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There is significant variability in Child Protective Services (CPS) utilization of medical-forensic experts. In 2016, Missouri legislation (HB 1877) mandated that CPS investigators submit screening forms to a Child Abuse Pediatrician (CAP) to review children 4years investigated for abuse. Compliance with this mandate is unknown. To measure compliance with HB 1877, hypothesizing that urban counties would have better compliance than rural counties. This retrospective study included evaluation of screening forms completed by Missouri