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a a 3 3 lack of access to a computer or online device, lack of permanent address or phone number,
prevalence of disinformation, lack of applicability or exclusion from advice given, inability
to reach vaccination sites, lack of speed needed to complete competitive booking
scheduling systems, lack of usability of online portals with alternative access systems
available, lack of literacy, and lack of status or power in a social unit. Additionally, the
current system for general access to booking vaccine appointments relies on adequacy of
technology which requires money (e.g. properly functioning computer, phone, internet,
etc.). It also requires skill. In the same way as technology savvy individuals can compete
for the best concert tickets, those with stable access to the system also require a high level
of speed in order to navigate the portal and make their booking.
13. Individuals who experience marginalization frequently learn that general public advice
does not apply to them. Scientific data is about the average or typical person within a
population. Simple guidance for the general population assumes many things that are
unavailable to marginalized individuals. For advice and services to reach individuals who
are excluded from the majority or average public, requires designing from their situation
and specifically addressing their highly diverse needs.
14. Other jurisdictions, such as Detroit have given specific assurances and commitments to the
disability community (Exhibit "6" and "7"). Several efforts in Europe have also arranged
for mobile vaccination units and house calls to reach people with disabilities who are
unable to leave their homes.
15. In Ontario, to my knowledge, no similar province-wide commitments have been made.
4 Digital
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circumstances,
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\ has intensified during the pandemic and has led to untenable anxiety and a frequent sense
of hopelessness.
24. Knowledge of data science should make obvious that while the vulnerability of disability
is invisible to standard statistical analysis, disability is at the extremes of every other
vulnerability group. In addition to the health-related vulnerabilities, people with disabilities
are also most vulnerable to the other negative impacts of the pandemic such as
unemployment, isolation, and digital exclusion. Most of the directives do not take into
account the barriers faced. For example, directives such as avoiding close contact when an
attendant is required, physical distancing when you cannot see, washing hands or donning
a mask when you cannot do this independently, and arranging for a test when the booking
system is inaccessible to you fail to account for the particular needs of persons with
disabilities. Addressing the needs of people with disabilities will help reach the most
vulnerable edge of the population, including the unidentified and unexpected
vulnerabilities.
25. Barriers and exclusion compound. Any one form of exclusion will render an individual
more vulnerable to other forms of exclusion. Among these vulnerabilities to
marginalization are race, language, poverty, gender, homelessness, and disability. One of
the compounding consequences of marginalization is the erosion of trust in public services
and institutions.
Its Not Too Late
26. If we are to reach the highly diverse vulnerable persons in our communities, we must
develop strategies that begin with an understanding of their lived experience and the
7 Conclusions
27.
28.
29.
30.
barriers guidance
Ontario
trusted
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of
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member, member, member
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member member member
Member,
Parliamentary
to
Accessibility
Editor,
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Board
Privy Steering
Accessibility
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Inclusive
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{Web
and
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Service
Industry
Architecture
ATAG
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Tutor
Toronto
and
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Design
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ISO/IEC
Council's
CollectionSpace
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Decapod
Secretariat,
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Accessibility
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Communication
UN
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(2006-)
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Roles
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the
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of
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for
for
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Health
external
{2008-)
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on
Ontarians
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Ontarians
(2009-2010)
Advisory
Accessibility
Web
Strategy
Force,
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Canadian
Consultant
Panel
Tool
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Initiative)
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International
for
Committee
Access!
