Our Developmental Services Crisis — and the Road Out
Ontario does not lack ideas for fixing developmental services. It needs a plan that turns funding, housing, a skilled workforce and accountability into something more fundamental: the ability for people with developmental disabilities to live ordinary, meaningful lives in their communities.
For most of us, adulthood comes with an expectation of possibility. We expect to have some say over where we live. We expect opportunities to work, volunteer, see friends, go shopping, participate in our communities and make decisions about our own lives. For tens of thousands of adults with developmental disabilities in the province, those day-to-day expectations can depend on something much less certain: whether the service that they need becomes available.
These are not luxuries. They are the building blocks of inclusion. And Ontario has reached a point where waiting itself has become one of the defining features of the developmental services system.
What the numbers tell us
Sector organizations using Developmental Services Ontario registry information report that more than 53,000 adults with intellectual and developmental disabilities are currently waiting for at least one form of developmental service. Community Living Ontario has reported more than 28,000 people waiting for housing-related supports, more than 42,000 waiting for community supports and more than 30,000 waiting to receive their full Passport funding allocation.
Ontario’s Financial Accountability Office (FAO) reported that the supportive-living waitlist increased from 18,152 people in 2017-18 to 28,128 in 2023-24. Yet the number of people served fell from 18,822 to 17,856 over the same reporting period.
Between 2018-19 and 2023-24, the number of recipients receiving less than their assessed full allocation more than doubled, from 14,973 to 30,667, according to the FAO.
A health-system problem too
In its 2025 Lost in Transition investigation, the Ontario Ombudsman reported that, as of December 2024, Ontario Health had identified 124 adults with developmental disabilities living in hospitals even though they no longer required acute medical care. The Ombudsman also cautioned that the number was incomplete.
An expensive hospital bed should never become someone’s home because Ontario could not build the right support in the community. More importantly, it can be devastating for the person occupying that bed. The Ombudsman’s investigation also documented people remaining in hospitals for prolonged periods while suitable housing and supports were sought, and concluded that the shortage of supportive living had become a major barrier to discharge. Thus 24 recommendations were made. The Province accepted all 24.
Acknowledging progress
Constructive advocacy requires talking about progress when it occurs. In fact, Ontario reported investing approximately $3.5 billion in developmental services in 2024-25. The 2026 Ontario Budget also committed an additional $407 million over three years to community organizations, including agencies serving people with developmental disabilities, to address rising operating costs.
The question is whether these investments can be translated into additional capacity, greater stability and measurable reductions in waiting lists. In other words, Ontario does not simply need to spend more. It needs to make these additional investments produce additional opportunity. That distinction gives us a path forward.
Build real supportive-living expansion plan
Ontario needs a real multi-year developmental services capacity strategy with publicly stated targets that are measures of citizenship and belonging.
The Ombudsman has already recommended that developmental services planning include capital needs, agency costs, vacancy management and an integrated approach between the Ministry of
Children, Community and Social Services and the Ministry of Health.
Supportive living also does not have to mean one model. Group living, supported independent living, host-family arrangements, individualized models and purpose-built supports for people with complex needs can all form part of the solution. The objective should be simple: the right support, for the right person, in the right community.
Treat the workforce as part of accessibility
There is a piece of accessibility infrastructure that is rarely described as infrastructure at all. It is people. A supportive-living space without enough trained staff is not really a supportive-living opportunity. Community participation funding is of limited value if there is nobody available to provide the support. A hospital discharge plan cannot work if an agency cannot recruit the workers needed to make the plan safe.
Developmental service workers routinely provide far more than basic personal care. The profession requires skills in person-centred planning, communication, health and wellness, behavioural support, community inclusion, advocacy and crisis intervention.
Ontario therefore needs a dedicated developmental services workforce strategy. It should include competitive compensation and benefits, stable full-time employment where possible, improved recruitment and retention, paid or supported student placements, stronger promotion of Developmental Service Worker college programmes, expanded educational pathways. Also needed, ongoing specialized training in areas such as autism, dual diagnosis, mental health, behavioural support, aging and complex medical needs.
