The federal Child Abuse Prevention and Treatment Act provides a minimum definition of child maltreatment that includes imminent risk of serious harm. Yet, in practice, many state and county child welfare jurisdictions impose narrower standards that demand observable injury or preclude parental substance use and prenatal exposure as sufficient grounds for action. These practices weaken the protective intent of federal law and endanger children. This policy misalignment occurs amid a measurable escalation in preventable child harm linked to caregiver substance use.