Health Care Standards Development Committee

Learn about the group of disability community and health sector representatives who develop recommendations for a new accessible health care standard under the Accessibility for Ontarians with Disabilities Act (AODA).

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Background

In 2017, the Minister Responsible for Accessibility established the Health Care Standards Development Committee—a group of representatives comprised of people with disabilities, disability organizations and sector experts—to develop recommendations for new accessibility health care standard for hospitals.

Recommendations

The committee put forward initial recommendations and asked for public feedback to help them draft their final recommendations to the Minister Responsible for Accessibility.

The committee has reviewed all comments, finalized their recommendations and submitted them to the Minister for Seniors and Accessibility for consideration. Read the final recommendations.

List of members and representation

The following is a full list of the committee members including the organization or sector they are representing. Committee membership may be subject to change.

Voting members:

Sandi Bell, Chair, President of EMPOWWORD Inc.
Serge Falardeau, The Ottawa Hospital
Sam Savona, Disability Community Representative
Melanie Marsden-Myers, Indigenous and Disability Community Representative and Consultant
Lorin MacDonald, Human Rights Lawyer and Accessibility Specialist
Marianne Park-Ruffin, Gender-Based Violence Activist and Disability Community Representative
Dr. Natalie Spagnuolo, Researcher and Consultant
Richard Welland, Disability Community Representative
Raj Chopra, Accessibility Advisory Committee of the Region of Peel and Co-Founder, Accessibility Advisory Committee of William Osler Health Systems
Peter Athanasopoulos, Spinal Cord Injury Ontario
Crystal Chin, Disability Community Representative (member in absentia)
Sue Anderson, Sioux Lookout Meno Ya Win Health Centre
Carol Anderson, Health Care Consultant
Yona Lunsky, Centre for Addiction and Mental Health
Diane Quintas,Réseau du mieux-être francophone du Nord de l’Ontario, Francophone Community Representative
Jacqueline Silvera, University Health Network
Barbara Collier, Communication Disabilities Access Canada
Dr. John McDonald, Independent Physician

Non-voting members:

Mary Bartolomucci, Ministry for Seniors and Accessibility
Tara Wilson, Ministry of Health and Long-Term Care

Scope and timelines

A Standards Development Committee will develop a new accessible health care standard as required by Section 9 of the AODA. To develop this standard, members of the committee are required to:

define the long-range objective of the proposed standard
determine the measures, policies, practices and requirements to be implemented on or before January 1, 2025, and the timeframe for their implementation
develop a proposed standard that the committee deems advisable for public comment
make such changes it considers advisable to the proposed accessibility standard based on comments received, and make recommendations to Minister for Seniors and Accessibility and Minister of Health

Feedback

Feedback from over 200 participants during pre-consultations, identified barriers that could potentially be addressed through a new health care standard.

Based on this feedback, the minister asked the committee to focus on:

addressing barriers in the hospital sector. Mayo Moran recommended that “…rather than extensive sector-wide obligations (which could easily take a decade or more to implement), the outcome could be a more timely series of targeted standards”
recommendations that are implementable given the complex regulatory environment, including the five existing standards under the AODA, and financial and resource constraints within the health care sector
ways to address barriers in the health care sector through non-regulatory approaches, such as education, outreach and best practices

The minister also requested the committee to consider the following accessibility barriers which have been identified through research and stakeholder feedback:

disability awareness and sensitivity when communicating with persons with disabilities
accountability for accessibility within the administration of health sector institutions
training for health care providers to accommodate persons with disabilities

The committee should consider the forward-looking spirit of the AODA and the long-range objectives of the health care standard as part of the continuum of care. Due to the technical nature of some of the accessibility barriers identified, the minister asked the chair to consider establishing technical sub-committees—with representation from the health and disability sectors—to assist in the timely completion of the committee’s work, such as accessibility training for health care providers.

Throughout the process, the members of the Accessibility Standards Advisory Council sitting on the committee are encouraged to keep council members informed of their progress.

Guidelines for recommendations

The following guidelines are intended to support the work of the committee as they develop their recommendations:

Respect, and be complementary to, the principles, purpose and requirements of the AODA, and support the end goal of achieving accessibility for Ontarians with disabilities on or before January 1, 2025, taking into account:
- the range of disabilities that the measures, policies, practices and requirements are intended to address
- the nature of the barriers that the measures, policies, practices and requirements are intended to identify, remove and prevent
- any technical and economic considerations/ impacts that may be associated with their implementation. (for example, for obligated organizations, sectors, and the province more broadly)
Focus efforts on preventing barriers both now and in the future.
Work within existing Ontario legislative and regulatory frameworks.
Consider inter-jurisdictional best practices and innovative solutions, keeping in mind the context of Ontario’s current regulatory framework.
Consider economic implications and feasibility for the sector to comply.
Consider the ‘enforceability’ of the requirements to support compliance and enforcement of the proposed standard.
Where appropriate, reflect international standards, legislation, regulation, codes, and best practices in Ontario, other provinces, and internationally, in the area of health care and accessibility.

Key deliverables and timelines

The committee will complete the following key deliverables within the specified timelines:

Mandatory orientation and training—all members of the committee will complete an initial orientation and training during their first meeting.
Meetings—the committee will meet for one or two-day sessions, approximately every five to six weeks as needed.
Committee work plan— the committee will prepare and provide to the minister of a draft work plan early in the development of a proposed health care standard. The work plan will outline key milestones, activities, and timelines to achieve the mandate described in this letter.
Proposed recommendations for a new health care standard—within 18 months or sooner of the first meeting, the committee will deliver to the minister proposed recommendations for public review.
Finalizing recommendations for revisions to the standard—a report on comments received during the public review will be prepared by the Ministry of Seniors and Accessibility and the comments will be given to the committee for its consideration. The committee will consider public comments, seek additional information if needed, and make changes based on public comments as the committee deems advisable.
The committee will submit the final recommendations to the minister along with a report on its consideration of public comments, no more than 14 weeks after receiving the report and public comments.
Meeting minutes and progress reports—within four weeks of each meeting, the committee will approve and provide the minister a copy of its meeting minutes which are to include a progress report on the development of a new health care standard.

Meeting Minutes

Meeting 19: February 15, 2022
Meeting 18: January 18 and February 1, 2022
Meeting 17: November 30 and December 14, 2021
Meeting 16: October 19 and November 17, 2021
Meeting 15: September 23, 2020
Meeting 14: September 15 and September 16, 2020
Meeting 13: August 10 and August 14, 2020
Meeting 12: July 13 and 16, 2020
Meeting 11: June 9, 2020
Meeting 10: January 16, 2020
Meeting 9: December 10, 2019
Meeting 8: October 10, 2019
Meeting 7: May 2 and 3, 2018
Meeting 6: February 27 and 28, 2018
Meeting 5: January 17, 2018
Meeting 4: November 1 and 2, 2017
Meeting 3: September 19 and 20, 2017
Meeting 2: June 26 and 27, 2017
Meeting 1: May 11 and 12, 2017
Orientation Meeting: March 29 and 30, 2017

Meeting 19: Tuesday, February 15, 2022

Letter from chair to the minister

Date: March 11, 2022

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 19 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee approved minutes from the virtual meeting (Meeting 19), held on Tuesday, February 15, and to provide you with a brief update on the Committee’s progress.

As I submit the minutes of this final meeting of the Committee, I am overcome with joy and delight as I reflect on our work over the past five years and the camaraderie that has formed. The discussions, sharing of diverse perspectives, as well as working through a pandemic, were instrumental considerations as the initial proposed standards was being finalized.

The Committee has worked through the following key deliverables:

Reviewed specific recommendations and feedback, as requested by members of the committee.
Approved 20 recommendations.
Finalized and confirmed support for all the committee’s recommendations through a final vote.

With the vote on the committee’s final recommendations completed and passed, the work of the committee has completed. Ministry staff will now be working to ensure that the final recommendations report is submitted to the Minister.

Sincerely,
(Original signed by)
Sandi Bell, Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: February 15, 2021 from 1:00 p.m. to 4:15 p.m.

Location: virtual

Format of committee minutes and references: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/minute items/sections/action items and ‘Partial’ represents limited attendance. Motion represents a vote that has occurred. All recommendations to date are considered draft until finalized and included in the Initial Recommendations Report submitted to the Minister.

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Sue Anderson, Peter Athanasopoulos, Raj Chopra, Serge Falardeau, Yona Lunsky, Lorin MacDonald, John McDonald, Melanie Marsden, Marianne Park, Diane Quintas, Sam Savona, Jacqueline Silvera and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Deputy Minister for Seniors and Accessibility: Carlene Alexander (partial)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Sophia Christopher, Alison Drummond, Ann Louise Fitzpatrick, Alex Ibrahim, Jenna Strathearn, Alexandria Tadman and Asim Zaidi

Ministry of Health staff: Yolanda Davidson (partial), Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Carol Anderson, Barbara Collier and Natalie Spagnuolo

Day 1 meeting minutes

M 19.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a welcome. Sue Anderson (committee member) made a land acknowledgement.

The Chair provided a quick report on electronic voting that had occurred since the last meeting. As of the last meeting, with support from the Chair and a small working group of committee members, recommendation 9 (access to third party supports) and recommendation 22 (access to health services for persons with disabilities during a declared provincial emergency situation) have been updated. The Committee held a successful online vote which closed February 11. The Chair commended the Committee on their first successful online vote.

The Chair also proceeded with an overview of the agenda for the meeting. The objective for the day was for members to discuss their review of the long-term objective, and the initial recommendations report, with the goal of holding a vote to submit the report in principle to the Minister by the end of the meeting.

M 19.2 Ministry for Seniors and Accessibility Deputy Minister remarks

Deputy Minister Carlene Alexander expressed her congratulations for the hard work, dedication, and passion that committee members showed throughout the standards development process. She looks forward to reading the report, as does Minister Cho.

M 19.3 Ministry of Health Directors’ remarks

Tara Wilson (Hospitals Branch) applauded the Committee for completing the final recommendations report. The Hospitals Branch looks forward to working with Mary Bartolomucci’s team in the next stages of policy further analysis on the recommendations.

Yolanda Davidson (Indigenous, French Language and Priority Populations Branch) also congratulated the Committee and looks forward to inter-ministerial consultations in the next phase of analysis.

M 19.4 Ministry for Seniors and Accessibility welcome

Jenna Strathearn and Alexandria Tadman conducted the roll call and reviewed best practices for meetings on an online format (Zoom) for full participation of members for the meeting.

M 19.5 review of Committee input and feedback document on long-term objective

Arminda Aliu read and facilitated review of the long-term objective. Members discussed potential edits that could address the issues raised by the public feedback.

The following vote took place:

Motion 19.1: carried – long-term objective:

Fair, rights-based, equitable, accessibility policies and practices that are enforceable and measurable with clear outcomes.

Barrier-free hospitals and health care that embraces empowerment, accessibility, diversity, and inclusion with an intersectionality lens.

Towards hospital and health care accessibility

Members of the Standards Development Committee proposed the following vision for an accessible health care system:

Our vision is that hospitals and health care remove all systemic barriers (for example, physical, verbal, communicative) that impede persons with disabilities fully benefitting from the available health services they require and provide them with accessible, fair, effective and user-friendly services in alternative formats and in both official languages.

In addition, the vision provides that institutions and decision makers:

design and operate accessible health care services, facilities and products using the principles of universal design, taking into consideration accessible public transit routes and sufficient accessible parking
provide health care workers with information on how to properly communicate with all persons with disabilities
provide health care workers with information on how to identify, provide and document accommodations and supports for patients who have disabilities (for example, that affect their communication)
provide health care workers with the necessary resources and monitor to ensure appropriate implementation
design and operate accessible diagnostic and treatment health care products
eliminate any policy or procedural (systemic) barriers to effective accommodation
design strategies, services and facilities that include accommodation for persons with disabilities
ensure persons with disabilities and their families are made aware of the complaint mechanism that has no reprisals
actively recruit persons with disabilities to ensure representation at all levels of paid, community and volunteer positions, especially in decision making capacities, such as the board, its committees and senior executive team
ensure that current, ongoing education and training, including the principles of accommodation under the Ontario Human Rights Code, is provided to all health care providers

Vote passed.
(Passed, February 15, 2022)

M 19.6 Ministry for Seniors and Accessibility Assistant Deputy Minister remarks

Assistant Deputy Minister Alison Drummond commended the Committee on reaching its milestone. She emphasized her appreciation for the Committee’s dedication to finding a common vision to advance accessibility in Ontario’s health care system and finalizing the initial recommendations report.

M 19.7 Discussion on final report

The Committee proceeded on to discussing the final report. The Chair reiterated that any suggested edits raised by members to the report would be considered before official submission to the Minister. Yona Lunsky (committee member) reviewed Easy Read principles and the benefits for reaching diverse populations with important information.

M 19.8 finalized recommendations to be submitted to the Minister

Motion 19.2 – Carried

After review was complete, the Committee voted to finalize their recommendations and submit them to the Minister.

Vote passed.
(Passed, February 15, 2022)

M 19.9 Note on next steps

Mary Bartolomucci provided an overview of next steps in the standard development and review process.

M 19-10 closing remarks and adjournment

Members of the Committee shared congratulatory remarks amongst each other. The Chair thanked Committee members and adjourned the meeting.

Meeting 18: Tuesday, January 18 and Tuesday, February 1, 2022

Letter from chair to the minister

Date: March 11, 2022

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 18 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee approved minutes from the virtual meetings (Meeting 18) held in two parts, on Tuesday, January 18 and Tuesday, February 1, 2022, and to provide you with a brief update on the Committee’s progress.

On January 18, the Committee discussed recommendations 5-10 and 21 which focused on accessibility accommodations in hospitals and outreach. The discussion highlighted some mergers of recommendations and through this discussion, recommendation 13 was also amended.

During the meeting on February 1, members held fruitful discussions around recommendations 9 and 22. Small working groups were again instructed to further review the recommendations before being circulated for electronic vote.

Details of all these votes are contained in the attached minutes. Staff will continue to work with me to maintain the online voting system that works best for the Committee.

Looking ahead to the Committee’s next meeting, we plan to discuss any outstanding recommendations, including the long-term objective, and are eager to submit the Final Recommendations Report to you.

Sincerely,
(Original signed by)
Sandi Bell, Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: January 18, 2022, from 1:00 p.m. to 4:15 p.m.

Location: virtual

Format of Committee minutes and references: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/minute items/sections/action items and ‘Partial’ represents limited attendance. Motion represents a vote that has occurred. All recommendations to date are considered draft until finalized and included in the Initial Recommendations Report submitted to the Minister.

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Peter Athanasopoulos, Raj Chopra, Serge Falardeau, Lorin MacDonald, John McDonald, Marianne Park, Diane Quintas, Sam Savona and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility) and Tara Wilson (partial) (Ministry of Health)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Paul Challen, Sophia Christopher, Ann Louise Fitzpatrick, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Sue Anderson, Barbara Collier, Yona Lunsky, Melanie Marsden, Jacqueline Silvera, Natalie Spagnuolo and Alex Ibrahim

Day 1 meeting minutes

M 18-1.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a welcome. Raj Chopra (committee member) made a land acknowledgement.

The Chair provided a quick report on electronic voting that had occurred since the last meeting. As of the last meeting, with support from the Chair and a small working group of committee members, recommendation 1-5 (hospital accessibility accommodations) and 21 (outreach) were under review. There was also a new recommendation for the creation of a new term: Accessibility Lead/Consultant, which has been added to the glossary accompanying the report. The term will be applicable to recommendations 1 and 3. The Committee held a successful online vote on some of the updated recommendations between December 22 and 29, with some proposed amendments being further discussed today.

The objective for the meeting today was for members to discuss their review of recommendations 5 and 6 (which would be merged), term objective.

M 18-1.2 Ministry for Seniors and Accessibility welcome

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Zoom) for full participation of members for the meeting.

M 18-1.3 review of Committee input and feedback document on hospital accessibility accommodations recommendations 5/6 (to be merged).

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 18-1.4 review of Committee input and feedback on outreach recommendation #21

The Committee proceeded on to discussing recommendation 21.

M 18-1.5 review of Committee input and feedback document on hospital accessibility accommodations recommendations #7

The Committee proceeded on to discussing recommendation 7.

M 18-1.6 review of Committee input and feedback document on hospital accessibility accommodations recommendations #8/10 and on education and training recommendations #13

The Committee began the review of recommendations 8/10 (now merged). Based on the discussion, part of the new merged recommendation 8/10 was removed and included under recommendation 13 as it related more closely to education and training. Due to time constraints, recommendations 9, 22, and the long-term objective will be reviewed at the next meeting on February 1. All the recommendations discussed today will be circulated for comment and electronic vote.

M 18-1.7 closing remarks and adjournment

The Chair thanked committee members. At the next meeting, the Committee will review proposed amendments to recommendations 9, 22, and the long-term objective.

Next meeting: Tuesday, February 1 at 1:00 p.m.

Day 2 meeting information

Date: February 1, 2022, at 1:00 p.m. to 4:15 p.m.

Location: virtual

Day 2 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Serge Falardeau, Lorin MacDonald, John McDonald, Melanie Marsden, Marianne Park (partial), Diane Quintas, Sam Savona and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Sophia Christopher, Paul Challen, Ann Louise Fitzpatrick, Jenna Strathearn, Alexandra Tadman and Asim Zaidi

Ministry of Health staff: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Barbara Collier, Yona Lunsky, Jacqueline Silvera, Natalie Spagnuolo; Tara Wilson (Ministry of Health)

Day 2 meeting minutes

M 18-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with welcome remarks. Diane Quintas (committee member) made a land acknowledgement in French.

The Chair provided a quick report on electronic voting that had occurred since the last meeting, indicating that the committee held a successful online vote on the five updated recommendations on January 24. The Chair commended the committee for their great work reviewing the recommendations and for holding another successful online vote.

The Chair also proceeded with an overview of the agenda for the meeting. The objective for the day was for members to discuss their review of recommendations 9 and 22, as well as the long-term objective.

M 18-2.2 Ministry for Seniors and Accessibility welcome

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Zoom) for full participation of members for the meeting.

