Oregon Administrative Rules
Chapter 413 - DEPARTMENT OF HUMAN SERVICES, CHILD WELFARE PROGRAMS
Division 20 - CASE MANAGEMENT
Section 413-020-0640 - Investigation
Universal Citation: OR Admin Rules 413-020-0640
Current through Register Vol. 63, No. 3, March 1, 2024
When additional information is necessary to substantiate a conclusion to the medical neglect report, the Medical Neglect Investigator shall form a special investigative team with a consultant neonatologist from a hospital other than the one where the infant is receiving care, a local CPS caseworker and any other necessary professionals such as a nutritionist or the local district attorney. The on-site investigation shall be completed in the shortest possible time.
(1) The Medical Neglect Investigator, with the assistance of the special investigation team members and designated hospital liaison, will complete the following:
(a) Interview treating physicians and others
involved in the treatment;
(b)
Arrange as early as possible meeting with HRC or other hospital review boards
or committees. Determine at minimum the following: Did the HRC verify the
diagnosis? How were the parents involved in the process? What treatment
alternatives exist?
(c) Review
medical records. The parents shall be requested to sign a release of
information to allow CPS investigation and/or medical consultant to review
records. If determined necessary, court intervention may be used to give access
to medical records;
(d) Interview
parents (after first determining with hospital social worker appropriateness
and context for interviewing parents) to determine the parent's understanding
of the child's condition and treatment alternatives, the decisions they have
made, and the basis for those decisions.
(2) When necessary, the Medical Neglect Investigator may take the following actions:
(a) Make an on-site visit to the medical
facility to observe the care and treatment being provided to the
infant;
(b) If an alternative
diagnosis was not entertained, and no consultants brought in, or there was not
a procedure for reviewing the diagnosis and treatment recommendation, then the
investigator may wish to arrange for an independent medical consultant and/or
exam. The Medical Neglect Investigator shall recommend to the parent(s) that an
independent medical examination or evaluation be performed. If the parent(s) do
not consent, the specialist will seek a court order to obtain an independent
medical examination or evaluation.
(3) Concluding the Investigation:
(a) Following the investigation, the Medical
Neglect Investigator will determine:
(A)
Whether the report of suspected medical neglect of the handicapped infant with
life-threatening conditions is valid. Information from the HRC or consulting
physicians, including the Designated Consultant Neonatologist, shall be used to
determine whether the treating physician exercised reasonable medical judgment.
The reasonable medical judgment of the treating physician may differ from that
of other physicians. Grounds for overriding the refusal of the parents of the
infant to consent to medical care and treatment exist only if any reasonable
medical judgment would be that treatment is medically indicated. The parents'
refusal to consent shall be respected if the attending physician, the Review
Committee, or a consulting physician finds that treatment is not medically
indicated;
(B) Whether further
action should be taken by the Department, and if there is a basis for juvenile
court jurisdiction.
(b)
If the parents of the infant refuse to consent to the medical care and
treatment found to be necessary and adequate by the attending physician and the
HRC, or by another consulting medical professional, or the attending physician
refuses to provide treatment, Child Welfare shall initiate the filing of a
petition in juvenile court on behalf of the infant requesting the court to take
jurisdiction of the infant so that medically indicated treatment may be
provided. Child Welfare will also request that a Guardian Ad Litem (GAL) or
Court Appointed Special Advocate (CASA) be appointed for the child. The
caseworker will document these actions in the case record;
(c) If the infant's parents do not desire
medical treatment beyond that being provided and if the reasonable medical
judgment of the attending physician, HRC, or other consulting medical
professional is that medically indicated treatment is being provided, the
Medical Neglect Investigator will document this agreement in the case record.
The CPS caseworker will close the case and take no further action;
(d) If the infant's parents desire medical
care or treatment for the infant which is not being provided by the attending
physician or the medical facility, the Medical Neglect Investigator will advise
the parents of their option to seek another medical opinion or additional
medical resources. The Medical Neglect Investigator shall document the advice
given the parents in the case record, the caseworker will close the case and
take no further action;
(e) The
Child Welfare caseworker shall assist the parent(s) with referrals to support
groups, community educational resources, and agencies which provide services
for disabled infants and their families, and to agencies with financial
resources for medical and rehabilitative services;
(f) Following completion of the
investigation, the Medical Neglect Investigator shall notify the assistant
administrator for the Program Operations by telephone of the report, the
investigation and the actions taken. The telephone report is to be followed by
a written report and documented in the case record.
Stat. Auth.: HB 2004
Stats. Implemented: PL 98-457
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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