Hello everyone and thank you for attending.

Welcome to the first province-wide webinar and the Minister of Children and Youth Services Ontario

Autism Program.

Today’s hosts are Sarah Hardy, Director of the Ontario Autism Program Project, and Jane Cleave,

Director of Special Services and Supports.

My name is Lisa Cancian. I am a member of the Ontario Autism Program Project and I will be leading the

webinar.

The Minister of Children and Youth Services has chosen this format because today is the opportunity to

communicate with a wide array of professionals and to support you in your roles and your conversations

with families.

Today Sarah and Jane will give a co-presentation on the Ontario Autism Program and what this means

for you as a practitioner, supporting autistic children and youth and their families.

There will be a question and answer period following the presentation.

You can submit your questions at any time using the “question and answers” box that appears on your

screen.

After the presentation, we will take the time to answer as many questions as possible.

We will review all of the questions asked today to help us develop new content for our website as well

as the information we will be sharing with practitioners and families.

We would also like to inform you that this webinar is being recorded and will available on the website at

ontario.ca/autism.

The whole presentation and the items we are currently reviewing will be available online via the link you

used to join this webinar.

The presentation will also be posted on the Ministry’s website.

Now, that we’re done with all of the administrative matters, let’s begin the presentation.

Hello and thank you, Lisa. My name is Jane Cleave and I work in the Ministry’s Program Design Division.

I’m here with my co-worker, Sarah Hardy. On behalf of the Ministry, thank you for attending.

We are truly delighted to have the opportunity to communicate directly with practitioners through this

series of webinars.

We know that you would like more information and have questions about the Ontario Autism Program,

also called OAP, and what this means for you, in terms of support for autistic children and youth. Sarah

will now introduce the purpose of this presentation and give you an overview of the main components

of the program.

Thank you Jane and Lisa. The purpose of this presentation is to give you an overview of the main

components of the Ontario Autism Program; what you need to do to refer children to the OAP; working

with OAP providers; or providing services under OAP. We hope the information we provide will help you

fulfill your roles.

Following the presentation, Jane and I will listen to you and answer all of your questions.

So, what is the Ontario Autism Program?

OAP was implemented on June 26, 2017 and consists of four main components.

First, one-stop access to make services more accessible to families.

All children and youth who have received a diagnosis of ASD from a qualified professional can access the

OAP until they are 18 years old.

Second, decision-making by the family will allow the family to participate actively, as a partner, in the

planning process for their children.

Third, a collaborative approach to services recognizing that children and youth can access a vast array of

services provided by a wide range of professionals.

Fourth, providing a flexible and customized program based on needs.

To reinforce the OAP, which was implemented in June, the Ministry launched a direct funding option as

part of the OAP last January, which lets families choose their behavioural services provider.

In January, we also made some program improvements to reinforce clinic responsibility, supervision and

quality assurance under the OAP, including new qualification requirements for clinic supervisors, as well

as an independent clinic review process for families with concerns regarding the OAP’s behavioural plan

for their child.

What services are available under the OAP?

The OAP offers an array of behavioural services, services to the family, training and support services for

the family.

All of these services are intended to help children and youth, as well as their families, acquire and

upgrade skills that can be used in the home and in the community.

Under the OAP, families will be able to call upon the services of a family support services officer,

through regional support services.

This officer is the family’s contact person, who helps the family by referring them to services that will

provide ongoing support, and who is available at any time to answer questions.

The officer’s ongoing participation is optional for families.

It is primordial that parents and care providers participate in the techniques and strategies taught to

children and for that technique to be implemented in daily practice in other environments and with

other people.

As a result, the training and services under the OAP are an essential component of the services provided

as part of the OAP.

These services are offered by regional providers and are available at any point in the families’ journey

through the OAP.

A few examples of this service are:

Essential basic information on ASD, behavioural services and the OAP, workshops, information sessions,

information and seminars for parents and care providers, brief consultations supported by the

intervention of third parties and by parents and clinic resources or information days.

In addition to family services and information, the OAP offers a range of evidence-based services to

promote acquisition of major functional and social skills, such as getting dressed or speaking to others,

or that can help discourage difficult behaviour that interferes with learning or wellness.

Behavioural services also consist of teaching parents and providers the skills necessary to promote the

child’s development.

The frequency, duration, intensity and range of the behavioural services will be based on clinical needs

and will be tailored to the objectives, strengths and needs of the child.

Sometimes, the function of the OAP behavioural plan, the child or youth and their family will work

actively toward acquiring and generalizing new evidence-based behavioural skills.