M 18-2.3 review of Committee input and feedback document on accessibility accommodations in hospitals recommendations #9

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback. The recommendation focuses on third-party supports and the Committee spent a lot of time discussing this recommendation as it is very important to people with disabilities.

M 18-2.4 review of Committee input and feedback on accessibility accommodations in hospitals recommendations #22

The committee proceeded on to discussing recommendation 22. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 18-2.5 review of Committee input and feedback on long term objective

Due to time constraints, the long-term objective will be reviewed at the next meeting on February 15. All the recommendations discussed today will be circulated for comment and electronic vote.

M 18-2.6 next steps and submission of Final Report to the Minister

Prior to the Committee’s final meeting on February 15, ministry staff with circulate an updated version of the report which will be reflective of all revisions accepted by the Committee. The report’s Introduction, conclusion and the glossary of terms will also be discussed at this final meeting.

M 18-2.7 closing remarks and adjournment

The Chair thanked committee members. At the next meeting, the Committee will finalize the report for the proposed Health Care Standards and Ministry Staff will work with the Chair to submit to Minister Cho.

Next meeting: Tuesday, February 15, 2022, at 1:00 p.m.

Meeting 17: Tuesday, November 30 and Tuesday, December 14, 2021

Letter from chair to the minister

Date: January 11, 2021

The Honourable Raymond Cho
Minister for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, Ontario
M7A 2J4

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 17 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee approved minutes from the virtual meetings (Meeting 17) held in two parts, on Tuesday, November 30 and Tuesday December 14, and to provide you with a brief update on the Committee’s progress.

On November 30^th, the Committee discussed recommendations 18, 19, and 20 which focus on accreditation and compliance and enforcement. The Committee did a quick review of the education and training recommendations 11-14 and decided they would be reviewed further by small working groups, before being circulated for electronic vote prior to the next session on December 14^th.

During the meeting on December 14^th members held fruitful discussions around recommendations 1-5 and 21. Small working groups were again instructed to further review the recommendations before being circulated for electronic vote.

Details of all of these votes are contained in the attached minutes. Staff will continue to work with the Chair to maintain the online voting system that works best for the Committee.

Looking ahead to the Committee’s next meeting, we plan to discuss recommendations 6-10 that focus on accessibility accommodations in hospitals, recommendation 22 which focuses on the impacts of covid 19 and the long-term objective.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: November 30, 2021 from 1:00 p.m. to 4:15 p.m.

Location: virtual

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Marianne Park, Diane Quintas, Sam Savona, Jacqueline Silvera and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Sophia Christopher, Ann Louise Fitzpatrick, Alex Ibrahim, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Olivia Arnaud

Regrets: Barbara Collier, John McDonald and Natalie Spagnuolo

Day 1 meeting minutes

M 17-1.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a welcome. Lorin MacDonald (committee member) made a land acknowledgement.

The Chair provided a quick report on electronic voting that had occurred since the last meeting. As of the last meeting, with support from the Chair and a small working group of Committee members, recommendation 17 (accessible complaints process) has now been condensed into recommendation 16 (patient relations and complaints process). The committee held a successful online vote on the updated recommendation 15 and 16 between November 24 and 26. The Chair commended the committee on their first successful online vote.

The Chair also proceeded with an overview of the agenda for the meeting. The objective for the day was for members to discuss their review of compliance and enforcement recommendations 18-20 and education and training recommendations 11-14, and potential amendments.

M 17-1.2 Ministry for Seniors and Accessibility welcome

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Zoom) for full participation of members for this virtual meeting.

M 17-1.3 review of Committee input and feedback document on compliance and enforcement recommendations #18

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 17-1.4 review of Committee input and feedback on compliance and enforcement recommendations #19

The committee proceeded on to discussing recommendation 19.

M 17-1.5 review of Committee input and feedback on compliance and enforcement recommendations #20

The committee proceeded on to discussing recommendation 20. Due to time constraints, recommendations 18, 19 and 20 will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-1.6 review of Committee input and feedback on education and training recommendations #11-14

The Committee began the review of recommendations 11-14. Based on the discussion at the meeting and due to time constraints, recommendations 11-14 will be reviewed by another small working group of Committee members, before being circulated for comment and electronic vote.

M 17-1.7 closing remarks and adjournment

The Chair thanked Committee members. At the next meeting, the Committee will review proposed amendments to Accessibility Accommodations in hospitals recommendations.

Next meeting: Tuesday, December 14 at 1:00 p.m.

Day 2 meeting information

Date: December 14, 2021 at 1:00 p.m. to 4:15 p.m.

Location: virtual

Day 2 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Marianne Park, Diane Quintas, Sam Savona and Jacqueline Silvera.

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health) (partial)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Sophia Christopher, Alison Drummond (partial), Alex Ibrahim, Harrison Luong, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Olivia Arnaud

Regrets: John McDonald, Natalie Spagnuolo and Richard Welland

Day 2 meeting minutes

M 17-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with welcome remarks and Marianne Park Ruffin made a land acknowledgement.

The Chair provided a quick report on electronic voting that had occurred since the last meeting, indicating that the committee held a successful online vote on the seven updated recommendations 18-20 and 11-14 between December 8 and 10. The Chair commended the committee for their great work reviewing the recommendations and for holding another successful online vote.

The Chair also proceeded with an overview of the agenda for the meeting. The objective for the day was for members to discuss their review of recommendations 1-5 and 21, and potential amendments.

M 17-2.2 Ministry for Seniors and Accessibility Assistant Deputy Minister remarks

Assistant Deputy Minister Alison Drummond of the Ministry for Seniors and Accessibility recognized the commitment and diligence of the Committee as they have been finalizing recommendations. She emphasized her appreciation and encouraged members to keep momentum so that the Final Recommendations Report could be submitted in February.

M 17-2.3 Ministry for Seniors and Accessibility welcome

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Zoom) for full participation of members for this virtual meeting.

M 17-2.4 review of Committee input and feedback document on accessibility accommodations in hospitals recommendations #1

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 17-2.5 review of Committee input and feedback on accessibility accommodations in hospitals recommendations #2

The committee proceeded on to discussing recommendation 2. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-2.6 review of Committee input and feedback on accessibility accommodations in hospitals recommendations #3

The committee proceeded on to discussing recommendation 3. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-2.7 review of Committee input and feedback on accessibility accommodations in hospitals recommendations #4

The committee proceeded on to discussing recommendation 4. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-2.8 review of Committee input and feedback on accessibility accommodations in hospitals recommendations #5

The committee proceeded on to discussing recommendation 5. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-2.9 review of Committee input and feedback on outreach recommendations #21

The committee proceeded on to discussing recommendation 21. This recommendation will be reviewed by a small working group of Committee members, before being circulated for comment and electronic vote.

M 17-2.10 closing remarks and adjournment

The Chair thanked Committee members and noted that during the next meeting in January the Committee will review proposed amendments to Recommendations 6-10 that focus on accommodations, third-party supports and effective communication, recommendation 22 that focuses around covid 19 and emergencies, and the long-term objective.

Next meeting: Tuesday, January 18, 2022 at 1:00 p.m.

Meeting 16: Tuesday, October 19 and Wednesday, November 17, 2021

Letter from chair to the minister

Date: December 9 2021

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5th Floor, 777 Bay Street,
Toronto, Ontario
M7A 2J4

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 16 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual meetings (Meeting 16) held in two parts, on Tuesday October 19 and Wednesday November 17, and to provide you with a brief update on the Committee’s progress.

At this two-part meeting, the Committee commenced the review of public feedback on the initial recommendations report. After receiving an overview presentation on survey and feedback results, the Committee began discussing the long-term objective, followed by Compliance and Enforcement Recommendations 15-20.

The Committee held great discussions on October 19^th which led to a change in process implemented for the November 17^th meeting. With this new process, members were given the recommendations and corresponding feedback and asked to provide their suggested edits to staff in advance of the meeting, allowing for targeted discussion.

During the meeting on November 17^th members held fruitful discussions around recommendation 15, 16 and 17. They were constrained by time and decided to move recommendation 18, 19 and 20 to the November 30^th meeting. Staff will work with the Chair to establish an online voting system that works best for the Committee, as they did not have quorum.

Looking ahead to the Committee’s next meeting, we plan to discuss Recommendations 11-14 that focus on education and training.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: October 19, 2021 from 1:00 p.m. to 4:15 p.m.
Location: virtual

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, John McDonald, Marianne Park, Sam Savona and Diane Quintas

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility) and Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility staff: Arminda Aliu, Alison Drummond (partial), Ann Louise Fitzpatrick, Alex Ibrahim, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Natalie Spagnuolo and Richard Welland

Day 1 meeting minutes

M 16-1.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a welcome. Due to technical difficulties, Ministry for Seniors and Accessibility staff Arminda Aliu made a land acknowledgement on behalf of Melanie Marsden (Committee Member). The Chair proceeded with an overview of the agenda for the meeting. The objective for the day was for Committee Members to hear an overview of public feedback, as well as begin discussions on the long-term objective and potential amendments.

M 16-1.2 Ministry for Seniors and Accessibility welcome and review plan for finalizing report and meeting workplan

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) for full participation of members for this virtual meeting.

Alex Ibrahim provided an overview of the public feedback, highlighting that they were very well received with over 90 per cent agreement or agreement with changes. As a recap for members, there was a brief review of the Standards Development Committee process with a description of policy analysis, including regulatory and non-regulatory measures that could be used to achieve intended outcomes.

M 16-1.3 presentation: overview of the public feedback received during the posting period

Ministry for Seniors and Accessibility staff Arminda Aliu provided further details regarding the feedback received as a whole, and the long-term objective specifically.

M 16-1.4 focused review of the long-term objective feedback

Committee members began discussing each of the 49 comments related to the long-term objective.

Members of the Committee agreed that prior to the next meeting, they would review feedback and submit discussion points or proposed amendments to Ministry for Seniors and Accessibility staff as they deemed necessary. This method would allow for targeted discussion and facilitate quicker resolutions for each recommendation.

M 16-1.5 Assistant Deputy Minister Alison Drummond to provide introductory remarks

Assistant Deputy Minister Alison Drummond of the Ministry for Seniors and Accessibility introduced herself and recognized the commitment and diligence of the Committee as they begin reviewing the public feedback and thanked them for their contributions thus far, especially under the pressures of the covid 19 pandemic.

Assistant Deputy Minister Drummond emphasized her appreciation for the Committee’s dedication to finding a common vision to advance accessibility in Ontario’s health care system and looks forward to working with them.

M 16-1.6 closing remarks and adjournment

The Chair thanked Committee members. At the next meeting, the Committee will review proposed amendments to Compliance and Enforcement recommendations.

Next meeting: Wednesday, November 17 at 1:00 p.m.

Day 2 meeting information

Date: November 17, 2021 at 1:00 p.m. to 4:15 p.m.
Location: virtual

Day 2 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Serge Falardeau, Lorin MacDonald, John McDonald, Marianne Park, Sam Savona, Diane Quintas, Richard Welland (partial)

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility)

Ministry for Seniors and Accessibility Deputy Minister’s Office staff: Sharan Bassi

Ministry for Seniors and Accessibility staff: Arminda Aliu, Ann Louise Fitzpatrick, Alex Ibrahim, Susannah Bush, Jenna Strathearn and Asim Zaidi

Ministry of Health: Lina Kapur, Janelle Ritchie, Sherina Macedo, Mary Marafiotti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Barbara Collier, Yona Lunsky, Melanie Marsden, Natalie Spagnuolo and Jacqueline Silvera, non-voting member: Tara Wilson (Ministry of Health)

Day 2 meeting minutes

M 16-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a land acknowledgement and welcome remarks.

M 16-2.2 Ministry for Seniors and Accessibility roll call and opening remarks

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (which has moved to Zoom) for full participation of members for this virtual meeting.

M 16-2.3 review of Committee input and feedback document on Compliance and Enforcement Recommendations #15

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 16-2.4 review of Committee input and feedback on Compliance and Enforcement Recommendations #16

Arminda Aliu read and facilitated review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 16-2.5 review of Committee input and feedback on Compliance and Enforcement Recommendations #17

Arminda Aliu continued to read and facilitate review of recommendations. Members discussed potential edits that could address the issues raised by the public feedback.

M 16-2.6 closing remarks and adjournment

The Chair thanked Committee members. At the next meeting, the Committee will continue review of proposed amendments to Compliance and Enforcement recommendations, and if time permits Education and Training recommendations.

Next meeting: Tuesday, November 30 at 1:00 p.m.

Meetings 15: Wednesday September 23, 2020

Letter from chair to the minister

Date: January 21, 2021

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5^th Floor, 777 Bay Street,
Toronto, Ontario
M7A 2J4

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 15 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual meeting (“Meeting 15”) held on September 23, 2020 and to provide you with a brief update on the Committee’s progress.

The Committee found consensus on outstanding recommendations, holding a total of seven votes. I am pleased to report that the Health Care Standard Development Committee conducted a final vote on their Initial Recommendations Report which will be shared with you as soon as final edits are made.

Looking ahead, the Committee is keen to hear from a diverse range of interested stakeholders and the general public over the course of a public consultation period.

I cannot understate the integrity and excellence of this Committee. With pride in my role as the Chair, I look forward to our discussion on our Initial Recommendations Report for advancing accessibility in Ontario’s health care sector.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Meeting information

Date: September 23, 2020 from 1:00 p.m. to 4:15 p.m.

Location: virtual

Present

Standards Development Committee members: Sandi Bell (Chair), Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, John McDonald, Melanie Marsden, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting members: Mary Bartolomucci (Ministry for Seniors and Accessibility)

Ministry for Seniors and Accessibility Minister’s Office staff: Michael Thomas

Ministry for Seniors and Accessibility Deputy Minister’s Office staff: Denise Cole, Mihaela Dumitrascu and Jacqueline Kiwanuka

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Jenna Strathearn, Dan Wilson and Asim Zaidi

Ministry of Health staff: Meagan Ward

Captionist: Kim Johnson

Regrets: Carol Anderson, Tara Wilson (Ministry of Health)

Meeting minutes

M 15.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a land acknowledgement, followed by a welcome and provided an overview of the agenda for the meeting. The objective for the day was to hold votes on any outstanding recommendations and vote to submit the initial recommendations report to the Minister.

M 15.2 Ministry for Seniors and Accessibility welcome and Deputy Minister’s remarks

Deputy Minister Denise Cole of the Ministry for Seniors and Accessibility recognized the commitment and diligence of the Committee as they worked to complete the initial recommendations and thanked them for their contributions thus far, especially under the pressures of the covid 19 pandemic. She emphasized her appreciation for the committee’s dedication to finding a common vision to advance accessibility in Ontario’s health care system.

Mary Bartolomucci, acting Assistant Deputy Minister and non-voting member of the Committee reflected on her learnings from Committee discussions over the course of their meetings, and thanked the Committee for this lasting influence along with their work.

Vinothini Kajendran conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) for full participation of members for this virtual meeting.

M 15.3 discussion on outstanding recommendations and vote

Ministry for Seniors and Accessibility staff Elisheva Bouskila-Fox and Margaret Hageman provided an overview of the Committee’s current outstanding recommendations, followed by committee discussion and amendments.

The following votes took place:

Motion 15.1: carried - recommendation 6:

Recommendation 6: electronic health records
(Passed, as amended September 23, 2020)

Preamble

Persons with disabilities are often adversely impacted during medical appointments, treatment during hospital visits, and when admitted to hospital. They are frequently excluded from decision-making about their care as health care providers may be unaware of the principles of independent living, which includes the ability to examine alternatives, make informed decisions and direct their own lives.

The electronic medical record has the capacity to be formatted in a manner that can assist persons with disabilities and hospital caregivers, pending approval from the person with disability with items such as accommodation needs.

The Committee proposes the following recommendation:

It is recommended that the Ministry of Health require all hospitals in Ontario to include mandatory fields/information in the demographic/admission screen of the electronic health record/electronic patient record that outlines the identification and provision of accessibility accommodations and support requirements for all patients with disabilities to ensure continuity of care.

Timeline: effective immediately

Vote passed.

Motion 15.2: carried - recommendation 4:

Recommendation 4: accommodations funding for hospitals

The Committee proposes the following recommendation:

It is recommended that the Ministry of Health create a dedicated and restricted line item of expanded funding to all hospitals directed for the purchase of accessible assistive devices, supportive equipment and accommodation of support services. Hospital procurement plans are approved by Ontario Health. Purchasing approvals must be based upon the assessment of local needs and requirements and must be planned and purchased in collaboration with persons with disabilities, and the hospital accessibility committee, and identified in every hospital’s annual accessibility plan.

Timeline: effective immediately

Vote passed.
(Passed, September 23, 2020)

Motion 15.3: carried - recommendation 20 (new)

Recommendation 20: enforcement strategy and framework - Hospital Accessibility Standards
(Passed, September 23, 2020)

Preamble

In addition to the recommendations that the Committee has made enhancing the existing enforcement measures in place under the Accessibility for Ontarians with Disabilities Act, 2005, the Committee is proposing an additional enforcement framework specific to the proposed new Health Care Standards.

This approach is based on a cycle of negotiated and mutually agreed on actions to meet the requirements of new Health Care Standards, and the goals identified in a hospital’s multi-year accessibility plan, with verification and enforcement action occurring every three years.

The intent is that hospitals and the Ministry for Seniors and Accessibility can work together on identifying goals with firm timelines, with mutual understanding that there will be enforcement actions if goals are not met as planned.

Full implementation of accessibility can fall short of its goals if it is not enforced.

