Ontario spent an estimated $691.2M on its Autism Program in 2023-24. Ministry documents obtained through Freedom of Information show less than half went to core therapy services. Structural gaps in accountability mean the public cannot see how the rest was spent.
End The Wait Ontario · Based on FAO reports, IPC statements, and MCCSS documents obtained via Freedom of Information. · Last updated: March 18, 2026
$691.2M
Total OAP Spending 2023-24
$307.3M
Core Clinical Services
44.5%
Share to Core Services
67,399
Children Without Funding
In 2019, the Ontario government promised a $600 million annual budget for its Autism Program. By 2023-24, the Financial Accountability Office of Ontario (FAO) estimated spending had reached $691.2M — above that promise. Yet the number of children waiting for services kept growing.
As of December 2025, 87,692 children and youth were registered with the Ontario Autism Program. Only 20,293 had active funding agreements. That left 67,399 children without access to core therapy funding.
This analysis explains how that budget was divided. It draws on two types of public-record sources. First, reports from the FAO, an independent officer of the Ontario Legislature created under the Financial Accountability Officer Act, 2013. Second, MCCSS spending figures obtained through a Freedom of Information request by The Trillium (Village Media), published on July 4, 2024. Every figure below is sourced, cited, and verifiable.
What are “core clinical services”?
These are the therapies that families on the waitlist are waiting for: applied behaviour analysis (ABA), speech-language pathology, occupational therapy, and mental health services. This is the main funding stream for therapy. It provides $6,600 to $65,000 per child per year based on assessed need.
How Ontario Autism Program spending breaks down by program area, the government's budget year (fiscal year 2023-24)
Source: MCCSS documents obtained via FOI by The Trillium (July 2024); FAO, MCCSS Spending Plan Review (June 2024). Note: Category totals are estimated spending figures reported by MCCSS.
Estimated $691.2M in OAP spending, grouped by function.
Source: MCCSS FOI documents (The Trillium, July 2024); FAO, MCCSS Spending Plan Review (June 2024).
These spending estimates come from MCCSS documents obtained by The Trillium through a request under Ontario's freedom of information law (FIPPA). Each figure is an estimated cost for 2023-24.
| Program Component | Amount | Share |
|---|---|---|
| Core Clinical ServicesABA, speech-language pathology, occupational therapy, and mental health services — $6,600 to $65,000 per child per year based on assessed need. | $307.3M | 44.5% |
| Urgent Response Services | $58.9M | 8.5% |
| AccessOAP OperationsConsortium led by Accerta Services Inc., with Autism Ontario, McMaster University, and Serefin. Handles registration, intake, care coordination, and payment reconciliation. | $57.9M | 8.4% |
| Entry to School Program | $54.7M | 7.9% |
| Other Legacy Autism ProgramsPre-OAP supports including respite services. | $104.0M | 15.0% |
| System Capacity Building Initiatives | $26.5M | 3.8% |
| Foundational Family Services | $23.2M | 3.4% |
| Caregiver-Mediated Early Years | $20.4M | 3.0% |
| Connections for StudentsJoint program with Ministry of Education. | $14.0M | 2.0% |
| Diagnostic Hubs (5 provincial) | $9.7M | 1.4% |
| Identified Line Items | $676.6M | 97.9% |
| Unallocated / OtherDifference between line items and reported total | $14.6M | 2.1% |
| Total Reported OAP Spending | $691.2M | 100% |
Source: MCCSS FOI documents (The Trillium, July 2024). Total spending from FAO, MCCSS Spending Plan Review (June 2024). The $14.6M difference may reflect rounding, inter-program transfers, or items not individually disclosed.
The single largest non-therapy spending item is the estimated $57.9 million that went to AccessOAP, the program's independent intake organization. AccessOAP is run by a group of companies led by Accerta Services Inc. Accerta describes itself as an organization with “a track record of delivering value for money” that manages benefits programs “exclusively for government and social services agencies in Canada.” The other partners are Autism Ontario, McMaster University (Centre for Health Economics and Policy Analysis and the Offord Centre for Child Studies), and Serefin (formerly HealthCare 365 Inc.), a care coordination company.
AccessOAP handles registration, intake, needs assessment, care coordination, payment tracking, and the family portal. Some of these tasks — especially care coordination — could be considered part of direct service delivery, not just administration. The publicly available MCCSS documents do not show how the $57.9M is divided among these tasks or among the partners.
