In wake of Jewish Week story, social service agency shared confidential files about abuse case with outsiders.
By Hella Winston (The Jewish Week)
May 31, 2011
In the wake of a Jewish Week story questioning the practice of Ohel Children's Home and Family Services in reporting suspected cases of sexual abuse, the Brooklyn-based social service agency has launched a campaign to clear its name. But while supporters and some former critics of the institution say the effort has proved Ohel acted correctly in the disputed case, others maintain that the promotional effort itself is raising serious ethical, if not legal questions about the agency's conduct.
The story in question was published in the Feb. 23 issue of The Jewish Week and described a case in which Ohel therapists suspected that a mother was sexually abusing her then 5-year-old son but were instructed by their supervisor not to make a report to the authorities. (The law requires a report to the Administration for Children's Services even if there is only a "reasonable cause to suspect" that abuse is taking place.)
After the article appeared, Ohel took out a full-page ad in The Jewish Week and another Jewish newspaper discrediting the paper's sources and asserting that the story was inaccurate and biased.
During the months leading up to publication of the story, Ohel officials refused this newspaper's repeated requests for comment about its policies on reporting suspected cases of sexual abuse to the authorities. Several sources had told The Jewish Week that, given the agency's close connections to the fervently Orthodox community, it is reluctant to report such cases for fear of contradicting rabbinic leaders, whose approval they court.
(Indeed, just two weeks ago representatives of the Agudath Israel, a major haredi umbrella group, publicly stated that even mandated reporters should consult a rabbi before making a report.)
Ohel's rabbinic adviser, Rabbi Dovid Cohen, plays a key role in deciding how the agency should act in situations where the mandates of religious law — which, for example, prohibits mesira (informing to the authorities on fellow Jews) — conflict with those of secular law, which require reporting any reasonable suspicion of abuse to the authorities.
Regarding the particular case of the woman and her young son, Ohel officials had told The Jewish Week they were prohibited from discussing the case, citing confidentiality requirements. But a key element of the recent effort by Ohel to bolster its reputation has been to show confidential patient files related to the case to former critics, raising questions about the agency's motives and practices.
There are, in effect, two parallel narratives to describe the current Ohel campaign. One is that the organization, widely praised for many of its services, is taking a number of steps to convince the community, including former critics and members of its own board, that its work in dealing with cases of sexual abuse is equally exemplary, and that The Jewish Week article was inaccurate and damaging. The agency cites testimonials, based on reviews of the case by outsiders, that Ohel acted properly in every way.
The other version, voiced by several former and current employees, abuse victim advocates and former clients, is based on the premise that Ohel is more concerned with protecting community members suspected of abuse — and in so doing, preserving the reputation of the community — than it is in protecting vulnerable children. (The child in question ultimately was removed from the mother's supervision.)
The Jewish Week has learned that the agency offered to show files from the disputed case to some leaders of advocacy groups, apparently seeking endorsement for the agency's conduct. That has led to the charge that Ohel sought to divide and co-opt members of the advocacy community, in part by implying that it would fund joint programs with those groups that supported the agency's position.
How could Ohel share files with outsiders after insisting for many months that privacy laws prohibited it from even discussing the mother-child case? Ohel explains the apparent contradiction by noting that the people it approached to review the case were engaged as outside consultants. (It is legal under confidentiality regulations to share files containing protected health information with a consultant if that person has signed an appropriate business associate agreement.)
A Face-To-Face Meeting
More than two months after the Feb. 23 story was published, Ohel CEO David Mandel agreed to an on-the-record interview with The Jewish Week. At a tense but cordial meeting at Ohel headquarters in Borough Park, Mandel, flanked by the agency's attorney/ quality-control officer and public relations director, sat across the table from this reporter and two Jewish Week editors and patiently made his case. He asserted that The Jewish Week story was inaccurate and that Ohel, highly rated by the city for its foster care and other services, is a well respected and professional organization that scrupulously follows the law in all of its actions.
Mandel explained that to restore its reputation, the agency hired a forensic psychiatrist who specializes in issues related to sexuality and sexual abuse, and his psychologist wife, to review the mother-child case because "the allegations made in the article"... "were completely false."
A March 10 letter from the consultants, Drs. Richard Krueger and Meg Kaplan, a copy of which was obtained by The Jewish Week, said they had "reviewed the chart and discussed the case" with Ohel's attorney and absolved the agency of any wrongdoing in the case.
Several critics noted, however, that Krueger and Kaplan were not given access to the mother, her son or anyone else with direct knowledge of the case, including The Jewish Week's sources. According to those sources, a number of discussions about the case that took place at the time among Ohel staff — and specifically about the mother's disclosures about her own behavior — were not recorded in any patient charts and, because of this, there exists no written record of them.
