A HeLPing Hand: Celebrating the HeLP Legal Services Clinic

When the judge at an administrative hearing for Social Security benefits leaves the room following the hearing, it can be weeks or months before a decision is rendered about whether to award benefits. Parents or caregivers making the appeal for a disabled child can sit in a stew of worry.

Sometimes, though, the nerve-shredding is limited because an appeal is so thoroughly put together that the judge rules immediately from the bench. You expect that kind of expert appeal work to be done by seasoned attorneys.

But in the fall of 2011, Megan Douglas (J.D. ’12) and Meredith Linscott (J.D. ’12), third-year law students at the time, delivered a rousing win for a 15-year-old client. They were representing the client as part of their work in the HeLP Legal Services Clinic, a subset of the Health Law Partnership (HeLP), an innovative community collaboration among Georgia State Law’s Center for Law, Health & Society; Children’s Healthcare of Atlanta Inc.; and the Atlanta Legal Aid Society.

Douglas and Linscott delivered such sound, compelling arguments before a Social Security Administration judge and a medical expert hired by the SSA that they did not even have to leave the room. The judge ruled from the bench in their favor in an obliteration of bureaucracy: a one-hour-long proceeding.

“It was our home run,” Douglas said.

The judge ruled the Social Security Administration incorrectly denied benefits when the 15-year-old’s mother first applied. The judge ordered the SSA to retroactively award the benefits that should have been paid the previous year.

There was one other win. The 30-page brief Douglas and Linscott submitted before the hearing included expert work from residents and medical students at the Morehouse School of Medicine, Douglas said. There is a difference between the medical standard and legal standard for arguments, and the team had both sides of the aisle covered for their young client. When the judge asked the SSA’s medical expert to weigh in following oral arguments, the expert completely agreed with the students.

A holistic relationship between law and medicine

This year, the HeLP Clinic is celebrating 10 years of interdisciplinary work in which students of medicine, social work, bioethics and law work together for a just cause. Among its successes in the past decade, the HeLP Clinic has been recognized as one of the top 25 innovative clinics in the country by National Jurist magazine. HeLP Clinic co-directors Lisa Radtke Bliss and Sylvia Caley (M.B.A. ’86, J.D. ’89) teach and preach about the benefits of a holistic relationship between law and medicine in the classroom and beyond. They have presented about their work all around the world, including in Brazil, Spain, Canada, India, Thailand, Turkey and the Philippines.

“What we built in terms of the interdisciplinarity of the program is a real achievement,” Bliss said. “Our goal was to have interprofessional education for students from the medical profession as well as the legal profession.

“This year we have at least a dozen medical students enrolled. That’s an incredible number of students from another discipline who want to come to our law clinic to study and work together with us to address the social determinants of children’s health.”

The clinic opened in 2007, but its roots go back to 1989. Charity Scott, Catherine C. Henson Professor of Law and founding director of the HeLP Legal Services Clinic, went to Boston with Caley to look at a collaboration between Harvard Law School, where she earned her degree, and Brigham and Women’s Hospital.

“I wanted to develop a service-oriented practice for law students and medical students to work together,” Scott said. “Interdisciplinary collaboration was my highest priority.” She smiled wide and said, “It took quite a number of years for folks to agree that this was a good idea.”

Determined to make friends in the medical community, Scott became a faculty fellow at Emory and spent a sabbatical year in the neonatal intensive care unit in 1994– 1995.

“Health care providers often think of lawyers as adversaries, that we are only there to sue them,” Scott said. “We let them know we are their allies: ‘We are here to work with you in order to help your patients by addressing the social and economic determinants of their health.’”

Working with Caley and the Atlanta Legal Aid Society, Scott approached Grady Memorial Hospital several times over the next decade to try to launch the overall community collaboration between medical and legal professionals that ultimately became known as the Health Law Partnership (HeLP).

During this time, Scott began teaching classes on medical ethics with Emory medical school faculty at Grady, and through those efforts successfully secured the enthusiastic support of Emory and Morehouse faculty for HeLP. The hospital administration remained unconvinced, however.

The breakthrough came when a friend, Dale Hetzler, general counsel at Children’s Healthcare of Atlanta, agreed to the idea in 2004. That was fitting because Hetzler is regarded as an expert in conflict resolution in health care. With a generous grant from the Woodruff Foundation, Atlanta Legal Aid hired lawyers to begin HeLP’s first component: providing legal services directly to patients and their families.

In June 2006, Georgia State Law gave Scott the go-ahead to set up HeLP’s second component: an interdisciplinary educational clinic for students to take cases referred to them from HeLP. The clinic doors opened in January 2007.

Knocking down that wall of mistrust between attorneys and doctors is one of the biggest accomplishments of HeLP overall and of the clinic in particular, Scott said.

“When we first get the med students and law students together, they regard each other with a little bit of suspicion and distance,” Bliss said. “We have them work on joint problem-solving exercises together, and they begin to realize they have many more similarities in their professions than differences.

“Most of them have joined the law or medical professions because they care about their communities and helping people. They care about good health outcomes and just results. By the end of their experience working together, they are exchanging emails, becoming friends on social media and developing professional connections.”

Experiential learning

The HeLP Clinic is a live-client clinic. Instead of having their noses in books, students are nose-to-nose with the issue of intractable poverty as they interview parents and children. Much of the work is getting disability benefits for children, but HeLP can also take landlords to task for poor housing conditions. They also meet with public school officials to remind them of the bedrock of the 1973 Rehabilitation Act — that children with disabilities get “free appropriate public education.”

“We are problem-solvers,” said Caley, who closely supervises the students’ work along with Bliss and supervising attorney Jimmy Mitchell. “Parents have an advocate with them. When we are successful in a disability case, they get a cash benefit, and that might mean the difference between housing and homelessness. It brings fee-forservice Medicaid, instead of managed care. It helps kids who need procedures and therapies. It means better health coverage.”

Caley said the hearing before an administrative judge is invaluable experience for a law student. But students studying social work and bioethics also benefit because they are part of the interdisciplinary problem-solving on behalf of children.

“What makes this so dynamic and always interesting is the mix of skills that we’ve got here. The strong belief is that everybody — regardless if they are law students, med students, social work students, bioethics students — is better for the experience,” Caley said.

From legal practice to public policy

With a strong background in the fundamentals of legal practice from her work in the clinic, Douglas has transitioned easily into the field of public policy. She was the first attorney to participate in the Health Policy Leadership Fellowship at Morehouse, where she is now interim director, as well as an instructor in the Morehouse School of Medicine. The fellowship focuses on health policy and health equity; having a lawyer in its leadership role is notable and underscores the HeLP Clinic’s interdisciplinary work.

While many HeLP Clinic students may not ultimately choose full-time careers in public interest law, lawyers exposed to the program are likely to start an internal dialogue with themselves: “Where can I help? Where do I spend my pro bono hours?” Their legal bandwidth becomes larger with exposure to the HeLP Clinic.

“We don’t have an expectation that they will be public interest lawyers, but we do hope to imbue them with the sense of responsibility that they need to give back somehow and that public service is important and rewarding to our community and that they will engage in some form of pro bono service after they graduate,” Caley said.

Just as important, lawyers who have participated in the clinic prove to doctors they are a trusted ally and that the welfare of children is non-partisan. The adversary is life’s bruises, not the other professionals in the room.

So when the yellow legal pad crosses with the stethoscope, there is a better chance for outcomes that rekindle spirits for children and their caregivers. If you are counting accomplishments for the HeLP Clinic in its 10 years, that might be the biggest of all.