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Opportunities for child welfare oversight discussed by Lehigh County committee

Olivia Marble
Lehigh County Human Services Committee Chairman Bob Elbich speaks at the latest meeting.

  • A Lehigh County commissioners committee discussed potential actions following calls for reform to the county’s Office of Children and Youth Services
  • One potential recommendation is requiring medical reports given to OCYS to be reviewed by an advanced medical consultant
  • Another is requiring feedback forms given to the agency to be reviewed by another department

ALLENTOWN, Pa. — Lehigh County's system for handling cases of suspected child abuse soon may get more oversight.

The Lehigh County Board of Commissioners’ Human Services Committee at its meeting Wednesday discussed potential actions county commissioners could take following calls for reform to the county’s Office of Children and Youth Services.

The discussion comes after Lehigh County Controller Mark Pinsley in August released a report that raises concerns about how child abuse accusations are handled and calls for an independent investigation of the county Children and Youth, among other recommendations.

Pinsley, who is up for reelection on Nov. 7, has worked with the Lehigh Valley’s Parents’ Medical Rights Group, which was formed in response to alleged false accusations of child abuse by Lehigh Valley Health Network’s Child Advocacy Center, or CAC.

LVHN spokesman Brian Downs said in a statement Tuesday that when cases are determined to be unfounded, it does not confirm that a false accusation has occurred.

"In some instances, it may mean that authorities have decided to pursue a different path such as providing support services and a safety plan for any child/children and family members involved," Downs said.

The potential recommendations

Human Services Committee Chairman Bob Elbich raised two potential recommendations the committee could forward to commissioners, once they have been reviewed by the solicitor.

One potential recommendation was requiring implementation of an optional standard set by the National Children’s Alliance, which says medical reports given to Children and Youth related to sexual and physical trauma could be reviewed by an advanced medical consultant.

According to the National Children’s Alliance, an advanced medical consultant is a child abuse pediatrician, physician or advanced practice nurse who has been trained to be a CAC provider, has performed at least 100 abuse examinations and has completed continued education.

The National Children’s Alliance develops standards and gives accreditation to CACs. According to Elbich, LVHN is in the process of getting full accreditation and “intends to be fully certified fairly soon.”

“I appreciate having a second expert reviewing that, but if they're not getting the correct information, it's just confirming what's on the chart."
Lower Macungie resident Jill Triffo

Lower Macungie resident Jill Triffo asked how that review would help if the doctor does not tell the truth in the report — something several parents have alleged.

“I appreciate having a second expert reviewing that, but if they're not getting the correct information, it's just confirming what's on the chart,” Triffo said.

Elbich said requiring a second medical assessment of a child is not required of any other CAC in the state, and that the system is set up to prevent multiple medical examinations in such cases because it could be harmful to the child.

He said he would look into more details of how the review would be conducted.

Downs said in a statement that LVHN supports the idea of a secondary medical review.

“We fully support strengthening the system by complying with an optional standard that is backed by the National Children’s Alliance (NCA) to implement peer review for the medical exam,” the statement read.

The other potential recommendation was requiring any feedback forms given by OCYS to be reviewed by another department, such as the Lehigh County Executive, to make sure the feedback was properly addressed.

"My approach was to pull this information together and see, looking at it critically, where there are areas that we can improve.”
Bob Elbich, chair of the Human Services Committee

Elbich said he approached the issue using his background as an auditor.

“I understand accreditations, I understand processes [and] I understand quality systems,” Elbich said. “And my approach was to pull as much of this information together and see, looking at it critically, where there are areas that we can improve.”

In response to the county solicitor’s letter that said county commissioners could investigate the county Children and Youth, Elbich also said the Department of Human Services already does an annual audit of the agency.

He said that if county commissioners do not have the technical expertise to do a similar investigation.

“But even if we decided we needed to do that, we'd basically be duplicating what the State Department of Human Services is already doing, and I'm not so sure that's an efficient use of resources,” Elbich said.

Elbich also said the county could potentially pursue funding that would help parents accused of child abuse get legal representation.

Overview of the system

Elbich gave an overview of the county’s child welfare system.

He said the county’s district attorney is required to convene a Multidisciplinary Investigative Team to coordinate child abuse investigations between different departments.

There is a memorandum of understanding (or an agreement made by formal document) between LVHN, Lehigh County, the Allentown Police Department, the district attorney’s office and the Crime Victims Council of the Lehigh Valley regarding what functions should be performed by which group.

