One Response to Provincial FASD Strategy

On April 27, 2017 the provincial government of Ontario released the Ontario 2017 Budget Providing $26 Million for FASD. While on the surface this seems like a lot of money, and is cause for celebration, it really isn’t much money for direct service and includes no funding for adults with Fetal Alcohol Spectrum Disorder.

I found a response to the announcement by Mark Courtepatte posted on the FASD Facebook group “Flying with Broken Wings”. There are some assumptions made by that author but overall it does provide some concrete and thought provoking responses and analysis on the new budget allocation for FASD.

It is important to note the original response is not mine – but I have expanded on it by adding hyper links to support the facts, and in some cases added my own comments to further illustrate the original author’s response.

While some people may look at the FASD investment and strategy as a huge positive step, if you look closer, the strategy and investment is sadly inadequate and does not meet their promises as stated during the FASD Roundtable sessions.

It is not a “leading” FASD strategy in Canada (and as well is 1.5 years late) and will provide no real value. The wording in the announcement is intentionally vague. 

The following provides some information that illustrates why the strategy is inadequate and inferior. – Mark Courtepatte

The $26 million investment over 4 years equals $6.5 million/year.

By comparison the Ontario 2016 Budget allocated $333 million over 5 years [or $66.6 million a year] for Autism or 13 times the FASD budget, yet research confirms the prevalence of FASD is greater.

According to Autism Ontario  1 in 94 children is diagnosed with ASD or approx 1%. Various websites quote the numbers from 70,000 – 100,000 of people diagnosed with Autism.

FASD Canada

The prevalence rate for FASD has been estimated from a low of 1% up to as high as 5% – meaning the total number of people with FASD could be as high as 699,150 people.

This amount of money allocated over the low estimate of 136,000 Ontarians with FASD would amount to approximately $6 per person for programs, services and support.

Note: This figure was arrived at by the original author subtracting his estimated cost for each of the 56 workers announced in the budget. If we use the total $6.5 million each year allocated for FASD and divide it by the low estimate of people with FASD, (136,000) each individual would receive $47.79 worth of service per year.  However, 136,000 people will not be receiving services.

The Province’s investment and strategy indicates it will support “approximately 2,500 Ontarians with FASD”.

Based on Ontario’s population of 13.6 million and Health Canada’s understated 1% incidence there are at least 136,000 people in Ontario affected by FASD.

It appears their strategy ignores 133,500 Ontarians with FASD.

The Ontario government’s $6.5 million annual investment for 2,500 people equates to $2,600 per person (or just $360 per person if we exclude the amount for the 56 workers. Refer to next point). 

Based on the Budget Committee’s estimate of 136,000 Ontarians with FASD and $2,600 per person, they would have had to invest $353.6 million per year or (approximately) 54 times the $6.5 million per year amount included in their budget. 

The $6.5 million allocated to FASD in the 2017 Ontario Budget amounts to only 2% of the funding required to support the accurate (low estimate) FASD population. 

I did a little research, and the population figure used by the Ontario government is not an up to date figure. According to Statistics Canada the actual population of Ontario in 2016 was 13,983,000. This means that if only 1% of the population is living with FASD in Ontario, there were 139,830 people in 2016 with FASD – 3,830 more than the Province is accounting for.

So, in reality, there are 137,330- 697,150 people in Ontario with FASD who will not have access to any of this money.

The Budget will provide funding for 56 FASD “workers”.

However as we all know, the thousands of healthcare and social workers in the system today have provided little to no support and services for people with FASD and the vast majority have little or no “real” knowledge of FASD.

The FASD Roundtable report clearly noted that one of the significant complaints is that the healthcare and social services workers today provide little to no support or assistance. 

We therefore ask, what value or services will these 56 additional people provide?  Or will it just mean that there is another 56 people added to the cost that will provide no greater value or help.  What skills or training will they have?  How will untrained resources provide any value or assistance? 

As well, even if they are trained in supporting FASD (any by training we don’t just mean that they know what causes FASD and the primary and secondary characteristics, etc), spreading 56 workers over their understated 2,500 FASD individuals amounts to each resource worker supporting 44 individuals. 

If we estimate the average cost for each of the 56 workers (salaries, benefits and business overhead, office space, expenses, etc) is $100,000 – this amounts to a total annual cost of $5.6 million, and only $900,000 would remain for programs and support. 

A recent interview referenced the 56 workers will only support the 2,500 children and youth the provincial government seems to think are the only ones requiring service.

