Investments needed to address 'threadbare' supports for Ontarians with complex needs: ombudsman (The Trillium)

June 27, 2024

27 June 2024

Paul Dubé's 2023-24 annual report highlighted concerns in a number of other areas including correctional facilities, which saw the highest number of complaints.

Sneh Duggal
The Trillium
June 27, 2024

Calling the stories he's heard "heartbreaking," the province's ombudsman said more investments are needed to tackle the "threadbare" supports and services for Ontarians with complex needs — including adults being housed in hospitals and children whose families are surrendering their care.

"Those supports and services are threadbare and they're just not available. So there are not enough, for example, housing options for people with complex needs," said Ombudsman Paul Dubé at Queen's Park, adding that there are often waiting lists for residential services.

A recent report from the Financial Accountability Office said the waitlist for supportive living for individuals with developmental disabilities had grown by nearly 10,000 since 2017-18 to more than 28,000 people in 2023-24.

"We need more investments and we need more resources to be able to house these people appropriately," Dubé said Wednesday, following the release of his office's 2023-24 annual report. "The plan was decades ago to move people out of institutions and provide those services and supports in the communities, and they're inadequate and they're just not there for a lot of people."

While Dubé's office is currently completing an investigation into adults with developmental disabilities being housed in hospitals, his annual report outlined several cases where his staff helped individuals find residential placements. His office received 20 new complaints from families, hospital staff and agencies on the issue since the investigation was launched in March 2023.

This included a man, 56, with schizophrenia and developmental disabilities who spent eight years in hospital and half that time waiting for a suitable place to live and a 22-year-old with autism who had a history of self-injury and spent much of his three years in hospital in restraints.

In the last fiscal year, the ombudsman's office also received 21 complaints from families of children with complex needs. Nearly 20 years after an investigation into this, Dubé's report said "overwhelmed parents and guardians of children with complex special needs continue to feel they have no option but to surrender their children to local children's aid societies (CASs) to get the proper care for them."

For example, a 12-year-old girl's family gave their local CAS temporary custody because they couldn't access intensive treatment to address her cognitive and mental health diagnoses. Another 12-year-old's "violent behaviours were out of control," forcing his mother to do the same, according to the report. Treatment options were ultimately found after the ombudsman intervened.

"We spoke to the ministry to confirm it would provide funding for supports, and the child was admitted to intensive treatment," the report said of the case involving the 12-year-old boy.

"I don't know if it surprises us, but it disheartens us," Dubé said. "We see the pain that the families are in and ... a lot of us are parents and you can just imagine what it would take to drive you to the point of relinquishing the care of your child just so that they'll get support."

His comments follow the Children’s Aid Society of Ottawa's warning earlier this month that the child welfare sector was "at a tipping point" because families of youth with complex needs are increasingly unable to access community treatments and supports and are turning to organizations like theirs for help.

"We are vigilant, we continue to work on this and we continue to raise the matter with government and the sector and the agencies involved," the ombudsman said. "We're doing our bit, but a lot more attention needs to be paid to this area and resources provided."

A spokesperson for the Ministry of Children, Community and Social Services said the government is working to help adults with developmental disabilities "receive the best supports possible."

"That is why we have invested $16 million in ongoing funding to move individuals from hospitals to community placements, in partnership with local health and Developmental Service partners," the spokesperson said. "We recognize that each person has unique needs, which is why each person’s situation is reviewed on an individual basis. Those who are assessed to be most at risk are prioritized for available resources — this is not a first- come, first-served system."

The ministry said it wants to see each person "integrated into their community" and has boosted funding for developmental services since 2018.

As for youth with special needs, the ministry said, "Complex Special Needs funding is available for children and youth with multiple or complex special needs in situations where there is immediate risk to their health and safety, and when their needs exceed the capacity of local services and their families."

The ombudsman's office received a near-record number of complaints and inquiries in the last fiscal year — 27,030 cases — with the highest number — 4,444 cases — being about correctional facilities, which he said were experiencing "severe overcrowding."

The main concerns within correctional facilities included health care, overcrowding, lockdowns, segregation and correctional officers' use of force, the report noted.

In one instance, an inmate wasn't given his prescription medication for three weeks. In another, an inmate who was HIV-positive said he was not getting his needed medications. The ombudsman's office said it helped arrange a doctor's appointment for the first inmate and a specialist appointment and medications for the second.

"As stated by the Ombudsman’s report our government continues to make substantial progress in advancing and modernizing Ontario’s correctional system," Hunter Kell, spokesperson for Solicitor General Michael Kerzner, said in response to the report. "This includes reducing, and where possible eliminating, the time that inmates experience segregation conditions."

Kell said the Ministry of the Solicitor General has "made significant strides" in implementing recommendations from the ombudsman on segregation and the use of force. He also pointed to funding for infrastructure and more than 1,500 staff hired since 2018, along with an announcement earlier this month on additional beds at various facilities across the province.

"Inmates have access to a variety of services and supports including mental health nurses, physicians, psychiatrists, psychologists, social workers and addictions counsellors," he said. "We will continue to do everything we can to ensure inmates have access to supports they may need while incarcerated."
Meanwhile, the ombudsman's office received complaints and inquiries about a range of other topics including municipalities (3,694), school boards (1,334), ODSP (978), Ontario Works (390) and youth in care (1,722).

The organization that was the focus of the most number of complaints was Tribunals Ontario. The ombudsman's office handled 1,457 cases, 1,284 of which were about the Landlord and Tenant Board.

"We continue to confront systemic issues related to access to justice, human rights in correctional facilities, transparency in municipal governance and the delivery of developmental disability services," Dubé said. "Specifically, we are seeing adults with developmental disabilities not getting the supports and services that they need. We are assisting people who have been deprived of access to justice by an under-resourced and overwhelmed tribunal system. We are hearing of children being housed by struggling children's aid societies in offices or trailers. We are addressing the human rights of inmates that are being violated in a corrections system that both staff and inmates say has inadequate resources and infrastructure."

Originally published on The Trillium’s website (for subscribers only).