Costing out the Tories’ Autism Cuts. (Subtitle: Ontario could have given every child their Childhood Budget six months ago — they chose to make kids wait).

A couple months ago I received this data from (someone else’s) Freedom of Information request. I’ve been sitting on it for awhile (been incredibly busy at work plus still recovering from pneumonia). It shows how many kids on the spectrum, as of March 31, 2019, were receiving support, and how many were waiting. I had never seen this data before:

I know that’s hard to read, so I entered the data into Excel.

As well, there was data by region:

I thought it would be interesting to take this data and cost out what the Tories’ various plans would have cost, had they been implemented.

Important note: We should not judge a program by how expensive it is. The problem with the Tories plans were not in the amount of money they were spending, but rather in how colossally wasteful they were (and still are) — how kids weren’t getting the help they needed, and Ontarians were seeing their tax dollars wasted. That said, it’s still worth knowing what they would have cost.

In a previous post I detailed the various Conservative plans. Let’s go over them one at a time.

Conservative System I — Introduced Feb. 6 2019, Killed Mar. 21 2019. Never implemented.

This was the introduction of the “Childhood Budget” model, where children would receive a maximum of $5,000 a year (for kids 6 and up), and $20,000 a year (for kids 5 and under) to spend on a variety of healthcare services, though most children would receive significantly less due to funds being clawed back based on parental income (aka the autism tax). Although the government claimed at the time they would not reduce the overall budget of the Ontario Autism Program, any reasonable estimate suggested it was a spending cut of at least $50 million a year.

Now we have exact figures for the number of kids under the age of 6 and over the age of 6, we can create a better estimate. What we don’t have as an idea of how much of the childhood budget would be clawed back thanks to the “autism tax”; to estimate this we’d need to know the income distribution of families with kids on the spectrum (as well, we’d need the “sliding scale” formula which the government has thrown into the memory hole). I’ve previously estimated it would be a 30% loss from the “tax”. I believe this is quite conservative and the actual value is closer to 50%. Of course, a responsible government would provide this information in a backgrounder, rather than forcing us to guess.

Using our costing calculator, we find that the cost of this program would be just a touch under $200 million. Given the budget under the previous government was $330 million, this represents an over $100 million budget cut, even when taking administrative and diagnostic costs into account.

Conservative System II — Introduced Mar. 21, 2019, Became Live on Apr. 1, 2019, First Childhood Budgets Received June 2019. Currently Live.

This was Conservative System I, with a handful of changes, most notably the abolishing of the “autism tax”.

This is a hybrid system, where kids currently in the system receive assistance based on the rules from the previous government, whereas kids who are waiting for service receive a childhood budget of $20,000 and $5,000.

We’re told that the Ontario government will spend $600 million on this system in 2019–20, though that money is vaporware; it didn’t show up in the budget and has not been approved.

Families have been slowly “invited” to apply for this new system as money comes available, so there is a waitlist to even apply. Had the $600 million been approved, there would be no waitlist. Here’s the math.

For the 10,365 kids in service, their cost is in the $330–360 million range. That doesn’t change (again, a hybrid system).

For the remaining 24,924 children, the cost of their Childhood Budgets looks as follows:

Add that $220 million for Chilhood Budgets to the $330–360 million spent on kids already in service, and you get something approximating $600 million. No need for waitlists.

But since the $600 million has yet to be approved, so roughly “23,000 children and their families [are] currently languishing on a waitlist for autism services.” (Todd Smith’s words).

That’s not to suggest that simply approving the $600 million would make things all better. Conservative Plan II is a colossal waste of money because the money isn’t targeted. Some kids get way more money than they need, to go out and buy a spare iPad. Others don’t get enough to pay for even 10% of the therapy they need. The government should have simply kept the old system until they come up with something better, rather than this execrable hybrid approach.

Of course, there’s two more Conservative Plans, because this isn’t confusing enough.

Conservative System III — Introduced Mar. 21, 2019, Killed Jul. 29, 2019. Never Implemented.

This program would have looked like Conservative System II, except with a “needs-based component”, which most likely would have been those larger cheques described above. Conservative System III would have a budget of $620 million, $300 million more than the Liberal system(s). (Here’s Minister Smith citing the $620 million figure).

No idea how to cost this, since we were never told what it would look like.

Conservative System IV — Introduced Jul. 29 2019, Details to be Released in Fall 2019. Planned Launch Date: April 2020.

Unlike Conservative Plan III, it would not simply have a “needs-based component”, but rather be a “needs-based system”, though it is unclear what that means in functional terms (e.g. would full-time ABA be covered? Will some form of DSO be re-introduced?). Also, the cost has been reduced by $20 million from Conservative System III, with a reduction from $620 million to $600 million.

We still have no idea what this looks like.

Summary

1. The original Conservative plan was a $100+ million dollar cut to health care for kids on the autism spectrum. That plan was killed after massive public outcry.
2. The government could, if it so chose, eliminate the wait list under their current plan by simply approving the $600 million they’ve promised for six months, but have yet to do so.
3. The government’s current plan is still a colossal waste of resources and should have never been implemented.
4. We still have no idea what the government has planned for April 2020.