JUST Committee Report
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Mr. Mike Wallace Dear Mr. Wallace: We are pleased to respond on behalf of the Government of Canada to the Nineteenth Report of the Standing Committee on Justice and Human Rights entitled Study of the Subject Matter of Bill C-583, An Act to amend the Criminal Code (fetal alcohol spectrum disorder), tabled in the House of Commons on May 8, 2015. On behalf of the Government of Canada, we wish to thank the Committee members for this valuable study. The Government recognizes that fetal alcohol spectrum disorder (FASD) is a serious public health issue affecting thousands of Canadians. Addressing FASD and other mental health disorders and disabilities is a priority for this Government. This includes mental health issues in the criminal justice system. Supporting those with mental health needs already in contact with the justice system is a priority. Prevention efforts are critical, as those who live with FASD without necessary supports may find themselves in conflict with the law and in contact with the criminal justice system as both victims and offenders. Preventing FASD requires a focus on raising awareness about the risks of drinking alcohol during pregnancy and promoting a healthy pregnancy. Recognizing that health care delivery is the primary responsibility of provinces and territories (PTs), the Government of Canada is committed to collaborating with PTs and stakeholders to address FASD in a manner consistent with the federal role. The Government takes a leadership role in preventing FASD through various activities, such as the Public Health Agency of Canada’s FASD Initiative. The Initiative’s goal is to raise awareness and change attitudes towards alcohol use during pregnancy, as well as to enhance capacity to diagnose and support children and adults with FASD. When the Initiative began, clear and concise information on FASD was not readily available; families and practitioners had limited options for finding useful information. The evidence had not been compiled or summarized in a way that made it easy to understand or use, and much of the most helpful information could only be found in a small number of scientific journals. That has now changed largely as a result of continued collaborative efforts with PTs and stakeholders. The Government of Canada takes a holistic, integrated approach to FASD, recognizing that FASD is not just a health issue, but has long-term societal and economic implications. Federal departments work in an integrated manner on prevention and awareness approaches, and undertake joint work on data collection and reporting. For example, the Public Health Agency of Canada and Justice Canada together funded and supported the development of www.FASDjustice.ca, a website for legal practitioners and others who require more information on FASD. To enable this work, the Public Health Agency of Canada leads the FASD Interdepartmental Working Group, comprising representation from multiple federal departments. Federal FASD work is undertaken through a range of partnerships with PTs, Aboriginal organizations, communities, academics, researchers, the medical community and other stakeholders. For example, Justice Canada co-chairs a FPT Steering Committee on FASD and Access to Justice. The Committee focuses on information sharing within the FPT community, education of the legal community, and identification of people with FASD in the criminal justice system. In addition, federal work is also addressing the specific needs of First Nations and Inuit and those along the justice continuum. The goal of all partners in all jurisdictions, including the federal government, is to prevent future alcohol affected births, and to improve outcomes for individuals already affected by FASD, together with their families, caregivers and their communities across Canada. This response addresses each of the Committee’s recommendations. Recommendation 1 The Committee recommends that more resources be allocated to crime prevention and diversion programs for individuals with fetal alcohol spectrum disorder. The Government supports crime prevention efforts across the country through Public Safety Canada’s National Crime Prevention Strategy (NCPS). Through the NCPS, Public Safety Canada provides time-limited funding to communities and organizations to implement evidence-based crime prevention interventions. These interventions are evaluated in order to build and share practical knowledge of what works in crime prevention in Canada. The NCPS prioritizes funding for children, youth, and young adults at risk of future offending; responds to priority crime issues (youth gangs, cyberbullying); and places a particular emphasis on fostering prevention in Aboriginal communities. In 2015-16, $41.8M will be available, through the NCPS, to support community-based crime prevention programming in Canada. NCPS-supported projects target multiple risk factors, including those that may be demonstrated by individuals affected by FASD. It is important to note that the majority of projects under the NCPS do not address FASD directly; however, the NCPS has provided funding to several innovative projects in recent years that have focused specifically on FASD. For example, the NCPS supported the project FASD and Justice Issues at the Community Level in Northwest Territories (NWT) from 2007-2011. Through this project, recipients undertook research and data collection to gain a better understanding of the number of youth in the NWT justice system affected with FASD. The project also provided training to frontline justice workers to increase their understanding of the impact that youth with FASD have on the justice