The following recent policy and practice changes align with Within our Reach and recommendations of the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF):

Executive Branch

U.S. Department of Health and Human Services report to Congress in response to CECANF recommendations
In its response to the commission’s report issued to Congress in October 2016, the U.S. Department of Health and Human Services (HHS) announced its intention to advance 60 percent of the commission’s recommendations impacting HHS. It listed support for several specific areas of focus, including improved data and research; greater leadership and accountability; enhanced support for home visiting programs (the only evidence-based practice identified by CECANF to impact fatalities); multidisciplinary support for families, including enhanced prevention programs; strengthened tribal child welfare systems; and efforts to address the disproportionate impact of fatalities on African American, American Indian and Alaska Native children.

New guidance from the Centers for Medicare and Medicaid Servuces on maternal depression screening and treatment
In May 2016, the Centers for Medicare and Medicaid Services (CMS) released new guidance about maternal depression screening and treatment. Some states cover maternal depression screening as part of a Medicaid well-child visit. These states may instruct providers to claim for this activity either as a service for the child or for the mother, depending on the mother’s Medicaid eligibility. In addition, states must cover any medically necessary treatment for the child as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.

Changes in the way HHS tracks state and tribal child abuse and neglect data
In May 2016, HHS replaced the Statewide and Tribal Automated Child Welfare Information Systems (S/TACWIS) rule with the Comprehensive Child Welfare Information System (CCWIS) rule. These changes support the use of cost-effective, innovative technologies to automate the collection of high-quality case management data and to promote its analysis, distribution, and use by workers, supervisors, administrators, researchers, and policymakers.

White House Foster Care and Technology Hackathon
In March 2016, the Obama White House hosted a foster care and technology hackathon to discuss various strategies related to breaking down barriers around information-sharing and real-time data exchange. HHS’s Children’s Bureau is committed to specific actions that advance several commission recommendations, including enhancing technology around the Comprehensive Child Welfare Information Systems (CCWIS) and developing new partnerships for data technology.

Department of Justice grant program to eliminate child fatalities through strategic partnerships initiative
The Department of Justice announced a $6 million grant program for the 2017 fiscal year to build on past efforts and existing partnerships to establish a more robust and data-driven approach to address and eliminate serious child injuries, near fatalities, and deaths due to victimization. This program will enable the field to examine current collaborations, expand partnerships, and transform its overall response to the issue using a public health model. This is a more comprehensive approach that encompasses prevention, intervention, and mitigation; considers the collective use of human, public, and private resources; and addresses needs that affect the family, community, and larger society. The program includes a two-year planning phase and a three-year implementation phase at up to four demonstration sites. The funds for this grant are currently frozen.

HHS grant to MITRE Corporation to explore considerations about predictive analytics
A grant to the MITRE Corporation issued on behalf of the HHS Assistant Secretary for Planning and Evaluation will provide an assessment of the potential benefits and pitfalls of predictive analytics as applied in the field of child welfare and will identify and assess federal opportunities to contribute to the advancement of predictive analytics approaches to promoting safety, permanency, and well-being for children in or at risk of entering the child welfare system. The evaluation will include reaching out to local agencies and their partners who have already implemented predictive analytics into their programs, to understand what impacts they have observed.

National Quality Improvement Center for Preventive Services and Interventions in Indian Country
The U.S. Department of Health and Human Services’ Administration for Children and Families announced a $1 million grant for a 5-year cooperative agreement to establish a Quality Improvement Center (QIC) on the prevention and intervention of child abuse and neglect in American Indian/Alaska Native (AI/AN) communities. The QIC will gather, generate, and disseminate knowledge regarding effective practice models for strengths-based, culturally relevant, trauma-informed, and preventive services and interventions for all forms of child maltreatment. As part of this work, the QIC will provide technical assistance and implementation assistance for two to five project sites. The purpose of the selected project sites is to implement and assess practice models that show promise in preventing child abuse and neglect and that may be implemented or adapted in other tribal child welfare systems.

Congress

Bicameral introduction of the Family First Prevention Services Act
The Family First Prevention Services Act is a bipartisan bill introduced in both the House (H.R. 5456 by Chairman Vern Buchanan (R-Fla.) and Rep. Carl Levin (D-Mich.)) and the Senate (S. 3065 by Chairman Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.)) in 2016. The bill passed the House in June 2016 but failed to move out of committee in the Senate. The act includes provisions that call for the delivery of more upstream prevention services and the requirement of state fatality prevention plans. The House bill was re-introduced in 2017.

House passage of the Infant Plan of Safe Care Improvement Act
In a rare unanimous vote, the U.S. House of Representatives passed legislation May 16, 2016, protecting opioid-exposed newborns and addressing their caregivers’ treatment needs. The Infant Plan of Safe Care Improvement Act (H.R. 4843), authored by Rep. Lou Barletta (R-Penn.) and Rep. Katherine Clark (D-Mass.), requires that states receiving federal funds for child protective services comply with federal law and enact certain guidelines for the welfare of children exposed to opioids. Although the bill focuses on safe care plans for opioid-exposed babies, it also addresses more generally the duties of HHS to more vigilantly review and monitor states’ assurances under all sections of the Child Abuse Prevention and Treatment Act (CAPTA).

Comprehensive Addiction and Recovery Act of 2016 signed into law
On July 22, 2016, President Obama signed into law the Comprehensive Addiction and Recovery Act (P.L. 114-198). This is the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic, encompassing all six pillars necessary for such a coordinated response—prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. Although it authorizes more than $181 million each year in new funding to fight the opioid epidemic, monies must be appropriated every year, through the regular appropriations process, in order for it to be distributed in accordance with the law. On January 17, the Children’s Bureau issued guidance to states on implementing provisions in CAPTA as amended by the Comprehensive Addiction and Recovery Act of 2016.

Talia’s Law (H.R. 3894) signed into law
In December 2016, President Obama signed into law H.R. 3894, known as Talia's Law. This bill directs any member of the Armed Forces, civilian Department of Defense (DOD) employee, or contractor employee working on a military installation who is required by federal regulation or state law to report known or suspected instances of child abuse and neglect to make the report directly to state child protective services or another appropriate state agency in addition to the member's or employee's chain of command or other designated DOD point of contact. DOD shall ensure that such individuals receive appropriate training in accordance with state guidelines to improve their ability to recognize evidence of child abuse and neglect and their understanding of mandatory reporting requirements.