[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1009 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 1009
To establish a demonstration program to explore effective practices to
improve early detection and management of injuries indicative of
potential abuse in infants under the age of 7 months, in order to
prevent future cases of child abuse and related fatalities.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 3, 2019
Ms. Baldwin (for herself and Mr. Cassidy) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To establish a demonstration program to explore effective practices to
improve early detection and management of injuries indicative of
potential abuse in infants under the age of 7 months, in order to
prevent future cases of child abuse and related fatalities.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Early Detection to Stop Infant Abuse
and Prevent Fatalities Act''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) According to the National Child Abuse and Neglect Data
System, an estimated 1,720 children died from abuse or neglect
in the United States in fiscal year 2017. Seventy-two percent
of child fatalities involved children younger than 3 years, and
50 percent involved infants younger than 1 year.
(2) According to the Commission to Eliminate Child Abuse
and Neglect Fatalities, infants and toddlers are at high risk
of an abuse or neglect fatality compared to other age groups
and require special attention. Because these young children are
seen by health care professionals, the Commission recommended
coordinated, cross-system approaches to prevention.
(3) Multiple studies have found that relatively minor,
visible injuries in young infants, including bruising and
intraoral injuries, are often indicators of abuse. Such
injuries are commonly overlooked by medical providers,
caregivers, and child welfare professionals because they seem
trivial. Without early intervention, physical abuse can
escalate, resulting in severe injuries or even fatalities. Many
child abuse professionals refer to such injuries as ``sentinel
injuries'' in young infants because of their importance as
early warning signs of abuse.
(4) Research conducted in Wisconsin showed that previous
sentinel injuries were identified in 27.5 percent of abused
infants and 30 percent of infants who suffer abusive head
trauma but were rare in infants who had not been abused. Other
studies have demonstrated similar rates of missed opportunities
to identify abuse in young infants.
(5) Proper identification of, and response to, such
suspicious injuries provides an opportunity for early
recognition and intervention to protect vulnerable children and
prevent many cases of abuse and related fatalities, as well as
an opportunity to detect medical conditions that require urgent
treatment.
(6) Early detection of such injuries and effective
evaluation and intervention requires education of caregivers of
young infants, child protective workers, and medical
professionals about the significance of such injuries in young
infants.
(7) Best practices and protocols need to be developed to
ensure an effective response by medical professionals, child
protective services, and other professionals when sentinel
injuries are detected.
SEC. 3. DEMONSTRATION PROGRAM.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish a
demonstration program to award grants to eligible entities in order to
test effective practices to improve early detection and management of
injuries indicative of potential abuse in infants under the age of 7
months to prevent future cases of child abuse and related fatalities.
(b) Activities.--Recipients of grants under this section--
(1) shall use such award to--
(A) develop, implement, or expand training and best
practices to assist medical professionals in
identifying, assessing, and responding to injuries
indicative of potential abuse in infants under the age
of 7 months, particularly bruising and oral injuries;
(B) develop protocols and policies that improve
communication and coordination between mandatory
reporters and child protective services when such
reporters identify such injuries; and
(C) conduct the evaluation under subsection (e);
and
(2) may use such award--
(A) to raise awareness regarding the significance
of such injuries by mandatory reporters, health
professionals, the public, professionals caring for
children, home visitors, child care workers, and child
protective services staff; and
(B) for other purposes, as the Secretary determines
appropriate, including using the approaches described
in subparagraphs (A) through (C) of paragraph (1) to
address injuries indicative of potential abuse in
children aged 7 months and older.
(c) Eligible Entities.--
(1) In general.--To be eligible to receive a grant under
this section, an entity shall--
(A) demonstrate knowledge and experience providing
health services to children and identifying and
responding to child maltreatment; and
(B) submit to the Secretary an application at such
time, in such manner, and containing such information
as the Secretary may require, including--
(i) a description of the entity's planned
activities, including--
(I) plans to reduce child re-
victimization and child fatalities; and
(II) plans to evaluate success,
including pertinent data sources that
will be developed or utilized; and
(ii) entities with whom the applicant will
collaborate in carrying out the activities
under the grant.
(2) Multidiscliplinary partnerships.--An eligible entity
shall be a multidisciplinary partnership of stakeholders with
knowledge and experience providing health services to children
and identifying and responding to child maltreatment, which may
include nonprofit organizations, community-based organizations,
administrators of any programs funded under the Child Abuse
Prevention and Treatment Act (42 U.S.C. 5101 et seq.),
children's health care providers, board-certified child abuse
pediatricians, child protective services, child advocates,
State child death review boards, child advocacy centers, State
department of justice officials, children's hospitals,
disability organizations, and mental health and social services
providers.
(d) Grant Period.--Grants awarded under this section are for a 3-
year period.
(e) Evaluations.--The Secretary shall require each recipient of a
grant under this section to--
(1) evaluate and assess--
(A) the efficacy of the projects carried out with
grant funds; and
(B) the extent to which such projects reduced re-
victimization of children and child fatalities; and
(2) submit a report on such evaluation and pertinent data
to the Secretary.
(f) Report to Congress.--Not later than 1 year after the conclusion
of the demonstration program under this section and the submission of
the report and data under subsection (e)(1), the Secretary shall submit
to Congress a report that includes--
(1) an analysis of the strengths and opportunities of the
program;
(2) barriers or challenges for implementing or replicating
best practices under the program;
(3) the feasibility of a national educational campaign on
injuries indicative of potential abuse in infants under the age
of 7 months; and
(4) areas for further research or evaluation to improve
early detection of such injuries.
(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $10,000,000 for the period of
2020 through 2022.
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