To put this in context: $57.9 million is 8.4% of total estimated OAP spending. The FAO reported that the average child received about $34,000 per year in core clinical services funding in 2023-24. At that rate, the same amount would fund about 1,703 children for one year of therapy. This comparison is for illustration only — it does not mean AccessOAP's work is unnecessary or that the money could simply be moved elsewhere.
Methodological note
The $57.9M figure is reported as a single line item. Without a public breakdown, we cannot tell what share goes to care coordination (a direct service), technology, or administration.
Why can't the public see how AccessOAP spends the $57.9M? Ontario has four main watchdogs that oversee public spending. Each one has real power — but also real limits on what it can see, especially when private companies deliver the services.
Ontario's Freedom of Information and Protection of Privacy Act(R.S.O. 1990, c. F.31) gives the public a right to see records held by “institutions” — meaning provincial government ministries and certain agencies, boards, and commissions. Private organizations that receive government funding are not automatically covered by FIPPA just because they get public money.
In practice, this means you can file a FIPPA request to MCCSS for records about the OAP. But you cannot file a FIPPA request directly to Accerta Services Inc. or the AccessOAP group for their internal records.
Records that MCCSS holds about AccessOAP — like the contract, performance reports sent to the ministry, and spending figures — may be available through FIPPA, subject to the law's exemptions. But internal records created and held by the group — such as how costs are split among partners, operational decisions, staffing models, and performance data not sent to the ministry — are beyond FIPPA's reach.
Under the Auditor General Act (R.S.O. 1990, c. A.35), the Auditor General has the legal power to audit “any grant, loan, or transfer payment made by the Crown” and how the recipient uses those funds. In theory, this extends to organizations that receive government funding — but the Auditor General chooses which programs to audit. As of the date of publication, the Ontario Autism Program and AccessOAP's use of funds have not been the subject of a published performance audit.
Note
The absence of an Auditor General performance audit of the OAP or AccessOAP does not imply deficiency. The Auditor General selects audit subjects based on risk assessment and resource constraints. This analysis notes the absence as a factual observation relevant to the accountability framework, not as an allegation.
The FAO was created by the Financial Accountability Officer Act, 2013 to provide independent analysis of Ontario's finances and spending plans. The FAO has published two reports directly about autism program spending: one in 2020 and one in 2024. These reports analyze program-level spending data from the ministry. They do not audit the internal operations of organizations that receive government funding. The FAO's June 2024 report found that the province had set aside $3.7 billion less than needed to fund existing MCCSS programs from 2024-25 to 2026-27.
The IPC oversees Ontario's freedom of information law (FIPPA) and decides disputes about access to government records. The IPC's authority covers “institutions” as FIPPA defines them — government bodies, not the private organizations that win government contracts. The IPC can order a ministry to hand over records it holds about a service provider. But the IPC cannot order the service provider itself to produce its own records.
Add all these limits together and the picture is clear: when the government hires an outside organization to run a public program, that organization's internal operations are largely inaccessible through Ontario's transparency tools — even when the money is publicly funded.
On March 13, 2026, the Ontario government announced proposed changes to FIPPA. The bill, to be introduced when the Legislature resumes on March 23, 2026, would remove records of the Premier, cabinet ministers, parliamentary assistants, and their offices from FIPPA's scope. Minister of Public and Business Service Delivery and Procurement Stephen Crawford said the changes would bring Ontario “more closely in line with practices used in other jurisdictions across Canada.”
The government said Ontario is currently one of only two Canadian provinces — alongside Nova Scotia — that does not explicitly exclude ministerial records from freedom of information law. The government described the change as “modernizing Ontario's privacy protections.”
Government's stated position
The Ontario government has stated publicly that the proposed amendments would “strengthen cyber security, protect cabinet confidentiality and ensure responsible modern governance.” Minister Crawford stated the changes would bring Ontario in line with other Canadian jurisdictions. The government noted that government decisions communicated to the public service, including formal direction from ministers, would continue to be subject to access rules. (Source: Ontario government news release and Minister Crawford's public remarks, March 13, 2026, as reported by CBC News.)
