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Jan. 28, 2005


Law School develops collaborative pediatric advocacy clinic

ANN ARBOR, Mich.—University of Michigan Law School students are working with medical professionals to help low-income families with legal issues, such as dealing with substandard landlords and applying for cash assistance.

The Pediatric Advocacy Clinic—one of the first known law school-connected, medical-legal collaborative clinics of its kind in the nation—offers advice and representation to those in need.

“The clinic will not only serve a community need that has not been previously met,” said clinical assistant professor Anne Schroth of the Law School, “but it will also provide a unique opportunity for students interested in poverty law and the legal issues that can complicate the health of low income children.”

Schroth collaborated with Bridget McCormack, U-M Law School associate dean for clinical affairs, to develop the clinic concept and structure. Several U-M law students also provided assistance to get the clinic opened last fall.

“The clinic has been great in both developing my legal skills and getting to help people who need it the most,” said Jenelle Beavers, a student from Kansas City, Mo.

The clinical work, she said, has been rewarding because it involved researching, writing, counseling and client interviewing.

The clinic is part of a larger project, the Pediatric Advocacy Initiative that is being developed by the Law School as part of its community outreach work with the Michigan Poverty Law Program. The Initiative partners legal advocates, including clinical law students, with the U-M Ypsilanti Health Center and the U-M C. S. Mott Children's Hospital.

“In my clinic, I see children with developmental or behavioral concerns who also live in poverty. There are a myriad of advocacy issues that arise with almost every patient,” said Dr. Julie Lumeng, clinical instructor in the Department of Pediatrics, Division of Child Behavioral Health, U-M's C. S. Mott Children's Hospital.

For many of my patients, advocacy is not just something to help implement my intervention—it actually is the intervention.” Students participating in the clinic provide a range of advocacy interventions to address issues such as:

•  Applying for food stamps or cash assistance.

•  Litigating against landlords of substandard housing that cause health problems.

•  Providing referrals and representation for victims of domestic violence.

•  Navigating the special education system to ensure children receive legally required services.

Students work with clinic faculty to develop relationships with the doctors, nurses and social workers in each of the pediatric settings. Students also help healthcare providers to better advise and advocate for their patients. Cases are referred to the clinic through health care providers at each site, a mechanism designed to encourage collaboration on advocacy strategies for patients.

“We provide training to health professionals on what kind of work we do so they know how to pick out which issues are legal,” Beavers said. “We also encourage the professionals to contact us if they are unsure. It's best for us to get issues at the beginning, before they have escalated to matters that no longer have a legal remedy.”

Dr. Terence Joiner, a pediatrician at Ypsilanti Pediatrics who initially set up the partnership there, said visiting schools to intercede for the family had been time-consuming and he didn't have the legal experience.

“Now I can go directly to the clinic, get the information to the family and the case is handled much faster,” he said.

Clinic casework covers many issues that will likely include public benefits access and coverage, health insurance problems, domestic violence and other family law issues and housing law issues. The clinic is designed to provide a preventive rather than reactive approach to legal advocacy.

Some cases referred to the Pediatric Advocacy Initiative so far:

•  A 14-month old girl is seen at the health center for possible developmental delays. Her aunt has cared for the child for more than a year, and the child's mother only sees the child a few times a month and does not contribute financially. The aunt is concerned about the mother's ability to care for the child and would like to file for legal custody, but can't afford an attorney.

•  A family with three children with cystic fibrosis lives in a two-bedroom rental apartment. The apartment building is under construction and the family's home is dusty as a result. The family would like to move into a larger home, but bad credit prevents them from obtaining a mortgage.

Student Ben Berkman, a Philadelphia resident, said his interest in the clinic developed from wanting to pursue a career in health law and policy.

“This program seemed like an excellent way to combine law and public health in a practical setting,” he said. “Patients and providers seem excited to take advantage of the services we offer. The clinic has been one of the highlights of my graduate education.”

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