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on
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{2008-)
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of
advisory
Accessibility
on
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(2007-2011)
Accessibility
AODA
{IDRP)
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Accessible
Board,
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Advisory
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with
Education
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E-learning
Look
Hamilton,
(2008-2010)
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Fund
on
Standards
Hamilton, Ontario,
of
Disabilities
HRDC
committee
Canadian
Inclusive
the
and
(2012-)
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Panel,
Technologies
Act
Committee
and
Guidelines)
Working
Learning
Royal
Feel,
specifications
Post-Secondary
Ontario,
AODA,
Social
Development
(2018-2020)
Information
Museum
Act
group
Architectural Industry
on communications
World
group
and Advisory
Affairs
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{1981-1983)
member
and
{1981-1983)
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of
Canada
panel
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Human
Students:
Committee
Council
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Development
Web
Rights
Consortium
A
of
Partnership
and
{GAATES)
Canada
Committee,
the
(RAIC),
of
12 • Advisor on Accessibility, MIT Physics Dept., Distance Education Project • Advisor, PEARL Project, Open University, UK • Member, Trace Centre, Advisory Panel, University of Wisconsin • Member, Texas Task Force on Accessible Textbooks • Expert Witness, Australian Human Rights Commission • CRTCexpert witness and technical expert Accessibility hearings Net Neutrality hearings • Expert Witness Canadian Human Rights Charter Challenge • EU4AII advisory panel • OECD consultant to Industry Canada Minister - OECD meetings in Korea (preparation of briefing and resolutions) • AODA, Minister's Advisory Committee {Information and Communication Standard) • UNESCO workshop on Open Education Accessibility expert member
Research and Development Projects funded (since 1995 in chronological order)
• "Accessibility Toolkit" funded by CANARIE and SoftQuad Inc., 4/1995-12/1997, (2.7M) • "Special Needs Opportunity Window" funded by Technology Incentive Partnership Programme, 6/1996-6/1998($650K) • "Info-ability" funded by Ministry of Citizenship and Culture, 9/1996-10/1999, ($7S0K) • "Audio Look and Feel" supported by Sun Microsystems, 9/1997-3/1998, ($75K) • "A-Prompt" funded by RERC(US) through Trace Centre, University of Wisconsin, 10/1998- 6/1999, ($75K) • "Providing Education by Bringing Learning Environments to Children" supported by CANARIE, Royal Bank of Canada, The Bay, Wayne Gretzky Foundation, 6/1994-present, (~$860K) • "Adding Feeling Touch and Equal Access to Distance Education" funded by CANARIE, 3/1998- 6/1999, ($2S0K) • "Toward Inclusive Education for all Learners", funded by Telecommunication Access Partnership, 5/1999-5/2001($680K) • "The Intelligent Guide" funded by Bell Emergis, 6/1999-6/2001, ($250K) • "Courseware Evaluation" funded by Office of Learning Technologies, 9/1999-9/2001, ($68K) • "Evaluation of Special Needs Opportunity Windows" funded by Office of Learning Technologies, 9/1999-9/2001, ($72K) • "Input Optimization Tool for Complex Software" funded by CITO, 9/2000- 9/2001, (lO0K) • "Promoting Early Intervention for Learning Disabilities (Programming Working Group)" LDAO as lead, funded by Children's Secretariat, (145K to ATRC) • "Community Information Access Project" Canadian Abilities Foundation as lead, funded by Ministry of Citizenship and Culture, (BOKto ATRC) • "Learning Disabilities Resource Community" funded by Office of Learning Technologies, 9/2000- 9/2002, (250K) • "Inclusive Access Compliance Tool" funded by Nortel Networks, (BOK) • "Application Software for Access by Users with Disabilities", funded by Nortel Networks, 3/2000-12-2000 (30K) • "Barrierfree Access to Broadband Learning Environments" funded by CANARIE, 6/2000 3/2002, {1.3M)
13
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• • • •
• •
• •
• •
• •
• •
• •
• •
• •
• •
• •
• •
• •
"FLOE" "FLOE"
2009-2010 2009-2010
and and Design Design "Inclusive
"AEGIS "AEGIS IOF) IOF)
"Inclusive "Inclusive
"AccessForAII "AccessForAII
"OpenCast"led "OpenCast"led
"Fluid "Fluid
"SNOW," "SNOW," AODA AODA
"Signlink," "Signlink,"
"SCYP," "SCYP,"
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"ATutor," "ATutor,"
CANARIE, CANARIE,
"AEGIS" "AEGIS"
2009, 2009, Association, Association, "CulturAII "CulturAII
Fluid, Fluid,
"CollectionSpace," "CollectionSpace,"
"Inclusive "Inclusive
"Access "Access
Foundation, Foundation, "Elearning "Elearning
"Smart "Smart "Flex-EC" "Flex-EC"
9/2001- "CulturAII" "CulturAII"
"Web "Web
programme, programme, "Stretch" "Stretch" {125K) {125K)
"New "New
"Canadian "Canadian
"Model "Model
"Opportunities "Opportunities
"E-Collab: "E-Collab:
"The "The
"Web4AII" "Web4AII"
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Flora Flora
Inclusive Inclusive
Case Case
funded funded
Technologies Technologies
(~sooK (~sooK
Based Based
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Information Information
Ontario" Ontario"
funded funded
Campus Campus
funded funded
Code Code
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3/2002, 3/2002,
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funded funded
the the
funded funded
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funded funded
01/2003-03/2004, 01/2003-03/2004,
Design Design
Change," Change,"
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2.0" 2.0"
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Software Software
Network Network
funded funded
(145K) (145K)
funded funded
funded funded
funded funded
6/2001-9/2002, 6/2001-9/2002,
2008, 2008,
Teaching Teaching
01/2003-03/2004, 01/2003-03/2004,
Gap," Gap,"
to to
by by
of of
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Canada" Canada"
funded funded
by by
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Andrew Andrew
ORF-
{30K) {30K)
by by
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by by
by by
by by
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U. U.