system, and worked with justice stakeholders to identify ways of accommodating the needs of youth who are, or may be, affected by FASD. This project was highly successful in raising awareness and educating stakeholders, and was sustained by the Government of NWT when federal funding ended. The NCPS also provided funding to the Youth Outreach Program in northern BC from 2008-2011. This project arose out of concern that there was a high number of youth in the target community who had behaviours and/or characteristics associated with FASD, and who were deemed at high risk of experiencing secondary effects of FASD, such as: alcohol and drug use; violence and/or victimization; and vulnerability to sexual exploitation and/or prostitution. The Youth Outreach Program was an intensive outreach and support program that incorporated: individualized advocacy and support; skill development; mentorship; family activities and workshops; and community education/awareness-raising about the challenges faced by populations living with FASD. The project was highly successful, with a substantial percentage of participants reporting: improved social relationships/support with and from peers; reduced substance use; and reduced involvement in criminal activities and in violence. Post-charge diversion out of the criminal justice system is a PT responsibility as it relates to the administration of justice. As such, the federal role in this area is limited. Each PT will operate its own diversion programs subject to its own priorities and specific policies. Recommendation 2 The Committee recommends that the federal government work with PTs to encourage the development of a FASD awareness campaign to inform the public and people who work with those living with FASD. The Government believes that information and awareness are the foundations to prevent FASD for women, families, professionals from all sectors and the general public. This is particularly true for vulnerable populations, such as those who have low incomes, Aboriginal people, those who are victims of violence or who suffer from addictions. They experience a greater risk of chronic disease, substance abuse, and poor mental and physical health than the general population. FASD awareness is integrated into federal FASD prevention initiatives that: i) provide support for those at risk of having a child affected by prenatal alcohol exposure; ii) raise awareness and support public education about FASD and healthy pregnancies in general; iii) talk to women about alcohol use; iv) provide specialized community-based supports for women who may be at-risk for using alcohol in pregnancy; and, v) support new mothers who face conditions of risk to maintain healthy changes and prevent future pregnancies affected by alcohol. The Government also provides direct supports for substance use issues among First Nations and Inuit. Canada’s Low-Risk Alcohol Drinking Guidelines Through Canada’s Low-Risk Alcohol Drinking Guidelines, information is provided on long-term (chronic) effects of alcohol consumption such as liver disease and certain cancers, and short-term (acute) effects such as injuries and overdoses. The Guidelines were developed by the National Alcohol Strategic Advisory Committee, which is comprised of 27 representatives from federal and PT governments, the Canadian Centre on Substance Abuse and other non-governmental organizations, academia, and industry. They indicate that zero alcohol consumption is the limit for those who are pregnant, or planning to be pregnant, and are an important resource for PTs and local jurisdictions to raise awareness about the risks of alcohol-related harm. Information for health care providers and justice system professionals The Government has worked closely with key stakeholders to support activities that raise awareness, provide information and serve as tools relating to FASD prevention, including: i) Fetal Alcohol Spectrum Disorder (FASD) Guidelines for Diagnosis Across the Lifespan (revisions anticipated to be released in 2015); ii) Alcohol Use and Pregnancy Consensus Clinical Guidelines (Journal of Obstetrics and Gynaecology Canada, 2010) that provide frontline health practitioners with clear guidance for talking with women about alcohol use; iii) National Screening Tool Kit for Children and Youth Identified and Potentially Affected by Fetal Alcohol Spectrum Disorder (Canadian Association of Paediatric Health Centres, 2010) to help frontline workers in various settings, such as health clinics, schools, and for those working with young offenders, to help identify and refer individuals for further evaluation; iv) workshops delivered by the University of Toronto across Canada between 2006 and 2012, entitled Pregnancy-Related Issues in the Management of Addictions, for doctors, nurses, midwives, and social workers on problematic substance use in pregnancy enabling training of over 3,300 community practitioners; and, v) an online evaluation model, entitled Evaluation of FASD Prevention and FASD Support Programs, designed for communities to increase their capacity to measure effective programming for prevention, for support, and for Aboriginal populations. Information for the public The Government supports public education on FASD through a variety of tools. Examples include: i) a booklet for the general public, entitled Fetal Alcohol Spectrum Disorder (FASD), that describes, in very straightforward terms what FASD is and provides advice on how to talk to a health care provider about FASD; ii) a resource for caregivers and parents, entitled Caregiver Curriculum on FASD, that contains information, guidance and strategies on how to support children with FASD; and, iii) a booklet, entitled Let's