While at other times, the child will focus exclusively on implementing and maintaining their skills.

It is important to note that children are not discharged from the OAP, which is a notable change from

the previous program.

Children and youth who participate in the OAP remain in it until 18 years of age; either the family wants

to withdraw them from the program or the diagnosis of autism spectrum disorder is withdrawn.

In either case, families will receive plenty of personalized support toward their departure from the OAP.

Among other things, these key results will allow families to receive effective, well-coordinated services

focused on the family and adapting to the changing needs of their child.

As such, families actively participate in planning their children’s activities and the professionals will

support the child by working in partnership to plan their care.

Given that a number of children with ASD are in school and in their community, within their family or as

part of other services provided outside of the OAP, the services of the OAP should be coordinated and

integrated with other services that the child might receive, and families would benefit from a high

degree of collaboration.

In order to support services focused on the child and youth and the family in promoting collaborative

services, the OAP includes the following elements:

The OAP Family Service Plan, the OAP Family Team and the OAP Behavioural Plan.

Today, we would like to talk about the different ways through which you, the professionals, can

participate in the implementation of these various elements.

First, the OAP Family Plan, what is it?

Each child, youth and his family will have his own Family Service Plan, FSP, which will be specific to him.

That plan will be rolled out by the Family Support Worker, the family’s contact person for the

implementation of the OAP FSP.

As you can see from the diagram in the slide, the service plan includes the following:

Key information regarding the child and their family as well as their needs and strengths.

Inter-professional training and the formation of a team, if the family wishes.

Family services and training, the OAP Behavioural Plan, transitional plans toward the OAP and to

withdraw from it.

The OAP’s FSP is a document that changes over time and reflects the family’s priority, the stage of the

child’s development, the projects completed toward achieving a goal or objective as well as the

transition plan.

Let’s look at your role as the professional in the Family Service Plan.

From the time of enrolment in the OAP, a Family Service Worker begins obtaining information to clearly

understand the situation of the child or youth and their family.

This information will be obtained from various sources and reports from various professionals who work

with the child, like yourselves, and will provide essential information to create a profile of the child or

youth and their family’s path.

If you are a professional who works with the OAP’s child or youth, the FSP, with the family’s consent,

will work with you to ensure that the FSP includes the data and reports and information you may have

obtained and that describes all of the services you may provide.

The FSP is captured at least every six months. It is essential for the professional working with the child to

provide ongoing feedback as part of the FSP, particularly given that the child’s needs change over time.

The formation of the OPA’s Family Team is an important element of the inter-professional collaboration.

This team can be formed to coordinate and match all of the services that the child may receive with the

OAP behavioural services they are currently receiving, including services that began prior to enrolment

in the OAP.

The Family Team is comprised of members chosen by the family.

The team members can include the child or youth, other family members, clinicians, educators, school

representatives, providers and OAP clinicians.

The team composition can change over time, as the child’s needs and the services they receive change.

The formation of the Family Team is optional for the family.

So, what will your role be as a professional and member of the Family Team?

You will be required to attend Family Team meetings that will take place at least every six months.

Discuss the child or youth’s objectives that you will work on and their consistency with the OAP

behavioural services.

Address and jointly resolve all possible concerns and difficulties, contribute by regularly communicating

new information and reviewing data and by evaluating the progress under the FSP toward achieving

behavioural objectives.

The first meeting will be conducted by the Family’s Support Worker.

However, the family will choose the person responsible for chairing subsequent meetings with the help

of the other team members.

The Family Team Lead will also be appointed.

It is not mandatory for this person to be the OAP Clinical Supervisor.

According to the family’s preference, it may be a collaborating professional or an OAP.

Promoting and maintaining acquired skills is also part of the main expectations.

As the child or youth achieves the objectives in the behavioural plan, the Family Team members,

particularly the Clinical Supervisor, should meet to reflect on strategies to facilitate the child’s learning

as much as possible.

Generalization and maintenance are coordinated regularly with the Family Team. It may consist of

helping the youth use their new skills to communicate with their friends during training with their

speech pathologist, or allow the child to maintain his learning skills at home with the help of a worker

during the session.

Now I’m going to turn it over to Jane.

Thank you Sarah. So, what is the OAP plan?

The process of using a clinic as part of the OAP framework is based on the principle of services focused

on the child, youth and family.

All of these support and treatment-related decisions are made in partnership with the family and the

youth.

The OAP behavioural plan is a detailed description of the evidence-based behavioural services that the

child, youth or family will receive as part of the OAP.

The behavioural plan summarizes the objectives set out in the OAP Family Service Plan.