There is also unfinished work surrounding Bill 124. Community and social-service workers affected by the legislation have continued to seek compensation remedies after the law’s wage restrictions were struck down and subsequently repealed. Any outstanding remedies for eligible developmental services workers should be resolved and properly funded rather than leaving individual agencies to choose between compensation and services.
During the pandemic, developmental services workers were routinely described as “our heroes”. That recognition was truly appreciated. But the most meaningful way to honour essential work is to build a system in which the people performing it can afford to stay. Workforce stability is not separate from quality of care. Workforce stability is quality of care.
Make Passport live up to its promise
Passport is one of the most important tools because its basic philosophy is right: give people greater control over the supports they receive. But the FAO’s finding that more than 30,000 recipients were receiving less than their full assessed allocation in 2023-24 shows the gap between eligibility and access. A clear multi-year plan should be created to eliminate that gap and make sure that Passport lives up to its promise.
Passport funding levels should also be reviewed regularly against the actual cost of purchasing support. Direct funding only creates choice if the amount available can purchase meaningful support in the real labour market.
Connect developmental services and healthcare before crisis
The developmental services and health systems too often meet at the worst possible moment: the hospital’s emergency department. That needs to change. Ontario’s Ombudsman has recommended a standing forum between the Ministry of Health and the Ministry of Children, Community and Social Services, better communication protocols, improved hospital education about developmental services, integrated planning and continued developmental and clinical supports during transitions.
Hospitals should know who to contact when a person with a developmental disability is admitted. Community agencies should become involved early when appropriate. Community professionals should be part of discharge planning.
And whenever possible, planning needs to start before a caregiver reaches exhaustion, a living arrangement collapses or somebody arrives in an emergency department. Ontario’s own internal work, reported by the Ombudsman, has recognized that appropriate supportive housing can reduce pressure on emergency rooms, hospitals, police, the justice system and long-term care. Developmental services should therefore be understood not simply as a social expenditure but as preventative public infrastructure.
Publish the numbers
There is another reform that could be implemented relatively quickly: radical transparency. At present, families, advocates, agencies, workers, hospitals and policymakers do not have an easily accessible public picture of the entire developmental services system. Ontario should publish a recurring Developmental Services Dashboard showing, by region: supportive-living demand and capacity; estimated waits; Passport recipients awaiting full allocations; new placements created; occupying hospital beds unnecessarily; workforce vacancies and progress toward provincial targets.
The Ombudsman has already recommended annual publication of meaningful information about supportive-living waitlists, possible wait times, vacancies and the number of people being served. If investments are working, Ontarians should be able to see the waiting lists fall.
Measure belonging, not programs
Ultimately, developmental services should not be judged by how many programs the government funds or how many forms an agency completes. The meaningful question is what those supports allow people to do.
• Does the person have a safe home?
• Do they have meaningful relationships?
• Can they participate in their community?
• Can they work or volunteer if they choose?
• Can they make decisions about their own life?
• Can an aging parent sleep at night knowing their son or daughter will be supported when they are no longer able to provide that care?
• Can somebody leave hospital when they are medically ready to leave?
A remarkable opportunity
There is plenty to criticize in the history of developmental services. But criticism alone will not build a single home, recruit a single worker or help a single person leave a hospital.
The Province has made new investments. The Financial Accountability Office has identified where capacity is failing to keep pace with demand. The Ombudsman has provided a detailed roadmap, and the government has accepted all 24 of his recommendations. Families, self-advocates, service agencies and frontline workers possess decades of practical knowledge about what works.
The ingredients for reform are already on the table. What Ontario needs now is a measurable commitment to bring them together: stable funding, expanded supportive living, full and meaningful individualized supports, a strong professional workforce, a renewed education pipeline, health-system integration and transparent public accountability.
A developmental disability should never condemn someone to spend years waiting for the opportunity to live. After all, an ordinary life should never be too much to ask.
Michael Macpherson is a developmental services worker and President of CUPE Local 2276 in Ontario. His advocacy focuses on strengthening developmental services for the people who rely on them, their families and the workers who make community inclusion possible. References available on request.
Photo: iStock