Talk FASD, which contains information on preventing FASD for women, as well as strategies for helping those who are affected by FASD. The Government promotes healthy pregnancies through the Public Health Agency of Canada’s Sensible Guide to a Healthy Pregnancy. The guide is a practical booklet that includes information on a variety of issues, including alcohol consumption, which helps women make good decisions about how to take care of themselves before, during and after pregnancy. It is disseminated widely throughout Canada and is available in multiple formats to ensure accessibility. Information to support First Nations and Inuit communities Although the health status for First Nations and Inuit in Canada is improving overall, substance use issues continue to be a priority. As such, Health Canada supports the delivery of a variety of culturally appropriate and community-based programs designed to prevent and treat the effects of substance use, such as FASD. Through Health Canada, the Government invests $14.2 million annually in First Nations and Inuit communities to educate and raise awareness about the impacts of FASD, to develop culturally appropriate prevention and early intervention programs and to train frontline workers. This includes: supporting 29 evidence-based mentoring projects in various First Nations and Inuit communities across the country; supporting community coordinator positions in 17 First Nations and Inuit communities; providing education, training and the use of asset mapping to help First Nations and Inuit communities identify their strengths, and develop a plan of action that informs FASD risk factors and protective factors. Through Health Canada, the Government is investing $500,000 over three years to provide additional FASD supports for First Nations in the Yukon, beginning in 2015-16, for a community of practice and for clinical supervision capacity. Clinical supervision will: strengthen local capacity through enhanced training and education to assess and diagnose individuals with FASD; share best practices and lessons learned in the areas of FASD diagnosis and awareness; extend the evidence base of what works in a Yukon context more broadly; and promote collaborative planning for individuals with FASD. The establishment of a FASD-specific community of practice through learning and training events will help support individual clients connect with needed housing, addiction recovery, counselling, and mental health services and education supports in their communities. In 2014-2015, Health Canada provided $25,000 to the Canada FASD Research Network (CanFASD) to complete a preliminary analysis of newly revised FASD diagnostic guidelines (Fetal Alcohol Spectrum Disorder: Guidelines for Diagnosis Across the Lifespan, 2015 forthcoming) in order to identify aspects of the Guidelines that could be adapted to meet the needs of First Nations and Inuit communities and populations. The CanFASD network, comprised of more than 150 partners, is already benefiting Canadians. For example, FASD researchers involved in this initiative have established a national dataset linking behaviours seen in the disorder to brain structure and genetic profiles. This will provide a better understanding of a child with FASD, better support the discovery of diagnostic biomarkers, and help assess therapeutic interventions for children affected by this condition. Community-based programs In addition to raising awareness, the Government invests in community-based programming to improve health outcomes for pregnant women, infants and young children facing conditions of risk, including FASD. The Health Portfolio’s Canada Prenatal Nutrition Program (CPNP) aims to improve maternal and infant nutritional health among high risk pregnant women. The program primarily targets pregnant women and mothers with infants up to 12 months of age and supports activities related to: nutrition screening, education, and counselling; maternal nourishment; and breastfeeding promotion, education and support. CPNP serves pregnant women most at risk—including adolescents, those who live in poverty, have issues with alcohol or substance use, and those exposed to family violence. Funding is $27.2 million annually, with an additional $12.7 million provided for those in First Nations and Inuit communities. Through the Public Health Agency of Canada’s Community Action Program for Children (CAPC), the Government invests $53.4 million annually to promote the health and social development of vulnerable children from birth to 6 years of age and their families who face conditions of risk, including poverty, isolation, teenage parents, substance use, and family violence. Caregivers attending the programs may themselves have FASD or have children with FASD and CAPC programs help them to work towards or maintain healthy lifestyles and learn strategies to help their children. CAPC programs are well placed to help mothers and their partners prevent secondary disabilities related to FASD and to prevent future births of children with FASD. In addition to this funding, Health Canada also invested $23.8 million in 2014-15 in the Maternal Child Health (MCH) Program, which supports home visits by nurses and family visitors to over 8,100 pregnant women and families with young children in 309 First Nations communities. The MCH Program supports an integrated and comprehensive approach to maternal and child health in First Nations and Inuit communities. Services include screening and assessment for risk factors such as the impacts of alcohol use during pregnancy as well as home visits to provide follow-ups, referrals and case management as required to improve health outcomes for pregnant women and families