Foundation, Foundation,
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Commission Commission
(1.2 (1.2
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funded funded
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by by
Ministry Ministry
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Andrew Andrew
Berkeley Berkeley
Accessible Accessible
Industry Industry
Canadian Canadian
Canadian Canadian
Research Research
Tool," Tool,"
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by by
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Andres Andres
M, M,
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funded funded
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W. W.
for for
Canadian Canadian
Museum Museum
and and
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375K) 375K)
funded funded
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by by
by by
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{300K) {300K)
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W. W.
of of
for for
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Heritage, Heritage,
Ontario Ontario
06/2003-03/2004, 06/2003-03/2004,
Canada, Canada,
Ministry Ministry
Andrew Andrew
Flora Flora
W. W.
funded funded
2009-
by by
FP7 FP7
with with
{1.4M) {1.4M)
Excellence Excellence
Education, Education,
Heritage, Heritage,
Heritage, Heritage,
funded funded
Mellon Mellon
Domain Domain
Cultural Cultural
Citizen Citizen
Youth Youth
Tool" Tool"
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of of
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programme, programme,
Foundation Foundation
Hewlett Hewlett
Disabilities" Disabilities"
2010 2010
of of
the the
by by
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Canada Canada
funded funded
by by
Ministry Ministry
W. W.
11/2001-08/2002, 11/2001-08/2002, 03, 03,
of of
Standard, Standard,
by by
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funded funded
Financial Financial
Foundation, Foundation,
through through
funded funded
Sun Sun
The The
Architecture" Architecture" Engagement" Engagement"
Exchange" Exchange"
Moving Moving
CCOP CCOP
2008, 2008,
Industry Industry
Foundation, Foundation,
Community Community
by by
Mellon Mellon
Fund Fund
Bell Bell
(1.6 (1.6
2003-03/2004, 2003-03/2004,
2008, 2008,
2008, 2008,
Research Research
Foundation, Foundation,
Microsystems, Microsystems,
Andrew Andrew CCOP CCOP
CANARIE, CANARIE,
Foundation Foundation
programme, programme,
by by
University University
M, M,
of of
programme, programme,
{SlK) {SlK) by by
03/2007 03/2007
by by
2009-2014, 2009-2014,
2008, 2008,
funded funded
Broadband Broadband
(114K (114K
Services," Services,"
(60K (60K
Ministry Ministry
(188K) (188K)