When asked whether it is standard practice in a forensic evaluation to review only selected charts and not interview those directly involved in a particular case, Krueger referred The Jewish Week to Ohel.
Asked for comment on this story early last week, the organization's spokesman, Derek Saker, said Ohel would "follow up in the near future." On Tuesday, pressed again for a response, Mandel asked that The Jewish Week "delay publication this week and wait for comprehensive factual information that we will provide in the next few days."
Jewish Week editors, however, concluded that Ohel has had ample time to confirm or deny whether the events described here indeed transpired, and if so, to provide an explanation for them.
Internal Friction Among Abuse Advocates
Among those with whom Ohel shared the case files to get an opinion are members of the Jewish Board of Advocates for Children (JBAC), an advocacy organization that has been a central force in the effort to address the issue of child sexual abuse and its cover-up within the Orthodox community.
JBAC's president, Elliot Pasik, declined to comment on his review and the circumstances under which it was solicited. But The Jewish Week obtained information indicating that without the knowledge or approval of the full JBAC board, Pasik, an attorney specializing in serious personal injury and general commercial litigation, and Rabbi Chaim Wakslak, a clinical psychologist who works with people with disabilities, went to one of Ohel's offices, where they reviewed selected charts and interviewed some individuals connected to the case; therapists were interviewed in the presence of their supervisors.
After the review, Pasik sought approval from some members of JBAC's executive and rabbinic committee to issue a statement clearing Ohel of any wrongdoing in the mother-child case and calling for a Jewish Week retraction. This was the first the members had learned of the review and some balked, citing the fact that JBAC's executive vice president is Asher Lipner, a therapist and former Ohel employee who was directly involved in the mother-child case and spoke on the record to The Jewish Week for its Feb. 23 story.
Others expressed concern that Ohel officials had manipulated Pasik. For example, Rabbi Yosef Blau, mashgiach ruchani (spiritual adviser) of Yeshiva University's Rabbi Isaac Elchanan Theological Seminary, argued that it was highly irregular for Ohel to pick and choose individuals to review the case and withhold certain information. He also cited Pasik's alleged lack of objectivity and qualifications to conduct a forensic review.
The Jewish Week has learned that, while neither Pasik nor Rabbi Wakslak were compensated for their review, Pasik made it clear to others involved with JBAC of the prospect for future collaboration with and funding from Ohel, based on his conversations with CEO Mandel.
The fact that Pasik may have had an expectation of his organization benefiting from his giving Ohel a positive report and that Ohel controlled the access he had to both documentation and personnel raises red flags among some experts on standard protocol for a forensic review process.
Conflict Of Interest?
Dr. Mary A. Connell, a board-certified clinical and forensic psychologist who has worked for Child Protective Services in Texas, said that typically, for the results of an investigation to have credibility, it is crucial that the investigators be "truly independent," and without, for example, "expectation of employment or good will" from the agency they are reviewing.
In this case, she said, the expectation of possible funding from Ohel and the fact that Lipner is a member of the JBAC board suggests a conflict of interest.
Similarly, Michael Salamon, the director of the Adult Development Center in Hewlett, L.I., and a psychologist in the Orthodox community, said that "one well-established approach [to conducting an evaluation] would be to hire an outside, unaffiliated group that has the breadth of resources and experience to do a complete and thorough forensic evaluation."
Even if it were technically legal for Ohel to show the files to handpicked outside individuals, sharing patient information with consultants for the purpose of clearing the agency's name may be an inappropriate use of the Health Insurance Portability and Accountability Act, which governs privacy regulations, according to Abner Weintraub, a national authority on HIPPA.
Mary Vandenack, another authority on HIPPA, told The Jewish Week that bringing in a consultant who is not an expert in the specific area or who has an interest in the outcome is unethical and may even constitute fraud if the agency and/or consultant make representations that the consultant is an expert.
Pasik may not have been the only abuse victim advocate approached by Ohel. Mark Meyer Appel, president of The Voice of Justice, said that an Ohel executive board member offered to the show the files to him. But Appel told The Jewish Week he declined to view them, citing a concern that "sensitive files should not be shared indiscriminately with advocates [as it is] a moral breach in governance."
Ohel CEO Mandel said there was no offer to share the files of the mother-son case with Appel.
In response to a request for comment on the situation, Survivors for Justice, another advocacy organization, called Ohel's request that JBAC leaders review the agency's practices "disingenuous" at best.
The group asserted that Ohel should rely on objective experts and law enforcement for review, and "find its way back to its core mission, namely providing quality foster care for Orthodox children."