with infants and young children. The Government also invests $80.9 million annually in support for substance use issues more broadly for First Nations and Inuit. Through the National Native Alcohol and Drug Abuse Program (NNADAP) and the National Youth Solvent Abuse Program (NYSAP), Health Canada provides funding to 44 First Nations addiction treatment centres, the majority of which have the capacity to accept pregnant women. NNADAP and NYSAP treatment centres include a range of mainstream and culturally relevant approaches. Through these national programs, First Nations and Inuit have access to inpatient, outpatient, and day treatment services, as well as specialized services for people with unique service needs, including gender-based programming, and programming for families. Federal FASD Initiative As mentioned earlier, the Government remains committed to working with PTs to raise awareness about FASD and support those who are affected by this disorder. The 2012 evaluation of the FASD Initiative confirmed the importance of the Public Health Agency of Canada’s role in raising the profile of FASD and continuing to build commitment across the country to support the prevention of prenatal alcohol exposure and to address the needs of those affected by FASD. The Government will continue to use the $1.5 million in the Public Health Agency of Canada’s FASD National Strategic Project Fund to advance awareness activities nationally. Recommendation 3 The Committee recommends a focus on FASD training for Correctional Service Canada (CSC) and Royal Canadian Mounted Police (RCMP) officers. The Government believes training is important to provide appropriate responses and help support those affected by FASD. CSC provides FASD-specific training to its staff. The two-day Fundamentals of Mental Health Training enhances knowledge of mental health and the ability to respond to the needs of offenders with mental disorders. In November 2012, following a national review of the Fundamentals of Mental Health Training, a component on FASD was included. This training component includes basic information on the causes and prevalence of FASD as well as an overview of the characteristics and symptoms of FASD and how they might appear in someone who is incarcerated. The primary focus of the module is to highlight some of the difficulties for adults living with FASD and to identify strategies that may improve outcomes for these individuals. From April 2007 to March 2014, approximately 10,800 CSC staff, including Correctional Officers, Parole Officers, Primary Workers, and Nurses working both in institutions and in the community, as well as an additional 560 community partners, received the training. The Fundamentals of Mental Health is required training for Correctional Officers, as well as Parole Officers. As of fiscal year 2013-14, the Fundamentals of Mental Health training is now part of the orientation training for newly hired Correctional Officers. The RCMP works to ensure its officers are trained to address issues they encounter in the line of duty. Every call for service is unique. RCMP members are trained to assess each situation individually, based on the totality of the circumstances, including situational factors and the client’s behaviour. Effective communication skills (e.g., patience, remaining calm, offering simple instructions and using repetition) acquired through standard training are found to be successful when interacting with clients who have FASD. This is consistent with a recent study of Saskatchewan police officers, including some RCMP members, which found that they had considerable knowledge regarding FASD. The study also discussed the importance of police officers in managing a client’s actions and behaviours, regardless of whether the client has FASD, as that is often unknown and impossible for an officer to diagnose. RCMP cadets receive their initial training over a 24-week period on techniques to manage a client’s actions and behaviour which includes de-escalation techniques which can be particularly effective in dealing with a person suffering from mental health issues. The RCMP has recently enhanced its annual Incident Management Intervention Model training by placing more emphasis on de-escalation and communication skills and by ensuring that all members participate in a scenario in which they have to deal with a person suffering from mental health issues. In addition, some Divisions of the RCMP offer a variety of training options to members, including Mental Health First Aid, Mental Health Awareness, Crisis Intervention and De-escalation (CID) and Critical Incident Stress Management. The RCMP is currently exploring the feasibility of offering a National CID course to enhance access to this training for all Members. Recommendation 4 The Committee recommends that CSC continue to evaluate community-based best practices to screen offenders for FASD and that FASD be built into existing mental health evaluations. The Corrections and Conditional Release Act requires the provision of essential health care and reasonable access to non-essential mental health care that will contribute to federal inmates’ rehabilitation and successful reintegration into the community. Mental health screening at intake is a key component of both CSC’s 2010 Mental Health Strategy and the 2012 FPT Mental Health Strategy for Corrections in Canada, and is considered a best practice in the provision of mental health services. As such, CSC policy requires that every offender undergo mental health screening within 24 hours of admission to one of CSC’s institutions, and an evaluation of mental health status within two weeks. In addition, the computerized mental health screening