The OAP behavioural plan is based on the expertise of the clinical supervisor, on the family’s feedback

and on a clear understanding of the objectives, strengths and priorities of the child and the family.

The OAP clinical framework and the OAP behavioural plan describe the common steps in the planning

process, which are guided by a Clinical Supervisor.

So, as a practitioner, how will you participate in the OAP behavioural plan?

An OAP Clinical Team will implement each OAP behavioural plan.

The composition of this team varies based on the family’s needs and the type of services provided.

Each family’s clinical team must include a clinical supervisor who is responsible for all aspects of the

behavioural plan and who, in particular, must confirm that all team members have adequate

qualifications.

A family can also work with frontline therapists who will provide services directly to the child or youth

under the clinical supervision of the clinical supervisor.

In some case, a clinical supervisor can also choose a new partnership with other qualified persons to

implement a specific component of the behavioural plan.

This person is called a professional with behavioural expertise.

As a general rule this person is introduced when the clinical supervisor wants to provide highly

specialized behavioural services that requires the contribution of a specialist.

The nature of this partnership depends on the child or youth’s needs. The clinical supervisor may simply

consult the specialist or the specialist may work directly with the children.

For example, a supervisor may determine when the child will receive supplemental ABA and follow a

nutritional program based on the behaviour.

If the clinical supervisor does not have the necessary nutritional expertise, he may ask a professional

who has done training and has expertise in the area to supervise the nutritional program.

In this case, the specialist might be an occupational therapist with in-depth knowledge or experience in

ABA services.

The clinical supervisor continues to supervise the other ABA services described in the OAP behavioural

plan.

This table sets out the roles and responsibilities of each member of OAP Clinical Team.

In January 2018, we updated the Clinical Team Guidelines to help promote the formalities, quality and

responsibilities of the OAP services.

In particular, new mandatory qualifications were set out for clinical supervisors.

As you can see in the blue frame on the slide, a series of qualifications has been set out by frontline

therapists.

To avoid service interruptions and to give the provider time to make the transition, we will gradually

integrate compliance with these requirements, which means that the clinical supervisor may continue to

provide the service as long as they make the effort to acquire the necessary qualifications within a given

timeframe.

Later this year we will indicate the deadline by which the OAP clinical supervisor must meet all of the

requirements and communicate to us all of the information regarding the government supports offered

to providers who wish to acquire the necessary qualifications.

For more information on the requirements related to the qualifications, see Section 5.4 of the OAP

Guidelines.

I’ll turn it back over to Sarah so she can address the next steps and resources.

Thank you, Jane. We’ve shared a lot of information with you today, although we have not been able to

cover all of the elements of the OAP.

This slide contains a screen capture of the webpage that we will develop with the practitioners on the

Ministry’s website.

It contains general information about the OAP, as well as links to tools for your use.

Also, other resources are available for families on the Ministry’s website, including documents intended

for practitioners.

I encourage you to visit the Ministry’s website.

Like I said at the beginning of my talk, we will hold a question and answer period available on the

Ministry’s website and at the end of this webinar.

So, consider visiting it regularly.

Before starting the question and answer session, I’d like to focus on the efforts we’re making to update

the OAP.

We will implement a review process on the quality of the session and the OAP behavioural plans.

We are launching a list of OAP providers to help families find a qualified service provider.

We will develop a common collection of OAP referral documents so that families can receive coherent

information on the services available under the OAP framework.

We are developing a transparent schedule for the OAP services in order to contribute to equitable

billing.

The Ministry continues to engage with clinical supervisors and service providers and other stakeholders

to continue to improve the OAP.

Jane and I thank you for taking the time to listen and we are available to take your comments and

answer your questions.

Thank you Sarah and Jane. Now that we’ve heard about the Ontario Autism Program, it’s time to hear

from you. Remember that you can send your questions via the box on the screen.

We will do our best to answer as many questions as possible.

Let’s get started. Our first question is for Jane. It is as follows:

What is the role of the clinical supervisor and how do they work with other professionals?

Jane Cleave. Thanks Lisa. So, the clinical supervisor is the behavioural specialist responsible for

overseeing all of the aspects of the child or youth’s behavioural plan and works closely with the family,

behavioural therapists and inter-professional professionals.

So, this supervisor can have several titles. For example, lead clinician or a similar title and they may work

for regional or private services.

They are responsible for the clinical certification that accompanies any OAP behavioural plan.

With regard to the direct funding option, the supervisor can also submit a budget for each behavioural

plan.

