[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1009 Introduced in Senate (IS)]

<DOC>






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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