Report by the Québec Ombudsman - The SAAQ must provide a better response to the home adaptation needs of severely disabled road accident victims

QUÉBEC CITY, Dec. 1, 2015 /CNW Telbec/ - In a report on the Société de l'assurance automobile du Québec (SAAQ) released today, the Québec Ombudsman calls attention to waiting periods of more than two years on average (results from a sample of 63 files handled by the SAAQ between 2012 and 2014) before the homes of severely injured persons are adapted to these people's new condition. According to Ombudsperson Raymonde Saint-Germain, "such delays have significant repercussions on the daily lives of injured persons and their families on many levels, for example, personal hygiene, independence and safety."

The causes of the long delays

The investigation by the Québec Ombudsman dealt with the management of home adaptation applications of more than $20,000. These applications are handled by two different SAAQ units, whose work is not sufficiently coordinated. This is the number one cause of the long delays. The investigation also revealed other causes such as the following:

• the difficulty recruiting external experts (occupational therapists and architectural consultants) and the frequent shuttling between the SAAQ and these experts;
• at times, rigid application of the principle of the "most appropriate and least expensive solution;"
• shortcomings in the information given to injured persons and in the support they receive, in particular, for calls for bids.

Even if in the meantime, the SAAQ adapts a home temporarily, the adaptation only partially meets injured persons' needs. During this waiting period, because the required amenities are lacking, injured persons often have no choice but to cut back on personal hygiene, limit their movement inside the home and ask their family for help.

The Québec Ombudsman's recommendations

The Québec Ombudsman made financially realistic recommendations to the SAAQ with a view to countering these long wait times:

1. Set at nine months the maximum wait time for handling home adaptation applications in 80% of cases, and produce an action plan for achieving this objective by December 31, 2016;
2. As of December 31, 2016, evaluate the process for handling home adaptation applications so as to determine whether the objective of nine months can be reduced;
3. Review its application processing methods and adopt methods that involve the injured persons more in the process;
4. Specify what is expected of external resources and ensure close follow-up regarding the requests it sends them;
5. Act so that the occupational therapists and architectural consultants enlisted apply the home adaptation directive uniformly;
6. Reduce delays in awarding mandates to external resources and in the production of reports;
7. Modify its home adaptation directive, in particular so as to define "most appropriate and least expensive solution" and its implementation framework;
8. Evaluate the possibility of issuing reimbursement for the cost of refitting a rental unit;
9. Standardize the type of information sent to injured persons;
10. Provide the injured persons who request it with follow-up on how their adaptation application is progressing;
11. Closely monitor stakeholders' requests to injured persons.

The SAAQ responded favourably to the Québec Ombudsman's recommendations and pledged to send it an action plan by December 15, 2015, and on March 31 and December 31, 2016, to report on how this plan is progressing.

See the report on the SAAQ's processing of home adaptation applications (summary).

SOURCE Protecteur du citoyen

Information and requests for interviews: Carole-Anne Huot [phone]/[phone] [email protected]; Joanne Trudel [phone]/[phone] [email protected]