A family may work with a certain number of people outside the OAP, like a psychologist or physician, a

speech pathologist, or an occupational therapist, an educator or a social worker or even a worker with

an SSVD.

These plans set out the services in detail, such as providers may also be members of the Family Team if

the family decides to create such a team.

Supervisors are only responsible for evidence-based services for children under the behavioural plan and

must also be aware of services that are part of the OAP and the ones that the family can use to

coordinate the care dispensed to the child.

The clinical supervisors and other professionals must work together in a logical fashion for the family

and the types of services received.

For example, with the family’s consent, a clinical supervisor may organize telephone meetings, emails or

otherwise to discuss the child’s and family’s objectives with other professionals.

Occasionally, the supervisor may observe the other professionals who work with the child.

Lisa Cancian, thank you, Jane. We expect several questions on the Family Teams, so there’s a two-part

question for Sarah.

First, who organizes this team and furthermore, after six months, do all of the professionals work on the

evaluation together?

Sarah Hardy. Thank you, Lisa. So, the Family Team is established at the family’s discretion. It’s up to the

family if they want to obtain this type of structure.

The objective of this team is to coordinate and align the services the child receives outside of the OAP

with the services the child receives under the OAP framework.

The Family Team is comprised of members selected by the family or the youth.

The members of the Family Team may include the physician who works with the child, other family

members, service providers, educators, school representatives or any other community provider.

Furthermore, all of that is determined by the family itself.

If the family has chosen to create a Family Team, the FSW will call the first meeting or the first meeting

can be organized and called by the family.

During the first meeting, the team will need to decide on who will lead all subsequent meetings.

This person is called the Family Team Lead and must be identified at the first meeting.

Coordination can be given to any member of the team. The Family Support Work (FSW), or any other

person who offers collaboration services with the OAP.

Once the team has been formed, the members are expected to share data and any progress made by

the child to develop the Family Service Plan.

Meetings are to be held every six months, as determined by the clinical table.

Each team member must participate and contribute to the data collection and this is all set out in the

framework found on the Ministry’s website.

Lisa Cancian. Thank you, Sarah. The next question is as follows: What do you think about expanding the

number of qualified service providers in Ontario? That’s for you, Jane.

Jane Cleave. Thank you, Lisa. Well, we are working closely with industry partners to expand staffing for

ASD, particularly in remote rural regions.

Today the Ministry will launch a survey on Autism Spectrum Disorders service providers and this survey

is being launched in partnership with other partners, like Autism Ontario.

We encourage all partners to participate in this survey because this will help strengthen the connections

and qualifications with service providers.

In the short term, we expect to use this data to relocate funding to provide additional grants and to

develop targeted strategies to reinforce staffing in underserviced areas, such as the North and rural

regions.

To develop schedules with which specialists will need to comply under the new requirements of ASD

programs.

If you would like more information or to participate in the survey, please complete the survey at the end

of this webinar and confirm your consent with the Ministry so that it may contact you.

Lisa Cancian, Thank you, Jane. Sarah, what happens when a family declines the OAP FSW, but the FSW is

required to review the situation every six months?

Jane Cleave, ah well, thank you Lisa. The hope is that everyone will have access to the FSW.

That being said, the family may prefer not have a FSW, Family Support Worker.

It’s the family’s choice; if it chooses not have a FSW, that choice will be respected.

But the family can change its mind at any time.

If a family chooses not to use a worker, that will be documented in its service plan.

As set out in the clinical framework and in the OAP guidelines, the FSW is expected to provide an update

every six months.

If the family has chosen to form a Family Team as I spoke about earlier, that meeting gives all team

members the opportunity to share the progress based on the service plan.

When the team or the family has chosen a Family Team, a form of communication will be established,

namely when the Family Team will be updated and what the updates will be and their frequency.

If a family does not have a Family Team and it did does not meet with a FSW regularly because this is its

choice, updates are expected every six months, regardless.

Therefore, it is an opportunity to answer the family’s questions and to update all of the information in

the Family Service Plan.

Some families may not need the ongoing services of a worker, or the family feels that it is important to

touch base regularly.

Lisa Cancian. Thank you, the next question is for Jane.

The question is how does the OAP Family Team align with Ministry’s new guidelines for coordinated

service planning and the single service coordination plan?

Jane Cleave. Thank you Lisa. So, in some situations if a child receives services under the OAP with

complex therapeutic needs, the FSW may refer the family to a local coordination agency for coordinated

service planning.

In that case the support worker continues to work with the family and will participate in the coordinated

service planning to avoid duplicating efforts.

