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OKDHS Home > Library > Policy > OAC 340 > Chapter 75. Child Welfare > 3. Child Protective Services > 8.3. Alleged medical neglect of infants born alive and infants with disabilities
340:75-3-8.3. Alleged medical neglect of infants born alive and infants with disabilities
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Revised 5-11-06


     Withholding needed medical treatment from an infant born alive at any stage of development or an infant with disabilities is prohibited by state and federal statutes and regulations.  Withholding medical treatment is the failure to respond in any manner to an infant born alive and failure to respond to the infant's life-threatening conditions by providing treatment that, in the treating physician's reasonable medical judgment, will most likely improve or correct such conditions.

  • (1) When treatment is not required.  Providing treatment to an infant with disabilities is not required when, in the physician's reasonable medical judgment, any of the following circumstances exist:
    • (A) the infant is chronically and irreversibly comatose;
    • (B) provision of treatment would merely prolong dying; or
    • (C) provision of treatment would be virtually futile in terms of the infant's survival and the treatment itself would be inhumane.
  • (2) Reports of medical neglect of infants born alive and of infants with handicaps.  Reports alleging denial by the parent(s) of medically beneficial treatment, including nutrition and hydration, to an infant born alive or an infant with disabilities are investigated by Child Welfare.  The worker obtains as much information as possible regarding the:
    • (A) infant's condition, including diagnosis and prognosis; and
    • (B) basis for the reporter's statement that medically indicated treatment is being or will be withheld.
  • (3) Reports of medical neglect by a medical provider.  Reports alleging denial of medically beneficial treatment by the medical provider are investigated by the Office of Client Advocacy.       • 1
  • (4) Protocol for investigating alleged medical neglect of infants born alive and infants with disabilities.  The protocol for investigating reports of alleged medical neglect of an infant born alive or an infant with disabilities is the same as other investigations of reported child abuse or neglect by a person responsible for the child (PRFC).     • 2

INSTRUCTIONS TO STAFF 340:75-3-8.3

1.  Reports of medical neglect.  When reports are received, Child Welfare immediately notifies the county director and Children and Family Services Division (CFSD) Child Protective Services (CPS) Section.  Reports involving medical neglect by a medical provider are referred to the Office of Client Advocacy by CPS programs staff.

2.  Investigative protocol.  Investigations are handled expeditiously utilizing investigative protocol, when possible.  The CPS worker:

  • (1) interviews the person who made the report to review the concerns or allegations and obtain additional information;
  • (2) immediately phones the designated hospital liaison to coordinate the investigation.
    • (A) If no liaison is designated or the liaison is unavailable, the CPS worker contacts the hospital administrator.
    • (B) Availability of information regarding the infant's status is determined through the hospital liaison.  Interviews, if needed, with the responsible physician and others involved in the treatment are arranged as quickly as possible;
  • (3) determines if an Infant Care Review Committee (ICRC) exists and whether a review was or will be conducted and interviews the ICRC chairperson or designee as appropriate;
  • (4) obtains information regarding the diagnosis, prognosis, and recommended treatment from appropriate medical personnel.  This is elicited by:
    • (A) interviewing the ICRC chairperson, treating physician, specialist, and other medical personnel;
    • (B) attending an ICRC meeting or medical staffing;
    • (C) reviewing medical records; and
    • (D) obtaining independent medical advice or examinations by nontreating physicians to determine if exemptions to treatment exist;
  • (5) if there is difficulty accessing hospital or pertinent records, requests a court order from the district attorney directing such access;
  • (6) interviews the parent(s) and others to obtain relevant information, including treatment decisions and the reasons for the decision;
  • (7) if medically indicated treatment is or will be withheld, attempts to resolve the situation by discussing the concerns with the parents.
    • (A) When medically indicated treatment is withheld, the infant's condition requires an urgent response, and efforts to obtain parental consent for treatment have failed, procedures in OAC 340:75-3-10.1 are followed.
    • (B) When a court order for emergency medical treatment is necessary, the parent(s) and responsible physician are promptly notified of the decision on court actions; and
  • (8) if there is difficulty in obtaining an emergency order or deprived petition, contacts CFSD CPS programs staff to promptly request assistance from Oklahoma Department of Human Services Legal Division.
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Oklahoma Department of Human Services
Street address: Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646
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