in time.
Mr Gerretsen: If you're asking me whether the report truly reflects what happened here that day, quite frankly, I don't think it does. There were a number of members who were here, present that day, who indicated, for example -- and it may have been placed in a minority position, which is not stated in the case at all from Mr Kaye's summary of it. They felt that for a program to be accessible, not only does the program itself have to be accessible but also the ability of the person to access the program, which in this case meant the ability of the person to travel to these centres in order to be adjudicated or to be assessed as to whether they are eligible for these kinds of devices.
It's my understanding that is made tougher because a lot of these -- if memory serves me correctly, a number of assessment centres have in fact been closed and so it would require these people to travel a much further distance than was the case previously.
What I'm saying is that if it's the committee's feeling that this report accurately reflects not only the decision of the case -- the decision of the case, presumably, is one line and that is that the committee does not uphold the Ombudsman's position in the matter. But if you want the entire report to reflect what happened here on that particular day, this report doesn't do it because it doesn't state the concern that was not only expressed by myself but by other members as well, to the effect that for the program to be accessible, the ability to get to the place to be assessed is a part of the accessibility issue.
Mr McLean: I have one paragraph I'd like to read. It says:
"The ministry indicates that if it receives a complaint respecting the inability to access an assessment centre, it works with the individual involved to find a mechanism which will provide access. These mechanisms include Easter Seals and service clubs, such as Rotary. In addition, if the person in question has little income, social assistance under the Ministry of Community and Social Services may pay a special travel grant. Such sources as the local hospital or persons who work in local long-term care might also be contacted for help in finding travel assistance."
That paragraph to me really says it all, that there is help there. My understanding is this individual is from Ottawa, who didn't qualify for the northern grants; therefore, there were other ways to do it. In my opinion, that is the main reason the committee did not accept the Ombudsman's recommendation, because there are other ways there and the ministry is there to be involved and to help. That to me satisfies.
Mr Gerretsen: If I might just respond to that, I think Mr McLean has put his finger right on it. It says, "The Ministry of Community and Social Services may pay a special travel grant" and other sources "might also be contacted for help in finding travel assistance."
The point of the matter is, and it was discussed here that day, certainly other organizations like Rotary clubs and other service clubs may be approached and sometimes assistance is available from those organizations, but what happens if the ministry decides not to fund -- I'm talking about Comsoc -- if a service club is not in a position to give funding? Is a person in effect being denied the ability to get to one of these assessment centres if there is no other possible funding available?
I think what the Ombudsman is talking about is building in some sort of guarantee that if all of these other funding mechanisms cannot be accessed, then can the funding not come out of the program itself in order for the person to get there.
Mr Douglas B. Ford (Etobicoke-Humber): You need a social worker or somebody to investigate this person or persons, whatever it is, to see if they are capable or if they are physically fit, or all these variables, to see if they are able to communicate with the Rotary clubs or these other people. If they are and they haven't done anything about it, then, quite honestly, they have to be satisfied with what the government has assisted them with. I know of cases where people complain verbally but never do a darn thing about accessing some of the services available locally.
The Chair: At this point in time I think I'll entertain a motion.
Mr Parker: I move that the report be adopted and that the Chair be authorized to present the report to the House.
The Chair: Discussion on the motion? If not, all those in favour of the motion? Opposed?
Mr Gerretsen: I'm opposed and I'd like it to be recorded. I want a recorded vote.
Ayes
Ford, McLean, Parker, Pettit, Vankoughnet.
Nays
Gerretsen.
The Chair: The motion is carried.
I would like to thank all the committee members and the staff. We are now adjourned.
The committee adjourned at 1030.