Noting that fundamental reform of child support policy that builds on state and local innovations is essential, this report provides recommendations for state policymakers and advocates to address deficiencies in child support enforcement. The recommendations are in the areas of resources, paternity, and outreach. They include: (1) establishing caseload standards; (2) maximizing federal funding; (3) providing training for child support enforcement workers; (4) enacting the Uniform Interstate Family Support Act; (5) establishing hospital-based and post-hospital voluntary acknowledgement of paternity; (6) establishing outreach about paternity; (7) expediting procedures for contested paternity; (8) expediting procedures for locating absent parents; (9) centralizing monitoring and enforcement; (10) making state licenses contingent on payment of support; (11) identifying and addressing barriers to access; (12) establishing interagency linkages; and (13) working with noncustodial parents. (MDM)