ARCH Disability Law Centre | Fact Sheet – Requesting Accommodations at the Human Rights Tribunal of Ontario

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Submission to the Post-secondary Education Standards Development Committee regarding its 2021 Initial Recommendations Report

Consider the following scenario: I am a self-represented applicant at the Human Rights Tribunal of Ontario. I have a hearing coming up, but I need disability-related accommodations to participate in the hearing meaningfully. What are my rights?

What does the law say?

The Human Rights Tribunal of Ontario (the Tribunal) is required to provide disability-related accommodations to the point of undue hardship to parties accessing the human rights application process.
Undue hardship means that the accommodation would cause health and safety issues for other people, or that it would cost the Tribunal too much money.
Some examples of accommodations include documents in large print, extra breaks during the hearing, real-time captioning, recording the hearing, sign language interpretation, or an in-person hearing.
You may be required to provide some medical documentation to support your request for accommodation. You do not have to provide your specific diagnosis, but you are required to provide information about your disability-related needs and why the accommodation is required.
The Tribunal may deny your request for accommodation if it would cause undue hardship.
The Tribunal may work with you to determine an accommodation that meets your needs and is fair to all parties.

In practice – How do I make a request for accommodation?

Make a request for accommodation to the Registrar of the Tribunal as soon as possible to avoid delay.
Complete a Tribunals Ontario Accommodation Request Form. You can find the form here: https://tribunalsontario.ca/en/supports-and-services/request-an-accommodation. In the form, tell the Tribunal that you have a disability and explain why your accommodation is necessary for your disability-related needs.
Email the form to the Registrar of the Tribunal at HRTO.Registrar@ontario.ca

Do not send your request for accommodation to the other parties. If the Tribunal decides that your request for accommodation may have an impact on the fairness of the hearing for the other parties, the Tribunal may give the other parties an opportunity to make comment on the accommodation.

In practice – Are requests for accommodation private?

If you have concerns about the privacy over your medical documents, talk to a lawyer or a paralegal about whether you can get a Confidentiality Order over those documents, or whether you can use your initials in the case instead of your full name.
Your request may not be kept private by the Tribunal. Your request and the supporting medical documents might form part of the “Record” of your case at the Tribunal.
This means that some or all of your medical documents may be accessed by the public, if the public files a request to the Tribunal.

For More Information

Persons with disabilities who live in Ontario can call ARCH for free, confidential, summary legal information and advice. To find out about the type of legal advice ARCH provides and how to book an appointment, go to: https://archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download Requesting Accommodations at the Human Rights Tribunal of Ontario 3 MB – PDF

Tags: Accommodations at the HRTO

The Convention on the Rights of Persons with Disabilities (CPRD) is an international agreement that promotes and protects human rights for persons with disabilities. The CPRD says that persons with disabilities have the right to be treated equally, make their own decisions, have their rights respected, and participate in society.

Canada agreed to follow the Convention in 2010. The Convention has 50 articles, and 33 of these articles provide specific rights for persons with disabilities.

These rights include:

Accommodations at work;
accessible voting;
getting accessible information, and many other rights and freedoms;
living independently;
being part of the community; and
getting access to education.

Can complaints be made about violations of the Convention rights that affect many people?

Yes. These complaints are called “Inquiries.
If the United Nations Committee gets reliable information that governments in Canada are violating Convention rights broadly and systemically, the Committee can begin an inquiry.

What is the Optional Protocol?

The Optional Protocol is an additional part of the Convention.
Canada agreed to follow the Optional Protocol in 2018. This means that in some specific situations, persons in Canada can make complaints to the United Nations Committee on the Rights of Persons with Disabilities.
This United Nations Committee is a group of independent experts who monitor how countries follow the Convention.

Who can make an Optional Protocol complaint?

If a person believes that their Convention rights were violated, they can make a complaint. They must be personally and directly affected by the violation.
The person making the complaint can have a representative, like a lawyer, family member, or disability organization. However, this is not required.
Another person can make the complaint on behalf of the person whose rights were violated. If this happens, they must show that the person whose rights were violated agreed to the complaint being made.
Under the Optional Protocol, complaints about violations of an individual person’s Convention rights are called “Individual Communications.

When can someone make an Optional Protocol complaint?