Image, Image,
09/2006-
Foundation, Foundation,
Culture, Culture,
Canada, Canada,
128K 128K
Industry Industry
Ministry Ministry
programme, programme,
funded funded
2008, 2008,
Infrastructure Infrastructure
W. W.
and and
to to
2008, 2008,
(travel (travel
funded funded
funded funded
10/2002-03/2004, 10/2002-03/2004,
annually) annually)
to to
by by
funded funded -
Mellon Mellon
ATRC, ATRC,
2010-2016 2010-2016
Labs, Labs,
(227K) (227K)
for for
of of
(160 (160
Social Social
2008, 2008,
03/2009 03/2009
ATRC) ATRC)
(SOOK) (SOOK)
04/2005-
2004 2004
SSHRC, SSHRC,
Canada, Canada,
funded funded
03/2008 03/2008
of of
by by
11/2001-
(2.4 (2.4
04/2005-03/2007, 04/2005-03/2007,
Web Web
(1.19 (1.19
Community Community
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grant grant
Education, Education,
04/2009-
by by by by
Canadian Canadian
01/2007- to to
SOOK SOOK
04/2007-03/2009, 04/2007-03/2009,
to to
Foundation Foundation
M) M)
by by
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(245K) (245K)
Treasury Treasury
HRDC, HRDC,
Applications," Applications,"
ATRC) ATRC)
M) M)
2003-2005, 2003-2005,
2006 2006
by by
Andrew Andrew
as as
2009-2014 2009-2014
(2.5 (2.5
2005-2006 2005-2006
{lO0K) {lO0K) (2.620M (2.620M
03/2006 03/2006
overall) overall)
07/2002, 07/2002,
the the
Canadian Canadian
M) M)
01/2003-10/2003, 01/2003-10/2003,
04/2010, 04/2010,
Heritage, Heritage,
(312K) (312K)
01/2010, 01/2010,
2009-2014 2009-2014
and and
Ontario, Ontario,
Canadian Canadian
{1.2M) {1.2M)
2008, 2008,
Board Board
W. W.
and and
Social Social
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(SOOK) (SOOK)
(60K (60K
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funded funded
participant) participant)
(SSK) (SSK)
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2003-2007-
(400K) (400K)
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to to
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with with 14 14
Recent Recent
• •
• •
• •
• •
• • • •
• •
• •
• •
• •
• •
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• •
• •
• •
• •
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CANARIE CANARIE
Canadian Canadian
2003 2003
2005 2005
2008 2008
2008 2008
2008 2008
2009 2009
2008 2008
2009 2009
2011 2011
2012 2012
2013 2013
2013 2013
2014 2014
2020 2020
Social Social (1.69M) (1.69M)
Intelligent Intelligent
Project Project
Coding Coding
Future Future TIPP TIPP
to to
Platform Platform
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Accessibility Accessibility
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(25K) (25K)
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IDRC) IDRC)
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2007 2007 Pilot, Pilot,
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2019-2022, 2019-2022,
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for for
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2017 2017
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York York
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New New
Maryland Maryland
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Book Book
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1995 1995
1997 1997
1998 1998
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Treviranus, Treviranus, Treviranus, Treviranus,
Treviranus, Treviranus,
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Journal Journal
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Inclusion. Inclusion.
Taylor Taylor
transformed transformed
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International International
Christensen Christensen
Association Association
Essential Essential inclusion inclusion
https://doi.org/10.1007/978-1-4471-7440-0_20 https://doi.org/10.1007/978-1-4471-7440-0_20
pp Montreal, Montreal,
Phenomenology Phenomenology
Manser, Manser, pp.40-63. pp.40-63.
Dublin). Dublin).
Harper Harper
M., M.,
D., D.,
S., S.,
S., S.,
Dunlop, Dunlop,
J., J.,
Treviranus, Treviranus,
.
14-15. 14-15.
J. J.
(2016): (2016):
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and and 1/47 1/47 3/16/2021 Information and Communications Standards Development Committee I Ontario.ea • Robert Gaunt, .CNJB • Gary Malkowski, Canadian Hearing Society • Jutta Treviranus, Inclusive Design Research Centre • Mattieu Vachon, Conseil des ecoles publiques de l'Est de l'Ontario • Diane Wagner, Learning Disabilities Ontario • Chantal Perreault, Regional Municipality of Niagara • Kevin Shaw, TellMe TV lnc., • Louie Di Palma, Ontario Chamber of Commerce
Non-voting members:
• Kathy McLachlan, Ministry for Seniors and Accessibility • Kate Acs, Ministry of Education • Michele Babin, Ministry Advanced Education and Skills Development • Adam Haviaras, Ministry of Tourism, Culture and Sport Scope and timelines
A standards development committee will review the information and communications standards, as prescribed in Section 9 of the Accessibility for Ontarians with Disabilities Act. It is summarized as follows:
• re-examine the long-term objectives of the standard • if required, revise the measures, policies, practices and requirements to be implemented on or before January I, 2025, and the timeframe for their implementation • develop another proposed accessibility standard containing modifications or additions that the committee deems advisable for public comment • make such changes it considers advisable to the proposed accessibility standards based on comments received and make recommendations for my consideration
The committee should also consider all possible solutions and tactics, including non-regulatory approaches.