The Committee proposes the following recommendation:

the Ontario government work with the disability sector, including persons with lived experience of disability, and key stakeholder groups to develop a new clear and transparent enforcement strategy and framework specific to hospital accessibility over the next three years
the enforcement strategy will be targeted to implementation of new accessibility requirements under Health Care Standards, as well as verification of all applicable requirements under the Integrated Accessibility Standards Regulation
the enforcement strategy and framework will:
1. clearly communicate how government will assess and verify for compliance with requirements within each hospital, with associated timelines
2. if requirements or agreed upon goals have not been met, government shall consider any potential extenuating circumstances that prevented the hospital from achieving agreed upon accessibility goals before applying enforcement actions
3. government work together with each hospital to develop an agreed upon plan for which monetary and/or non-monetary enforcement actions will be taken if compliance is not achieved, in order to clearly communicate what consequences would be applied
the enforcement strategy and framework will be publicly available once complete. This should include being posted online, in both official languages, in accessible format with alternate formats available
each hospital’s agreement and goals will identify priority areas for improvement. These are to be selected based on the requirements under the proposed Health Care Standards, and the goals identified in each hospital’s multi-year accessibility plan
The Ontario government will evaluate its enforcement, compliance, and accountability approach to hospital accessibility every three to six years once the new requirements and enforcement framework are in place. The results of this review will be publicly reported. Following this review, government would be required to update the framework and make any appropriate changes
at the end of each three year cycle, all infractions and non-compliance to hospital accessibility regulations will be available to the public within a searchable database along with its mandated annual accessibility plans
all high performing and compliant hospitals will be available to the public within a searchable database along with its mandated annual accessibility plans

Vote passed.

Motion 15.4: carried - recommendation 19

Recommendation 19: outreach
(Passed, as amended September 23, 2020)

Preamble

Government must pursue outreach and education programs to broaden awareness about accessibility rights and duties within the health care sector. This should be undertaken together with hospitals and persons with disabilities and include programs to broaden awareness of hospital complaints and patient relations processes. The lack of awareness creates an accessibility barrier to implementation of accommodations and supports as well as to having patient complaints heard or resolved.

The Committee proposes the following recommendation:

government shall create an outreach campaign (including public service announcements) to heighten awareness and inform Ontarians about accessibility rights and accommodations and supports in the hospital/healthcare environment. This outreach shall provide content specific to the healthcare standards including but not limited to:
1. accommodation/accessibility, including the principles of dignity, respect and independence such as:
  1. anti-ableism awareness/education
  2. anti-stigma awareness/education including stereotypes, unconscious/conscious bias
  3. accessibility awareness/education
  4. examples of the range and types of disabilities and accessibility accommodations and supports required at the point of care and health risks if accommodation and supports are not provided
  5. communication accommodation and supports for understanding spoken and written language, effective communication about healthcare concerns, treatment choices, and/or making decisions to give informed consent
  6. information about accessibility rights, accommodations and supports
2. the complaint process and procedure, including how to file a complaint about the lack of accessibility accommodation and supports in services, facilities or goods, timelines and the right to communication that is accessible and available in alternate formats on request
3. third party responsibilities under the health care standard
the outreach campaign shall be provided in both official languages and additional languages as appropriate, and in different accessible media formats including but not limited to:
1. social media and internet ads
2. virtual ad
3. podcast
4. television
5. print campaign
6. audio for radio
7. available in alternate format
outreach campaign materials shall be supported by sign language interpretation and Communication Access Realtime Translation provided by accredited steno captioners
the government shall create an outreach campaign in partnership with Persons with Disabilities
the ministry shall ensure that adequate funding is provided to create an Accessibility 2025 outreach campaign for hospitals/healthcare

Timeline: government shall pursue this outreach recommendation as soon as possible

Vote passed.

Motion 15.5: carried - recommendation 9

Recommendation 9: access to third party supports
(Passed, as amended September 23, 2020)

Preamble

Hospitals have a duty to accommodate persons with disabilities with supports to access hospital services and directed by the patient(s), and in cooperation with the care team when required. This includes sight/hearing support, communication, personal support services, transfers on equipment such as x-rays.

The Committee proposes the following recommendation:

Hospitals shall ensure that there are policies, procedures and practices that comply with existing legislation, to provide persons with disabilities with appropriate, authorized personal support services, including unpaid supports. This includes but is not limited to:

identify and provide the support and services that the person with disabilities may require while in hospital. This may include relying on the existing services of the person with disabilities or engaging external support services
if the person with disabilities chooses to use their own existing services, then the hospital or health care provider is required to utilize these services without impediments, including harmonizing liability issues and any staffing issues
the support person will assist the patient as directed by the patient and in consultation with healthcare providers
all hospitals shall have explicit policies, procedures, and guidelines that enable the utilization of third-party providers to support patient care. This policy must include the requirement for all third-party providers to meet the confidentiality and privacy requirements of the hospital
document on the care plan the support service personnel and the role they play in the provision of care, as outlined by the person with disabilities (for example, communication assistants(s), person(s) to provide input on decision making, and attendant services for personal care, or other supports)
if the person with disabilities does not have the communication assistance they require, the hospital shall refer to formal, qualified, independent communication support
the person with disabilities is to determine how and with whom information can be shared

Timeline: effective immediately

Vote passed.

Motion 15.6: carried - recommendation 10

Recommendation 10: effective communication and informed consent
(Passed, as amended September 23, 2020)

The Committee proposes the following recommendation:

Hospitals shall ensure that there are policies, procedures and practices, compliant with existing legislation, to provide persons with disabilities with the individualized accommodations and supports they require to ensure understanding of information provided, retain and weigh consequences of options, and make and communicate their decision(s). This includes policies, procedures, and practices including training for all health care providers and capacity assessors in:

identifying and providing communication accommodations and supports that persons with disabilities may need to communicate consent
identifying and providing communication accommodations and supports that persons with disabilities may require to make decisions in consent situations
ensuring that communication supports when needed, are in place and documented to assist persons with disabilities in making decisions about their health care
identifying and providing formal, qualified independent communication support in situations where persons with disabilities do not have the communication accommodations and supports, they require to give informed consent, including:
1. where there is a perceived conflict of interest between the person with the disability and their support person(s), or evidence of coercion and abuse of power
2. in high risk situations such as medical assistance in dying

Timeline: to be determined following public feedback

Vote passed.

M 15.4 vote on Initial Recommendations Report

As all the recommendations had been voted on, the Committee agreed to a vote in principle to approve the Initial Recommendations Report.

Motion 15.7: carried - motion to approve the Initial Recommendations Report (in principle)

Vote passed.
(September 23, 2020)

Ministry for Seniors and Accessibility staff will work in conjunction with the Chair to make any final edits to the Initial Recommendations Report. Committee members will be asked to review the report after today’s changes for their final review before it is submitted to the Minister.

M 15.5 closing remarks and adjournment

On behalf of the Minister for Seniors and Accessibility, Michael Thomas congratulated members of the Committee on reaching the milestone. The Chair echoed this sentiment and thanked Committee Members.

Staff advised the Committee that the Initial Recommendations Report would be posted online for public feedback, and that the next meeting of the Committee would occur after that public feedback period.

Meetings 14: Tuesday September 15 and Wednesday September 16, 2020

Letter from chair to the minister

Date: January 21, 2021

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5^th Floor, 777 Bay Street,
Toronto, Ontario
M7A 2J4

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 14 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual two-part meeting (“Meeting 14”) held September 15 and 16 2020, and to provide you with a brief update on the Committee’s progress.

In this meeting the Committee reviewed compliance and enforcement recommendations, as well as a recommendation related to State of Emergencies, as a result of reflections on the current covid 19 pandemic. The Committee found consensus and voted on six initial recommendations. This represents a significant advancement of Committee work.

Looking ahead to the next meeting, the Committee anticipates finalizing all remaining recommendations, and voting to submit the completed Initial Recommendations report.

I look forward to continuing to update you on the Committee’s ongoing progress.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: September 15, 2020 from 9:30 a.m. to 11:45 a.m.

Location: virtual

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Lorin MacDonald, Melanie Marsden, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting members: Mary Bartolomucci (Ministry for Seniors and Accessibility) and Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility Deputy Minister’s Office staff: Mihaela Dumitrascu

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Jacqueline Kiwanuka, Jenna Strathearn, Dan Wilson and Asim Zaidi

Ministry of Health staff: Mary Marafioti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Carol Anderson, Yona Lunsky and John McDonald

Day 1 meeting minutes

M 14-1.1 Chair’s welcome and review of agenda

Committee Chair, Sandi Bell, opened the meeting with a land acknowledgement, followed by a welcome and an overview of the agenda for the meeting.

The Chair recognized two ad-hoc working groups (compliance and enforcement and covid 19 reflections) who met since the last meeting advancing these recommendations. The Committee was encouraged to maintain their momentum toward completing the Initial Recommendations Report by September 23.

M 14-1.2 Ministry for Seniors and Accessibility welcome and roll call

Vinothini Kajendran conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) and teleconference for full participation of members.

M 14-1.3 discussion guide – compliance, accountability and enforcement (Tab 1A and 1B)

Ministry for Seniors and Accessibility staff Elisheva Bouskila-Fox and Margaret Hageman guided the Committee through proposed compliance and enforcement recommendations. After robust discussion and amendments, there were two votes on the following recommendations:

Motion 14-1.1: carried - recommendation 18

Recommendation 18: enforcement/compliance

Preamble

There needs to be a focus on and strengthening of government accessibility compliance mechanisms for the Accessibility with Ontarians with Disabilities Act (given the discrepancy between member experiences and compliance results are incongruent).

The Committee proposes the following recommendation:

that the Ministry enhance and improve accuracy of the self-report digital attestation process through modifications to the Accessibility Compliance Report. Such modifications will include enforcement of mandatory validation of meeting accessibility requirements with sign-off requirements in order to complete the electronic tool. Mandatory verification is based on specific and accurate information regarding what full compliance for the specific item would entail. Furthermore, the attestation should include a reminder of the fines applicable for non-compliance
that the Ministry implement an additional component to the Accessibility with Ontarians with Disabilities Act compliance and enforcement framework. This new component would entail an accessibility verification and compliance site visit, a site visit similar to Accreditation Canada whereby evidence of compliance must be visible across the organization. Such standardized and routine site visits could be carried out from either a randomly selected segment of the hospitals in the province or scheduled with the Accessibility with Ontarians with Disabilities Act team attending to all Ontario hospitals within a five-year window
every year as part of every hospital funding agreement with the Ontario government, an accessibility plan should be developed by each hospital to address weaknesses and barriers to accessibility documented by hospital and other healthcare facilities specifically within their evaluation processes including but not limited to:
1. independent evaluation
2. complaints
3. feedback mechanisms
all hospital accessibility plans must, under the regulation, be uploaded into a searchable public database (created by the Ministry for Seniors and Accessibility) where communities can easily understand the accessibility of the hospitals that they are visiting and/or being treated within and have the ability to determine the level of accessibility progress of each hospital
that government ensure that hospital funding agreements are contingent on successful accessibility verification and compliance site visit action plan compliance, “and Transfer Payment Agreements will not be administered by government until all measures are met.”
the ministry will amend the existing Accessibility Compliance Report attestation to include a specific requirement regarding the hospitals’ patient relations process, ensuring that it is publicly displayed, fully accessible and available in alternate formats. Evidence of this requirement will be part of the on-site validation site visit to ensure full compliance with an accessible patient relations process
every hospital and healthcare facility in Ontario must develop fully accessible webpages in accordance with the Information and Communications Standards on their websites informing people with disabilities what is available to them to meet their accessibility and accommodation needs. This includes, but is not limited to:
1. all accessible services and supports available
2. all training and accessibility professional development offered
3. service navigation and contact persons for assistance
4. partnerships with organizations to achieve accessibility and accommodation needs
5. complaints process
6. feedback mechanisms for improvements

Timeline – to be confirmed

Vote passed.

Motion 14-1.2: carried - recommendation 17:

Recommendation 17: accreditation

Preamble

The Committee considered existing requirements under the Integrated Accessibility Standards Regulation and determined that these requirements were not consistently in place or applied. These requirements were determined to have high impacts on accessibility and therefore a compliance and accountability priority.

There is a gap between “policy and practice” or “principle and reality”. Accordingly, the Committee has determined accreditation is an effective self-regulation tool to ensure accessibility requirements and policies are put into action.

Accreditation provides several advantages including:

accreditors meet with staff, patients and families to track them through the hospital system providing a comprehensive review that goes beyond existing compliance checks
accreditors also require evidence through documentation, visual confirmation and other potential sources of information. Accordingly, the process is verified and validated in a manner that prevents hospitals from merely producing manuals or policies for regulatory compliance

The accreditation recommendation below is meant to build capacity for hospitals to deliver high quality service and to comply with existing human rights and accessibility legislation, while building the confidence of the general public.

The Committee proposes the following recommendation:

it is recommended the government, through Ontario Health/Health Quality Ontario, or the appropriate governing body, advise Accreditation Canada/Commission on Accreditation of Rehabilitation Facilities to amend the Leadership and Governance Standards to explicitly reference hospital/health care organization requirements related to accommodation/accessibility and the provision of services for persons with disabilities. This includes a standard statement, guidelines and a test for compliance that aligns with requirements under the Accessibility with Ontarians with Disabilities Act. These revisions to standards should be completed by 2025. This initiative shall be undertaken with the involvement of both persons with lived experience of disability and with disability organizations (Disabled Peoples Organizations)
it is recommended the government work with all hospitals or an affiliated organization (such as the Ontario Hospital Association) to develop a hospital Accessibility with Ontarians with Disabilities Act compliance toolkit and centralized repository of best practices as a resource to support hospital compliance with existing accessibility standards and new Health Care Standards. The toolkit should consist of best practices in Accessibility with Ontarians with Disabilities Act compliance, as well as tips on leveraging existing resources and requirements. The toolkit should include, but not be limited to, any information, documents and resources included in this report’s appendices

Timeline

Revisions to accreditation standards should be completed by 2025.

Vote passed.

M 14-1.4 remaining compliance and enforcement recommendations

Staff will incorporate Committee suggestions to proposed recommendations 15 and 16 for next meeting review.

M 14-1.5 covid 19 reflections

Committee member Richard Welland provided an overview and report back of a draft recommendation produced by the ad-hoc committee regarding covid 19 and other potential State of Emergencies.

Due to time constraints, the Committee agreed to submit any desired amendments for the draft recommendation to staff who will incorporate them in advance of the next meeting for any further discussion and vote.

M 14-1.6 next steps and closing remarks

The Chair thanked committee members.

The second part of the meeting will be held on Wednesday, September 16, at 2:00 p.m.

Day 2 meeting information

Date: September 16, 2020 from 2:00 p.m. to 4:15 p.m.

Location: virtual

Day 2 present

Standards Development Committee members: Sandi Bell (Chair), Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Sam Savona, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility Minister’s Office staff: Jay Jung

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Susan Picarello, Jenna Strathearn, Dan Wilson and Asim Zaidi

Ministry of Health staff: Mary Marafioti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Carol Anderson, Marianne Park and John McDonald

Day 2 meeting minutes

M 14-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a land acknowledgement, followed by welcoming remarks.

M 14-2.2 Ministry for Seniors and Accessibility roll call and opening remarks

Vinothini Kajendran conducted the roll call and reviewed best practices for meetings using virtual (Microsoft Teams) and teleconference formats for full participation of members.

M 14-2.3 review and vote on covid 19/States of Emergency recommendation

Elisheva Bouskila-Fox (Ministry for Seniors and Accessibility staff) facilitated review of the updated recommendation. Following Committee discussion, the Chair called a vote.

Motion 14-2.1: carried - recommendation 22

Recommendation 22 - accessibility and disability during a pandemic or emergency situations

Preamble

Over the past few months, the pandemic revealed many cracks in our health care system. We recommend a range of ways to enhance health care across all settings, in particular long-term care facilities for all residents, especially older adults. Accessibility standards are needed in all settings, not only hospitals, and their implementation should be considered by health care providers and administrators across the spectrum. As a result, the Committee proposes that all recommendations included here should apply, with revisions as needed, to health care facilities other than hospitals. This would include nursing homes, outpatient rehabilitation centres, community health centres, freestanding diagnostic imaging and laboratory facilities, medical clinics, and agencies providing support services.

The impact of the covid 19 pandemic on individuals and communities is unprecedented. The Committee noted the personal and professional toll on many committee members, including as persons with disabilities, as family members or family caregivers of persons with disabilities, and as health care professionals working to respond to the impact of the pandemic in hospitals.

In June 2020, the Health Care Standards Development Committee had the opportunity to share insights related to the profound challenges faced by people with disabilities seeking health care services and disability supports during the ongoing covid 19 pandemic. The Committee met to:

consider and discuss how the pandemic may influence their recommendations for accessibility in hospitals
share hospital-related and lived experiences and insights

The Committee emphasized that these challenges and concerns may apply broadly to any states of emergency in the future.

These included concerns such as access to clear and understandable information about available services, access to services normally provided in hospitals as part of discharge planning, and the need for an accessibility and disability lens as part of the development of medical triage protocols. These concerns are heightened by the more severe impact of the pandemic on persons with disabilities from marginalized populations. Communities that were disproportionately impacted include people who are Black, Indigenous, and people of colour, Francophone communities, LGBTQ2S+ people, lower-income communities, and persons with disabilities living in congregate environments, such as group homes or nursing homes.

This recommendation is intended to guide government and the health care sector as they manage the ongoing covid 19 pandemic, and for future states of emergency.