Only if the same complaint has not already been made to the United Nations Committee or another United Nations body.
Only if the rights violation happened after December 3rd, 2018, or if the rights violation happened before December 2018 and also continued after that date.
Only if the complaint is about a violation of Convention rights.
Only after the person has already gone through all the relevant complaint procedures available in Canada. These could include legal complaint procedures like making a human rights complaint or going to court. These could also include administrative complaint procedures like asking a government official to review their decision.
The complaint procedures that are available will depend on how the person’s rights were violated, who is responsible for the rights violation, and when the rights violation happened.

Get legal advice if you want to know what complaint procedures are available for your situation.

What happens after someone makes an Optional Protocol complaint?

The UN Committee will tell Canada that a complaint has been made. Canada then has 6 months to send a written response to the Committee.
The person who made the complaint may get a chance to respond in writing.
The Committee will then make a decision.
It usually takes about 2 to 4 years to get a decision.

What decisions does the UN make about Optional Protocol complaints?

The UN Committee may decide to reject the complaint because it is not admissible. This means that the complaint did not meet all the requirements in the Optional Protocol and so the Committee cannot decide whether the person’s Convention rights were violated.
If the complaint is accepted (or admissible), then the Committee will decide whether the government has violated the person’s Convention rights.
When Convention rights are found to have been violated, the Committee will make recommendations to the Government of Canada about steps it should take to stop or prevent the rights violation. It is up to governments to decide whether to follow the Committee’s recommendations.

For More Information

To learn more about ARCH’s work to advance the Convention in Canada, go to https://archdisabilitylaw.ca/initiatives/advancing-the-un-CRPD/

ARCH offers public legal education presentations and free, confidential, summary legal advice about the Convention, the Accessible Canada Act, and other accessibility laws to persons with disabilities in Ontario. To find out more about ARCH’s services, go to: www.archdisabilitylaw.ca/services

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download What is the United Nation’s Convention on the Rights of Persons with Disabilities (CRPD) and the Optional Protocol?3 MB – PDF

Tags: CRPD Optional Protocol

What does the law say?

Ontario’s Human Rights Code (the Code) is a provincial law that says persons with disabilities in Ontario have the right to be free from discrimination in their employment.
Persons with disabilities are protected from discrimination in all stages of the employment relationship, including applying for a job, recruitment, interviews, returning to work after time off for a disability-related reason, and termination.
The law says that persons with disabilities have the right to access equal opportunities such as training, rate of pay, performance evaluations, and promotions.
The Code protects different kinds of employment relationships, including short-term work, part-time work, internships, and volunteer positions.

Duty to Accommodate

The Code says that employers have a duty to accommodate persons with disabilities. Accommodations are things that give persons with disabilities equal opportunity to get a job and perform their job in a meaningful way when they encounter barriers. Barriers at work may include:

physical barriers, such as inaccessible buildings, technologies or workspaces; and
non-physical barriers, such as attitudinal barriers, workplace rules, or job qualifications.

The duty to accommodate means that your employer has to listen to your request for accommodation and work cooperatively with you to find a solution that meets your disability-related needs. Your employer is required to pay for the accommodation.

How do I make a request for accommodation?

It is your responsibility to make your disability-related accommodation needs known to your employer.
It is best to make your request in writing as early as possible.
Accommodation requests should be made to the person who has the authority to put the accommodation in place, such as your boss, manager or Human Resources department.

Is my employer allowed to ask for medical information?

Your employer is allowed to ask for more information in order to understand your disability-related needs. The law says these requests are allowed as long as they are limited to only necessary information.
You do not have to share the cause of your disability or your diagnosis with your employer unless this information is necessary to accommodate you.
The kinds of information that may be important to share with your employer are:
- notes from your doctor explaining your abilities and limitations, and;
- how the accommodation is needed due to your disability.

I’m concerned about privacy. Will other people have access to my information?

The law says your employer must keep your accommodation request and any supporting documents confidential. The only persons who are allowed to have access to this information are those who need to be a part of putting the accommodation in place.

Note: federally-regulated employment

For employers that are federally-regulated (like the federal government, banks and air transportation companies), the Canadian Human Rights Act (the CHRA) applies instead of the Code.