Ontario's Information and Privacy Commissioner, Patricia Kosseim, published a formal statement the same day. That statement is available in full on the IPC's website. It is a public document by an independent officer of the Legislature.
“This amendment is about hiding government-related business to evade public accountability.”
In the same statement, Commissioner Kosseim pointed out that FIPPA already protects personal, confidential, and constituency records from being released. She said the proposed change goes further — it would also exclude government-related business records held by elected officials and their staff.
The IPC's statement raised three more concerns. First, the changes would apply retroactively to 1988 — the year FIPPA took effect. Nearly four decades of government records would be placed outside FIPPA's reach. Second, the bill would weaken the IPC's oversight of FIPPA's data-linking rules, which allow the government to connect personal records across departments, including health information. The IPC called this “an inherent conflict of interest that seriously weakens accountability.” Third, the bill would let government employees carry email accounts containing personal information when they change ministries. The IPC said this “increases the risk of privacy breaches exponentially.”
The IPC also noted that the government was trying to appeal a court ruling that upheld the IPC's order for the Premier's office to produce call logs from the Premier's personal cellphone that relate to government business. The proposed retroactive change would make that order meaningless.
NDP Leader Marit Stiles said publicly she would reverse these changes. The Ontario Liberal Party, under then-leader Bonnie Crombie, also promised to undo the amendments. Green Party Leader Mike Schreiner called the proposal “changing the rules to make it easier to hide the truth.” The Ford government holds a majority in the Ontario Legislature.
The proposed FIPPA changes and the existing accountability gap around programs run by outside organizations create a troubling combination for anyone who relies on publicly funded services in Ontario.
Think about how the spending data in this analysis became public. The Trillium filed a Freedom of Information request to MCCSS and obtained ministry documents. That request went to the ministry — a FIPPA institution.
Under the proposed FIPPA changes, decisions about program design, who gets the contract, and how the budget is divided — if discussed or documented in the minister's office — would no longer be available through FIPPA, even when they involve hundreds of millions of dollars in public money. The ministry's day-to-day operational records would still be available in theory. But the policy decisions that shaped those records would not.
This creates a compounding effect. Information about what happens inside the outside service provider (AccessOAP, in this case) was already mostly beyond FIPPA's reach because the provider is not a FIPPA institution. Now, information about the government decisions that set up the arrangement — the ministerial direction, the contract structure, the policy reasons — would also be placed beyond FIPPA's reach. The accountability chain has gaps at both ends.
| Program Component | Delivery Model | Estimated Amount |
|---|---|---|
| AccessOAP Operations | Group of companies (Accerta-led) | $57.9M |
| Other Legacy Autism Programs | Various external providers | $104.0M |
| System Capacity Building | External service providers | $26.5M |
| Diagnostic Hubs (5 provincial) | External clinical partners | $9.7M |
| Core Clinical Services | Funding to families; services from OAP-listed private providers | $307.3M |
Source: MCCSS estimated spending, FY 2023-24, obtained via FOI by The Trillium (Village Media), July 4, 2024. “External” does not imply impropriety; it describes the organizational relationship to government for the purpose of analyzing which transparency mechanisms apply.
The Canadian Audit and Accountability Foundation has published guidance noting that when governments hire outside organizations to deliver programs, “the importance of effective oversight has also been heightened” and that accountability requires clear tools for “ensuring that key risks are identified, monitored, and mitigated.” The Foundation's Practice Guide to Auditing Oversight identifies this type of arrangement as a governance challenge that needs stronger scrutiny, not less transparency.
The FAO estimated $1.35–1.4B per year was needed to eliminate the waitlist. Annual OAP spending has stayed below $723M.
Source: FAO, Autism Services — A Financial Review (July 2020). Actual spending: FAO, MCCSS Spending Plan Review (June 2024) and 2024 Ontario Budget.
The Financial Accountability Office is Ontario's independent, non-partisan budget watchdog. It was created by law in 2013. The FAO has produced two key reports on autism program spending.
In July 2020, the FAO published Autism Services — A Financial Review of Autism Services and Program Design Considerations for the New Ontario Autism Program. The FAO estimated that clearing the waitlist entirely would cost about $1.4 billion per year — more than double the $600 million commitment. (The FAO officer publicly stated a figure of $1.35 billion in media interviews.) The estimate was based on about 40,700 children and youth, with an average per-child annual cost of about $29,900 for therapy. The total also covers program administration and non-clinical costs.
