Recommendation 1: That the Ministry of Children and Family Development (MCFD) fully fund and implement a CYSN service framework and plan, fully inclusive of children and youth with FASD. The formation of the service framework and plan must extensively engage Delegated Aboriginal Agencies (DAAs) and all appropriate partners. This framework must articulate a comprehensive and accessible array of CYSN services, delivered based on both an assessment of functional needs and diagnosis and, therefore, fully including children and youth affected by FASD. MCFD to begin implementation by Sept. 30, 2021 and complete full implementation of the CYSN service framework and plan over a three-year period ending March 31, 2024.

Recommendation 2: Pending full implementation of Recommendation 1, that MCFD immediately include suspected or confirmed FASD, based on an assessment of functional needs, in the eligibility criteria for CYSN Family Support Services, thereby allowing children and youth with FASD and their families to access services available to others with specific neuro-developmental conditions. The ministry should seek appropriate funding to expand the capacity of these services to adequately support the number of newly eligible FASD families so that this recommended expansion of service eligibility does not lead to reduced services or longer wait lists for other CYSN families. MCFD to secure immediate funding enhancements and begin implementation of the expanded eligibility criteria by Sept. 30, 2021.

Recommendation 3: MCFD to complete a comprehensive review of evidence-based and promising practices specific to serving children and youth with FASD, including from the Key Worker Parent Support Program, for integration into the CYSN framework. In the meantime, MCFD to take immediate action to ensure that the KWPSP has consistent quality service across all regions of B.C. and is accessible to all families of children and youth with FASD. MCFD to take immediate action to ensure equitability and accessibility of the KWPSP by Sept. 30, 2021 and complete the best practice review by March 30, 2022.

Recommendation 4: As a first step toward realizing fundamental changes in practice that address racism, stigma and bias, MCFD, in collaboration with DAAs, community service agencies and caregivers, to conduct a review of existing FASD awareness training and the training needs of all front-line staff working with children and youth with FASD. MCFD, working with DAAs, to use this review to support the development of evidence-based, culturally attuned and regularly updated training materials that ground a required training program for current staff across the range of MCFD service lines and, in particular, CYMH, CYSN, child welfare and youth justice. This awareness training should then be incorporated into basic entry training for newly hired staff and made accessible to community service agencies and caregivers. MCFD to complete the reviews and curriculum development and begin training by March 31, 2022 and complete training of all relevant ministry and agency staff by March 31, 2023.

Recommendation 5: That the Ministry of Mental Health and Addictions (MMHA), in collaboration with MCFD, DAAs and the Ministry of Health, lead a review, and develop and implement a plan, to provide effective and accessible mental health services for children and youth with special needs, including FASD. This should include a review of evidence-based, culturally attuned and promising practice models of therapy, intervention and care for children and youth with special needs including FASD, who have mental health impacts, as well as an assessment of current resourcing and resource gaps. The findings of this review and planning should be prioritized and built into MMHA’s Pathway to Hope for implementation. MMHA to complete the review and plan by March 31, 2022, with MCFD and Health beginning the implementation of new service approaches and enhanced services by Oct. 1, 2023, and completing implementation by March 31, 2024.

Recommendation 6: That the Ministry of Health incrementally reduce wait times for complex developmental behavioural conditions (CDBC) diagnostic clinics, and also secure additional resources to provide for periodic follow-up assessments, at key development stages from infancy through to adolescence. The Ministry of Health to reduce wait times to nine months by March 31, 2022; to six months by March 31, 2023; to three months by March 31, 2024; and thereafter increase capacity to provide for follow-up assessments.

Recommendation 7: That the Ministry of Health, in collaboration with the First Nations Health Authority and with guidance from the Task Team formed as a result of the In Plain Sight report, apply learnings from the review of systemic bias to referral pathways and assessment processes for CDBC diagnostic clinics. The changes/improvements should specifically address the issue of bias with regard to the referrals of First Nations, Métis, Inuit and Urban Indigenous children and youth for FASD assessments and ASD assessments. Ministry of Health to complete the review and implement recommended improvements by March 31, 2022.

Recommendation 8: That the Ministry of Health conduct an assessment of existing FASD awareness training and the training needs of appropriate front-line staff working with children and youth with FASD, leading to the development of evidence-based, culturally attuned, Nation-specific and regularly updated training materials that ground a mandatory training program for current staff across the range of health services. Ministry of Health to complete the assessment of existing FASD awareness training by March 31, 2022. Sequentially, the Ministry of Health to identify appropriate priority front-line providers to receive training, by Sept. 30, 2022, and develop training and access to training by Sept. 30, 2023.

Recommendation 9: MCFD together with the Ministry of Citizens’ Services to initiate the development of a cross-ministry plan, in collaboration with the ministries of Health, MMHA, Social Development and Poverty Reduction, and Education, and in association with DAAs, health authorities and Community Living BC, to routinely collect high-quality demographic and service data that allows for disaggregation, providing an essential foundation for more effective policy development, program provision and service monitoring for children and youth with special needs and their families, including those with FASD who are receiving services from these public bodies. The cross-ministry plan to be completed and implemented by April 1, 2022 and fully implemented by March 31, 2024.

Recommendation 10: That the Ministry of Education update its Inclusive Education Policy and supporting documents and incorporate information to increase awareness and understanding of the specific learning needs of children and youth with FASD and related disorders into the supporting documents. Ministry of Education to update Inclusive Education Policy and supporting documents and incorporate information to enhance awareness of FASD and related disorders by Sept. 1, 2021.