system is administered to offenders between 72 hours and 14 days of admission. This automated screening system provides information on mental health status and is designed to identify offenders who may have mental health needs and require mental health services. This screening includes a general measure of cognitive impairment that helps to identify offenders who have cognitive and intellectual disabilities, including those that may be related to FASD. Through CSC’s ongoing engagement with other FPT health partners and professional associations such as the Canadian Psychological Association/American Psychological Association, provincial Colleges of Social Workers and Colleges of Nursing, and the Mental Health Commission of Canada, CSC is kept abreast of current approaches in early detection measures for mental health concerns. Recommendation 5 The Committee recommends that CSC consider strategies to help integrate and rehabilitate individuals with FASD sentenced to two years or more in prison. The Government is committed to supporting those affected with FASD who are incarcerated. Specifically, CSC has implemented strategies to help the integration and rehabilitation of individuals with FASD who are sentenced to two years or more in prison. It has adopted a multi-pronged approach to strengthening the provision of correctional services to offenders with mental health needs. This includes: providing resources to CSC staff; supports for offenders with mental health and/or cognitive disorders prior to release; ensuring CSC’s correctional programs assist offenders with cognitive deficits, including those demonstrated within the FASD continuum; adapting correctional programs to maximize the learning of individual offenders, including those with FASD; offering additional individualized supports; and ensuring offenders undergo education assessments upon admission to maximize their potential to benefit from CSC programs. CSC has developed an online Responsivity Portal to provide CSC staff with information on the specific needs of offenders with mental health considerations. This portal provides information and best practices to assist program facilitators in implementing specific strategies for offenders with mental health issues. It also includes specific information for offenders with intellectual, learning and physical disabilities, FASD, Attention Deficit Disorder, and other needs. CSC also provides offenders who have mental health issues and/or cognitive disabilities with additional support for their release. Clinical discharge planners and community mental health specialists provide reintegration support based on individual need to identified offenders prior to their release and while under supervision in the community. The effective management of cognitive deficits, including those demonstrated within the continuum of FASD, is associated with the likelihood of successful functioning in the community. As a result, all of CSC’s correctional programs encourage and assist offenders to manage hostile attributions, impulsivity, life planning, and crime free goal attainment in order to improve public safety and the quality of life of offenders. CSC employs cognitive and behavioral change strategies in their correctional programs that are consistent with psychotherapies recommended for individuals with a range of cognitive deficits. CSC correctional programs have been accredited by international external experts and are regularly evaluated for empirical public safety outcome results. In addition, all CSC correctional programs are designed to be adapted by program facilitators to maximize the learning of the individual offender. Specifically, the Responsivity Portal is used by program facilitators to provide information pertaining to adapting program delivery to individual needs and circumstances, including for individuals with FASD. The specific resource kit for FASD on the Responsivity Portal includes such information as prevalence, causes, identification, primary and secondary disabilities, challenges to program delivery, what works and what does not work, and how to accommodate and adapt delivery style and correctional program material. All correctional program facilitators are required to attend training and to undergo a quality review and certification process. This process includes, amongst other factors, evaluation of the extent to which the facilitator is able to individualize and adapt his or her approach to effectively respond to responsivity factors for a range of cognitive impairments, including those typically found within the continuum of FASD. Correctional programs, while predominantly delivered in a group format, allow for individual sessions to supplement group work in order to accommodate offenders with cognitive deficits and learning disabilities. Consequently, a facilitator will consider appropriate adjustments or accommodations whenever an individual learning need appears (including FASD or cognitive deficits). If warranted, specialized correctional program groups can be assembled to accommodate individuals with cognitive deficits. CSC has, for example developed an “adapted” version of the Integrated Correctional Program Model, which has specifically designed and tested content, training, and delivery modalities to assist federal offenders suffering from severe cognitive deficits. Upon admission, all federal offenders undergo education assessments. Depending on literacy level, Adult Basic Education may be targeted as a priority referral in order to maximize an offender’s ability to benefit from other CSC interventions. In fact, because of the lower average educational level of offenders at intake, correctional program facilitators are