System entities.jpg
Lehigh County
A slide from Human Services Committee Chair Bob Elbich about the relationship between different entities that deal with cases of suspected child abuse.

Elbich said all the statutorily required duties of the MDIT are transferred to the CAC through that memorandum.

But while the CAC makes assessments, it does not have the power to make decisions in child abuse cases. That falls to the OCYS, which uses the CAC’s assessment and other information to make its determinations.

Elbich emphasized that the CAC, which has been the center of much of the criticism, is independent from the county and is funded solely by LVHN and grants. That means county commissioners are limited in what they can do related to the CAC.

Kim Steltz, member of the Lehigh Valley’s Parents’ Medical Rights Group, argued during public comment that the CAC is not independent from OCYS.

“Lehigh Valley [Health Network] is funding the CAC and your caseworkers are getting free office space there,” Steltz said. “So if there's competing doctor opinions against the doctors from the CAC and LVHN, the caseworkers are not going to go against Lehigh Valley Hospital.”

Steltz also said Elbich’s presentation showed how the system is supposed to work, rather than what is happening now.

“We want you to hear how it really works from the people that have gone through it, the people that have been in that flowchart,” Steltz said.

Olivia Marble
Lehigh Valley Parents' Medical Rights Group member Kim Steltz speaks at the Human Services Committee meeting.

Stacy Feeny, another member of the Parents’ Medical Rights Group, agreed.

“I would love to have maybe a meeting with families where we can tell you what actually happened and how it worked for us and see where the disconnect is, and maybe we could work on fixing that,” Feeny said.

Elbich said he understands that systems can look different depending on who is operating it, but that commissioners are limited in what they can do to ensure people are following the system.

“About the best you can do in my opinion… is provide the guidance, audit the procedures and audit the activities,” Elbich said.

‘This is going to be really hard work’

Cathleen Palm, founder of the Center for Children's Justice in Berks County, gave a presentation at the meeting about the challenges child welfare systems face.

In her presentation, Palm outlined several layers of oversight on the child welfare system, including the state Department of Human Services, the General Assembly and the Auditor General.

“And yet families feel, in their heart they genuinely believe, there's no checks or balances in the system,” Palm said.

“That's a really important thing because whether it's true or not, it clearly has become a preset perception. And no system, no party, no entity works well when what people think is very different than what it is.”

Palm referenced a report from the Keystone State Child Abuse Medical Forum, which she said should be released soon.

Key findings Keystone child abuse.png
Lehigh County
A slide from Cathleen Palm's presentation detailing the key findings from the Keystone State Child Abuse Medical Forum report.

One finding was that there are currently high volumes of child abuse reports because of mandatory reporting requirements. The report recommends the state look into the quality of child abuse reports and whether more training for mandatory reporters would help.

Palm said one potential action item there is wide agreement on is reforming the statewide child abuse registry.

“When someone ends up on the registry, they can be treated the same whether they took their eyes off their child, and it was just a temporary supervisory neglect issue, as somebody who has sexually assaulted two children. So the registry can be very harsh,” Palm said.

People can be put on the registry before going before a judge if their case is “indicated,” or found to have substantial evidence.

Palm said she thinks the work the Human Services Committee is doing is important.

“These hearings are going to be really important to be able to think through and from a research, not just an anecdotal, but from a research perspective based on data, where does Lehigh County want to go,” Palm said.

“This is going to be really hard work because you're going to have to tease out what needs to happen in terms of policy and practice development, all the while not diminishing the trauma that is very real in this work.”

Pinsley said in a statement that he thinks Palm “is an activist, not an expert.”

“Once again the board isn’t focused on finding an academic. If they are letting Cathleen [Palm] speak, they should have let Kim [Steltz] speak,” Pinsley said.

Elbich said he considers Palm an expert because she has worked in the field for 25 years. He said he is not aware of Steltz’s background but that she could possibly give a presentation at a future meeting.

Elbich said the next meeting of the Human Services Committee will be on Nov. 15 from 6 p.m. to 8 p.m. It will be virtual only.

EDITOR'S NOTE: Lehigh Valley Health Network is a financial supporter of Lehigh Valley Public Media and a founding supporter of LehighValleyNews.com. LVHN has no influence on our editorial or business operations.