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SECTION 4: Administration of the Independent Clinical Review Process

The ICR Coordinator

The Ministry contracts with a third party agency to act as the ICR Coordinator and to administer the ICR process. This agency is independent from the OAP and is not involved in the development of OAP Behaviour Plans or the delivery of behavioural services. It provides services in English and French. Its role is to coordinate the independent clinical review process in Ontario by:

The ICR Coordinator’s role in the independent clinical review process is strictly administrative; it does not have any clinical decision-making authority over OAP service providers or independent clinical reviewers.

Roster of Independent Reviewers

The ICR Coordinator is responsible for recruiting and maintaining a roster of independent Clinical Reviewers who conduct reviews of OAP Behaviour Plans.

The roster is composed of BCBAs and psychologists/psychological associates with extensive knowledge of ASD and who work in the field of ASD. These professionals may include private practitioners, public sector BCBAs and psychologists/psychological associates.

Practitioners who are also OAP service providers, or were formerly employed by service providers delivering MCYS-funded autism services and supports, may qualify as reviewers on the roster. However, they may not review decisions made by the OAP service provider with which they are/were associated, or from within their region, nor can they make decisions regarding children who may have been their clients. Conflicts of interest will be mitigated by ensuring that reviewers are not assigned to case files from within their Ontario service delivery area (see Appendix 6.1 for map). The ICR Coordinator will identify these and other potential conflicts of interest so that reviews are not conducted by reviewers who may have a conflict of interest related to the review.

Qualifications of Independent Reviewers
To be considered for the roster of Clinical Reviewers, clinicians must be either a psychologist/psychological associate in good standing with the College of Psychologists of Ontario or comparable regulatory body in the jurisdiction where the psychologist or psychological associate practices; and/or a BCBA with current certification from the Behaviour Analyst Certification Board (BACB).

The ministry has communicated required qualifications for Clinical Supervisors in the OAP. Independent Reviewers will be expected to meet the required qualifications for Clinical Supervisors in the OAP, as outlined in the OAP Guidelines, or demonstrate that they are working towards achieving the qualifications and confirm the timeframe within which they expect to achieve them.

Out-of-province BCBAs with current BACB certification, and psychologists and/or psychological associates who are registered in good standing to practice in their home jurisdiction are eligible for roster membership. However, they must be familiar with Ontario’s autism service system.

Training of Independent Reviewers
The ICR Coordinator develops and delivers training on an ongoing basis to Clinical Reviewer roster members on up-to-date research on ABA, the policies and procedures of the OAP and the Ontario context more broadly.

Quality Assurance
The ICR Coordinator promotes quality in the ICR procedure by monitoring independent reviewers for adherence to timelines and guidelines, to establish whether or not an appropriate rationale is provided for decisions, and to determine inter-rater reliability (i.e., concordance in the degree of agreement among reviewers). The ICR Coordinator establishes a quality management system that includes providing feedback to the Ministry as well as OAP service providers.

Roster of Family Representatives

The ICR Coordinator is responsible for recruiting, training and maintaining a roster of Family Representatives who will work with families and the Clinical Reviewers to help provide a clear understanding of the family perspective in the ICR.

The ICR Coordinator assigns a Family Representative to the Review Committee for each review. Conflicts of interest will be mitigated by ensuring that Family Representatives are not assigned to families from within their Ontario service delivery area (see Appendix 6.1 for map). The ICR Coordinator will identify these and other potential conflicts of interest so that reviews are not conducted by reviewers who may have a conflict of interest related to the review.

Qualifications of the Family Representatives
The roster of Family Representatives is composed of parents, guardians, and/or primary caregivers of children with ASD, with general knowledge of ASD services and supports in Ontario.

Training of the Family Representatives
The ICR Coordinator develops and delivers training on an ongoing basis to the roster of Family Representatives, including but not limited to the OAP, the ICR and their role within the review process.

Monitoring and Evaluation

The ICR Coordinator has a service contract with MCYS. The service contract includes requirements for the collection of information consistent with the Ministry’s approach to performance measurement to support decision-making and business planning.

The ICR Coordinator collects and reports information pertaining to ICR service delivery and system outcomes to the Ministry, for example, information related to the:

The ICR Coordinator develops a summary of ICR outcomes and performance measures based on the requirements outlined in their service contract, and submits this to the Ministry on a quarterly basis.

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