In June 2024, the FAO published its MCCSS Spending Plan Review. It found the province had set aside $3.7 billion less than needed to fund existing MCCSS programs and announced commitments from 2024-25 to 2026-27. For the autism program specifically, the FAO calculated that at the $600 million base funding level, the province could fully fund about 10,142 children and youth per year. At the higher 2024-25 level of $723 million (which included a one-time $120M boost from the 2024 Ontario Budget), about 12,629 children could receive full annual funding.
The FAO also estimated that just keeping current service levels — without shrinking the waitlist — would need an extra $96 million per year by 2025-26. That breaks down to $47 million for population growth and $49 million for inflation. As of the FAO's June 2024 report, the government had not publicly committed to this increase.
Government's stated position
In response to the FAO's June 2024 report, MCCSS stated publicly that “the FAO's opinions are not representative of actual government spending” and noted that the government had “met our target of 20,000 children enrolled in Core Clinical Services.” The ministry also stated that it does not “allocate core clinical services funding based on average amounts” and therefore could not confirm the FAO's per-child calculations. (Source: MCCSS statement as reported by CBC News, June 5, 2024.)
Illustrative calculation
With 67,399 children waiting and the FAO's reported 2023-24 average annual allocation of approximately $34,000 per child, immediately funding all waiting children at that average would cost approximately $2.3 billion per year. This is a simplified illustration only — it assumes all children would receive the current average, does not account for varying needs levels, and uses a different cost basis than the FAO's 2020 elimination estimate (which used $29,900 per child across a smaller cohort of approximately 40,700). The actual cost of waitlist elimination would depend on the needs distribution of children currently waiting.
Of 87,692 children registered, 20,293 had active core clinical services funding agreements as of December 2025.
Source: OAP registration and enrollment data (December 2025). Active funding agreements from OAC FOI.
These are questions for public debate, not accusations or conclusions.
1. Is the spending split fair?
$307.3M (44.5%) went to core clinical services. The other 55.5% was spread across intake operations, older programs, and capacity building. How does this compare to other Canadian provinces?
2. Should AccessOAP spending be public?
The $57.9M for the AccessOAP group is one lump sum. Should MCCSS publish a detailed breakdown — showing partner payments, technology costs, and what share goes to care coordination versus administration — as a basic condition of public accountability for a program this large?
3. What are the legacy programs?
$104M (15%) was listed under "other legacy autism programs." What specific programs does this cover, and has anyone checked whether they still deliver good value?
4. Is the funding sustainable?
The FAO estimated $96M in extra annual funding was needed by 2025-26 just to maintain current service levels. The 2024 Budget's $120M increase was one-time only. What is the plan to cover this gap on an ongoing basis?
5. Has anyone updated the waitlist cost?
The FAO estimated $1.35B/year was needed when about 40,700 children were registered. The number has since grown to 87,692. Has anyone commissioned an updated cost estimate?
6. Should FIPPA cover organizations that receive large amounts of public funding?
Should Ontario extend FIPPA — or create a similar transparency framework — to cover organizations that receive more than a set amount of public money? What should that threshold be, and what protections would be needed for legitimate business interests?
7. Should the Auditor General look at this?
The Auditor General has the legal power to audit how government funding is used. Has the Auditor General considered auditing the OAP's model of hiring outside organizations to deliver services? What would trigger such an audit?
8. What watchdog is left?
When (a) the service provider's internal records are outside FIPPA's scope because the provider is not a FIPPA institution, and (b) the ministerial decisions that shaped the delegation are proposed to be exempted retroactively, what independent mechanism remains for the public to assess whether public funds in delegated programs are being used effectively?
This analysis focuses on structural accountability gaps. It does not allege that AccessOAP, Accerta Services Inc., Serefin, Autism Ontario, McMaster University, or any other organization has acted improperly, misused public funds, or failed to deliver on contractual obligations. To the contrary, the public evidence suggests that AccessOAP has enrolled thousands of children and facilitated care coordination at significant scale.
The point is different: whether these organizations are performing well or poorly, the public currently has limited independent means to assess the answer. That assessment depends on information that, for structural reasons, is largely inaccessible through Ontario's existing transparency mechanisms. The proposed FIPPA amendments would further narrow the available channels.