The Committee recommends the following:

following the end of declarations of a State of Emergency, government conduct a review of successes and failures in relation to persons with disabilities and their access to health care. This should include:
- establishing an advisory panel to provide guidance throughout the ongoing state of emergency, and on an ongoing basis following the end of emergency orders. The advisory panel must include a majority of members with lived experience of disability
- conducting a broad, accessible consultation of persons with disabilities on their experiences during the State of Emergency to inform future government programs and services in similar states of emergency. This should occur as soon as possible following the end of the current emergency orders
government work with public health units and other public sector partners to gather data and report on the impact of the State of Emergency on persons with disabilities. Data collection and reporting should specifically consider the impact on persons with disabilities who face additional health inequities due to social determinants of health. These include but are not limited to:
- people who are Black, Indigenous, and people of colour
- Francophone populations
- persons who are LGBTQ2S+
- lower-income communities
- persons with disabilities living in congregate environments, such as group homes or nursing homes
These data and subsequent reporting must be used to underpin an equity and disability lens for future planning.
government develop authoritative and clear guidance, to be provided as a resource for municipalities and the public when mandatory masking orders are in effect. Mandatory masking orders typically require the use of non-medical face coverings or masks, which may impede communication. Guidance should include:
- additional information on when exemptions may be required for persons with disabilities
- a comprehensive explanation of the impact of masking on communication for Deaf persons and persons who are hard of hearing or deafened and people who have speech and language disabilities
- the importance of the availability of accessible masks for improved communication (examples of accessible masks may include full face shields).
government develop and distribute guidance to pharmacies and health care product/services vendors on accessible service delivery and accessible customer service in emergency situations. This could include ensuring that pharmacies and health care product / services vendors offer options for telephone or online shopping as well as options for delivery and curbside pickup, as well as ensuring that services are provided within a timely manner
government conduct a broad review of emergency management policies and processes, and update policies based on a disability lens. This review and update should include:
- prioritizing clear and accessible information about emergencies, as well as information about accessing health care services during an emergency
- ensuring that accessible and easy to understand information is made available to individuals with cognitive or developmental disabilities
- ensuring press conferences and other emergency updates are supported by sign language interpretation and Communication Access Realtime Translation provided by accredited steno captioners
- ensuring that human rights and accessibility requirements are reflected in all policies and procedures
during a health-related State of Emergency, government provide guidance to relevant testing centres on accessible queueing protocols and ensuring staff are trained on accessible customer service. This may include prioritizing persons with disabilities in the queue when appropriate or providing the option of a mobile testing service to an individual’s home
government work with hospitals and other public sector partners to ensure a disability and accessibility lens is applied to management of emergency situations. This should include the following considerations:
- ensuring that Ontario's clinical triage protocol is consistent with an accessibility and human rights lens and with current, established scientific principles of testing (for example, validity and reliability)
- maintaining access to supports and services (for example, Assistive Devices Program, onboarding programs for individuals with newly acquired disabilities, and discharge programs to the home or to other health care settings)
- maintaining access to home care services and support services
- maintaining access to visitors for persons with disabilities in hospitals in an infection-control framework and recognizing that visitors may be essential for persons with disabilities
- recognizing the heightened impact of delayed or cancelled health care appointments on persons with disabilities, emphasizing continued accessibility of health care services for persons with disabilities, including prioritizing in-person care where possible, and recognizing that the shift to virtual care may not be appropriate or accessible for all persons with disabilities
- providing access to communication aids and support person(s) during triage and in-patient services
- providing speech language pathology services for patients with acquired communication disabilities due to intubation, ventilation and other medical interventions to support them communicating about healthcare, healthcare decisions and with family members, and to provide support with swallowing disabilities
- requiring all hospitals to develop a process to ensure continued access for persons with disabilities to their personal caregivers and support persons while admitted in hospital during a state of emergency, either virtually or in person, in a safe manner and in a manner respecting the individual’s choice. Support people include ‘essential caregivers’ or ‘essential partners in care’ and are to be exempt from visitation restrictions, including but not limited to the following environments:
  - hospitals
  - long-term care homes
  - disability group homes.
- maintaining access to available and affordable transportation to and from medical appointments
- accommodating service animals in an infection-control framework
all guidance and information from the provincial government and public sector partners (including hospitals, public health units, and municipalities), including emergency information and mandatory masking orders, to be made available online, in both official languages, in accessible formats, with alternate formats available

Vote passed.

M 14-2.4 review and vote on new and updated recommendations

Elisheva Bouskila-Fox (Ministry for Seniors and Accessibility staff) facilitated review of the updated recommendation on making existing complaint processes accessible which began last meeting, as well as of recommendations 15 and 16. After Committee discussion, the Chair called a vote as follows:

Motion 14-2.2: carried - recommendation 21:

Recommendation 21: accessible complaint process

The Committee proposes the following recommendation:

It is recommended that government augment current requirements for patient complaints processes in hospitals, which are currently laid out in regulation 188/15 of the Excellent Care for All Act (2015), to include the following accessibility measures:

recognize that certain accessibility and disability-related complaints are urgent, in particular in emergency or pandemic contexts, and require hospitals to establish a fast track process for urgent complaints. This could include complaints related to essential visitor designations or medical triage protocols
require hospitals to provide alternate, accessible formats to report a complaint or concern
require hospitals to establish a timely, effective, and documented process to address a patient’s individual accessibility concerns and complaints
require hospitals to establish a process for reviewing and updating policies, procedures, and practices based on complaint patterns, and to carry out this review on a regular basis
amend the regulation to specifically reference the right of patients to make anonymous complaints, in order to identify recurring barriers
require hospitals to publicize the specific process by which patients can make complaints without fear of reprisal
require hospitals to provide information to patients on the complaints and patient relations processes, at a patient’s first interaction or encounter within the hospital

Timeline: to be determined following public feedback

Vote passed.

Motion 14-2.3: carried - recommendation 15

Recommendation 15: hospital Declaration of Values

Preamble

Persons with disabilities have experienced adverse responses and inaction when making a complaint and may fear reprisal, to their detriment. Therefore, individuals are often hesitant to make a complaint about health care providers or hospital services despite these existing processes. In addition, patients may be unaware of their accessibility rights or the mechanism to make a complaint, be unable to make a complaint or may not trust that their complaint will be addressed.

The Committee proposes the following recommendation:

Every hospital’s Declaration of Values and/or Patient Bill of Rights shall include:

a commitment statement to accessibility
explicit reference to the rights of patients to raise concerns and make complaints without fear of reprisal

Timeline: to be determined after public feedback

Vote passed.

Motion 14-2.4: carried - recommendation 16:

Recommendation 16: accessible patient relations process

The Committee proposes the following recommendation:

It is recommended:

Designate an individual as their patient relations process delegate. This individual is required to oversee the hospital’s patient relations process and to present aggregate data regarding the patient relations process to the hospital’s Quality Committee twice annually. Hospitals must put processes and procedures in place that enable the patient relations process delegate to fulfill his/her responsibilities. Hospitals must make contact information for the patient relations process delegate publicly available, fully accessible and in alternate formats as requested.

that government amend regulation 188/15 of the Excellent Care for All Act (2015) that requires hospitals to have robust patient relations process. It will be amended to add that contact information must be “fully accessible and in alternate formats as requested.” The amended section would read as follows:
that the Patient Declaration of Values for Ontario (2018) developed by the Minister’s Patient and Family Advisory Committee be adopted by all Ontario hospitals and Excellent Care for All Act amended accordingly
that “disability” as a ground is added to Equity and Engagement, Item 1

Appendix:

Timeline: To be implemented on a three-year cycle

Vote passed.

M 14-2.5 remaining agenda items

Due to time constraints, remaining agenda items will be tabled to the next meeting.

M 14-2.6 next steps and closing remarks

The Chair thanked committee members and notified them that staff would follow up with materials for the next meeting.

Meetings 13: Monday August 10 and Friday August 14, 2020

Letter from chair to the minister

Date: January 21, 2021

The Honourable Raymond Cho
Minister for Seniors and Accessibility
5^th Floor, 777 Bay Street,
Toronto, Ontario
M7A 2J4

Dear Minister,

Re: Health Care Standards Development Committee: Meeting 13 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual two-part meeting (“Meeting 13”) held on August 10 and August 14, 2020, and to provide you with a brief update on the Committee’s progress.

At this two-part meeting, the Committee ratified two email votes for education and training recommendations and set out to review and build consensus on four compliance and accountability recommendations. The Committee was constrained by time. The Committee agreed that an ad hoc enforcement group will review these specific recommendations for gaps.

Looking ahead to the Committee’s next meeting, we plan to complete a review of four proposed compliance and accountability recommendations and review all remaining outstanding recommendations for a vote. The following step is for the Committee to vote on the completion of our Initial Recommendations Report.

I look forward to continuing to update you on the Committee’s progress.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Day 1 meeting information

Date: August 10, 2020 from 2:00 p.m. to 3:30 p.m.

Location: virtual

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility Deputy Minister’s Office staff: Jacqueline Kiwanuka

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Kelly Donaher, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Sherina Macedo and Steven Wong

Captionist: Gemme Hummeny

Regrets: Carol Anderson, John McDonald and Marianne Park

Day 1 meeting minutes

M 13-1.1 Chair’s welcome and review of agenda

The Chair, Sandi Bell, opened the meeting with a land acknowledgement, followed by a welcome and provided an overview of the agenda for the meeting.

The Chair thanked members for finishing a vote by email since the last meeting regarding recommendations 13 and 14 so that that the Committee can keep to its workplan and to finalizing the Initial Recommendations Report. The Committee was encouraged to maintain their momentum toward completing the Initial Recommendations Report by September 23.

M 13-1.2 Ministry for Seniors and Accessibility welcome and roll call

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) for full participation of members for this virtual meeting.

M 13-1.3 report on e-vote of recommendations 13 and 14 (Tab 2)

Ministry staff reported that two Committee email votes were conducted since the last meeting. Committee members ratified recommendation 13 and recommendation 14 as follows:

Motion 13-1.1: carried - recommendation 13:

Recommendation 13 - training resources and core competencies

(Passed, as amended July 27, 2020)

The Committee proposes the following recommendation:

Government shall address the relevant topics when developing standardized Accessibility for Ontarians with Disabilities Act health care education and training modules, including but not limited to:

mechanisms to meet the requirements for an accessible patient relations process under the Excellent Care for All Act
wayfinding and other ways of creating a barrier-free/accessible hospital environment
creating an accessible website with information on programs and services, as well as on the availability of alternative formats if needed
clear print guidelines for people with low vision
best practices for communicating with people who are hard-of-hearing, deafened, and Deaf
a link to the demonstration of the Accessibility Compliance Report with examples and scenarios
plain language and people-first language guidelines
awareness and understanding about person-centered care, particularly anti-ableism education and health care accommodation required to provide accessible health care, within an anti-oppression framework respecting Indigenous peoples
policies, procedures and practices to identify, provide and document required accessibility supports and accommodations and how and when these accommodations were addressed (beyond existing customer service training)
an awareness that there is a vast range of disabilities, among them the following:
- visible
- invisible
- congenital
- acquired
- stable
- intermittent
- progressive
- declared
- undeclared
an understanding that the manner in which persons with disabilities present to health care providers is variable amongst patients who have disabilities. Many individuals can have more than one disability at the same time, some disabilities are congenital, and others acquired. Some are permanent, temporary, or episodic
an understanding that every person with a disability presents with a unique profile, with its own complexities, and that identities intersect (for example, that persons with disabilities have a variety of racial, cultural, ethnic, and gender identities)
an understanding that there are different models or ways of understanding disability and the impact of disability on health care delivery (for example, medical model, social model, World Health Organization-International Classification of Functioning, Disability and Health model)
accommodations and supports for patients with communication and cognitive disabilities, and others who experience communication barriers, to determine capacity and provide informed consent to treatment
familiarity with community-based services available to persons with disabilities and their linkages to health care services provided in hospital
an understanding through current, evidence-based training that health care providers have a personal responsibility to overcome attitudinal barriers, negative stereotypes, and implicit bias toward persons with disabilities during the delivery of health care services to that segment of the population. Training must be available in accessible formats
policies, procedures and practices to provide equal access to services in emergency and pandemic situations
guidelines for working with essential third-party support persons, such as personal attendants, communication assistants and people who assist with decision-making
an understanding of relevant legislative responsibilities pertaining to health care
an understanding of current, evidence-based practices for maintaining oral care for persons with disabilities and others who are unable (temporarily or otherwise) to maintain oral care independently
an understanding that persons with disabilities can be (and are) victimized by their significant others, by other family members, and by paid caregivers on whose care they might rely

Recommendation to be implemented 18 months following a regulation being enacted.

Vote passed (ratified August 10, 2020)

Motion 13-1.2: carried - recommendation 14:

Recommendation 14 training for regulated health care professionals

(Passed, as amended August 10, 2020)

Preamble

It is acknowledged that the issue of accessibility and interacting with persons with disabilities is a key component to achieving an accessible Ontario. Jurisprudence covers all applicable legislation in the province of Ontario.

The Committee proposes the following recommendation:

It is recommended that all regulatory professions under the Regulated Health Professions Act include in their jurisprudence/ethics component of their Certificates of Registration, matters pertaining to accessibility law.

The contents would include government Accessibility for Ontarians with Disabilities Act Health Care Education and Training, or a curriculum that addresses the core competencies listed in Appendix A (now recommendation 13).

This requirement applies as well to current regulated health professionals and should be integrated into annual College membership renewal requirements.

Recommended timeline for implementation: 18 months

Vote passed (ratified August 10, 2020)

M 13-1.4 member presentation and discussion (Tab 1) – approach to enforcement (Peter Athanasopoulos)

Committee member Peter Athanasopoulos facilitated discussion on enforcement and accountability for a health care standard. The discussion centered around whether the current compliance structure of the Accessibility for Ontarians with Disabilities Act is adequate in addressing infractions, especially in light of concerns raised by committee members due to covid 19 experiences.

The Committee agreed to strike an ad-hoc subcommittee that would review the questions around enforcement, and work towards a possible recommendation.

M 13-1.5 compliance and accountability barrier overview amendments recommendations 15 - 18 (Tab 2)

The Committee reviewed wording amendments to the overview section of compliance and accountability.

M 13-1.6 next steps and closing remarks

The Chair thanked committee members. At the next meeting, the Committee will continue to review proposed amendments to compliance and accountability recommendations.

The next meeting will be held on Friday August 14 at 2:30 p.m.

Day 2 meeting information

Date: August 14, 2020 from 2:00 p.m. to 3:30 p.m.

Location: virtual

Day 2 present

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility Deputy Minister’s Office staff: Jacqueline Kiwanuka

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Kelly Donaher, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Garth Napier, Susan Picarello, Jenna Strathearn and Asim Zaidi

Ministry of Health staff: Mary Marafioti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: John McDonald

Day 2 meeting minutes

M 13-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a land acknowledgement and welcome remarks.

M 13-2.2 Ministry for Seniors and Accessibility roll call and opening remarks

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) for full participation of members for this virtual meeting.

M 13-2.3 review of Committee input and feedback document on compliance and enforcement recommendations 15, 16, 17, #18 (Tab 2)

Elisheva Bouskila-Fox facilitated review of recommendations.

M 13-2.4 review of Committee input and feedback on enforcement/compliance recommendations 18 (Tab 2)

Motion 13-2.1: vote not passed - proposed recommendation 18: enforcement/compliance

Preamble

There needs to be a focus on and strengthening of government accessibility compliance mechanisms for the Accessibility for Ontarians with Disabilities Act (given the discrepancy between our members’ experiences and compliance results are incongruent).

The Committee proposes the following recommendation:

that the Ministry enhance and improve accuracy of the self-report digital attestation process through modifications to the Accessibility Compliance Report. Such modifications will include enforcement of mandatory validation of meeting accessibility requirements with sign-off requirements in order to complete the electronic tool. Mandatory verification is based on specific and accurate information regarding what full compliance for the specific item would entail. Furthermore, the attestation should include a reminder of the fines applicable for non-compliance
that the Ministry implement an additional component to the Accessibility for Ontarians with Disabilities Act compliance and enforcement framework. This new component would entail an accessibility verification and compliance site visit, a site visit similar to Accreditation Canada whereby evidence of compliance must be visible across the organization. Such standardized and routine site visits could be carried out from either a randomly selected segment of the hospitals in the province or scheduled with the Accessibility for Ontarians with Disabilities Act team attending to all Ontario hospitals within a five-year window
every year as part of every hospital funding agreement with the Ontario government, an accessibility plans should be developed by each hospital to address weaknesses and barriers to accessibility documented by hospital and other healthcare facilities specifically within their evaluation processes including but not limited to:
1. independent evaluation
2. complaints
3. feedback mechanisms
that government ensure that hospital funding agreements are contingent on successful Accessibility Verification and Compliance Site Visit action plan compliance
the ministry will amend the existing Accessibility Compliance Report attestation to include a specific requirement regarding the hospital’s patient relations process, ensuring that it is publicly displayed, fully accessible and available in alternate formats. Evidence of this requirement will be part of the on-site validation site visit to ensure full compliance with an accessible patient relations process
every hospital and healthcare facility in Ontario must develop fully accessible webpages in accordance with the Information and Communications Standards on their websites informing people with disabilities what is available to them to meet their accessibility and accommodation needs. This includes but is not limited to:
1. all accessible services and supports available
2. all training and accessibility professional development offered
3. service navigation and contact persons for assistance
4. partnerships with organizations to achieve accessibility and accommodation needs
5. complaints process
6. feedback mechanisms for improvements

Timeline: Clause b mentions five years (to be confirmed)

Vote failed.

M 13-2.5 outstanding agenda items

An enforcement ad-hoc subcommittee will meet later in the month to:

review the existing recommendations 15-18 and determine where gaps remain
develop a potential enforcement recommendation that addresses those gaps
formulate a potential survey question for public feedback on enforcement issues related to accessibility in hospitals

The ad-hoc subcommittee will report back at the next Committee meeting in September.

M 13-2.6 next steps and closing remarks

The Chair thanked committee members and notified them that staff would follow up with materials for the next set of meetings in September.

Meeting 12: Monday July 13 and Thursday July 16, 2020

Letter from chair to the minister

Date: September 22, 2020

The Honourable Raymond Cho
Minister for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, Ontario
M7A 2J4

Re: Health Care Standards Development Committee: Meeting 12 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual meetings (“Meeting 12”) held on July 13 and July 16, 2020 and to provide you with a brief update on the Committee’s progress.

At this two part meeting, the Committee set out to review and build consensus on education and training recommendations. The Committee was highly engaged to find consensus on finalizing initial recommendations. The Committee voted on two initial recommendations and agreed to hold an email vote on the remaining two proposed education and training recommendations.

Looking ahead to the Committee’s next meeting, they will discuss an approach to enforcement and work through a review of proposed Compliance and Accountability recommendations.

I look forward to continuing to update you on the Committee’s ongoing progress.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Day 1 meeting information

Date : July 13, 2020 from 9:30 a.m. to 11:00 a.m.