You can find the interview here: CBC “All in a Day”  in which Sophie Kiwala, MPP and Parliamentary Assistant to the Minister responsible for the Ministry of Children and Youth Services, and “point person” for the Province’s FASD Strategy speaks about the 2,500 children and youth the new workers will support.

The money for hiring FASD workers would have been better spent  providing mandatory FASD training to all healthcare workers, doctors, nurses, and social services staff.

The strategy does not include a single dollar for diagnostic services.

Diagnostic services were identified as a major gap during the Roundtable sessions and their report.   Ignoring this means that not only the currently undiagnosed population, but the ones being born each year with FASD will not able to easily obtain a diagnosis will not receive the services and support.

In addition it means, the Ontario government will continue to underestimate the real impact of FASD….and therefore the incidence will continue to grow.

The strategy does not include any money for awareness and prevention.

Without awareness the incidence of FASD will continue to grow…and the 136,000 – 699,150 people with FASD in Ontario will continue to encounter people who have never heard of FASD and will not understand how best to support these individuals.

Autism, which receives more money and is more recognized and understood.  FASD is still (and will continue to be) the least known, but leading cause, of neurological disorders in Canada.

The Ministry of Children & Youth Services FASD Roundtable report indicated 5 themes as noted below – clearly their strategy ignored the report (comments in brackets):

  1. Awareness and Prevention (there is no specific mention in their strategy goals – people will continue to encounter healthcare workers, teachers, social workers and the general public who know nothing about FASD Screening);

2. Assessment and Diagnosis (this is totally absent from the strategy);

3. Programs, Services and Supports for Individuals and Caregivers (as noted above, the resources and investment will provide inadequate support);

4. Training for Front-Line Staff and Professionals (the strategy states “One stop access to information training/resources – however this clearly does not suggest a formal training to all front line staff and professionals); and

5. Evidence-Based Service Delivery Models (totally absent from the strategy).

In summary, Mark states: their FASD strategy does not achieve the goals and promises by the Ontario Ministry of Children & Youth Services.

The newly funded worker positions will only provide support to 2% of the estimated total Ontarians with FASD.  The strategy lacks awareness, prevention, screening, assessment and diagnostics.  It also does not provide any formal mandatory training to the thousands of healthcare and social services resources that exist today.

The cost for 56 FASD workers will use up an estimated 86% of the FASD investment budget, and their value is not expected to provide any greater value or support than the thousands of healthcare workers today.

He further notes: no one knows what causes autism but we do know what causes FASD.

Warning Signs must be posted where alcohol is sold in Ontario.

FASD is caused by alcohol consumption during pregnancy. As well, there are studies now showing that not only do birth mothers, but birth fathers who drink alcohol can affect an unborn child.

A recently published study  suggested that initial estimates show an 11% reduction in women consuming alcohol while pregnant when signage and warnings were posted. You can find that study here.

We should remember that FASD is caused by a product that is distributed by the Province of Ontario.

The Province owns and regulates the sale of alcohol, mainly through the Liquor Control Board of Ontario. LCBO profits from alcohol sales in 2016 was $1.9 billion.

Autism received $333 million (over 5 years in the 2016 budget) however Autism is not as a result of a product (alcohol) the Province regulates and receives profits from.

The Liquor Licence Act requires certain premises to post signs warning women that drinking alcohol during pregnancy can cause Fetal Alcohol Spectrum Disorder.  It must be prominently displayed in all locations where beverage alcohol is sold or where customers brew their own wine or beer for take home consumption. Failure to comply with the signage requirements may result in administrative action by the AGCO. The government should go one step further and donate proceeds of sales to a larger scale FASD awareness and prevention campaign.

FASD will receive $26 million over the next 4 years and most of the investment (according to this author’s estimates) will go the pay salaries for Ontario government employees (the author of this response assumes the workers will be government employees, but there is no information to support who the workers will be employed by) …it is shameful.  We are still one of the worst provinces in Canada…this is a “non-strategy”.

We need to speak out and tell the Ontario government that their FASD Strategy and investment is grossly inadequate, it fails to deliver on their promises or provide any meaningful support to individuals with FASD in Ontario!  As to their strategy being “leading”… it is not even close!!   I believe that the province released this in anticipation of the next election thinking it would appease the FASD voters.

So what can we do?

Write your Member of Provincial Parliament and Michael Coteau, the Minister of Children and Youth Services. Tell them that the Budget is inadequate, it failed to meet the provincial Roundtable recommendations and will not provide any meaningful support to the (low) estimated 136,000 people with FASD in Ontario. In fact up to 697,150 people will not be served by this Budget.

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