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grapevine from medical personnel of cases that gounreported." 10 A Florida administrator stated, "Isuspect that these cases are occurring in the State ofFlorida, but that the hospitals are handling thesituations appropriately—which is the best of allworlds, really." 11 An administrator for the Districtof Columbia declared that "all of these cases havebeen resolved at the hospital level and we have notbeen called in." 18When State CPS agencies do not delegate theirauthority to internal hospital committees, they sometimesdelegate it to the same organized elements ofthe medical profession who have strongly objectedto the Child Abuse Amendments. In Nebraska, theState CPS agency simply turned over principalresponsibility for evaluating reports of such denial tothe State chapter of the American Academy ofPediatrics. 13On September 30, 1985, Dr. Kenton Shaffer, on behalfof the Committee on Maternal and Child Health of theNebraska Medical Association and the Fetus and NewbornCommittee of the Nebraska Chapter of the AmericanAcademy of Pediatrics, notified the Nebraska Departmentof Social Services (DSS) that an Ad-Hoc ResourceCommittee had been formed to offer assistance to DSS inevaluating cases of suspected medical neglect of infantsborn with a handicapping condition. . . .Gina Dunning, state director of the DSS, accepted thisoffer on October 8, 1985, and entered into an agreement.. . .The DSS will refer all reports to the Ad-HocResource Committee, which will supply consultativeservices 24 hours a day, at no charge to the department. 1410Telephone interview with Michelle Gore, CPS Specialist,Kentucky Department for Social Services (July 21, 1988).11Telephone interview with Chris Christmas, Senior HumanServices Specialist, Florida Department of Health and HumanServices (July 25, 1988).12Telephone interview with Carolyn Smith, Chief of Intake forProtective Services, District of Columbia Department of HumanServices (Aug. 9, 1988).13See chap. 6, and text accompanying notes 59-62, 70, for adescription of the position taken by the American Academy ofPediatrics on government intervention to protect children withdisabilities.14Eggert, Shaffer & Bausch, Baby Doe—The Saga Continues,Neb. Med. J., April 1986, at 103, 103-104. Commenting on a draftof this report, the Nebraska Department of Social Services tookissue with the "inaccuracy" of these statements, stating: "Whilethis Committee of experts MAY provide consultation to theDepartment regarding planning for and intervention steps of theinvestigation, by no means has the '. . .state CPS agency simplyturned over principal responsibility for evaluating reports of suchdenial to the state chapter of the American Academy ofPediatrics.'" Letter from Kermit R. McMurry, Director, NebraskaDepartment of Social Services, to William J. Howard, GeneralCounsel, U.S. Commission on Civil Rights (Oct. 3, 1988)(emphasis in original). However, the letter concedes that casesThe Arkansas Department of Human Services,Division of Children and Family Services, seems torely almost entirely for enforcement on the ArkansasChildren's Hospital. The hospital has estimated it"treat[s] 90-95 percent of the 'Baby Doe' cases inthe entire state." 15 The State agency even contractedwith the hospital to provide training workshopsfor its own "agency attorneys and child protectiveservice workers." 16 It worked with the hospital indeveloping its procedures, without input or consultationfrom disability groups. 17 The "independent"physician who advises the State agency aboutwhether medically indicated treatment is in factbeing withheld is also selected by the hospital. 18 Inother words, in 90 to 95 percent of the cases, thehospital under investigation for medical neglect ispermitted to name the "independent" medical authoritywho will rule on whether the course oftreatment or nontreatment is proper.Special Relationship Among CPSAgencies and DoctorsThis widespread and remarkable readiness of CPSagencies to surrender their arms-length oversightresponsibility concerning medical neglect appears inpart to be rooted in the special relationship that hasdeveloped between CPS workers and many membersof the medical profession. In dealing withtraditional forms of child abuse and neglect, CPSagencies rely primarily on health care professionalsfor diagnosis and reporting. These include situations"may require independent consultation from practicing, specializedphysicians which are available to the Department under anagreement with the Committee on Maternal and Child Health ofthe Nebraska Medical Association." Id. Furthermore, the Nebraska"Central Office Procedures in Regard to a Report ofSuspected Medical Neglect of an Infant Born with HandicappingConditions" state that upon receiving notification of such a reportCPS agency staff "will immediately contact a representative ofthe Ad-Hoc Resource Committee for consultation of the report"and that based on "discussion and consultation with the Ad-HocResource Committee" the agency general counsel will be contactedfor a legal opinion. These procedures do not makeinvolvement of the Ad-Hoc Resource Committee optional; theymake it mandatory. It is clear that the agency's reaction to anyreport is heavily dependent on the advice of the Ad-HocResource Committee.15Letter from Bobbie Ferguson, Acting Administrator, ChildProtective Services, to Mr. Tommy Sullivan, Regional Director,Administration of Children, Youth and Services 2 (Apr. 10, 1986)(available in files of U.S. Commission on Civil Rights).16Id at 1.17Telephone interview with Sandra Haden, Arkansas Departmentof Human Services, by Dr. Leon Bourke (June 10, 1987).18 Id.113