Accountability is not adversarial. Effective transparency mechanisms serve well-run programs as much as they expose poorly-run ones — by providing independent validation that public money is being well spent and public trust is being earned.
This analysis combines data from two types of public sources. First, reports from the Financial Accountability Office of Ontario (FAO), an independent officer of the Ontario Legislature with legal power under the Financial Accountability Officer Act, 2013. Second, Ministry of Children, Community and Social Services (MCCSS) estimated spending figures obtained through a Freedom of Information request under the Freedom of Information and Protection of Privacy Act by The Trillium (Village Media), published July 4, 2024.
All spending figures are estimated costs for 2023-24 (April 1, 2023 to March 31, 2024) as reported by MCCSS. These are ministry estimates, not audited figures from the Public Accounts of Ontario. The FAO's June 2024 MCCSS Spending Plan Review reports total autism program spending of an estimated $691 million for 2023-24. The FOI-obtained line-item breakdown totals $676.6M across identified categories; the $14.6M difference is disclosed and may reflect rounding, inter-program transfers, or items not individually itemized in the FOI disclosure.
Percentage shares are calculated against the FAO's reported total of $691.2M. The illustrative “children served” comparison ($57.9M ÷ $34,000 = ~1,703) uses the FAO's reported average annual core clinical services funding allocation per child in 2023-24. This is a mathematical illustration and does not imply that funds could be or should be directly reallocated.
This analysis also draws on published statements by the Information and Privacy Commissioner of Ontario (IPC), the statutory text of Ontario legislation, and reported public statements by government officials and opposition leaders.
No anonymous sources, leaked documents, or confidential information are used. All claims of fact are attributed to specific, named, verifiable sources. Descriptions of organizations (Accerta Services Inc., Serefin, Autism Ontario, McMaster University) use language drawn from those organizations' own public-facing materials. No characterization of intent, motive, or wrongdoing is made or implied in this analysis. Organizations described in this analysis, including Accerta Services Inc. and AccessOAP, are invited to provide statements for inclusion via our contact page. No statement had been received as of March 18, 2026.
In response to the FAO's June 2024 MCCSS Spending Plan Review, the Ministry of Children, Community and Social Services stated publicly that “the FAO's opinions are not representative of actual government spending.” The ministry noted that it had increased investment in its budget “by more than $630 million” and had “met our target of 20,000 children enrolled in Core Clinical Services.” The ministry further stated that it does not “allocate core clinical services funding based on average amounts” and therefore could not confirm the FAO's per-child calculations. (Source: MCCSS public statement as reported by CBC News, June 5, 2024.)
The Ontario government's stated reasons for the proposed FIPPA amendments are presented in the body of this article, including Minister Crawford's public remarks. These positions come from public statements as reported by CBC News (June 5, 2024) and the Ontario government's own news release (March 13, 2026).
This analysis presents the FAO's published calculations alongside the government's stated position. We encourage readers to consult the original FAO reports and government statements directly.
End The Wait Ontario is committed to factual accuracy. If any figure, attribution, legal citation, or characterization in this analysis is inaccurate, we will correct it promptly and publish a dated note of correction. Organizations and individuals referenced in this analysis are invited to contact us with corrections, clarifications, or responses, which we will publish in full or in relevant part.
Contact: endthewaitontario.com/contact
No corrections have been issued as of March 18, 2026.
© 2026 End The Wait Ontario. This analysis is published as fair comment on a matter of public interest, based entirely on public records, government documents, published statements by independent officers of the Ontario Legislature, and organizations' own published materials. All data is sourced and cited. No allegation of wrongdoing, fraud, impropriety, or breach of contract is made or implied against any individual, organization, or government entity. The policy questions raised are presented for democratic deliberation, not as conclusions. This page does not constitute legal, financial, or professional advice. Reproduction is permitted with attribution to the original source and a link to this page.
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Verified Facts
87,692 — children are registered in the Ontario Autism Program
23.1% — 23,875 children enrolled in Core Clinical Services; 20,293 have active funding agreements ()
WHO recommends accessible, community-based early interventions for children with autism — timely evidence-based psychosocial interventions improve communication and social engagement
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20,293
Active funding agreements (23.1%)
67,399
Without funding agreements (76.9%)