The Ministry for Seniors and Accessibility has undertaken research and consultations with people with disabilities, obligated organizations and some industry experts.
Feedback
The majority of feedback and findings relate to accessible website requirements under the standard. The Ministry for Seniors and Accessibility heard that the need for accessible digital communications is increasingly important to people with disabilities. For obligated organizations, flexibility to adapt to advancements in technology, while balancing the need for clear compliance requirements is a challenge, and these challenges may be unique based on sector (public or private).
Common difficulties in the Canadian and international experience with technical requirements similar to this standard presents the opportunity for Ontario to lead. Additionally, during the 2016 Ontario Budget discussions, a commitment was made to the Legislative Assembly to review the use of specific file formats. The Ministry for Seniors and Accessibility will be sharing this research with the committee.
In addition to the above, the committee's review may take into account all information and communications standards, such as website requirements, formats, and educational and training institutions and public libraries. The government has, however, heard from obligated organizations that changing requirements before they have completely taken effect can create a significant implementation burden.
The minister requested the committee to focus the review on requirements for sectors that have been in effect for more than 24 months, as well as to identify any gaps that may remain in the standards. 29 https://www.ontario.ca/page/information-and-communications-standards-development-committee 2/47
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A specialized market of assistive technologies is not technically viable because, to successfully fulfill the role, each technology must be fully compatible and remain fully compatible with all applications on a given platform. Many of these applications are proprietary and do not share interoperability specifications at the level that assistive technologies require. Updates and upgrades to the applications happen frequently and are increasing in frequency as these can be done automatically over networks. Most updates or upgrades require a responsive update in the assistive technology. Many applications are now constructed by many sources, meaning there is no one mainstream developer to appeal to or to seek information from. Consequently a user of a screen reader, onscreen keyboard, or screen enhancer cannot assume that they can access all functions of essential applications or that if they can today, that they will be able to tomorrow.
With the aging of western populations and improved survival rates globally there is an increase in the incidence of people experiencing disabilities. Special services intended to provide funding for assistive technologies, and training in their use, are experiencing greater demand, at a time of financial constraint in almost all jurisdictions. The response has been to tighten the criteria that must be met to qualify for these services. As a result, an increasing amount of the budget is spent on policing or excluding individuals (that are deemed not to qualify) from the service, leaving a smaller amount of the budgets available to provide the service. This causes groups of individuals to be excluded from the service. These individuals then advocate for service, this may result in a new category of service which requires further administrative processes to administer and police ( e.g., services for individuals with autism). In addition the technologies funded through the special programs must be certified. This certification process frequently takes longer than the updates to the technologies meaning that an individual who has successfully passed the qualification requirements may be provided with an outdated assistive technology.
Legislation has been seen as a means of addressing this gap. Legislating in a domain that advances as quickly as ICT is a difficult process. Legislation requires clear, testable criteria. The life cycle oflegislation is far far slower than the speed of technical advances. Consequently accessibility legislation is frequently seen to constrain technical innovation and advance. Developers who want to innovate will often respond to accessibility legislation by attempting to find ways to be exempt from legislation rather than finding creative ways to address accessibility requirements.
