OneJustice Blog

Bring life-changing legal help to Californians in need.

Category Archives: Access to Medical Care

I could see happiness in their eyes

Healthy Nonprofits Program’s Christopher McConkey tells us about the civil justice shortfall and the need for free legal assistance.

We asked our Staff Attorney Christopher McConkey to give us his insight on why it’s necessary for organizations and programs in the legal sector to transform the civil legal aid delivery system.


Guest Blogger: Christopher McConkey, OneJustice Staff Attorney for the Healthy Nonprofits Program

[Photo: Huffington Post]

Photo Credit: Huffington Post

There is a phenomenon in our society where people who are less able to afford legal help are often the people who need it the most. These low-income individuals struggle every day to find the legal assistance they need to preserve basic life necessities like housing, health care, economic security, and child custody.

This is not a minor phenomenon. Over 60 million people in the United States might qualify for free civil legal services because they live at or below 125% of the federal poverty guidelines. However, people are less likely to access these services due to limited resources, mental health issues, and inexperience with our legal system.

Worsening this crisis, insufficient funding prevents many legal aid programs from serving 50% or more of the people who actively seek their help, leaving attorneys to address less than 20% of lower-income people’s legal needs.1 All of these shortfalls ultimately leave low-income individuals without critical legal assistance.

The Civil Justice Shortfall

The civil justice shortage is especially acute in California. As a legal aid attorney right after law school, I encountered hundreds of people slowly moving from one legal services project to another with the same issues. The recurring problem was program capacity. Staff attorneys reached full caseloads, projects offered fewer services to help more people, and funders carved programs to reflect their priorities. Even waves of talented and eager volunteers could expand an organization’s capacity only superficially, and only to a point.

I recall a monthly legal clinic I helped coordinate in Los Angeles. This clinic aimed to reduce an overwhelming and countywide need for immigration legal aid. The immigration attorneys who volunteered–I was not one of them–helped numerous lower-income Angelenos to understand and pursue their legal options. Limited capacity, however, left some clients on the waitlist for months. Those who persevered accessed expert immigration services for free. Those who dropped off the waitlist continued the long search for assistance or, worse, gave up.

For the clients who received assistance, legal help gave them their safety, jobs, family cohesion, dignity, and peace of mind; I could see happiness in their eyes. To me, this clinic exemplifies why finally eliminating the justice gap is worth our collective effort, resources, and ingenuity.

Transforming the Legal Services Sector through Innovation

As with all solvable problems, we should be optimistic! Our resourceful and morally ambitious society can overcome this justice shortfall. More funding is necessary, but for now, we can and should innovate additional ways to expand legal services for people who are lower-income.

[Photo: Legal Services Nonprofit leaders discussing trainings.]

Legal Services Nonprofit leaders discussing trainings.

OneJustice is already strengthening California’s legal services infrastructure to provide greater access to the legal system. In the Healthy Nonprofits Program (“HNP”), we are supplying nonprofit management consulting, legal technical support, and public policy advocacy to legal services organizations throughout the state.

Additionally, we help connect hundreds of public-interest-minded law students to nonprofit and government employers every year. We are invigorating legal nonprofits while enhancing the environment in which they operate—all so we can transform the legal services sector.

Individual attorneys will close the justice gap one client at a time. Several factors can coalesce to make that possible: additional funding, robust nonprofit management, public policies that value legal services organizations, and the gumption to innovate strategies that will solve one of the most stubborn justice crises of our time.

1 For more information about this civil justice gap, please see the Legal Services Corporation’s report titled Documenting the Justice Gap in America: The Current Unmet Civil Legal Needs of Low-Income Americans


Chris_CROPPED

As a Staff Attorney in the Healthy Nonprofits Program, Chris helps guide legal services organizations on matters of nonprofit law and management. He also advocates for public policies that foster the growth of legal nonprofits and–through them–meaningful access to justice for all Californians. In this way, his work bolsters California’s infrastructure for civil legal assistance at the organizational and systemic levels. As part of his role, Chris provides legal support for OneJustice’s consulting and policy work. Additionally, he provides policy briefings and advocacy for OneJustice’s statewide community of legal services organizations.

 

What helps keep children healthy? Access to an attorney!

An apple a day?  What really helps keep low-income children healthy is access to medical care – and that often takes access to an attorney!

Children's Health DayIn theory, our state’s low-income children should all have access to health care through a complex array of state and private health programs.  To be able to take their children to the doctor, parents frequently have to navigate the complicated map of Medi-Cal, AIM, Healthy Families, CHDP (Children’s Health & Disability Prevention) and privately available coverage. But, as a recent article in the New York Times Parenting blog so aptly states, enrolling in these programs can be like clearing a jungle of red tape with a weed wacker! (“When Parents Can’t Enroll in Medicaid, Children Stay Uninsured,” by Bryce Covert, 9/26/12).