The OAP Family Team, if the family wishes to have one, with the family’s consent, may be part of the

team that develops the service plan, which may include, again with the family’s consent, providers from

the entire child services sector from the health and educational perspective who participate in servicing

the child or youth.

Therefore, a service planning coordinator may work with the family who was referred to the OAP.

In that case, the coordinator will work the OAP FSW and, with the family’s consent, the coordinator and

their team will be expanded to include the OAP FSW and clinician.

The Ministry works closely with coordinated services planning agencies to promote local alignment

between the FSW and the local coordinators as well as the OAP Family Team and the service

coordination team for children with complex therapeutic needs.

We know that in some communities certain plans have already been made to define the roles in order

to rationalize the family’s actions.

Lisa Cancian. Thank you, we have a question for Sarah regarding the OAP information sheet.

Does the worker need to review this sheet with the family?

Some families have received these sheets with no explanation; we are told not to write anything on the

line where the worker is required to sign.

Sarah Hardy. Thank you, Lisa. So, the purpose of this sheet was to give the family information about the

services available for children and youth through the OAP.

It’s a public document on the Ministry website.

The purpose of this information sheet is to support conversations with the families and to help them

understand the service possibilities.

Its purpose is not to replace the conversation with the family.

Also, this information sheet is expected to be used to clarify conversations with the family.

It should be presented to the family in person, so the document can be explained and the family can

have the opportunity to ask questions about the program and all of the information contained in the

sheet.

The sheet is to be signed before the OAP Family Service Plan is completed, at a logical time for the

family.

The information sheet may be useful at any time during the development of the Family Service Plan and

when the family decides on the type of service to which it would like to subscribe.

Depending on whether the family signs the sheet, it should be clearly explained that the family is only

signing to state that they have received the information.

This signature does not confine them to choosing one service or another under the OAP.

In the OAP information sheet, there is a signature sheet, as stated in the question, and the purpose of

that signature line is to give the family the opportunity to first acknowledge that they have received the

information and have had the opportunity to read and understand the question regarding the

information.

The Family Support Worker must sign to state that they will provide information and that they have

explained the information and also that he has answered the family’s questions. Thank you, Lisa.

Lisa Cancian. Thank you, Sarah. The next question is for you, Jane.

How is the Ministry going to ensure that private service providers will be available throughout the

province given that at this time most private service providers are in the urban centres?

Jane Cleave. Thank you, Lisa.

So, we know that staffing is difficult to obtain, particularly in rural and Northern communities and we

are continuing to work to fill that gap.

First, we are implementing the requirements for the OAP Clinical Supervisor, and this is to ensure better

continuity for families, particularly in areas where there are few service providers.

That means that in the interim, people who do not have the requirements yet, but who are working to

obtain and meet them, may continue to offer these services.

The Family Support Worker is also a good resource for finding a clinician.

To meet the capacity in the long term, we are working with our industry partners to train more

specialists.

Today, I remind you that we are going to launch a province-wide survey that will give us more

information on other initiatives that are being taken to increase staffing.

We have an advisory board that includes representatives from Northern Ontario, which helps us clarify

certain processes.

Lisa Cancian. Thank you, Jane. Sarah, what services can families access immediately?

Well, the OAP offers a wide range of services. Among others, if offers training support for families.

We’ve mentioned a few times that families may have access to the support of a FSW, a Family Support

Worker, who is the family’s main point of contact within the OAP and will help the family find services

and provide ongoing service to the family, like I said earlier.

Following initial contact with the FSW, families can determine when they access the service provided by

this worker.

Once the family has registered with the OAP and has confirmed their spot, we confirm the available

spot, the families will also receive fundamental services.

Those services may include a workshop, a seminar on autism, information about the services available

under the OAP, and so forth.

When developing the Family Service Plan, families will be made aware of the training available.

They will have access to these services based on their needs and strengths. These services might include,

for example, one-on-one training with the parents, online training modules that the family can do at

their convenience, support groups, consultations for interventions subject to mediation and also clinical

training days or even additional counseling on the services available as part of the OAP and outside of

the OAP.

Families are encourage to consult the local coordinators about the availability of support services in

their community.

Lisa Cancian. Thank you, Sarah. Jane, the next question is for you.

What are the new requirements in effect from a staffing perspective with regard to the behavioural

review?

Jane. Thank you, Lisa. So, the new requirements for Clinical Supervisors are set out in the Guidelines,

5.4.

All providers are encouraged to read them. OAP Clinical Supervisors must have one of the following

professional designations:

BCBA or BCABA, clinical psychologist with college training with documented expertise in ABA.