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Monitoring Monitoring ARIA ARIA
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have have
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are are
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through through
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litigation litigation
province province
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not not
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all all 39 39 Kemper, A., Stolarick, K., Milway, J.,Treviranus, J.,(2010) Releasing Constraints: Projecting the Economic Impacts of Increased Accessibility in Ontario. Martin Prosperity Institute. http: //www.martinprosperity.org/media/ReleasingConstraintsAccessible. ht ml
Contact Details: http://www.mcss.gov.on.ca/en/mcss/programs/accessibility/
Key Recommendations
Governments 1) Accessibility should be regarded as a regulatory responsibility of the government just as public health, environmental regulations, traffic regulations are enforced and monitored by the government. 2) Public policy regarding digital inclusion should be established in such a way that it outlives the political term of any one government and is not vulnerable to political changes. 3) Governments should set an example with respect to accessibility and institute accessible practices in all internal areas of ICT, through mechanisms such as accessible Web templates, authoring tools that support accessible content creation and the adoption of open standards and accessible file formats.
UN 1) The UN should support a global shift in policy and legislation that requires that mainstream software and hardware manufacturers are responsible for addressing the needs of individuals with disabilities rather than relegating this to assistive technologies. This will shift the rising cost of alternative access systems from people with disabilities and the public purse to the corporations, it will increase the availability of integrated access solutions and it will increase cooperation between mainstream developers and developers of assistive technologies. 2) The UN should mount an effort to support open standards. This will support greater interoperability with alternative access systems. 3) The UN should support the convergence of mobile and internet technologies. This will reduce the fragmentation and redundancy in standards, training, maintenance and accessibility strategies.
International standard organizations 1) Accessibility should be an integrated consideration in the development of all interoperability or technical standards. 2) There should be greater representation of people with disabilities in standards organizations.
40
UN UN International International
Governments Governments
Contact Contact
http
Kemper, Kemper,
Key Key
2) 2)
3) 3)
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1) 1)
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3) 3)
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Recommendations Recommendations
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Milway, Milway,
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ca/en/mcss/programs/accessibility/ ca/en/mcss/programs/accessibility/
Web Web
political political
technical technical
cooperation cooperation
practices practices
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increase increase
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be be
people people
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technologies. technologies.
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integrated integrated
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of of
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manufacturers manufacturers
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BertelsmannStiftung BertelsmannStiftung
and and
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complexity complexity and and
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of of
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of of
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technology, technology,
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challenges challenges
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digitalization, digitalization,
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Discussion Discussion
promise promise
a a
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'Tryingto get in the line'
Advocates for people with disabilities who have been pushing for vaccine priority across the country applauded Detroit's decision, especially given the many ways that residents here are struggling.
In a city where nearly 90 percent of residents are Black or Latino and where 35 percent live in poverty, people with disabilities face multiple layers of discrimination and barriers to health care that put them at higher risk for Covid-19, said Justice Shorter, the disaster protection adviser for the National Disability Rights Network.
Detroit has been hit hard by the pandemic, tallying more than 1,800 deaths, including Wayne County Sheriff Benny Napoleon, state Rep. Isaac Robinson and a long list of community leaders.
Some of the disabilities on the city's list might seem surprising to people not living with those conditions, Shorter, who is blind, said.
"In medical terms, blindness itself might not be considered something that would put you at a heightened risk for Covid," she said, unless you consider that people with visual impairments rely on others to drive them around or point out hazards, and can't see whether someone offering to help is wearing a mask.
"You have to consider the ways in which you maneuver through society," she said.
The pandemic'simpact on Americans with disabilities and their families (Part 2)
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8. CDC recommends transporting vaccine in vials. However, there may be instances when the only option is to transport vaccine in a predrawn syringe. U.S. Pharmacopeia includes guidance for transporting predrawn vaccine in syringes in the COVID-19 Vaccine Toolkit: Operational Considerations for Healthcare Practitioners ~ .
Guidance for transporting vaccines can be found in CDC's Vaccine Storage and Handling Too/kit, COVID-19 Vaccine
addendum■.
Vaccine Administration
Vaccine administration involves a series of actions: assessing patient vaccination status and determining needed vaccines, screening for contraindications and precautions, educating patients, preparing and administering vaccines properly, and documenting the vaccines administered.