For More Information

For specific questions about your situation, persons with disabilities who live in Ontario can call ARCH for free confidential, summary legal information and advice. To find out about the type of legal advice ARCH provides and how to book an appointment, go to: https://archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download My Rights at Work: Requesting Disability-Related Accommodations in Ontario 4 MB – PDF

Tags: Accommodation in the workplace

The Accessible Canada Act (ACA) is a law with the goal to remove disability-related barriers across Canada by 2040. The ACA aims to achieve a barrier-free Canada by identifying, addressing and preventing barriers. A barrier is anything that makes the full and equal participation in society difficult for persons with a disability.

Does the ACA impact persons with disabilities living in Ontario?

Yes! The ACA may remove barriers within the federal government and federally regulated private industries that impact persons with disabilities living in Ontario.

For example, the ACA may make it more accessible for persons with disabilities living in Ontario to:

work for the Government of Canada and other federally-regulated employers;
receive benefits like Canada Pension Plan – Disability or Employment Insurance;
apply for Disability Tax Credit and interact with Canada Revenue Agency;
travel on planes, trains and inter-provincial buses; and
file a complaint or have their case heard by the Canadian Human Rights Commission, the Canadian Transportation Agency, the Immigration and Refugee Board, the Canadian Radio-television and Telecommunications Commission, or the Social Security Tribunal.

The ACA is a federal law. What does this mean?

The ACA is federal accessibility legislation. This means that it only applies to organizations that are regulated by federal Canadian laws, not provincial and territorial laws. In practice, this means that the ACA may remove barriers that prevent persons with disabilities from:

travelling on railways, airplanes and inter-provincial buses;
being employed by or working for the Government of Canada, banks, mining companies, railways, airlines, trucking companies, and other federally-regulated industries or companies;
accessing federal buildings;
accessing federal programs and services, like Canada Pension Plan-Disability, Employment Insurance, Registered Disability Savings Plan, Disability Tax Credit, Canada Revenue Agency, Service Canada, the Social Security Tribunal, the Immigration and Refugee Board, the Canadian Human Rights Commission and Tribunal, and others;
communicating with federally-regulated service providers like railways, airlines, inter-provincial buses, telecommunications companies, and federal programs and services; and
using information and communication technologies, like television, radio and internet.

What does the ACA do to identify, address and remove barriers?

The ACA created Accessibility Standards Canada to develop accessibility standards.

The ACA gives powers to the Government of Canada, the Canadian Transportation Agency and the Canadian Radio-television and Telecommunications Commission to create new legal requirements for accessibility in federal:

Transportation;
Procurement of goods, services and facilities;
Employment;
Information and communication technologies;
Built environment;
Communication; and
Design and delivery of programs and services.

Under the ACA, organizations in federal jurisdiction must create accessibility plans. These plans must be developed through consultations with persons with disabilities. Organizations also need to create processes to receive and respond to feedback. They must report on their progress to implement their accessibility plans.

For More Information

ARCH conducted extensive legal analysis and advocacy to strengthen the ACA and as it was known before becoming law, Bill C-81. You can learn more about ARCH’s work at https://archdisabiitylaw.ca/accessibility-laws/accessible-canada-act.

ARCH offers public legal education presentations and free, confidential, summary legal advice about the ACA and other accessibility laws to persons with disabilities in Ontario. Persons with disabilities who live in Ontario can call ARCH for free, confidential, summary legal information and advice. To find out about the type of legal advice ARCH provides and how to book an appointment, go to: https://archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download What is the Accessible Canada Act?4 MB – PDF

Tags: Accessibility Laws Accessible Canada Act

When can my service provider refuse access to my records?

A service provider may refuse access to your personal health information if:

the information is legally protected, or was collected as part of an ongoing legal proceeding, or the law says you cannot have the information;
the information is part of an ongoing investigation about receiving services or benefits; or
granting access could result in a risk of serious harm to someone.

When the law limits access to your personal health record, a service provider must still give you the part of the record that is about you if it can be separated from the rest of the information.

Can I access my personal records from my attendant service provider? What does the law say?

