OAR 413-020-0630: Preliminary Investigation

(1) When a report of suspected medical neglect of a disabled infant with life-threatening conditions is received and assigned for investigation, the CPS caseworker will immediately contact a Medical Neglect Investigator for consultation and assistance in initiating a preliminary investigation. The Medical Neglect Investigator will have the responsibility to determine the role/activities of the CPS caseworker and the Medical Neglect Investigator during preliminary investigation and “on site” investigation of a report. The Medical Neglect Investigator will conduct the investigations whenever possible. (2) During the preliminary investigation, the CPS caseworker or Medical Neglect Investigator will contact the Designated Consultant Neonatologist from a hospital other than the one where the infant is receiving care, for consultation and assistance. (Names of consultant neonatologists are available from the CPS program manager.) (a) The Medical Neglect Investigator (or Designated Consultant Neonatologist) shall contact the hospital liaison, advise that person of the nature of the reported suspected medical neglect, and request assistance to obtain the following information: (A) Whether the infant is in the hospital; (B) The name and location of the infant’s parents; (C) The medical condition of the infant, i.e., does the infant have a life-threatening condition; (D) The nature of the care and treatment being provided to the infant and what, if any, additional or alternative treatment could be provided; (E) If the infant’s parents are in agreement with the care and treatment being provided or if they have refused to consent to recommended treatment; (F) If there is a critical time pressure and thus a need for immediate court action; (G) The analysis of the HRC or other review body; (H) Whether the attending physician has consulted with other medical professionals concerning the care and treatment of the infant and whether the medical professionals are in agreement with the care and treatment being given. (b) If treatment is indicated and recommended by the physician and the parents are refusing to consent to treatment, then court action should be immediately initiated or further counseling with the parents pursued. In addition to filing a petition in juvenile court, Child Welfare shall request that a guardian ad litem (GAL) or court appointed special advocate (CASA) be appointed for the child. (c) Criteria for continuing or closing preliminary investigation: (A) If the facts confirmed by the treatment team indicate any of the following circumstances, then the investigation shall be terminated and the case closed: (The facts should be documented in the case file.) (i) The infant is chronically and irreversibly comatose; (ii) The provision of treatment would merely prolong dying, not be effective in ameliorating or correcting all the infant’s life-threatening conditions, or otherwise be futile in terms of survival of the infant; (iii) The provision of treatment would be virtually futile in terms of survival of the infant and the treatment itself under such circumstances would be inhumane. (B) Where there remains doubt about the hospital’s compliance with state laws, parents refuse to authorize medically-indicated treatment, or there is a need for additional information to substantiate a conclusion, the investigation should be continued.