Location: virtual meeting – Microsoft Teams and teleconference

Day 1 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Dr. John McDonald, Marianne Park, Sam Savona, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility staff: Mihaela Dumitrascu, Elisheva Bouskila-Fox, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Jacqueline Kiwanuka, Susan Picarello, Jenna Strathearn, Dan Wilson and Asim Zaidi

Ministry of Health staff: Mary Marafioti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Jacqueline Silvera

Day 1 meeting minutes

M 12-1.1 Chair’s welcome and review of agenda

At the request of the Chair, Melanie Marsden provided land acknowledgements. The Chair, Sandi Bell, opened the meeting with welcome remarks and provided an overview of the agenda for the meeting. The hair recognized that the Committee was close to finalizing the initial recommendations and encouraged the Committee to maintain their momentum toward completing the Initial Recommendations Report.

M 12-1.2 Ministry for Seniors and Accessibility welcome and new staff introduction

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) and provided a demonstration on procedures for full participation of members for this virtual meeting. Mary Bartolomucci noted that Melanie Kohn has moved to another position at the Ministry of Health and introduced Tara Wilson, Interim Director, Hospitals Branch at the Ministry of Health as the newest non-voting member on the Committee.

M 12-1.3 Committee review of education and training recommendations

Committee members discussed recommendation #11 regarding the development of mandatory and standardized accessibility training for hospital workers, before a call to vote.

Motion 12-1.1: carried - recommendation #11:

Recommendation #11: development of education and training in hospitals and colleges

Preamble: Health care providers typically receive limited education on how to provide appropriate and sensitive accommodations during the delivery of health care to people with disabilities. Furthermore, the education and training they do receive can be outdated and from an ableist perspective. In order for people with disabilities to receive timely and appropriate health care, there is a need to address provider knowledge, skills and attitudes. Such education should begin early in their educational journey with mandatory training updates to ensure that the learning remains current.

Recommendation:

That government, in partnership with persons with disabilities and educational specialists, shall develop standardized Accessibility for Ontarians with Disabilities Act health care education and training modules to be used across all Ontario hospitals. This educational preparation will be made mandatory for all health care workers to ensure that expectations are clear and that heath care workers feel prepared to provide barrier-free care.
This education must be developed for health care workers who interact with persons with disabilities at the point of care and include the core competencies outlined in appendix A.
The educational format shall contain mandatory components with clear learning objectives, delivered as modules with associated testing components throughout (similar to Workplace Safety format).
The curricula must be updated regularly based upon evolving knowledge, best practices, as applicable regulatory and legislative changes occur and/or a minimum of every two years.
That government mandates all Regulated Health Professions Act colleges to develop, in conjunction with professional associations and education providers, continuing education on working with people with disabilities, including attention to intersecting identities.

Timeline: To be confirmed

Vote passed.

M 12-1.4 remaining education and training recommendations

Due to time constraints, recommendation #12, #13 and #14 were deferred to the next agenda on July 16.

The Committee agreed to submit any desired amendments for recommendations #12, #13 and #14 to staff who will incorporate them into one document and forwarded to all committee members in advance of the next meeting for any further discussion and vote.

M 12-1.5 next steps and closing remarks

The Chair thanked committee members.

Next Meeting: Thursday July 16 at 9:30 a.m.

Day 2 meeting information

Date: July 16, 2020 from 9:30 a.m. to 11:00 a.m.

Location: virtual

Day 2 present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Dr. John McDonald, Marianne Park, Sam Savona, Natalie Spagnuolo, Diane Quintas and Richard Welland (partial)

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Tara Wilson (Ministry of Health)

Ministry for Seniors and Accessibility Minister’s Office staff: Patrizia Nigro

Ministry for Seniors and Accessibility staff: Elisheva Bouskila-Fox, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Susan Picarello, Jenna Strathearn, Dan Wilson and Asim Zaidi

Ministry of Health staff: Mary Marafioti, Meagan Ward and Steven Wong

Captionist: Gemme Hummeny

Regrets: Dr. John McDonald

Day 2 meeting minutes

M 12-2.1 Chair’s welcome

The Chair, Sandi Bell, opened the meeting with a land acknowledgement and welcome remarks.

M 12-2.2 Ministry for Seniors and Accessibility roll call and opening remarks

Jenna Strathearn conducted the roll call and reviewed best practices for meetings on an online format (Microsoft Teams) and provided a demonstration on procedures for full participation of members for this virtual meeting. Assistant Deputy Minister Susan Picarello of the Accessibility for Ontarians with Disabilities Division provided opening remarks. She thanked members for meeting virtually and in working diligently toward the completion of the initial recommendations, with staff support.

M 12-2.3 in-camera session for members of the Standard Development Committee

The Committee held an in-camera session.

M 12-2.4 review of committee input and feedback document and vote on education and training recommendations #12, #13, #14

M 12-2.1: carried - proposed new recommendation #12:

Recommendation #12: implementation of education and training in hospitals

(Passed, as amended July 16, 2020)

The Committee proposes the following recommendation:

In addition to current training requirements under the Integrated Accessibility Standards Regulation, Ontario hospitals shall implement the government Accessibility for Ontarians with Disabilities Act health care education and training. In addition to this, hospitals may supplement this education and training to address their local needs.
All Ontario hospitals shall implement this mandatory Accessibility for Ontarians with Disabilities Act health care education during hospital orientation, prior to any health care provider’s interaction with persons with disabilities at the point of care.
This education shall be provided to all staff (including administration), physicians and volunteers, as well as all third parties conducting business for/within the hospital. This requirement shall be included in all contracts and/or agreements for such contractors/partners.
All Ontario hospitals shall provide Accessibility for Ontarians with Disabilities Act health care education refresher training annually as part of the organizations’ core curriculum requirements. The hospital shall set a deadline for completion of the annual mandatory training for each employee. Any employee who has not completed the requirements by the deadline shall be removed from service until such training is completed.
The Ministry shall amend the existing Accessibility Compliance Report attestation to include a self-report indicator related to the percentage of staff compliance with the mandatory core curriculum related to Accessibility for Ontarians with Disabilities Act health care education curriculum.
Recommendation to be implemented 18 months following a regulation being enacted.

Vote passed.

M 12-2.5 member presentation approach to enforcement (Peter Athanasopoulos) followed by discussion

Due to time constraints, this presentation and review of related Accountability and Compliance recommendations will be moved to the next meeting in August. Members were asked to review the presentation.

M 12-2.6 next steps and closing remarks

To increase the effectiveness of the Committee, members agreed that amendments to recommendations #13 and #14 be finalized, and the recommendations then voted upon by email. The Chair thanked committee members and notified them that staff would follow up with instructions for amendments to recommendations, and email voting procedures.

Meeting 11: Tuesday June 9, 2020

Letter from chair to the minister

Date: August 7, 2020

The Honourable Raymond Cho
Minister for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, Ontario

Dear Minister,

Re: Health Care Standards Development Committee: Meeting #11 Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee (the Committee), I am pleased to submit the Committee-approved minutes from the virtual meeting (“Meeting 11”) held on Tuesday June 9, 2020 and to provide you with a brief update on the Committee’s progress.

At the meeting, which served as a re-engagement meeting, the Committee discussed a proposed revised workplan. The workplan outlines a review schedule for summer 2020 that will advance the work of the Committee with an aim to submit their Initial Recommendations Report in September 2020.

Committee Members also provided insights about their experiences and observations on how the covid 19 pandemic impacts accessibility in the hospital sector. This discussion will form the basis of a section of the Initial Recommendations Report. It will also provide an additional ‘lens’ for recommendation review.

Looking ahead to the Committee’s next virtual meeting, we will review an Enforcement and Accountability framework and associated recommendations, as well as Education and Training recommendations.

I look forward to continuing to update you on the Committee’s ongoing progress.

Sincerely,
(Original signed by)
Sandi Bell,
Chair, Health Care Standards Development Committee

Meeting information

Date: June 9, 2020

Location: virtual

Format of committee minutes and references: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/minute items/sections/action items and ‘Partial’ represents limited attendance. Motion represents a vote that has occurred. All recommendations to date are considered draft until finalized and included in the Initial Recommendations Report submitted to the minister.

Present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Dr. John McDonald, Marianne Park, Sam Savona, Jacqueline Silvera, Diane Quintas and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility), Melanie Kohn (Ministry of Health)

Deputy minister’s office staff: Mihaela Dumitrascu, Jacqueline Kiwanuka

Ministry for Seniors and Accessibility staff: Susan Picarello, Alex Ibrahim, Margaret Hageman, Elisheva Bouskila-Fox, Asim Zaidi, Vinothini Kajendran and Jenna Strathearn

Other staff: Mary Marafioti (Ministry of Health), Carley Hay (Ministry of Health) and Steven Wong (Ministry of Health)

Captionist: Gemme Hummeny

Regrets: Natalie Spagnuolo

Meeting minutes

M 11.1 Chair’s welcome and review of agenda

The Chair, Sandi Bell, opened the meeting with welcome remarks and provided an overview of the agenda for the meeting. The Chair noted the remarkable journey of the Committee to date and shared her gratitude and appreciation as the Committee moves forward, especially in consideration that the March meeting was cancelled due to the covid 19 pandemic.

M 11.2 Ministry for Seniors and Accessibility welcome

Assistant Deputy Minister Susan Picarello of the Accessibility for Ontarians with Disabilities Division provided remarks. She recognized that the Committee was close to finalizing the initial recommendations and encouraged the Committee to maintain their momentum toward completing the Initial Recommendations Report.

She appreciates that many members are contributing professionally to the fight against the covid 19 pandemic and are taking time to complete this work virtually.

Vinothini Kajendran reviewed best practices for meetings on an online format (Microsoft Teams) with teleconference ‘plug-in’ and provided a demonstration on procedures for full participation of members for this virtual meeting.

M 11.3 overview of summer 2020 workplan

Accessibility for Ontarians with Disabilities Division staff Margaret Hageman provided an overview of the proposed summer workplan for the Committee to advance their work toward an Initial Recommendations Report by September 2020. The workplan will consist of a series of short regular virtual meetings that review recommendations by theme. Feedback from the Committee for dates and times, materials and approach will be incorporated into an updated workplan. The Committee gave overall commitment to participate in the workplan. Members request to receive material a minimum of one to two weeks ahead of time.

M 11.4 committee discussion of covid 19 insights

The Committee had the opportunity to share experiences and observations about covid 19 pandemic impacts on accessibility for people with disabilities and the hospital sector. Members highlighted that people with disabilities faced profound challenges seeking health care services and disability supports during the pandemic. Specific concerns included:

access to clear and understandable information about what services were available, particularly for those people with disabilities who regularly received health care services in hospitals on an outpatient basis
access to services and supports normally provided during hospital discharge planning for patients who sustained a new disability during the pandemic
the need for an accessibility and disability lens as part of the development of medical triage protocols

This discussion will form the basis of a section of the Initial Recommendations Report. It will also provide an added ‘lens’ for recommendation review.

M 11.5 Enforcement and Accountability recommendation: overview

Due to time constraints, the scheduled presentation regarding enforcement will be deferred to the next meeting.

M 11.6 next steps and closing remarks

The Chair thanked Committee members and notified them that staff would follow up regarding scheduling and materials for summer meetings.

Meeting 10: Thursday January 16, 2020

Letter from chair to the Minister

Date: January 17, 2020

The Honourable Raymond Cho
Minister Responsible for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, Ontario
M7A 1S5

Dear Minister,

Re: Health Care Standards Development Committee Meeting #10 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting #10 held on January 16, 2020 and to provide you with a brief update on the Committee’s progress.

The Committee continues to discuss and draft recommendations to address health care accessibility barriers, starting with hospitals. The Committee has completed the following key deliverables:

meeting #10 resulted in passing 3 initial recommendations related to Administrative, Accountability and Communication barriers.
productive discussions on both Education and Training barriers and Accountability barriers took place and recommendations will be refined by members of the Small Teams and forwarded to the Technical Sub-Committee before going to the full Committee at their next meeting.

We look forward to our next meeting where we hope to conclude discussions on recommendations to addressing barriers in healthcare and finalizing our Initial Recommendations report to be submitted to you for public posting and feedback.

Sincerely,
(Original signed by)
Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: January 16, 2020

Location: 777 Bay Street, Toronto, Ontario, 6^th floor, Universal Boardroom

Format of committee minutes and references: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/agenda items.

Present

Standards Development Committee members: Sandi Bell (Chair), Carol Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden (p.m.), Dr. John McDonald, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, Diane Quintas and Richard Welland

Non-voting Standards Development Committee members: Mary Bartolomucci (Ministry for Seniors and Accessibility)

Minister’s office staff: Michael Thomas

Ministry for Seniors and Accessibility staff: Margaret Hageman, Alex Ibrahim, Elisheva Bouskila-Fox, Vinothini Kajendran, Jenna Strathearn, Asim Zaidi, Nilusha Rattansi and Kulpreet Thukral

Other staff: Mary Marafioti (Ministry of Health), Steven Wong (Ministry of Health)

Guests: David Lepofsky (Chair, AODA Alliance)

Captionist: Gemme Humenny

Attendant support: Samira Kassam, Mike Bertznazh

Regrets: Sue Anderson, Crystal Chin and Melanie Kohn (Ministry of Health, non-voting member)

Meeting minutes

M10.1 opening remarks

Chair Sandi Bell started the meeting with an Indigenous Land Acknowledgement of where the meeting took place and then called the meeting to order. Opening remarks acknowledged Committee members and the work done to date. The Chair took roll call of committee members in person and on teleconference. Quorum was met.

M10.2. logistics/emergency exit information

Jenna Strathearn provided technical and venue logistics and emergency information.

M10.3 Hospital Technical Sub-Committee report

Co-chairs Serge Falardeau and Jacqueline Silvera presented the Technical Sub-Committee review of recommendations to date, proposing refinements to strengthen and better align with hospital environments.

Motion 10.1: carried – proposed new recommendation four

Preamble: Critical information related to accommodation for people with disabilities are often not communicated when individuals are transitioned within or between health care organizations.

Recommendation: Hospitals shall have policies, procedures and practices in place that address system wide requirements that ensure that the accommodation needs of people with disabilities are identified, recorded, shared and acted upon at each point of contact. These policies, procedures and practices must include the following requirements, at a minimum:

Health care providers must proactively offer people with disabilities an opportunity to identify their individualized accommodation needs.
If an accommodation is required by the patient, the hospital shall provide this accommodation and identify it on the plan of care.
With patient consent, hospitals shall share information on patient accommodation requirements within hospital health services and in discharge planning.

Vote passed.

Motion 10.2: carried – proposed new recommendation five

Preamble: As a mechanism to build an overall organizational culture of accommodation, it is important to ground such requirements within the principle of shared accountability amongst all staff, physicians and volunteers working in hospitals. Hospitals shall ensure their policies and practices empower staff to make the necessary changes required to accommodate patient needs.

Recommendation: Senior executive leadership of the hospital and/or boards must advance the culture of accommodation within their person-centered care philosophy (or patient and family centered care work) and ensure that their education reinforces practices that enable people with disabilities to fully participate in their care. This shall ensure that sufficient time is allowed as required by people with disabilities to be full participants in the design and delivery of their care by health care providers, including physicians, while receiving care.

Vote passed.

Motion 10.3: carried – proposed new recommendation six

Preamble: To eliminate barriers when people with disabilities interact with health care providers in all health care situations, people with disabilities shall be provided accommodations to improve two-way communication.

Recommendation: Hospitals shall ensure that they have both education and up to date policies, procedures and practices that have been implemented to ensure that:

Health care providers, staff and physicians recognize, understand and respect the capacity of all people with disabilities to be full participants in their care. When unsure, health care providers have access to expertise to facilitate discussions and understanding.
Staff and physicians shall ensure that people with disabilities who require supports for effective communication, shall be accommodated. This includes appropriate communication, aids and authorized support persons in all face to face interactions and telephone communication.
As required, written health care information will be available in simplified language and alternate formats (for example, large print, digital formats).
As required, accommodations will be provided to complete and sign forms.

Vote passed.

M10.4 barrier discussion: education and training-related barrier discussion

Small teams proposed recommendations and the Committee advanced the discussion related to attitudinal barriers, skill and knowledge gaps. The Committee endorsed the principles of the recommendations and instructed the small group to finalize inputs from discussions and refine accordingly. Recommendations will be circulated to the Hospital Technical Sub-Committee for their technical review before returning to the full Committee at their next meeting.

M10.5 accountability small team report

Carol Anderson and Diane Quintas facilitated a discussion on compliance and enforcement both in the context of the Integrated Accessibility Standards Regulation and in the larger health care setting. There was a larger discussion on whether compliance mechanisms achieved desired outcomes. The committee endorsed the recommendations developed by the small team report. The recommendations will be reviewed and finalized by the Hospital Technical Sub-Committee, then returned to the full Committee at their next meeting.

M10.6 AODA Alliance presentation

David Lepofsky, Chair of AODA Alliance, made a presentation to the Committee on the brief ‘Accessible Health Care Framework.’

M10.7 amendment proposed

A proposed amendment to a recommendation related to communication barriers was tabled to the next meeting due to time restraints.

M10.8 Initial Recommendations Report discussion

The Committee discussed options and timelines for the writing of the Initial Recommendations Report. The Chair will lead the process and will seek inputs from the Committee working in coordination with ministry staff.

M10.9 additional areas to be considered

Review of additional areas for potential recommendations was referred to the Technical Sub-Committee for resolution at the next meeting.

M10.10 closing remarks and next steps

The Committee agreed that all draft recommendations made to date will continue to be refined and reviewed by the Technical Sub-Committee with inputs from Committee members. Finalized recommendations are to be prepared for the next meeting.

Next meeting will take place at a to-be-determined date.

Meeting 9: December 10, 2019

Letter from chair to the minister

December 12, 2019

The Honourable Raymond Cho
Minister for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, ON M7A 1S5

Dear Minister,

Re: Health Care Standards Development Committee Meeting #9 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting #9 held on December 10, 2019 and to provide you with a brief update on the Committee’s progress.

The Committee continues to discuss recommendations to address health care accessibility barriers, within the hospital setting. The Committee has completed the following key deliverables:

Meeting #9 resulted in passing 5 initial recommendations.
Productive discussions on Education and Training barriers will be refined and forwarded to the Technical Sub-committee for their review before going to the full committee for voting at its next meeting in January.