Ontario’s Personal Health Information Protection Act, 2004 (PHIPA) creates rules about your personal health information. Personal health information includes any information about your physical or mental health, including your attendant service plan.
Service providers must follow the rules set out in PHIPA to protect your personal health information from improper collection, use, disclosure, or loss.
The Home Care and Community Services Act, 1994 states that a person receiving community services, such as attendant services, has the right to have their records kept private.
You have the right to have a copy of your personal health records.
The right to your personal health records does have some limits and exceptions.
If you want a copy of your records that don’t include your personal health information, you can only get the part of the records that can be separated from the other information.
Your service provider cannot refuse to give you a copy of your service plan.

In practice – How do I make a request to access my files?

Review Policies: Your service provider’s policies should describe what you need to do to get a copy of your personal information. Usually, you must make a request in writing.

Be Clear and Detailed: Make sure your request has enough detail so that your service provider can easily find what you are asking for. You can also ask your service provider to give you the information in an accessible format.

Expect a Reply: Your service provider must reply no later than 30 days after receiving your request.

More Information: Your service provider may ask for more information to help them find the record you want. They can also ask for additional time depending on the amount of information you want.

Fees for your Files: Your service provider cannot refuse to give you a copy of your service plan.

What can I do if my service provider refuses to give me my records?

If your service provider does not answer your request for records in time or refuses access altogether, you can complain to the Information and Privacy Commissioner of Ontario. For more information about complaining to the Privacy Commissioner, go to: www.ipc.on.ca

For More Information

Persons with disabilities who live in Ontario can call ARCH for free, confidential summary legal information and advice. To find out about the kind of legal advice ARCH provides and how to book an appointment, go to: www.archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download Service Rights in Attendant Services: Accessing Personal Information3 MB – PDF

Tags: attendant services

Is my employer allowed to say no to my request for accommodation? What does the law say?

According to the Ontario Human Rights Code, employers in Ontario have to make changes at work to help employees with disabilities such as modifying tasks, schedules, or workspaces unless doing so would be too difficult or expensive (cause undue hardship) or if the job has specific requirements that cannot be changed.

If your request for accommodation is a change to a job-specific requirement (justified job requirement), then the employer may be able to justify saying no to your request because that job-specific task is essential for the job that they hired you to do. To prove this, the employer must show that the job-specific task:

Is required to perform the job;
was put in place honestly and in good faith; and
cannot be changed without causing the employer unreasonable difficulty (undue hardship).

When this happens, the employer may be obligated to offer you another job that you are able to do.

Example:

Riley was hired for the job of delivery driver.
Riley’s disability-related needs prevent them from driving a truck.
Being able to operate a delivery truck safely is a justified job requirement.
Riley’s employer may be able to say no to their request but may have to work with them to find a different job that works for their needs.

Undue Hardship

The employer is not required to provide the accommodation if it causes the employer hardship that reaches the point of being “undue.” “Undue” is a legal term. The law says that only three things can be considered when considering whether an accommodation would cause undue hardship. These are:

Cost;
Outside sources of funding, if any; or
Health and safety requirements.

No other factors can be considered as “undue hardship.” For example, inconvenience is not an excuse for whether the employer is allowed to say no to your accommodation request.

If your employer shows you that your request for accommodation will cause them undue hardship, they are obligated to work with you to find a different accommodation that works for your disability-related needs.

Example:

Parker works at a small family-owned flower shop in an old building.
Parker requests that they install an elevator for their disability-related needs. Because Parker’s employer is a small business, installing an elevator may be so costly that it causes the employer undue hardship.
Parker’s employer may be allowed to say no to install an elevator if they can show undue hardship, but they are required to keep working with Parker to find another appropriate accommodation.

Note: federally-regulated employment

For employers that are federally-regulated (like the federal government, banks and air transportation companies), the Canadian Human Rights Act (CHRA) applies instead of the Human Rights Code. Some of the laws are different for these types of employment relationships.

For More Information

For specific questions about your situation, persons with disabilities who live in Ontario can call ARCH for free, confidential, summary legal information and advice. To find out about the type of legal advice ARCH provides and how to book an appointment, go to: https://archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download My Rights at Work: The Duty to Accommodate in Ontario and its Limits3 MB – PDF

Tags: Accommodation in the workplace

The Accessibility for Ontarians with Disabilities Act’s (AODA) goal is to remove disability-related barriers across Ontario by 2025 and beyond. It asks some organizations to find, remove, and make sure that there are no barriers that stop persons with disabilities from being fully included in society. Barriers are anything that stop persons with disabilities from equally participating in society.