Clinical Supervisors must also have at least 3000 post-certification hours of ABA experience with

children and youth with ASD, and this is over and above their experience before writing the BACB exam.

Clinical Supervisors must also follow an exemplary practice, have or hold, rather, a certificate of

competence to work with vulnerable persons and comply with the code of ethics.

These requirements have been in place since January 15; now the period for compliance with this

requirements has been extended.

The Ministry will have a new deadline for compliance with these requirements; the deadline for

completing training.

That is to say, the stage at which all Clinical Supervisors will be required to fully comply with all of these

requirements will be announced later this year.

During this interim period, which we hope will be brief, although compliance with these requirements is

gradual, people who do not have these qualifications yet, but are working to obtain them, may continue

to dispense clinical care.

They are required to provide details about their plan for obtaining the qualifications, including a

deadline.

On the OAP Clinical Supervisor’s attestation, this form may be audited as part of the quality audit

process for the OAP behavioural plan, which will be filed a little later in 2018.

As I mentioned earlier, we are launching a survey today and we encourage you to complete it.

The results will shape staffing over time.

The Ministry continues to work with its industry partners to find ways to reinforce the skills of the

working staff, including study grants, as I mentioned earlier, to help practitioners obtain the

qualifications they need.

Lisa Cancian. Thank you, Jane. So the next question: how can schools be incorporated into the

behavioural plan?

Thank you, Lisa. Sarah, Sarah Hardy. We know that large part of children who receive services under the

OAP are also in school, as we mentioned earlier, as part of the presentation.

One of the key principles of the OAP is the inter-professional approach of the services, between OAP

clinicians, community clinicians and other support workers and others who help the children and youth

who learn at school, in the home or in the community.

When working with OAP children who also go to school, all service providers are encouraged to

collaborate with the local school boards.

Also expanding the number of ways that we can incorporate and guarantee the objectives by creating a

Family Team, creating a Family Service Plan and a behavioural plan.

Youth and families work with their Clinical Supervisor and their Family Support Workers, if they have

chosen to have the support of a FSW based on their objectives and priorities.

When an objective is tied to school, school staff should participate.

If the family has chosen to form a Family Team, they may want to communicate with an educator to

participate in the Family Team so as to allow for joint communication between the family, the Family

Service Plan and the behavioural plan.

I also spoke about the Family Service Plan. One of the key elements of the Family Service Plan is, in fact,

an education plan if the child wants it, and it is a plan that will be part of the Family Service Plan and

that will contribute to achieving the objectives of the Family Service Plan, but also the behavioural plan.

Lisa Cancian. Thank you, Sarah. Jane, can regulated professionals, like speech pathologists and

occupational therapists, provide care?

Jane Cleave. Well, thank you, that’s a question we’ve also had in the past.

As of January 15, 2018, Clinical Supervisors under the OAP, like I said in the previous questions, must

either have or be working toward obtaining the following professional title, among other requirements.

They must be either BACB accredited, or be a registered or associated psychologist with experience in

ABA.

In some exceptional cases, a speech pathologist or occupational therapist may offer part or all of the

service to the family.

There are three scenarios in which that could happen.

First, a Clinical Supervisor may have two qualifications; in this situation a Clinical Supervisor is working

toward obtaining the title that allows them to offer OAP services, or is also a speech pathologist or

occupational therapist.

A speech pathologist who holds, for example, the BACB title comes to mind.

A second scenario would be a therapist who has two qualifications in this situation.

If you have a service provider with enough experience to offer these services under the supervision of

the Clinical Supervisor, and who is also a speech pathologist or occupational therapist.

For example, an experienced occupational therapist who would work under the supervision of an

integrative psychologist who holds the title of BACB.

So, you also have the situation where a Clinical Supervisor who works with a speech pathologist or

occupational therapist can offer a specific service.

On the clinical level, the Clinical Supervisor may want to refer the family to a behavioural specialist for

some services of the plan.

In some cases, this specialist may be a speech pathologist or occupational therapist with extensive

behavioural experience.

The nature of this partnership depends on the needs of the youth or child; the clinical results may simply

be to consult the specialist, or the specialist works directly with the child.

Given that the supervisor is a common party, the ABA specialist does not need to be supervised by a

Clinical Supervisor.

That being said, the Clinical Supervisor is still responsible for confirming that the service provided is

evidence and behaviour-based and that the specialist has the necessary qualifications to provide the

services, and that the services are offered in an appropriate manner and in accordance with the family’s

goals. We gave the example of this situations in the presentation at the very beginning of the webinar.

