I’m writing in support of The FASD Respect Act (HR4151/S2238). Congress first addressed Fetal Alcohol Spectrum Disorders (FASD) as Fetal Alcohol Syndrome in 1998. Since then funding has dwindled in the case of research and surveillance, and stopped all together in the case of support, training or intervention on a federal level. Currently only 1 million dollars at HRSA for a pilot project on screening and intervention exists as a federal investment for this population with an estimated prevalence of 1:20 and a rate of drinking among pregnant women rising from 1 in 9 to 1 in 7 in recent years. The House Appropriations Committee report in the 2023 Presidents budget urges the CDC to do more, but no additional funding was granted. Without federal investment, few if any states have implemented or maintained programs serving people with prenatal alcohol exposure despite investment in those impacted by prenatal drug exposure, a condition known to cause far less long-term harm. Despite findings that prenatal alcohol exposure remains the number one preventable cause of birth defects and neurodevelopmental disabilities in the United States (Alcohol Research & Health, Vol. 34, No. 1, 2011), the National FAS Task Force authority expired in 2007, annual SAMHSA funding of $9.8 million was reduced to $1 million in FY2014 and eliminated in FY2016, other FASD-related funding has declined and action has stalled on legislation to update federal statutes to address FASD specifically and strengthen federal programming to reverse the upward trend in prevalence and prevent FASD. The mental health toll of a Fetal Alcohol Spectrum Disorders is astonishing, over 95% of individuals with a FASD have co-existing mental health conditions, with high rates of suicide, addiction and homelessness. Unfortunately, standard mental health practices do not work effectively with this population or take into account the brain-based learning differences in a person with FASD. FASD informed supports and services are desperately needed but are not regularly available to the vast majority of the population. The FASD Respect Act would help to change that.