Who does the AODA apply to?

The AODA applies to organizations under provincial jurisdiction. These include municipal or provincial government agencies or Ministries, non-profits and businesses. These are called “obligated organizations.
Obligated organizations have at least one employee and must follow the rules under the AODA.
The AODA has different rules depending on the size of the organization. A small organization has 1 to 49 employees and a large organization has 50 or more employees.

What are the requirements under the AODA?

The AODA requires that Standards are developed and become Regulation. Standards set some minimum requirements that help organizations identity, remove or prevent barriers in order to promote accessibility. There are currently five areas under the AODA. They are combined into one Integrated Accessibility Standards Regulation. They include:

Transportation: Transportation companies are required to use accessible equipment and features on their vehicles, routes and services. They must provide this information in accessible formats when asked. When accessible equipment is not working, companies must find other ways to accommodate passengers. They must also ensure that the equipment is fixed as soon as possible.

Information and Communication: Organizations must make information easy for persons with disabilities to access.

Employment: Employers must make their workplace accessible to potential or current workers with disabilities. Employees can be full-time, part-time, and seasonal or contract employees. This Standard does not apply to volunteers or unpaid persons.

Design of Public Spaces: Newly constructed or redeveloped communal spaces like sidewalks, parks, benches, parking spaces, or recreational trails accessible must be accessible.

Customer Service: Service providers must make their goods, services, and facilities accessible for customers with disabilities. This Standard covers any businesses or organization with more than one employee, including grocery stores, clothing stores or similar businesses.

In 2015, amendments were made to the Ontario Building Code that require accessibility features in all newly built or extensively renovated buildings.

For More Information

ARCH offers public legal education presentations and free, confidential, summary legal advice about the AODA and other accessibility laws to persons with disabilities in Ontario. Persons with disabilities who live in Ontario can call ARCH for free, confidential, summary legal information and advice. To find out about the type of legal advice ARCH provides and how to book an appointment, go to: https://archdisabilitylaw.ca/services.

You can also contact ARCH by telephone at 1-866-482-2724, teletypewriter service (TTY) at 1-866-482-2728 or by email at intake@arch.clcj.ca.

This information is not intended to be legal advice. Consult a lawyer or legal worker if you need legal advice on a specific matter.

This information is current as of September 2025.

Download What is the Accessibility for Ontarians with Disabilities Act?3 MB – PDF

Tags: Accessibility for Ontarians with Disabilities Act Accessibility Laws

Submissions of ARCH Disability Law Centre to the Standing Committee on the Legislative Assembly regarding Bill 37, An Act to enact the Fixing Long-Term Care Act, 2021 and amend or repeal various acts

November 25, 2021

A. Introduction

ARCH Disability Law Centre welcomes the opportunity to provide written submissions on Bill 37, An Act to enact the Fixing Long-Term Care Act, 2021 and amend or repeal various acts to the Standing Committee of the Legislative Assembly.

The fundamental principle of Bill 37 is that “a long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met”.

However, this essential goal has not been met by Bill 37. The Bill fails to modernize a long-term care system that is woefully out-dated, underfunded, understaffed and that has desperately failed Ontario’s seniors. Bill 37 is primarily a restatement of the current Long-Term Care Act 2007 and does not deliver a transformed and improved sector, as recommended by the Marrocco Commission [1].

The concerns raised and recommendations offered herein flow from a fundamental concern that Bill 37 does not contemplate or address the particular, complex, and specific needs of seniors and persons with disabilities.

Similar to other pieces of legislation, Bill 37 has been quickly pushed through provincial parliament[2]. Bill 37 was introduced on October 28, 2021. The legislature rose for a week, and when it returned on November 17, Bill 37 received second reading and was referred to this Standing Committee on November 18, 2021. Oral submissions were made from November 22 – 25 and written submissions are due November 25, 2021. There is little time afforded to interested advocacy groups to make their concerns about Bill 37 known. There is only a slight nod to public consultation, sending the message that this government is uninterested in public consideration and discourse on important issues affecting persons with disabilities and seniors. Indeed, given this short timeframe, ARCH was unable to meaningfully consult with communities of persons with disabilities and those who support them. Our submissions rely on the work we have done with marginalized communities but has not been informed by direct consultation with those impacted by this Bill.