To review, the example would be a Clinical Supervisor who determines that a child needs nutritional

service based on the behavioural plan.

The Clinical Supervisor would oversee the ABA services, but for example, does not have experience in

nutrition.

When the Clinical Supervisor asks the professional what nutritional and ABA training, the supervised

professional should provide the program.

That person might be a therapist who has a great deal of training and experience in dispensing ABA.

An example might be a child who is beginning to speak after having spent a great deal of time signing.

If it is basically a delay in speech pathology, speech therapy, in that case, the Clinical Supervisor may call

on a speech pathologist for an ad hoc or ongoing consultation to provide suitable speech therapy.

Lisa Cancian. Thank you, Jane. The next question is for Sarah and it confirms the budget for the OAP

plan.

So, how will the budget be developed?

So, the budget is essentially an established plan, the necessary services and the costs associated with

each of these services.

The Clinical Supervisor to whom Jane is referring is responsible for the service, both in terms of the

behaviour plan and the child as well as the budget associated with these services.

The Clinical Supervisor must submit these documents with a certificate to the unique service providers.

Hence, it is the Clinical Supervisor’s responsibility to calculate the necessary funding to obtain evidence-

based services, as set out in the behavioural plan.

One of the major changes we’ve announced, implemented in January, is that direct funding is now

granted and includes hours spent directly with the child, family or any member of the Family Team.

This includes the time to re-assess the child’s and the family’s needs.

It also includes an indirect travel rate, supplies and report writing and these costs should be included in

the price.

All of this should be documented in the behavioural plan budget.

It is also very important to note that Clinical Supervisors are required to comply with ethical billing as

determined by the code of ethics of the BACB and professionals in Ontario.

Like I said, this budget should be filed with the one-stop; it will be reviewed with the Clinical Supervisor.

The review consists simply of ensuring that the budget has been properly set out; that it contains all of

the necessary services.

We have developed instructions for the behavioural plan and we will also develop a few examples. You

can access them on the Ministry’s website in order to properly complete the budget template.

Lisa Cancian. Thank you, Sarah. Jane, how does the Ministry guarantee quality assurance for the OAP

behavioural plans?

Jane Cleave. Well, we have a quality assurance program that allows us to review the quality of the plans.

This program will be implemented this year, thanks to this process, the OAP plan was also developed by

regional service providers; they will randomly be selected using independent guides by third-party

clinicians.

We will have more information about this quality assurance process in the upcoming months.

Lisa Cancian. Thank you, Jane. Our next question is for Sarah.

Do you intend help teens until adulthood?

Excellent question. So, as you may have noticed in the orientation, one of the key elements of the

Family Service Plan is, in fact, transition.

The goal is to support youth and their families for those who can make the transition from the OAP to

adult and community support services, such as post-secondary education and employment.

As we said in the presentation, the Family Service Plan, which changes over time to take into account

the family’s needs and objectives and the child’s progress and objectives, as well as planning and

transition, as I just explained.

So, the Family Service Plan should include and focus on all of the planning and transition earlier in the

child’s life.

Youth, children and their families, like I said earlier, can also receive training to strengthen their skills

and this may include a transition to adulthood.

For example, there is specialized training that supports skills for independent living or obtaining a job.

Transition planning should be customized, set out in advanced and carried out in partnership with the

OAP providers, the family, the youth, and any educators or other service providers, if applicable.

These services, as well as childhood and training services, vary based on the needs identified for each

youth and his family.

Another important element to note is that youth with autism or a developmental delay sometimes

participate in the integrated transition planning.

The purpose of this is to allow those youth to have a unique integrated transition plan so they can

transition into adulthood.

At about 14 years of age, all youth with developmental delays may have access to a plan that prepares

them for the transition to adulthood and that gives them access to services in a coordinated manner.

Lisa Cancian. Thank you, Sarah. Next question: what qualifications are professionals with specialized

expertise required to have?

Jane. Jane Cleave. I spoke about that a few moments ago, in a few rare cases, the Clinical Supervisor has

both, in terms of function, the direct funding or direct services option to enter into a partnership with a

specialist to service a portion of the behavioural plan.

This is generally done when the Clinical Supervisor wants the child to received highly specialized services

for which they do not have the expertise and for which they require the participation of a specialist with

qualifications.

This specialist’s participation will vary based on the service provided; the Clinical Supervisor will confirm

that the professional has the necessary qualifications to provide the service they are seeking.

Lisa Cancian. Thank you, Jane. The next question is for Sarah: Will the Ministry provide information

about the OAP services?