Sincerely,
(Original signed by)
Sandi Bell
Chair, Health Care Standards Development Committee

Meeting Information

Meeting Date: December 10, 2019

Location: 777 Bay Street, 6th floor, Universal Boardroom

Format of Committee Minutes and References: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/agenda items.

Present

Standards Development Committee Members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Serge Falardeau, Gordon Kyle, Yona Lunsky, Lorin MacDonald (a.m.), Melanie Marsden, Dr. John McDonald, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, Diane Quintas, Richard Welland (p.m.)

Non-voting Standards Development Committee Members: Mary Bartolomucci, Ministry for Seniors and Accessibility; Melanie Kohn, Ministry of Health

Staff: Minister’s Office: Michael Thomas; Ministry for Seniors and Accessibility: Susan Picarello, Marie Dannhaeuser, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Sonya Del Monte, Jenna Strathearn and Asim Zaidi; Ministry of Health Staff: Mary Marafioti, Eleni Tsoutsias

Captionist: Gem Humenny

Attendant Support: Carolyn Loppie, Mike Bertznazh

Regrets: Crystal Chin (Voting member)

Meeting Minutes

M9.1 Opening Remarks:

Chair, Sandi Bell started the meeting with an Indigenous Land Acknowledgement of where the meeting took place and then called the meeting to order. Opening remarks acknowledged committee members and the work done to date. The Chair took roll call of committee members in person and on teleconference. Quorum was met for any votes.

M8.2 Logistics/Emergency Exit Information:

Vinothini Kajendran provided technical and venue logistics and emergency information.

M9.3 In Camera Caucus

M9.4 Hospital Technical Sub-Committee Report

Co-chairs Serge Falardeau and Jacqueline Silvera presented Technical Sub-Committee (TSC) review of recommendations to date, proposing refinements to strengthen and better conform to hospital environments.

New Recommendation #1 (to Replace Draft Initial Recommendation #1):

Senior Executive Leadership of the Hospital and/or Boards shall ensure there is a formal mechanism to engage with persons and organizations that represent people with a broad range of disabilities regarding health service planning, quality improvement and capital planning, and shall make information regarding this mechanism available to persons with disabilities.
Senior Executive Leadership of the Hospital and/or Boards shall approve multi-year accessibility plans.
Hospital Quality Committees shall consider the needs of persons with disabilities during the development of the hospitals strategic plan and quality improvement planning.

Vote Passed

New Recommendation #2 (to Replace Draft Initial Recommendation #2):

Preamble:
Existing hospital premises, identified hospital equipment and identified patient services are expected to be accessible to people with disabilities. Hospitals are required to work with their accessibility consultation mechanism to identify Universal Design principles that will guide all procurements.

Recommendation:
Hospitals shall have in place a mechanism to consult with/include the participation of accessibility specialist(s) and/or groups of individuals with disabilities on the procurement process for:

the purchase of equipment
service contracts
extensive renovations or redevelopment projects
leased space

This recommendation applies to circumstances where the equipment, service or renovation project will have a direct impact on access to health care services for persons with disabilities.

Vote Passed

New Recommendation #3 (to Replace Draft Initial Recommendation #3):

Preamble:
Physical space, medical equipment, lack of staff support and assistive devices are often barriers that interfere with access to health services for persons with disabilities. The need for accommodation will not delay or prevent equitable access to timely care.

Recommendation:
Hospitals shall work in collaboration with their accessibility specialist and group of individuals with lived experience of disabilities in order to ensure that mechanisms are in place to facilitate access to health services for persons with disabilities including:

additional staff resources
access to an updated inventory and location of specialized equipment intended to accommodate persons with disabilities
as part of the annual equipment planning process, an allocation is made for the purchase / repair / replacement of specialized equipment used to meet accessibility related patient needs

Vote Passed

Discussion and votes for Initial Draft Recommendations #4, #5 and #6 deferred to Meeting #10.

Draft Initial Recommendation #7:
Hospitals shall ensure that there are policies, procedures and practices that comply with existing legislation, to provide persons with disabilities with appropriate, authorized personal support services, inclusive to regulations that protect privacy of their information. This includes policies, training, procedures and practices to:

Identify the support and services that persons with disabilities may require in hospital and whether people with disabilities have existing services that they can use, will want Health Care Providers (HCPs) to provide these supports or engage external support services.
If HCPs are to provide support services, they should be directed by people with disabilities or informed by trusted people as identified by persons with disabilities.
Source and engage appropriate support services as required by persons with disabilities.
Have guidelines in place to work with third- party support services.
Document the person with disabilities’ identification and the authorization of their third-party support service providers and the specific role they play (for example, communication assistants(s), person(s) to provide input on decision making, or attendant services for personal care).
Ensure all third-party support service providers comply with privacy regulations.
Refer to speech language pathology services if persons with disabilities do not have the communication assistance that they require.
Determine how and with whom information can be shared as authorized by persons with disabilities.

Vote Passed

Draft Initial Recommendation #8 deemed unnecessary.

Draft Initial Recommendation #9:

Recommendation:
Hospitals shall ensure that there are policies, procedures and practices, compliant with existing legislation, provide persons with disabilities with the individualized accommodations and supports they require to ensure understanding of information provided; retain and weigh consequences of options, make and communicate their decision(s). This includes policies, procedures, training and practices for all health care providers (HCPs) and capacity assessors in:

Identifying and providing communication accommodations and approved supports that persons with disabilities may need to communicate consent.
Identifying and providing approved supports that persons with disabilities may require to make decisions in consent situations.
Ensuring that communication supports when needed, are in place to assist persons with disabilities in making decisions about their health care.
Identifying and providing formal, qualified independent communication support in situations where persons with disabilities do not have the communication, accommodations and supports they require to give informed consent.

Vote Passed

M9.5 Barrier Discussion: Education and Training-related Barrier Discussion:

Small teams presented their reports on all four identified barriers related to attitudinal barriers, skill and knowledge-gaps.
Small teams will synthesize inputs from discussions and make recommendations which will be circulated to the Hospital Technical Sub-Committee for their technical review, then back to the full committee at their next meeting.

M9.6 Standards Development Committee Process Discussion:

Alex Ibrahim, Manager, AODA Standards Development Unit, led a discussion on the process to finalize the mandate of this Standards Development Committee.

M8.10 Closing Remarks and Next Steps:

The Committee agreed that all draft recommendations made to date will continue to be reviewed by the Technical Sub-Committee. Small teams will continue to meet for recommendations to be ready for the next meeting.

Adjournment

Meeting 8: October 10, 2019

Letter from chair to the minister

November 1, 2019

The Honourable Raymond Cho
Minister Responsible for Seniors and Accessibility
777 Bay Street, 5^th Floor
Toronto, ON M7A 1S5

Dear Minister,

Re: Health Care Standards Development Committee Meeting #8 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting #8 held on October 10, 2019 and to provide you with a brief update on the Committee’s progress. The Committee continues to discuss recommendations to address health care accessibility barriers, within the hospital setting. The Committee has completed the following key deliverables:

Meeting #8 resulted in excellent discussions on the progress of the initial recommendations on two administrative and accountability barriers as well as two communication barriers at the meeting.
The Draft Recommendations resulting from these discussions will be forwarded to the Technical Sub-committee for their review and refinement and then provided to the full committee for voting at its next meeting in December

Sincerely,

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Meeting Date: October 10, 2019

Location: 777 Bay Street, 6th floor, Universal Boardroom

Format of Committee Minutes and References: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/agenda items.

Present

Standards Development Committee Members: Sandi Bell (Chair), Carol Anderson, Peter Athanasopoulos, Raj Chopra, Barbara Collier, Gordon Kyle, Dr. John McDonald, Marianne Park, Sam Savona, Natalie Spagnuolo, Diane Quintas

Non-voting Standards Development Committee Members: Mary Bartolomucci, Ministry for Seniors and Accessibility

Staff: Minister’s Office: Michael Thomas; Ministry for Seniors and Accessibility: Marie Dannhaeuser, Margaret Hageman, Alex Ibrahim, Vinothini Kajendran, Hayden Porch, Stephanie Van Laeken and Asim Zaidi ; Ministry of Health Staff: Carley Hay, Mary Marafioti, Eleni Tsoutsias

Guests: Honourable Minister Raymond Cho; Deputy Minister Denise Cole; Assistant Deputy Minister Susan Picarello

Captionist: Deanna Santedicola

Attendant Support: Samira Kassem

Regrets:

(Voting members): Sue Anderson, Crystal Chin, Serge Falardeau, Yona Lunsky, Lorin MacDonald, Melanie Marsden, Jacqueline Silvera, Richard Welland
(Non-Voting Members): Melanie Kohn, Ministry of Health

Meeting minutes

M8.1 Opening Remarks

Chair, Sandi Bell started the meeting with an Indigenous Land Acknowledgement of where the meeting took place and then called the meeting to order.
Due to lack of quorum at this meeting, the Chair indicated that any draft initial recommendations would be subject to voting at the next opportunity.
Assistant Deputy Minister Susan Picarello highlighted the important nature of the Committee work for all Ontarians.

M8.2 Roll Call and Logistics/Emergency Exit Information

All staff and Committee members introduced themselves.
Vinothini Kajendran provided venue logistics and emergency information.

M8.3 Finalize the Workplan

The Chair reviewed the workplan with the Committee and noted that barriers previously identified in the parking lot will be addressed during discussions and referred to the Parking Lot small group.

M8.4 Hospital Technical Sub-Committee

Technical Sub Committee (TSC) representative Carol Anderson provided context for the Hospital Technical Sub-Committee work for the purpose of reviewing and revising Draft Initial Recommendations.
A TSC refined recommendation was reviewed and received consensus. A formal vote from SDC members will take place in a subsequent meeting.

M8.5 Barrier Discussion: Administrative and Accountability Barriers D and G (related to existing AODA requirements)

The Committee worked through the Tab 6 i) worksheet to initiate action on high priority items and provide considerations for the TSC. Upon further development, this document will be brought back to the Committee at the next meeting.

M8.6 Greetings from the Minister, Honourable Raymond Cho and Deputy Minister Denise Cole

The Honourable Raymond Cho thanked members for their participation. Minister Cho stated that he looks forward to receiving the Committee’s recommendation in early 2020.
Deputy Minister Denise Cole addressed the committee, recognizing the expertise of the members and the role the committee has in the standards development process.

M8.7 Barrier Discussion: Communication Barrier C (related to support services)

Small teams presented on communication barriers related to support services.
The Committee discussed the kinds of policies, practices and procedures that could enhance interactions with health care providers including third party supports.

M8.8 Barrier Discussion: Communication Barrier D (related to informed consent and capacity)

Small teams presented information on communication barriers related to informed consent.
The Committee discussed policies, practices and procedures that could assist the way people with disabilities understand and retain information and communicate their decisions in a hospital setting.

M8.9 Committee Caucus

The Committee had an in-camera session.

M8.10 Closing Remarks and Next Steps

The Chair thanked everyone for their participation emphasized the need for quorum at the upcoming meetings.
The Committee agreed that all draft recommendations made at this meeting and the previous meeting, will go to the Hospital Technical Sub-Committee for their technical review.

The Chair adjourned the meeting

Meeting 7: May 2 and 3, 2018

Meeting information

Dates: May 2 and 3, 2018

Location: Courtyard Marriott Toronto City Centre, 1 Blue Jays Way, Toronto, Northern Lights meeting room

Format of Committee Minutes and References: For the purposes of referencing Committee documents and items in the minutes: ‘M’ (Meeting) represents the meeting number/minute items/sections/action items.

Day 1 present

Standards Development Committee Members: Sandi Bell (Chair), Sue Anderson, Carol Anderson, Crystal Chin, Raj Chopra, Barbara Collier, Serge Falardeau, Gord Kyle, Yona Lunsky, Dr. John McDonald, Lorin MacDonald, Melanie Marsden, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo

Non-voting Standards Development Committee Members: Mary Bartolomucci, Director of AODA Standards Development and Review Branch of the ADO and Melanie Kohn, Director of the Health System Quality and Funding Division, Ministry of Health and Long-Term Care (MOHLTC)

Staff: (Accessibility Directorate of Ontario) ADO: Susannah Bush, Sonya Del Monte, Margaret Hageman, Antonia Hammer, Ann Hoy, Spencer Jacklin, Phil Simeon, Meridith St. Pierre (Ministry of Health and Long-Term Care) MOHLTC: Stoni Astley, Ann Marie Corrado, Andrew Drummond (partial by teleconference), Joanne Plaxton (partial), Lysa Priolo (partial by teleconference), Joanne Thanos

Guest: Jeffrey Bagg, Ontario Hospital Association

Captionist: Gemme Humenny

Attendant Support: Jayne Jalouniko, Samir Kassem, Gerald Ruiz-Alvarez

Regrets: (Voting members): Peter Athanasopoulos, Jennifer Schipper, Richard Welland

Day 1 meeting information

M 7.1 Chair’s Opening Remarks

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.
The Chair thanked the considerable engagement of members since the last meeting to advance the Committee’s discussion documents. Further input from the full committee over the course of the meeting informed the policy discussions.
The Chair introduced Assistant Deputy Minister Ann Hoy who briefed the Committee on the impact on committee work over the writ and transition periods of the June election.

M 7.2 Roll Call and Logistics/Emergency Exit Information

All staff and Committee members introduced themselves.
Meridith St. Pierre provided venue logistics and emergency information.

M 7.3 Learning Moment

Sam Savona presented a first person account of his experience using personal support workers in the course of his life. This was followed by a committee discussion on issues surrounding the use of personal support workers in hospital settings.

M 7.4 Learnings from other Standards Development Committees (SDCs)

Using examples from other SDCs, Phil Simeon, Manager of AODA Standards Development and Review Unit at the ADO provided an overview of the types of recommendations that this Committee might consider, depending on the need identified. Four types of recommendations were discussed:

Direct and Focused Recommendations, targeting a technical or specific requirement
Open and Interpretative Recommendations, providing allowance for an obligated organization to meet the goal of a recommendation in way that suits the organization
Best Practices Recommendations, taking a non-regulatory approach
Beyond the Sector Recommendations, made to government, if found to be out of scope of the Committee

Susannah Bush, Manager of AODA Planning, Policy and Oversight Unit of the ADO provided an overview of the status of other Standards Development Committees and the Accessibility Standards Advisory Council.

Susannah also reported on the 3^rd Legislative Review of the AODA. The AODA must be reviewed every three years after the tabling of the previous review as required by the legislation. Mr. David Onley, former Lieutenant Governor of Ontario, Special Advisor on Accessibility and previous Chair of the Accessibility Standards Advisory Council, has been appointed to conduct the 3^rd legislative review. Mr. Onley will conduct public consultations throughout 2018.

M 7.5 Communication-related barrier discussion: Communication Barrier A: Barriers to Effective Communication

The Committee discussed why and how communication between a health care provider and a person with a disability can be compromised, and how to address these types of barriers.

A recommendation was tabled to Day 2.

M 7.6 Communication Barrier D: Accessibility Barriers in Administration of Policies about Capacity, Informed Consent and Privacy

The Committee discussed the particular communication barriers faced by patients with disabilities associated with the Administration of Policies about Capacity, Informed Consent and Privacy.

Recommendation Tabled to Day 2

M 7.7 Indigenous Engagement

Joanne Plaxton, Director of Health Equity Branch at the Ministry of Health and Long-Term Care (MOHLTC) discussed how the MOHLTC engages with Indigenous people on various issues and provided options for engagement to the Committee. Committee members accepted her proposal to pursue development of an Indigenous reference table.

M 7.8 In Camera Session

Day 2 present

Staff members:

(ADO): Sonya Del Monte, Margaret Hageman, Antonia Hammer, Ann Hoy, Spencer Jacklin, Phil Simeon, Meridith St. Pierre
(MOHLTC): Stoni Astley, Joanne Thanos

Guest: Melissa Prokopy, Ontario Hospital Association

Captionist: Gemme Humenny

Attendant Support: Jayne Jalouniko, Samira Kassem, Gerald Ruiz-Alvarez,

Regrets: (Voting Committee Members): Peter Athanasopoulos, Jennifer Schipper

Day 2 meeting information

M 7.9 Learning Moment

Yona Lunsky discussed challenges on how health care professionals provide care for persons with disabilities and opportunities to improve patient experiences through education and training in the areas of increasing knowledge about disability and health, learning skills in adapting care for persons with disabilities and addressing stigma faced by patients with disabilities in health care.

M 7.10 Rolling Draft Report:

ADO proposed they create a draft report to capture and document Committee discussions and recurring themes from meetings to date. This living document will serve as a draft for the final report and sets a foundation to understand recurring key themes. Members accepted this proposal.

M 7.11 Tabled Communication Barrier A: Barriers to Effective Communication

The Committee discussed the many ways that patients with disabilities require communication accommodations to maintain autonomy in providing consent and decision-making, and to maintain engagement with health care providers.

Initial Recommendation:

PWDs shall be provided necessary and appropriate accommodations and supports so they can effectively communicate in all health care situations. Policies, procedures and practices shall be in place and implemented to ensure that:

HCPs shall recognize and respect the capacity of all persons with disabilities.
PWDs who require supports for effective communication, shall be provided with appropriate communication accommodations, aids and supports and shall have access to these aids and supports at all times.
The communication of health information, including face-to-face interactions, materials and forms, shall take into account a person’s disability. Hard copy, digital and plain language and alternate formats shall be made accessible to PWDs.
HCPs shall use strategies to facilitate effective patient-provider communication in face-to-face, telephone and digital communications.

(Note: glossary of terms should define health information and note there are existing AODA requirements for alternate formats).

Motion carried.

M 7.12 Technical Subcommittee report

Jacqueline Silvera, Subcommittee Chair, reported on subcommittee discussions with the Ontario Hospital Association, resulting in the OHA being invited to this meeting.

M 7.13 Tabled Communication Barrier D: Accessibility Barriers in Administration of Policies about Capacity, Informed Consent and Privacy

The Committee will discuss the issue of Privacy in another barrier, and concentrated discussions on needs of a range of persons with disabilities in approaches and accommodations to maintain autonomy in decision-making.

Initial Recommendation:

That all hospitals have policies, procedures and practices in place to ensure that PWDs are supported to exercise their presumed capacity to give informed consent.

This includes the recognition of inherent capacity of all PWDs and the development of processes of supported decision-making practices.

Hospitals shall ensure that these policies, procedures and practices include the requirement to provide PWDs with individualized accommodation and supports they require so they can fully understand information provided, retain and weigh consequences of options, make and communicate their decision(s), including assessments when required.

Motion did not carry. More discussion to follow pending receipt of additional information.

M 7.14 Preliminary Discussion on Education and Training Barriers

ADO staff introduced the broad barriers identified by the Committee in anticipation of the next meeting. The Committee will resume discussions then.

M 7.15 The Chair adjourned the meeting

Next Meeting: June 26^th and 27^th, 2018

Meeting 6: February 27 and 28, 2018

Letter from chair to the minister

March 23, 2018

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street
Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 6 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting 6 held on February 27^th and 28^th, 2018 and to provide you with a brief update on the Committee’s progress.

The Committee continues to propose solutions to health care accessibility barriers, within the hospital setting. The Committee has completed the following key deliverables:

Discussed regulatory and non-regulatory approaches to address identified accessibility barriers in the administration and accountability of health care and have begun formulating initial recommendations to these barriers.
Voted on two initial recommendations at meeting 6, bringing the total to five initial recommendations to date.

Sincerely

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: February 27^th and February 28^th, 2018

Location: Courtyard Marriott Toronto City Centre, 1 Blue Jays Way, Toronto, Northern Lights room

Day 1 present

Non-voting Standards Development Committee Member: Mary Bartolomucci, Melanie Kohn

Ministry staff:

(Accessibility Directorate of Ontario): Nidhi Baghat, Dalveer Birk, Sonya Del Monte, Margaret Hageman, Antonia Hammer, Ann Hoy, Phil Simeon, Meridith St. Pierre, Casey Teixeira, Dan Wilson
(Ministry of Health and Long-Term Care): Stoni Astley, Ann Marie Corrado, Mary Marafioti, Joanne Thanos, Eleni Tsoutsias

Captionist: Gemme Humenny

Attendant Support: Jayne Jalonikou, Vesal Karimiaslchors

Regrets: (Voting members): Peter Athanasopoulos, Diane Quintas, Jennifer Schipper

Day 1 meeting minutes

M 6.1 Chair’s Opening Remarks

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.
Sandi Bell announced 3 vacancies on the committee:
- Seble Makonnen, representing Canadian Mental Health Association (Ontario division)
- Gurwinder Gill, representing William Osler Health System
- Toni Lemon, representing Waterloo-Wellington LHIN

Staff are working to find replacements for these vacancies.

M 6.2 Roll Call and Logistics/Emergency Exit Information

All staff and Committee members introduced themselves
Casey Teixeira provided an overview of logistics and emergency information.

M 6.3 Learning Moment

Gordon Kyle and Natalie Spagnuolo led a presentation on Accessibility Issues in Consent, Capacity and Decision-Making followed by discussion.

M 6.4 Equity considerations in drafting recommendations

The Committee struck a working group to further explore ways to apply an equity lens to draft recommendations.

M 6.5 Administrative and Accountability Barrier Discussion: Uncoordinated Care Transitions

The Committee discussed the options for recommendations on barrier reduction, removal and prevention for Uncoordinated Care Transitions.

Initial Recommendation:

Preamble: A system-wide standardized requirement for ensuring that the accommodation needs of PWDs are identified, recorded, shared and acted upon.

Within health services, inquiries shall be made and opportunities offered for PWDs to identify their accommodation needs in all interactions.
With their consent this information shall be recorded/documented in the plan of care.
Hospitals shall provide the identified accommodation needs in all service interactions.
Each hospital shall develop a procedure to identify patient accommodation needs which includes:
1. Pro-active offer by health care provider for persons with disabilities to identify individualized accommodation needs.
2. If accommodation is required by the patient, hospital shall consult with patients to ensure that the accommodation meets their needs.
3. With patient consent, hospitals shall share information on patient accommodation requirements within hospital health services and in discharge planning.

Motion carried.

M 6.6 Administrative and Accountability Barrier Discussion: barriers related to insufficient time for accommodations and communication

Tabled to day 2

M 6.7 Wrap-Up Day 1

Sandi Bell provided a recap of the day.

Day 2 present

Standards Development Committee Members: Sandi Bell (Chair), Peter Athanasopoulos, Sue Anderson, Carol Anderson, Crystal Chin, Raj Chopra, Barbara Collier, Serge Falardeau, Gord Kyle, Yona Lunsky, Dr. John McDonald, Lorin MacDonald, Melanie Marsden, Marianne Park, Sam Savona, Jennifer Schipper, Jacqueline Silvera, Natalie Spagnuolo, Richard Welland

Non-voting Standards Development Committee Member: Mary Bartolomucci, Melanie Kohn

Staff member: (Accessibility Directorate of Ontario): Nidhi Baghat, Dalveer Birk, Sonya Del Monte, Margaret Hageman, Antonia Hammer, Ann Hoy, Phil Simeon, Meridith St. Pierre, Casey Teixeira, Dan Wilson

(Ministry of Health and Long-Term Care): Stoni Astley, Ann Marie Corrado, Mary Marafioti, Joanne Thanos, Eleni Tsoutsias

Captionist: Gemme Humenny

Attendant Support: Jayne Jalonikou, Vesal Karimiaslchors

Regrets: (Voting members): Diane Quintas

Day 2 meeting minutes

M 6.8 Administrative and Accountability Barrier Discussion: barriers related to insufficient time for accommodations and communication

The Committee discussed the options for recommendation on barrier reduction, removal and prevention related to time needed for accommodations and for communication in health care interactions.

Initial Recommendation:

Preamble: As a mechanism to build an overall organizational culture of accommodation it is important to ground this principle of shared accountability. While hospitals shall examine their policies and practices, staff should be empowered to make the necessary changes required to accommodate patient needs.

In a hospital setting, there may be additional time, supports and resources required to accommodate Persons with Disabilities. In these cases, Hospitals shall support health care practitioners to allocate adequate time to meet stated needs:

Taking into consideration the accommodation needs documented in the plan of care, the Health Care Providers shall plan and schedule the delivery of their services according to the accommodations, including extra time required.
When delivering inpatient and outpatient services, hospitals shall consider in their scheduling practices, any additional time required for accommodation.

Motion Carried.

M 6.9 Technical Subcommittee report

Jacqueline Silvera, Subcommittee Chair, reported on subcommittee discussions since the last meeting.

M 6.10 Stakeholder Engagement

The Committee discussed ways to keep their networks apprised of their work, with optional use of communication materials available. Communication with networks will focus on alerting networks to opportunities for public input.

M 6.11 Discussion for Draft Recommendations: Accountability and Accountability Barriers related to alternate formats and alternate ways to interact with health information systems.

The Committee discussed inaccessible hospital forms and alternate methods to communication in health service information are not always accessible; and (related barrier) existing policies on accessibility not consistently operationalized. This barrier is tabled to the next meeting.

M 6.11 Communication Barriers – Round Table Discussion

Addressing Communication-related barriers will be the focus for the next meeting.

M 6.12 In Camera

M 6.13

The Chair requested that Ministry of Health and Long Term Care (MOHLTC) provide information to the Committee on how the ministry engages with Indigenous communities on health issues, and how the Health Care SDC can include engagement of Indigenous peoples in the Committee’s deliberations.

Next Meeting: May 2 and 3, 2018

Meeting 5: January 17, 2018

Letter from chair to the minister

February 12, 2018

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street

Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 5 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting 5 held on January 17^th and to provide you with a brief update on the Committee’s progress.

The Committee has entered a new phase of work by addressing solutions to health care barriers, within the hospital setting. The Committee has completed the following key deliverables:

Discuss regulatory and non-regulatory approaches to address identified accessibility barriers in the administration and accountability of health care and have begun formulating draft recommendations to these barriers.
Built consensus on draft recommendations with voting planned for Meeting 6.

Sincerely

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: January 17, 2018

Location: Courtyard Marriott Toronto Downtown, 475 Yonge Street, Courtyard Rooms A,B,C

Present

Standards Development Committee Members: Sandi Bell (Chair), Peter Athanasopoulos, Sue Anderson, Crystal Chin, Raj Chopra, Barbara Collier, Serge Falardeau, Gord Kyle, Yona Lunsky, Dr. John McDonald, Lorin MacDonald, Seble Makonnen, Melanie Marsden, Marianne Park, Diane Quintas, Sam Savona, Jennifer Schipper, Richard Welland

Non-voting Standards Development Committee Member: Mary Bartolomucci

Supporting Staff:

(Accessibility Directorate of Ontario): Nidhi Baghat, Dalveer Birk, Susannah Bush, Margaret Hageman, Antonia Hammer, Phil Simeon, Meridith St. Pierre, Casey Teixeira
(Ministry of Health and Long-Term Care): Stoni Astley, Ann Marie Corrado, Mary Marafioti, Joanne Thanos

Captionist: Gemme Humenny

Attendant Support: Jayne Jalonikou

Regrets:

(Voting members): Carol Anderson, Gurwinder Gill, Toni Lemon, Jacqueline Silvera, Natalie Spagnuolo
(Non-Voting member): Dr. Melanie Kohn

Meeting minutes

M 5.1 Chair’s Opening Remarks

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.
Sandi Bell’s remarks included acknowledging the SDC will work toward a goal of submitting initial recommendations to the Minister Responsible for Accessibility by November 30, 2018.
Sandi Bell introduced the SDC’s newest member, Seble Makonnen, who is replacing Uppala Chandrasekera who is on parental leave from Canadian Mental Health Association (Ontario division).
All staff and Committee members introduced themselves.

M 5.2 Logistics/Emergency Exit Information

Casey Teixeira provided an overview of logistics and emergency information.

M 5.3 Update on Administration of SDC

The ADO Governance representatives, Susannah Bush and Casey Teixeira, presented updates regarding reimbursements and streamlined administration processes.

M 5.4 Stakeholder Engagement Discussion

The SDC discussed options for consulting with SDC stakeholders before public posting of initial recommendations and will continue the discussion at the next meeting.

M 5.5 Policy Development Tool and Application to Barrier Discussion: Uncoordinated Care Transitions

The SDC discussed the options for recommendations on barrier reduction, removal and prevention for Uncoordinated Care Transitions. Following extensive discussion, the matter was tabled.

The SDC discussed and supported an updated approach for developing options and recommendations for upcoming meetings.

M 5.6 Wrap-Up

Sandi Bell provided a recap of the day. Staff provided a brief overview of the themes of upcoming meetings.

Meeting 4: November 1 and November 2, 2017

Letter from chair to the minister

November 29^th, 2017

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street

Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 4 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting 4 held on November 1^st and November 2^nd, and to provide you with a brief update on the Committee’s progress.

The Committee has entered a new phase of work by addressing solutions to health care barriers, within the hospital setting. The Committee has completed the following key deliverables:

Discuss regulatory and non-regulatory approaches to address identified accessibility barriers in the administration and accountability of health care and have begun formulating draft recommendations to these barriers.
Built consensus and voted on draft recommendations:

Motion M 4.4 to approve an Initial Recommendation to address the following Barrier: lack of engagement with people with disabilities on planning, policy development, quality improvement, etc. – carried

Motion M 4.5 to approve an Initial Recommendation to address the following Barrier: lack of consideration for disability accommodation during procurement process, including products and services – carried

Motion M 4.10 to approve an Initial Recommendation to address the following Barrier: lack of access to hospital equipment for all providers, care staff – carried

Sincerely,

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: November 1^st and November 2^nd, 2017

Location: Westin Harbour Castle, 1 Harbour Square, Queens Quay Room

Day 1 present

Standards Development Committee Members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Raj Chopra, Barbara Collier, Serge Falardeau, Gord Kyle, Toni Lemon, Yona Lunsky, Dr. John McDonald, Lorin MacDonald, Melanie Marsden, Marianne Park, Sam Savona, Jacqueline Silvera, Natalie Spagnuolo, and Richard Wellend.

Non-voting Standards Development Committee Members: Mary Bartolomucci and Dr. Melanie Kohn.

Supporting Staff: (Accessibility Directorate of Ontario): Kimberly Campos, Sonya Del Monte, Margaret Hageman, Antonia Hammer, Phil Simeon, Meridith St. Pierre, and Casey Teixeira.

(Ministry of Health and Long-Term Care): Stoni Astley, Ann Marie Corrado, and Mary Marafioti.

Captionist: Gemme Humenny

Note Taker: James LeBlanc

Attendant Support: Jayne Jalonikou

Regrets (Voting members): Crystal Chin, Uppala Chandrasekera, Jennifer Schipper, Diane Quintas, Gurwinder Gill and Peter Athanasopoulos.

Day 1 meeting minutes

M 4.1 Chair’s Opening

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.
Sandi Bell provided welcoming remarks and thanked the committee for the effort in their working groups on Administrative and Accountability barriers.

M 4.2 Logistics/Emergency Exit Information

Meridith St. Pierre provided an overview of logistics and emergency information.

M 4.3 Standards Development Review Process: “Where We Are”

The ADO Governance representative, Casey Teixeira presented a refresher of the standards development process as outlined in the AODA, pointing out the current status of the Committee work.

M 4.4 Follow Up Discussion: Barriers regarding lack of engagement with people with disabilities on planning, policy development, quality improvement, etc.

The ADO presented a summary to Committee of the work they completed in the previous meeting.
The Committee had a discussion, and voted on the following draft recommendation.

M 4.4: Initial Recommendation: That all Ontario hospitals shall establish a Hospital Accessibility Advisory Committee (HAAC) to advise on accessibility matters to hospital boards regarding services and quality care.

(Motion Carried)

M 4.5 Barriers regarding procurement

Lack of consideration for disability accommodation during procurement process, including products and services.

Working group #1 presented their report back.
The Committee had a discussion and made the following recommendation.

M 4. 5: Initial Recommendation:

Preamble: Existing premises, hospital equipment and patient services are often not accessible to people with disabilities, which can compromise their quality of care.

The hospital shall collaborate with the Hospital Accessibility Advisory Committee (HAAC), related to facilities, services and construction to a building, equipment or premises that A) a hospital purchases, constructs or renovates and/or B) where the hospital enters into a new lease and C) as well as other planning around procurement and services.

(Motion Carried)

M 4.6 Wrap-Up

Sandi Bell provided a recap of the day and a brief overview of the next day’s agenda.

Day 2 present

Standards Development Committee Members: Sandi Bell (Chair), Carol Anderson, Sue Anderson, Raj Chopra, Barbara Collier, Serge Falardeau, Gurwinder Gill, Gord Kyle, Yona Lunsky, Dr. John McDonald, Lorin MacDonald, Sam Savona, Jennifer Schipper, Jacqueline Silvera, Natalie Spagnuolo, Toni Lemon, Richard Wellend, and Marianne Park (Partial).

Non-voting Standards Development Committee Members: Mary Bartolomucci

Supporting Staff: (Accessibility Directorate of Ontario): Kimberly Campos, Sonya Del Monte, Margaret Hageman, Antonia Hammer, Phil Simeon, Meridith St. Pierre

(Ministry of Health and Long-Term Care): Stoni Astley, Ann Marie Corrado, Mary Marafioti

Captionist: Olivia Arnaud

Note Taker: James LeBlanc

Attendant Support: Jayne Jalonikou

Regrets (Voting members): Crystal Chin, Uppala Chandrasekera, Peter Athanasopoulos, Diane Quintas, Melanie Marsden; and Dr. Melanie Kohn (Non-Voting member).

Day 2 meeting minutes

M 4.7 In-Camera Session

Sandi Bell called for an in-camera session with the Committee.

M 4.8 Chair’s Acknowledgement of Indigenous Land and Welcome

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.

M 4.9 Learning Moment: Access to Health Care for People With

Communication Disabilities

Committee member Barbara Collier presented on the topic of access to health care for people with communication disabilities.

M 4.10 Barriers regarding hospital equipment

Lack of access to hospital equipment for all providers, care staff.

Working group #3 presented their report back.
The Committee had a discussion and made the following recommendation.

Initial Recommendation:

Preamble: When physical spaces and hospital equipment prevent people with disabilities from receiving barrier-free care, their quality of care is compromised. Health care professionals may not have the capacity, equipment, or personnel support to accommodate people with disabilities when these barriers exist in hospitals.

Specifically, hospitals must ensure that:

In areas where hospital equipment is not accessible to people with disabilities, that staff have access to enabling devices and/or additional personnel to ensure equitable access for people with disabilities. The need for accommodation will not delay or prevent equitable access to timely care.
Hospital equipment meant for accommodation will be purchased, inventoried, tracked and maintained so that it is readily available to personnel as required.
(Motion carried)
M 4.11 Stakeholder Communications

Raj Chopra reported on the discussion of the working group on possible ways Committee members should engage with stakeholders on initial recommendations. The ADO offered to help develop with the committee, a uniform and accessible template for Committee members for this purpose.

M 4.12 Remarks from the Deputy Minister

Deputy Minister Marie-Lison Fougère addressed the Committee and emphasized the importance of the work of the Health Standards Development Committee in providing advice to government on how to remove barriers for people with disabilities in the delivery of health care.

M 4.13 Review of Communication-related Accessibility Barriers

Presentation from the ADO and MOHLTC staff on communication barriers identified by the Committee and pre-consultation documents.
The committee had a group discussion facilitated by Sandi Bell.

M 4.14 Wrap-Up

Sandi Bell provided a recap of the day. The next Committee meeting will be on January 16 and 17, 2018.

Meeting 3: September 19 and 20, 2017

Letter from chair to the minister

October 10, 2017

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street

Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 3– Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting 3 held on September 19 and 20, and to provide you with a brief update on the Committee’s progress.

The Committee has completed the following key deliverables:

Approved the Long-Term Objective of Health Care Standards.
Finalized the work-plan (including use of technical sub-committees).
Established a hospital technical sub-committee.

Looking ahead to Meeting 4, the Committee intends to continue discussions on barriers in the area of accountability for accessibility within the administration of health sector institutions, with a focus on hospitals, as identified in the mandate letter to support the Committee work-plan.

Sincerely,

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: September 19 and 20, 2017

Location: Hyatt Regency Hotel, 370 King Street West, King 1 Ballroom

Day 1 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Raj Chopra
Barbara Collier
Serge Falardeau
Gurwinder Gill
Gord Kyle
Toni Lemon
Yona Lunsky
Dr. John McDonald
Lorin MacDonald
Melanie Marsden
Marianne Park
Diane Quintas
Sam Savona
Jacqueline Silvera
Natalie Spagnuolo

Non-voting Standards Development Committee Members:

Mary Bartolomucci

Supporting Staff:

(Accessibility Directorate of Ontario):

Kimberly Campos
Sonya Del Monte
Margaret Hageman
Antonia Hammer
Phil Simeon
Meridith St. Pierre

(Ministry of Health and Long-Term Care):

Stoni Astley
Ann Marie Corrado
Mary Marafioti
Shannon Jeffries
Joanne Plaxton
Joanne Thanos

Presenter Guests:

Lauren Bates and Rebecca Cheff, from the Wellesley Institute

Captionist:

Gemme Humenny

Regrets:

Crystal Chin
Uppala Chandrasekera
Jennifer Schipper
Richard Welland
Dr. Melanie Kohn (Non-voting)

Day 1 meeting minutes

M 1.1 Chair’s Opening

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.
Sandi Bell provided welcoming remarks to the Committee, and introduced new members of the Committee: Barbara Collier from Communication Disabilities Across Canada and Dr. John McDonald, lead physician from PrimaCare Community Family Health Team.

M.1.2 Logistics/Emergency Exit Information

Kimberly Campos provided an overview of logistics and emergency information.

M 1.3 Learning Moment

Marianne Park gave a presentation on the intersections, dynamics and statistics of disability and gender-based violence.

M 1.4 Inclusive Frameworks

Various inclusive policy frameworks were presented and explored:
- Carol Anderson gave a presentation on Patient and Family Centred Care.
- Lauren Bates from the Wellesley Institute gave a presentation on Social Determinants of Health and Intersecting Identities.
- Joanne Plaxton and Shannon Jeffries of the Ministry of Health and Long Term Care presented on the use of Health Equity Impact Assessment Tool.
- Margaret Hageman of the ADO presented a Disability Perspective of the Convention on the Rights of Persons with Disability and Ontario Human Rights Code.

M 1.5 Long Term Objective of Health Care Standards

Peter Athanasopoulos provided an overview of the deliberations and rationale for the proposed Long Term Objective.

M 1.5.1 Recommendation:

Fair, rights-based accessibility policies and practices that are measurable, enforceable, and result in barrier-free hospitals and healthcare that embraces accommodation as well as an equity and diversity lens for all Ontarians with disabilities.

(Motion carried)

M 1.6 Report from Hospital Working Group

Jacqueline Silvera reported to the Committee on the hospital sub-committee purpose.

M 1.6.1 Recommendation:

Recognizing the diversity of the hospital sector (including size, geography, patient population, and specialty), and in alignment with the mandate letter, the purpose of a Hospital Technical Sub-Committee would be to assist the Health Care SDC by networking with as many Ontario hospitals as possible in order to:

1) Create an opportunity and a mechanism to facilitate deliberation on items/issues where broader hospital-specific expertise and feedback is crucial to identifying, removing and preventing systemic barriers hospitals face in achieving compliance both now and in the future, and;

2) Support broad hospital engagement, including building consensus, on strategies to improve accessibility to hospital services for people with disabilities.

The subcommittee will collect, share and report back information to deliver the tasks as set out by the SDC.

(Motion carried)

Day 2 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Raj Chopra
Barbara Collier
Serge Falardeau
Gurwinder Gill
Gord Kyle
Yona Lunsky
Dr. John McDonald
Lorin MacDonald
Melanie Marsden
Marianne Park
Diane Quintas
Sam Savona
Jennifer Schipper
Jacqueline Silvera
Natalie Spagnuolo

Non-voting Standards Development Committee Members:

Mary Bartolomucci

Supporting Staff:

(Accessibility Directorate of Ontario):

Kimberly Campos
Sonya Del Monte
Margaret Hageman
Antonia Hammer
Phil Simeon
Meridith St. Pierre

(Ministry of Health and Long-Term Care):

Stoni Astley
Ann Marie Corrado
Mary Marafioti
Joanne Thanos

Regrets:

Crystal Chin
Uppala Chandrasekera
Toni Lemon
Richard Welland
Dr. Melanie Kohn (Non-voting)

Day 2 meeting minutes

M 1.7 Chair’s Opening and Welcome

Sandi Bell opened with an Acknowledgement of the Indigenous Land upon which the meeting took place.

M 1.8 Stakeholder Communication strategy:

Members discussed forming a Stakeholder Communication working group.

M 1.9 SDC Open Forum and Focus Area Report

Further to a discussion on focus areas from Meeting 2, Jennifer Schipper presented a report on findings of a barrier identification activity.
The Committee discussed the report in combination and alignment with pre-consultation findings.

M 1.10 Proposed Work-plan

Recommendation: From the Chair, that the work-plan, as shared with SDC for this meeting, be accepted.

(Motion carried)

M 1.11 Tool for Developing Draft Recommendations

ADO staff introduced a policy tool for members to analyze and work through barrier definitions, and explore options for removing and preventing barriers.

M 1.12 Wrap-Up

Sandi Bell provided a recap of the day. The next Committee meeting will be November 1 and 2, 2017.

Meeting 2: June 26 and 27, 2017

Letter from chair to the minister

July 19, 2017

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street
Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 2 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee approved minutes from Meeting 2 held on June 26 and 27, and to provide you with a brief update on the Committee’s progress.

The Committee discussed the following:

Priority focus areas as identified in Mandate Letter to support the workplan;
An initial Long-Term Objective for Health Care Standards; and
The workplan, including use of technical sub-committees.

The Committee was unable to vote on the workplan as attendance did not allow for quorum to be met.

Looking ahead to Meeting 3, the Committee intends to complete the following key deliverables:

Form consensus on priority focus areas as identified in the Mandate Letter to support the workplan;
Develop an initial Long-Term Objective for the Health Care Standards;
Finalize the workplan, including identifying and reaching consensus on the use of technical sub-committees;
Begin discussions on exploring existing frameworks that may assist with developing recommendations; and
Continue discussions regarding accessibility barriers in the hospital sector to support the Committee workplan.

Sincerely,

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: June 26 and 27, 2017

Location: Chelsea Hotel, 33 Gerrard Street West, Toronto, Ontario, Rossetti Room

Day 1 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Raj Chopra,
Crystal Chin (Partial)
Serge Falardeau
Gord Kyle
Toni Lemon
Lorin MacDonald
Diane Quintas
Sam Savona
Jennifer Schipper
Jacqueline Silvera (Partial)
Richard Welland

Non-voting Standards Development Committee Members:

Mary Bartolomucci

Supporting Staff: (Accessibility Directorate of Ontario (ADO)

Susannah Bush
Kimberly Campos
Sonya Del Monte
Margaret Hageman
Ryan Nichols
Sakshi Pachisia
Phil Simeon
Meridith St. Pierre
Casey Teixeira
Dan Wilson (Ministry of Health and Long-Term Care)
Stoni Astley
Ann Marie Corrado
Mary Marafioti
Joanne Thanos
Ellen Wankiewicz

Regrets:

Uppala Chandrasekera
Barbara Collier
Gurwinder Gill
Dr. Melanie Kohn (Non-voting),
Yona Lunsky
Melanie Marsden
Marianne Park
Natalie Spagnuolo

Captionist:

Gemme Humenny

Day 1 meeting minutes

M 1.1 Chair’s Opening

Sandi Bell opened the meeting with the Acknowledgement of the Indigenous Land upon which the SDC is meeting.
Sandi Bell provided welcoming remarks to the Committee, and introduced a new member of the SDC, Toni Lemon from Waterloo/Wellington Local Health Integration Network (LHIN).
Sandi Bell informed the Committee that a new member has joined the SDC, Barbara Collier, from Communication Disabilities Access Canada.

M.1.2 Logistics/Emergency Information:

Meridith St. Pierre provided the Committee with an overview of logistics and emergency information for the day.

M 1.3 Learning Moment

Sandi Bell provided an overview of the learning moment where SDC members are invited to share expertise and insights with the Committee.
Richard Welland gave a presentation on communication and swallowing disabilities and led a discussion.

M 1.4 Report from Hospital Working Group

Jacqueline Silvera provided an overview of discussions of the proposed hospital working group.
Sandi Bell led a discussion.

M 1.5 SDC Open Forum and Focus Area Mapping Activity

Sandi Bell provided an overview of the open forum and focus area mapping activity.
Sandi Bell and Jennifer Schipper facilitated discussion with SDC members.

M 1.6 Long-Term Objective

Phil Simeon and Casey Teixeira gave a presentation on Long-Term Objectives.
Sandi Bell led a discussion.

M 1.7 Wrap-Up/Recap

Sandi Bell provided a recap of the day and a brief overview of the next day’s agenda.

Day 2 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Raj Chopra
Serge Falardeau
Gord Kyle
Toni Lemon
Lorin MacDonald
Marianne Park
Diane Quintas
Sam Savona
Jacqueline Silvera (Partial)
Richard Welland

Non-voting Standards Development Committee Members:

Mary Bartolomucci

Supporting Staff: (Accessibility Directorate of Ontario (ADO)

Susannah Bush
Kimberly Campos
Sonya Del Monte
Margaret Hageman
Ryan Nichols
Ann Hoy (Partial)
Sakshi Pachisia,
Phil Simeon
Meridith St. Pierre
Casey Teixeira
Dan Wilson (Ministry of Health and Long-Term Care)
Stoni Astley
Ann Marie Corrado
Mary Marafioti
Joanne Plaxton (Partial)
Joanne Thanos
Ellen Wankiewicz

Regrets:

Uppala Chandrasekera,
Crystal Chin,
Barbara Collier,
Gurwinder Gill,
Dr. Melanie Kohn,
Yona Lunsky,
Melanie Marsden,
Jennifer Schipper,
Natalie Spagnuolo

Captionist:

Gemme Humenny

Presenter:

Benjamin St. Louis (ADO Staff)

Day 2 meeting minutes

M 1.8 Chair’s Opening and Welcome

Sandi Bell opened the meeting with the Acknowledgement of the Indigenous Land upon which the SDC was meeting.
Sandi Bell welcomed the Committee and recapped items members raised on Day 1.

M 1.9 Information Sharing with Community

Phil Simeon and Margaret Hageman gave a presentation to SDC members regarding sharing information with networks for feedback.
Sandi Bell facilitated a discussion.

M 1.10 Proposed Work-plan

Phil Simeon and Casey Teixeira gave a presentation on the proposed work-plan.
Sandi Bell facilitated a discussion regarding actions and preparations for Meeting 3.
The Committee was unable to vote on the workplan as attendance did not allow for quorum to be met.

M 1.11 Interim Long-Term Objective(s)

Sandi Bell led a discussion on a proposed initial Long-Term Objective.

M 1.12 AODA Compliance and Hospital Sector Presentation

Ben St. Louis gave a presentation on AODA Compliance in the Hospital Sector.

M 1.13 Wrap-Up/Recap

Sandi Bell provided a recap of the day.

Meeting 1: May 11 and 12, 2017

Letter from chair to the minister

June 2, 2017

The Honourable Tracy MacCharles
Minister Responsible for Accessibility
900 Bay Street

Mowat Block, 6^th Floor
Toronto, Ontario M7A 2E1

Dear Minister,

Re: Health Care Standards Development Committee Meeting 1 – Minutes and Progress Report

On behalf of the members of the Health Care Standards Development Committee, I am pleased to submit the Committee-approved minutes from Meeting 1 held on May 11 and 12, and to provide you with a brief update on the Committee’s progress.

The Committee has completed the following key deliverables:

Received a high-level overview of the health care / hospital sector;
Received a high-level summary of pre-consultation findings; and
Began discussions on the focus areas identified in the Mandate Letter.

Looking ahead to Meeting 2, the Committee intends to finalize and approve the Committee work-plan. The Committee will also continue discussions on the outlined focus areas within the hospital sector as identified in the Mandate Letter.

Sincerely,

(Original signed by)

Sandi Bell
Chair, Health Care Standards Development Committee

Meeting information

Date: May 11 and 12, 2017

Location: Metro Toronto Convention Centre, South Entrance, 222 Bremner Blvd, Toronto, ON (Boardroom 701A)

Day 1 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Uppala Chandrasekera
Raj Chopra
Crystal Chin
Serge Falardeau
Gurwinder Gill
Gord Kyle
Lorin MacDonald
Melanie Marsden
Diane Quintas
Sam Savona
Jennifer Schipper
Jacqueline Silvera
Natalie Spagnuolo
Richard Welland
Yona Lunsky

Non-voting Standards Development Committee Members:

Mary Bartolomucci
Dr. Melanie Kohn

Supporting Staff: (Accessibility Directorate of Ontario)

Susannah Bush (partial)
Elisheva Bouskila-Fox (partial)
Kimberly Campos (partial)
Sonya Del Monte (partial)
Margaret Hageman
Ryan Nichols
Sakshi Pachisia
Phil Simeon (partial)
Meridith St. Pierre
Casey Teixeira, (Ministry of Health and Long-Term Care)
Stoni Astley
Mary Marafioti
Joanne Plaxton
Simon Rabinovitch (partial)
Andrej Sikic (partial)
Joanne Thanos
Ellen Wankiewicz

Presenters:

Harriett Grant (partial)
Allison Henry (partial)
Jillian Paul (partial) – Ministry of Health and Long-Term Care

Regrets:

Marianne Park

Day1 meeting minutes

M 1.1 Chair’s Opening

Sandi Bell opened the meeting with the acknowledgement of Toronto as a sacred gathering place for Indigenous Peoples and the long history of Indigenous Peoples in Ontario.

M 1.2 Logistics/Emergency Information:

Meridith St. Pierre provided the Committee with an overview of logistics and emergency information for the day.

M 1.3 Chair’s Welcome and Roundtable Introductions of Members

Sandi Bell provided welcoming remarks to the Committee, and the Committee did roundtable introductions activity.

M 1.4 Mandate Letter

Sandi Bell gave a presentation of the Chair’s Mandate Letter from Minister Tracy MacCharles (Minister Responsible for Accessibility).

M 1.5 SDC Roles, Responsibilities and Process

Phil Simeon asked the Committee to read the presentation on the SDC roles, responsibilities and process to support the legislative requirements of the Accessibility for Ontarians with Disabilities Act and the Committee’s mandate. This item was presented at SDC orientation.

M 1.6 Long-term Objective

Phil Simeon and Casey Teixeira gave a presentation on the requirement for a long-term objective in the standards. Sandi Bell led a group discussion.

M 1.7 Self-Regulation of Health Providers

Allison Henry gave a presentation providing an overview of the Self-Regulation of Health Providers. Sandi Bell led a brief question period between the presenter and members.

M 1.8 Patients First Action Plan

Harriett Grant gave a presentation on the Patients First Strategy. Sandi Bell led a brief question period between the presenter and members.

M 1.9 Patient Engagement

Jillian Paul gave a presentation on the Patient Engagement Strategy. Sandi Bell led a brief question period between the presenter and members.

M 1.10 Wrap-Up/Recap

Sandi Bell provided a recap of the day and a brief overview of the next day’s agenda.

Day 2 present

Standards Development Committee Members:

Sandi Bell (Chair)
Carol Anderson
Sue Anderson
Peter Athanasopoulos
Uppala Chandrasekera
Raj Chopra
Crystal Chin
Serge Falardeau
Lorin MacDonald
Melanie Marsden
Marianne Park
Diane Quintas
Sam Savona
Jennifer Schipper
Jacqueline Silvera
Natalie Spagnuolo
Richard Welland
Yona Lunsky

Non-voting Standards Development Committee Members:

Mary Bartolomucci
Dr. Melanie Kohn

Supporting Staff: (Accessibility Directorate of Ontario)

Susannah Bush
Elisheva Bouskila-Fox
Kimberly Campos
Sonya Del Monte
Margaret Hageman
Ann Hoy (partial)
Ryan Nichols
Sakshi Pachisia
Phil Simeon
Meridith St. Pierre
Casey Teixeira, (Ministry of Health and Long-Term Care)
Stoni Astley
Mary Marafioti
Joanne Thanos
Ellen Wankiewicz

Presenter:

Dr. Melanie Kohn

Regrets:

Gord Kyle
Gurwinder Gill

Day 2 meeting minutes

M 1.11 Chair’s Opening and Welcome

Sandi Bell opened the meeting with the acknowledgement of Toronto as a sacred gathering place for Indigenous Peoples and the long history of Indigenous Peoples in Ontario.
Sandi Bell welcomed the Committee and recapped items members raised on Day 1.

M 1.12 Logistics/Emergency Information:

Meridith St. Pierre provided the Committee with an overview of logistics and emergency information for the day.

M 1.13 Health System / Hospital Overview

Dr. Melanie Kohn provided an overview of the health system and hospital sector. Sandi Bell led a brief question period between the presenter and members.

M 1.14 Setting the Context: Health Care Standard Steps to Date and Group Discussion

Phil Simeon and Margaret Hageman gave a presentation on the context of the proposed Health Care Standards and led a group discussion. Sandi Bell facilitated discussion.

M 1.15 Overview of the Accessibility for Ontarians with Disabilities Act Hospital

Phil Simeon and Margaret Hageman provided an overview of AODA hospital requirements and led a group discussion. Sandi Bell facilitated discussion.

M 1.16 Proposed Draft Work-plan

Sandi Bell introduced the Proposed Draft Work-plan and led a group discussion.

M 1.17 Draft Workplan Working Session

Susannah Bush and Ryan Nichols led the Committee in a working session on the draft work-plan.

M 1.18 Wrap-Up/Recap

Phil Simeon and Sandi Bell led a group discussion for the Standards Development Committee Meeting 2 agenda.
Sandi Bell provided a recap of the day and outlined the expectations for members regarding actions and preparations for the next meeting.

Updated: June 29, 2022

Published: March 04, 2021