Finally, the title of the proposed legislation is misleading. Bill 37 doesn’t “fix” the documented problems in the long-term care sector. A careful analysis of Bill 37 demonstrates that language is added to make it appear that the government is doing something, when it is actually maintaining the status quo. Younger adults with disabilities and seniors deserve so much more than a restatement of the current Act, particularly against the background of COVID-19 and substantial criticism that the current legislation fails society’s most vulnerable.

Recommendation:

1) This government should withdraw Bill 37, conduct meaningful consultations with seniors, persons with disabilities and/or their families, carers and rights advocacy groups so that Bill 37 addresses important considerations based on lived experience.

B. About ARCH

ARCH is an Ontario-based specialty legal clinic that is dedicated to defending and advancing the equality rights of persons with disabilities. ARCH is governed by a volunteer board of directors, a majority of whom are people with disabilities. ARCH provides a telephone summary advice and referral service and represents individuals as well as provincial and national disability organizations in test case litigation at all levels of tribunals and courts. We provide education to persons with disabilities on disability rights and to the legal profession about disability law. We make submissions on matters of policy and law reform. ARCH maintains a website at: www.archdisabilitylaw.ca

The comments and recommendations herein are informed by ARCH’s legal work which includes the direct representation of persons with disabilities, and working with community organizations and disability groups, on issues related to long-term care facilities.

C. Issues and Recommendations

I. Younger Persons with Disabilities Should Not Be Housed in Long-Term Care Facilities

Bill 37 ignores the unfortunate reality that many persons with disabilities who are under age 65 are forced to live in long-term care facilities because of the paucity of options available to them. Recent statistics show that 7% of all residents in long-term care homes are persons with disabilities aged 19 – 65. [3]

ARCH supports the rights of persons with disabilities to live with dignity in their chosen community, to fully participate in all aspects of their life, and control and make decisions and choices about issues that affect them. Article 19 of the Convention on the Rights of Persons with Disabilities confirms the essential right to live independently and be included in the community [4]. However, these important values are undermined if persons with disabilities are denied choices about where, and with whom, they live.

Young adults with disabilities do not belong in facilities where it is difficult to form friendships or relationships with persons who are at the end stages of life, or with persons who have different life experiences and interests than they do. Loneliness and social isolation can result from the lack of peers of a similar age. Programming frequently does not meet the needs of younger adults with disabilities and it is next to impossible to individually tailor programs or services to engage and keep younger people active. Staff may not be trained to provide appropriate services to a younger cohort. There is an emotional toll and significant grief to contend with when people around you are dying. Younger people with disabilities may age more quickly when surrounded by aging and dying long-term care residents.

The absence of effective community supports, which would allow younger adults with disabilities to live in and age in their own homes, is a fundamental barrier to independent living. The lack of supported, affordable, and accessible housing is another barrier younger adults with disabilities face. However, reliance on the long-term care system to house persons with very different needs will continue if the government does not make it a priority to provide adequate community supports or appropriate housing. The government must create options that give younger persons with disabilities choice and control over where they live, and with whom.

Recommendations:

2) The government must adopt the principle that a person with a disability cannot be deprived of choice and control regarding where they live, with whom they live, their lifestyle and daily activities.

3) The government must invest in community supports and services for young adults with disabilities, so they can live and age in a setting or community of their choice.

4) The government must invest in affordable, accessible and appropriate housing options for young persons with disabilities to enhance choice and decision-making options.

II. Remove “Mission-driven” from the Legislation

Bill 37 erodes government commitment to non-profit organizations. It opens the door wider to for-profit operators to enter, as long as they are “mission-driven”.

Newspaper coverage and the Long-Term Care COVID-19 Commission Report[5] have shown us that the death toll of seniors, and persons with disabilities, in long-term care homes was primarily in for-profit settings. However, instead of pushing for more public sector control over long-term care, this government has affirmed its commitment to private sector operations and management as long as they are “mission driven”. Mission-driven is not defined in the Bill.

It has been well documented that for-profit housing represents a conflict of interest in long-term care settings.

After almost 4,000 deaths in long-term care facilities, this government has not heeded the urgent signal that drastic change is necessary to protect long-term care home residents from degrading and hostile living settings, where profit can override considerations of quality of life and quality services.