Sarah Hardy. Thank you, Lisa. I spoke a bit about the information sheet developed by the Ministry to

provide basic information on the OAP and the services offered under the OAP, and this is publicly

available on the Ministry’s website.

For families who are new to access the OAP, they are also offered fundamental services in the first six

weeks of their enrolment in the OAP.

These services are offered by the regional providers directly to the families.

Like I said a little earlier, things such as workshops and seminars on autism and information on the OAP

or healthcare services.

Families will also receive fundamental information on the OAP from the Family Support Worker.

One fundamental element of the feedback received by the Ministry is to strengthen the standardization

of information documents and the Ministry is committed to creating information documents to

standardize including videos or other online resources to try to direct families who are new to accessing

the OAP.

This is one thing we are committed to doing and the information pages will be available shortly in that

regard.

Thank you, Sarah. We have about five minutes left for this webinar.

We will take one or two questions; the next question is for Jane.

How does the OAP ensure staffing models?

Jane. So, the OAP does not mandatorily designate the team members, except for the Clinical Supervisor.

Therefore, they have all the skills necessary to implement a good behavioural plan. People can choose

the type that is logical in terms of organization, based on the service model, provided their model

complies with the OAP guidelines.

Lisa Cancian. Thank you, Jane. One next question. Sarah, this is for you: if a family misses a session due

to illness or other unforeseeable circumstances, the agency bills; is the family required to pay for the

next session given that it must always pay for the therapist’s time?

Also, some families want to take holidays. How does this billing take that holiday period into account? Is

the family required to pay the hours missed under the contract?

Sarah Hardy. So, I will answer all of the elements of this question.

So, for the OAP direct funding option, all of the fees of a private agreement that are not necessarily

reimbursed, the Ministry is not responsible; fees associated with direct services options and the

professionals’ cancellation fees.

Parents are encouraged to ask all of the professionals questions in writing so they understand the

service fees they are taking on.

The decision to take a break from the child’s plan should be addressed with the Clinical Supervisors.

If there are major changes to the OAP behavioural plan due to a break or a new behaviour or a holiday,

the Clinical Supervisor should amend the budget to show when the service will be provided and how.

Clinical Supervisors who provide care should send this amendment to their one-stop.

If the break spans more than six months, and if funding is necessary, the Clinical Supervisor should

submit a new plan and a new budget to the one-stop.

Lisa Cancian. Thank you, Sarah. Jane, the next question is for you.

Will you verify the clinicians’ qualifications?

Jane Cleave. Thank you, Lisa. The Ministry will produce a public list to help families choose a qualified

provider under the OAP.

The list will include your formal process for verifying the qualifications of practitioners who want to

provide ABA services.

In the interim, Autism Ontario has updated the website to help families search for service providers.

The website includes a list of professionals from Ontario as well as those who identify as Clinical

Supervisors under the OAP.

That list also includes resources the families may access to choose a provider as well as tools, such as a

questionnaire administered to a potential professional.

Lisa Cancian. Thank you. So, this is the last question for this afternoon. The question is for Sarah: how is

the funding determined for each child and who makes the decision?

Sarah. If I understand the question correctly, I think it’s about the direct funding option, so that’s how I’ll

answer the question.

If a family has chosen to receive evidence-based care resources under the direct funding option, the

family must choose a provider, who in my opinion, is competent and meets its needs and we have tools

available on the Ministry of Child and Youth Services website to help families choose the providers.

Once the families have chosen the provider, the Clinical Supervisor works along with the family to create

the behavioural plan we talked about today.

We’ve already explained that the behavioural plan is based on the child’s needs and on the clinical

assessment done by the child’s Clinical Supervisor, and that will result in the clinical recommendations

for evidence-based services.

The plan will determine these services in detail and which services the child will receive through the

OAP.

I said a little while ago in the question regarding the budget, the Clinical Supervisors are responsible for

developing and sending a budget along with Clinical Supervisor attestation, each behavioural plan

developed.

Like I said, evidence-based services will be funded up to about $55 per hour.

So, I think we’re out of time so we will stop here.

Lisa Cancian. Thank you Sarah, it’s all the time we have. Thank you to Sarah Hardy and Jane Cleave for

sharing this information and thank you to each of you for attending.

We greatly appreciate your commitment.

At the end of this webinar, we encourage you to complete a questionnaire that will be displayed on your

screen.

Your feedback is valuable because it helps clarify upcoming webinars from the Ministry of Child and

Youth Services.

Thank you for attending and we hope you found this webinar useful.

We look forward to continuing to work with you to help families as part of the Ontario Autism Program.

Thank you and have an excellent end of the day.