1. Vaccines should be prepared and administered following aseptic technique. Prepare the injection in a designated, clean medication preparation area that is not adjacent to potential sources of contamination, including sinks or other water sources. Keep in mind that water can splash or spread as droplets more than a meter from a sink. In addition, any item that could have come in contact with blood or body fluids, such as soiled equipment used in a procedure, should not be in the medication preparation area.
2. Give each recipient a copy of the EUA fact sheet (Pfizer, ~ Moderna ~ , or Janssen ~ ) for recipients and/or caregivers.
o V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check ins for recipients after COVID-19 vaccination. Through v-safe, recipients can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on the answers, someone from CDC may call to check on recipients that have signed up for the program.
3. Ask the person if he or she has any questions or concerns prior to vaccination, and address them, as appropriate. 4. Although there are no federal requirements for documenting informed consent (or assent for people who work with a medical proxy), best practices are to document consenUassent in the medical records.
5. Before administering vaccine, screen recipients for contraindications and precautions (use the prevaccination checklist for COVID-19 vaccination in English ■ or Espanol ■ ),even if you are administering the second dose. The recipient's health condition or recommendations regarding contraindications and precautions for vaccination may change from one visit to the next. See Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States at Interim Clinical Considerations for Use of COVID-19 Vaccine for more information.
6. For homebound persons who might be at increased risk for anaphylaxis following vaccination (i.e., persons with a for vaccination or a history of anaphylaxis due to any cause), consider whether they can be vaccinated in a setting where medical care is immediately available if they experience anaphylaxis following vaccination. If home vaccination is the only option for these persons and, through risk assessment, it is determined that the benefits of vaccination outweigh the potential risk for anaphylaxis, home vaccination providers should be able to manage anaphylaxis. This includes
64 https://www.cdc.gov/vaccines/covid-19/clnlcal-consideratlonslhomebound-persons.html 3/1612021 VaccinatingHomebound Persons with COVID-19 Vaccine I CDC
appropriate screening; post-vaccination observation; medications and supplies; staff qualifications for recognition and treatment of anaphylaxis; and ability to contact and availability of emergency medical services in the area.
COVID-19 vaccination provider should have at least 3 doses of epinephrine on hand when administering vaccine. CDC currently recommends that persons without contraindications to vaccination who receive a COVID-19 vaccine be observed after vaccination for the following time periods:
o 30 minutes: Persons with a history of an immediate allergic reaction (within 4 hours) of any severity to a vaccine or injectable therapy, and persons with a history of anaphylaxis due to any cause.) o 15 minutes: All other persons Additional information about potentially managing an anaphylactic reaction is available.
7. COVID-19 vaccination providers must document vaccine administration in their medical record systems within 24 hours of administration and use their best efforts to report administration data to the relevant system for the jurisdiction (i.e., immunization information system) as soon as practicable and no later than 72 hours after administration. 8. Adverse events that occur in a recipient after COVID-19 vaccination must be reported to the Vaccine Adverse Event Reporting System (VAERS). FDA requires vaccination providers to report vaccine administration errors, serious adverse events, cases of multisystem inflammatory syndrome, and cases of COVID-19 that result in hospitalization or death after administration of COVID-19 vaccine under an EUA. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. Complete and submit reports to VAERSonline. [1 9. To prevent wasting vaccine doses, as appropriate and approved by jurisdictions, healthcare personnel may administer vaccine to caretakers and family members, given their high risk of exposure.
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65 https:I/WwW.cdc.govlvaccines/covld-19/dinlcakonslderatlons/homebound-pe,sons.html 414 DANESHVAR and HER MAJESTY THE QUEEN IN Court File No: 223/21 Applicant RIGHT OF ONTARIO AS REPRESENTED BY THE MINISTER OF HEALTH et al.
Respondents ONTARIO SUPERIOR COURT OF JUSTICE (DIVISIONAL COURT)
AFFIDAVIT OF DR. JUTTA TREVIRANUS (Affirmed March 16, 2021) bakerlaw 4 711 Yonge Street, Suite 509 Toronto, ON M2N 6K8
David Baker LSO# 17674M Kimberly Srivastava LSO# 69867U Tel: (416) 533-0040 Email: dbaker<@bakcrlaw.ca [email protected]
Lawyers for the Applicant
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