The current Act commits to the delivery of long-term care by non-profit organizations. Given the horrific backdrop to the proposed legislation, we expect nothing less than a renewed commitment to non-profit management of long-term care.

Recommendation:

5) The government remove any reference to mission-driven organizations in the proposed legislation.

III. The Bill of Rights and Enforcement

Many of the current rights under the Bill of Rights have been simply moved around under the proposed Act. Additional rights have been added, and while we do not want to detract from their importance, the fact is that these additional rights are already mandated by the Ontario Human Rights Code. However, ARCH’s primary concern is how these rights can be enforced.

ARCH has not been able to find any decisions where the Bill of Rights has been the subject of a breach of contract action in courts. Enforcing rights through the courts is time consuming and expensive, with many procedural rules that must be followed.

The Health Service Appeal and Review Board (HSARB) is established to decide cases about quantity of service complaints. ARCH believes that the jurisdiction of HSARB could easily be expanded to include quality of service complaints and breaches of the Bill of Rights. Administrative tribunals have flexible processes, with fewer evidentiary rules, and can more quickly resolve grievances so they do not fester. HSARB has a pre-hearing or mediation process that happens quickly, and attempts to settle disputes before a hearing begins.

If the government does not want to rely on HSARB to resolved breaches of the Bill of Rights or quality of services complaints, then ARCH recommends that a different, but similar, independent administrative body be established to determine grievances in an expeditious and non-adversarial manner. Residents and staff must continue to work together and collaborative approaches to dispute resolution help to maintain a positive working relationship without fear of reprisal.

Recommendations:

6) Expand the jurisdiction of the Health Services Appeal and Review Board to hear appeals on the quality of services provided to resident by living in long-term care, in accordance with the Bill of Rights.

7) Alternatively, the government must establish an independent tribunal responsible for resolving quality of service complaints and reaches of the Bill of Rights.

IV. Enforcement By Annual Surprise Inspections

Bill 37 does not reintroduce annual surprise inspections. ARCH believes that the only way to maintain quality standards and quality services in long-term care facilities is to have annual surprise inspections. These would add to quality control measures. They would encourage long-term care facilities to be proactive in the services it provides.

Recommendation:

8) Bill 37 be amended to require annual surprise inspections of all long-term care facilities.

V. Service Targets

Bill 37 introduces an improvement for residents by recommending that an average of 4 hours of direct service be provided to them. However, these targets are a restatement of promises made in the 2020 budget. The end date for implementation of these services is 2025. Back loading the introduction of direct care to residents by 2025 is insupportable. Residents need direct services now, not in four years when many current residents will not benefit from these dedicated service targets.

Four hours of direct care per resident is based on an average across the long-term sector. ARCH strongly recommends that the four hours of direct service average be calculated on a per resident per facility basis. This would significantly increase the amount of services a resident can expect, that best meets their changing needs as they age.

In addition, facilities must be required to publicly report that they are meeting the standard of four hours care per resident, so they can effectively be monitored in reaching this goal. Explanations regarding why service targets are not being met must also be publicly reported.

Moreover, no consequences for failing to meet the four hour standard of care are spelled out in the legislation. Penalties must be imposed on facilities that do not meet this standard of care, otherwise the provision can be virtually meaningless.

Recommendations:

9) The target of four hours of direct care for residents must be implemented immediately.

10) The average of four hours per resident should be calculated on a facility by facility basis.

11) Facilities are required to publicly report that they are meeting the four hours of direct services per resident. Explanations must be provided if the four hour standard is not being met.

12) Meaningful penalties must be imposed for failure to meet the four hour direct service average.

VI. Address the Staffing Crisis

ARCH relies on and adopts the critical submissions and recommendations of the United Steelworkers[6] on this important topic.

D. Conclusion

Throughout these submissions, ARCH has highlighted some of the underlying issues in the Long-Term Care sector that must be addressed by Bill 37. ARCH believes that if the recommendations included in these submissions, as well as the thoughtful submissions and recommendations from other rights’ based advocacy groups, are implemented, an improved framework for persons with disabilities and seniors will result.

Thank you for the opportunity to provide our submissions on this important Bill. If you have any questions or if ARCH can be of further assistance, please do not hesitate to contact us.

Appendix A

Recommendations