trained to match their delivery style and language to the level of functioning of offenders in their respective groups as an overall strategy. A recent research report entitled “Prevalence rates, profile, and outcomes for federally sentenced offenders with cognitive deficits (Stewart, Sapers, Cousineau, Wilton, and August, 2014) has demonstrated that CSC’s correctional program strategy for Federally Sentenced Offenders with Cognitive Deficits is effective. The report found that the “level of cognitive deficit... was not consistently related to institutional charges or completion of required correctional programs. Furthermore, level of cognitive deficit was not related to returns to custody on release, even when significant covariates were held constant. Likewise, level of cognitive deficit was also not associated with returns to custody with an offence.” In addition, Public Safety Canada announced in 2014 the launch of the Mental Health Action Plan to address the serious mental health needs of offenders. This is a concerted effort to enhance the CSC capacity to effectively and appropriately treat offenders with serious mental health needs through agreements with PT healthcare systems. This Action Plan contains five pillars which are: timely assessment; effective management; sound intervention; ongoing training; and robust governance and oversight. Recommendation 6 The Committee recommends that the federal government work with PTs and key stakeholders to support research on FASD. The Government continues to support innovative research initiatives so that we may better understand this condition. Through the Canadian Institutes of Health Research (CIHR), the Government of Canada is supporting research in neurosciences, maternal health, mental health and addiction, which includes research related to alcohol addiction and research related to the prevention, treatment and diagnosis of FASD. In 2013-14 alone, CIHR invested $129 million in neurosciences, $50 million in mental health research and $17 million in addiction research. The Government of Canada, through CIHR, the Natural Sciences and Engineering Research Council of Canada, and the Social Sciences and Humanities Research Council of Canada, is investing $39.1 million between 2009 and 2020 to support NeuroDevNet, a research network that has FASD as one of its three research priorities. CIHR is also supporting a number of research projects in the area of FASD through its investigator-initiated suite of programs. For example, CIHR supported the work of Dr. James Brien from Queen’s University who investigated new and effective ways of improving memory function, which could in turn increase learning ability and help correct the deficits created by FASD. Since 2013, the Government has provided almost $2 million in funding to projects addressing FASD and the justice system. For example, Justice Canada is currently funding an evaluation of the FASD Youth Justice Program (YJP) at the Manitoba Youth Centre. The evaluation focuses on whether the FASD YJP has built capacity within the family, community and other systems to address the needs of FASD affected youth in the youth justice system and if it has reduced recidivism rates in youth living with FASD. Recommendation 7 The Committee recommends that the federal government work with PTs to encourage standardized data collection on FASD in Canada. It is challenging to accurately assess the number of people affected by the disorder; therefore, the prevalence of FASD in Canada is not known. Only a small percentage of those born with FASD have the sentinel features that would allow identification at birth. Generally, FASD is recognized later in life when individuals begin to exhibit developmental or behavioural issues. The general prevalence rate commonly used in Canada, based on international studies, is approximately 9.1 in 1,000 people. The Government supports studies of prevalence in specific populations. For example, Justice Canada supported a FASD prevalence study in Yukon Corrections. The Public Health Agency of Canada supported studies on the prevalence of FASD in children in care in three provinces. The Public Health Agency of Canada is also currently supporting an ongoing study in Ontario on the prevalence of FASD among school-aged children. The Government of Canada undertakes a number of initiatives that support national data collection related to alcohol use and FASD. For example, the Public Health Agency of Canada supports surveillance of alcohol use and pregnancy through the Canadian Perinatal Surveillance System. These data illustrate the trends in alcohol consumption during pregnancy and indicate that the rate of 15.5% remained stable between 1993 and 2004 but decreased to 10.7% by 2008. The Government also collects data on alcohol use through national surveys, including: the Canadian Community Health Survey; the Canadian Tobacco, Alcohol and Drugs Survey; and the Health Behaviour in School-aged Children Study which reports every four years on alcohol use by youth. Public Safety Canada collects data on whether participants in crime prevention projects have diagnosed mental health issues, conduct disorders, neurobehavioural disorders, and FASD, as well as whether projects include substance abuse treatment and/or mental health supports. Conclusion In closing, we would like to thank the Committee for its important work. This report is both timely and relevant, and has helped to shed light on the challenge facing all of us in preventing FASD. We trust this response articulates the Government’s commitment to continue supporting important initiatives to help address this disorder. Sincerely, The Honourable Rona Ambrose The Honourable Steven Blaney |