1.4.9 Children with FASD

This section contains policies and standards relating to children in care of a child and family services agency who have been diagnosed with or suspected of being affected by Fetal Alcohol Spectrum Disorder (FASD).

Fetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe impacts on the brain and body of individuals prenatally exposed to alcohol. FASD is a lifelong disability. Individuals with FASD will experience some degree of challenges in their daily living, and need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential. Each individual with FASD is unique and has areas of both strengths and challenges. More information about diagnostic criteria can be found in the Canadian Diagnostic Guidelines or the Manitoba FASD Network.

• Legislation

  The Child and Family Services Act
  The Personal Health Information Act

  The Child and Family Services Act
  The following provisions in The Child and Family Services Act (the Act) are particularly relevant to this manual section:

  Section 16 pertains to the voluntary surrender of guardianship of a child (VSG).
  Section 25 sets out the responsibilities of an agency for a child who has been apprehended and the authority an agency has to authorize a medical examination or treatment of the child under apprehension.
  Section 38 gives the courts the power to, among other things, grant a temporary or permanent order of guardianship to an agency or, in the case of a regional office, the director (subsection 7(2)).
  Section 48 pertains to the responsibilities of an agency or, in the case of a regional office, the director as guardian of a child.
  Section 76 addresses privacy concerns that are relevant to the sharing of medical records, as it relates to standard 7 and it outlines cases where access to personal records may be granted.

  The Personal Health Information Act
  Section 22(1) and (2) of The Personal Health Information Act prescribes when a trustee is in a position to share personal health information as defined in section 1 of this Act. Child and family services agencies and their authorities are considered trustees under this Act.

  These provisions allow (among other things) for sharing of relevant health information when that information “…is necessary to prevent or lessen a serious and immediate threat to the health and safety of the individual the information is about or another individual….”

• Policy

  Manitoba’s FASD Strategy
  Manitoba's FASD Strategy is committed to realizing five important goals:

  • Knowledge: drinking alcohol during pregnancy can cause FASD
  • Prevention: before, during and after pregnancy, girls and women have information, support and services
  • Intervention: people with FASD and their families have assessment and diagnostic opportunities, supports and services
  • Evidence: services are based on strong research, evaluation and community input
  • Quality: trained service providers using best practice approaches

  FASD Related Resources
  The Department of Families website contains information about prevention, supports, networks and resources in Manitoba. Healthy Child Manitoba has developed a list of FASD Services in Manitoba that individuals and families can access across Manitoba.

  Referrals/Services Available for Adults
  Youth with FASD may be eligible to receive adult services from Community Living disAbility Services (CLDS), Community Mental Health (CMH) or Employment and Income Assistance (EIA). Planning for transition to adulthood should start when the youth is 15 years old. This is essential to ensure funding, medical assessments and school records are available. In some situations youth need to move because services are not available in their home community.

  Medical Information and Records – The agency transitioning a youth out of care must ensure the youth’s medical record and FASD diagnosis are available and used to connect the youth with the appropriate community services.

  School Records – Children are required to attend school until they attain 16 years of age. As schools close their files when youth leave their system, school systems prefer to provide information when the youth in question is 16 years of age. For that reason, schools should be approached when the youth is still fifteen.

  Community Living disAbility Services (CLDS)
  To be eligible for CLDS, an individual must:

  • Have significantly impaired intellectual functioning with impaired adaptive behaviour, existing prior to age 18. Usually the individual must have an IQ that is lower than 70 and require assistance to meet his/her basic needs.
  • Be 18 years or older,
  • Be a Canadian citizen; and
  • Live in Manitoba.

  Community Living disAbility Funding needs to be secured through the CLDS annual budget cycle in the year before the youth makes the transition out of care. As a result the youth’s referral to CLDS must be submitted by their sixteenth birthday.

  Delayed Access to Community Living disAbility Services – Being eligible to receive CLDS services, such as funding and residential support, does not guarantee these services will be available when the youth turns 18. The individual may be placed on a waiting list until resources become accessible, but the serving agency is still responsible to provide case management services, and is expected to collaborate with other community programs as offered through Manitoba’s FASD Strategy or Manitoba’s Home Care Program.

  Note: Additional information about transitioning youth to CLdS is available in the Community Living disAbility Services document Transition Planning: Child and Family Services to Adult Supports. The Bridging to Adulthood Guide, Checklist to Support Transition to CLdS and the CLdS application are available in CFSIS forms\Case Managment\CS\Transitoning to Adulthood. 

  Community Mental Health Services include assessment, case management, rehabilitation, supportive counselling and crisis intervention. Community-based mental health services are operated by regional health authorities or through contracted organizations. These services assist people with mental health difficulties to develop coping and living skills and obtain other community services needed to meet their living needs and personal goals.

  Employment and Income Assistance (EIA) provides financial help to Manitobans who have no other way to support themselves or their families. This includes benefits from the Rent Assist Program that helps with housing costs. For people who are able to work, EIA will help them go back to work by providing supports to employment.

• Standards

  Services to Children in Care and Caregivers

  1. Identification and Diagnosis of FASD – A child suspected of having FASD is referred for a medical examination and diagnosis, before the age of six or as early as possible thereafter. The referring worker obtains:
  • reliable confirmation of prenatal exposure
  • written evidence of child’s learning and behavioral difficulty, and
  • the consent of the child’s legal guardian if the agency does not have guardianship

  Referrals for diagnosis can be made to the Manitoba FASD Network. A Regional FASD Diagnostic Co-ordinator will coordinate screening, diagnosis, and follow up with those suspected of having FASD.

  2. Preparing and Involving Caregivers for Children with FASD – The development, implementation and review of care plans for children with FASD are done in close collaboration with the child’s caregivers from the beginning of the planning process. Activities such as specialized training, arranging support and respite, and involving them with external collaterals, are recorded on the child’s file on a monthly basis at minimum.
  3. Support and Respite – The case manager responsible for the child in care ensures support and respite are consistent with:
  • child assessment standards in Section 1.1.2, Assessment
  • care plan standards in Section 1.1.3, Planning
  • case evaluation standards in Section 1.1.5, Evaluation
  • when relevant, respite and support provisions for foster and place-of safety homes

  4. Transitioning Youth with FASD – The case plan prepares adolescents living with FASD for better transitioning into adulthood and inter-dependence. The agency, in collaboration with other service providers, begins creating a transitional plan for the child before the age of sixteen.

     The development of a care plan may involve referring the adolescent to Community Living disAbility Services, or other services as warranted, which address issues around housing, finances, work, health care, mental health and addictions.

     As outlined in section 2(1) (f) of the Act, the child or youths’ views should be taken into account when formulating a care plan.

     The guardian agency may seek the extension of services it provides to a youth up to the age of 21, where the youth was formerly a permanent ward. Section 50(2) of the Act explains that the youth may require such assistance as part of making the transition to independence.
  5. Personal Health and Mental Health Information – Information on the personal health, including mental health of a person is recorded in the agency worker’s case notes and collected by the client’s guardian agency.  This information is stored in the service record of the person or family to which it applies.
  6. Medical Records and Transition Planning – Medical information and records on individuals living with FASD is recorded or stored on the child’s file and kept up-to-date. This is an important part of tracking because it can be used to connect those 16 or older with various community services once they have transitioned out of care.

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