For many families, just figuring out which program to apply for  – or how it interacts with privately available health insurance – is more complicated than filling out annual IRS tax return forms (and we all know how much fun those forms are!).  In some families, older and younger children are actually eligible for different health programs – with different types of access to medical care.  And if the parents’ income changes, children may have to transition from one health program to another.  Applying for these programs thrusts parents into a sometimes bizarre world of legal eligibility, federal and state regulations, confusing formulas for counting families’ income, and stacks and stacks of paperwork to fill out.  This maze of bureaucracy sadly leads to some children being incorrectly denied access to health insurance programs for which they are actually eligible – preventing them from accessing doctor appointments, medical treatment, and more.

Nonprofit legal organizations and their attorneys can be the weed wackers that cut through red tape and increase children’s access to health care.

And even if parents are able to thread the application needles and obtain health coverage for their children, sometimes it is difficult to get the medical care prescribed by the doctor.  Both private and state health coverage programs have complicated review structures and just because a doctor writes a prescription for medicine, a piece of durable medical equipment, or speech or physical therapy is no guarantee that the health coverage program will actually approve – and provide – it.

This is where the lawyers come in.  Because these kids – and their families – face a sometimes overwhelming set of legal rules and regulations, lawyers are the ones who can serve as the weed wackers needed to cut through all the red tape.  When kids apply for a program and are denied, they have a right to appeal that decision – and that often takes a lawyer.  When a doctor prescribes a piece of medical equipment or a course of speech therapy that is denied by the health insurance plan, the family can appeal – and that often takes a lawyer.  Lawyers can be the ones who slice through the legal issues – allowing families and doctors to focus on what is most important – actually getting a child the treatment she needs.  In fact, there is a statewide network of nonprofit legal organizations that have formed the Health Consumer Alliance to focus on exactly that work – and their website, www.healthconsumer.org, has a wealth of resources for families.

The Medical-Legal Partnership for Children Team in Seattle combines medical and legal professionals.

Increasingly, doctors are also bringing lawyers into the medical system as team members in preventing children’s health problems. These Medical-Legal Partnerships bring nonprofit legal organizations and their attorneys into the hospitals and medical clinics to work side by side with the doctors, providing legal assistance to children and families that complements the medical treatment they need.  For example, when a little boy with life-threatening asthma comes to a clinic, the doctor can prescribe the various inhalers he needs.  But when that boy returns to his mold-infested apartment – his asthma is triggered once again.  In these Medical-Legal Partnerships, the doctor can make a same-day referral to the attorney (sitting in the next office over) who then gets to work on negotiating with the family’s landlord to correct the illegal mold problem.  The little boy ends up with a safe housing environment and the prescriptions – a preventative legal measure coupled with medical treatment.  California is home to many of these cutting-edge collaborations. Some of these programs have lawyers doing rounds with the medical teams, and some even train law and medical students on how to work together.  Can we actually imagine a day when doctors and lawyers think of themselves first as allies in improving children’s health, rather than as antagonists over medical malpractice and other legal issues?

Today – October 1st – is national Children’s Health Day.  Created in 1928 by President Calvin Coolidge to spark or increase people’s awareness of ways to minimize or alleviate health problems that children may face, the day focuses on a range of child health issues such as prenatal care, adolescent health, the impact of daycare on a child’s development, preventing injuries, healthy eating and lifestyle choices, and immunization.  As part of the annual presidential proclamation for the day, organizations interested in child welfare are invited to observe exercises to stimulate or increase people’s awareness of the need for a year-round program to protect and develop children’s health in the United States, and health professionals and health organizations across the United States take part in this day through various activities and events.

So what do we advocate for Children’s Health Day?  We say bring on the lawyers who will fight to get children on the health insurance programs they need, make sure the doctor’s plans for treatment are approved and become more than just a piece of paper, and who team up with medical professionals for a holistic approach to the complicated medical and legal causes for health problems.

And did you know we are Pinning?  Pinterest (a content sharing service that allows members to “pin” images, videos and other objects to an online scrapbook) is growing increasingly popular as the next social media site.  While most people use the visual bookmarking site to plan weddings, sketch out gardens, or share clothes, jewelry and other designs, nonprofits are starting to use the site to communicate their mission and share helpful links and resources – and so are we!  So in honor of Children’s Health Day, we created a board dedicated to helping families find the health coverage programs – and legal advocates – that their kids might need. Happy Pinning!

Tell us what you think – can you imagine a day when there is a lawyer assigned to every medical team to ensure a holistic approach to the legal barriers that cause health problems?

%d bloggers like this: