Program Description
MetroWest Legal Services (MWLS) provides legal advocacy to protect the rights and improve the lives of poor, elderly, disabled and otherwise disenfranchised individuals and families in the 45 cities and towns in our service area. MWLS is the only provider of free civil legal aid in our geographic region. In FY17, MWLS handled 2,675 legal cases for clients. MWLS conducted 30 outreach or training events benefitting 1,485 attendees and held 111 legal clinics where 620 participants received legal advice or assistance completing pleadings or paperwork related to their legal case.
Program Updates
May 1, 2018
The Board of Trustees
The Ilene Beal Foundation
Fiduciary Trust Company
175 Federal Street, #16
Boston, MA 02110
RE: Update and Request for Continued Funding of Medical Legal Partnership
Dear Foundation Trustees:
I am writing to update you on the work of the Medical Legal Partnership (MLP) which you are funding between MetroWest Legal Services and the Edward M. Kennedy Community Health Center in Framingham. I would like to start by telling you how appreciative we are of your funding and the great work that MLP Attorney Katie Condon Grace is doing addressing the legal needs of the patients of the health center.
Over the past year, 80 patients/clients received direct legal representation through the MLP. Demographically, 37% of those served were age 19 or under; 58% were between the age of 20-59; and 5% were over the age of 60. 90% of those served were minorities. In terms of the legal issues presented by clients, the breakdown is as follows: 39% - immigration; 31% - family law/domestic violence; 12% - health care access; 9% - housing; 5% - government benefits; and 3% - education.
In addition the MLP Attorney provided 185 consultations to Community Health Workers, medical providers and behavioral health providers. These consultations resulted in referrals to the MLP attorney, clarification about the need for legal assistance, and guidance about how to assist patients whose issue had not risen to the level of being a legal need.
Finally, 4 trainings were given to 38 Health Center staff on legal issues faced by their patients so that they could better understand and spot legal issues that would be appropriate for referral to the MLP. 3 of the 4 trainings in the past year were given on various aspects of immigration including: 1) Immigration basics and updates on the implications of several Executive Orders issued by the Administration; 2) Immigration Know Your Rights for health care center providers and intake staff relating to their rights as a health center when Immigration officials come into the health center and request patient information; and 3) A training on Deferred Action for Childhood Arrivals (DACA) status and the implications of the Administration ending that program in March 2018. The fourth training was given as an overview of the MLP to new staff which included referral protocols, case acceptance criteria, and consultations.
The MLP attorney along with other immigration attorneys at MWLS also held a DACA clinic at the Health Center for those who needed to renew their status or apply for DACA status prior to the end of the program. This was well attended by many patients of the Health Center.
A number of external factors directed some of the work of the MLP over the past year. The hostile political climate caused great fear in the immigrant community which presented challenges to providing both health care and legal representation. They included: 1) patients/clients not coming to appointments for fear that ICE would show up at the Health Center and detain them; 2) Clients are leery about attending court proceedings for the same reason which means that they may not seek restraining orders if they are victims of domestic violence; may not attend family court hearings seeking child support or to enforce an existing child support order; and may not appear at an eviction hearing and thus become homeless; and 3) some legal cases are becoming more difficult due to changes in policies relative to the approval of Special Immigrant Juvenile Status applications by the current Administration.
A number of emerging needs were identified during the last year:
The following is a vignette about a client helped through the MLP this year:
After her two teenage daughters informed her that they had been raped by acquaintances at a party, Catia did what any parent would do, she called the police and immediately took her daughters to the emergency room for necessary medical care. The closest emergency room at the time was in Rhode Island, so Catia took them there to be treated. Since her daughters had MassHealth, Catia assumed that their insurance would cover the medical emergency. After having to deal with the trauma and heartache over what had happened to her daughters, Catia received bills for the medical care the girls received in Rhode Island, totaling over $9,000.
Catia was distraught and unable to pay the bills with the small income she earned as a house cleaner. She sought assistance from a Community Health Worker at the Health Center who referred her through the Medical Legal Partnership to Katie Condon at MetroWest Legal Services. Attorney Condon discussed the matter with MassHealth to clarify coverage for out-of-state emergencies, and she researched other options for coverage. She helped Catia prepare and apply for coverage through the State of Rhode Island Crime Victim Compensation Fund. The program approved Catia’s application and they covered the medical bills for both daughters in full. Catia can now focus her attention on her daughters and their recovery, instead of worrying about how she will pay thousands of dollars in medical debt that resulted because her daughters were victims of crime.
As you can see, the MLP continues to be very busy with great demand for services and excellent results. I am also writing to you to request that you fund a second year of the MLP as previously discussed in the amount of $50,000. When we met to discuss funding for the MLP, you asked about plans for sustainability. I am pleased to let you know that the MetroWest Health Foundation, after recently completing a Strategic Plan, have decided to fund “Basic Critical Health Needs” by providing funding for 8 community partners for a 5 year period starting next year. They have determined that the Medical Legal Partnership is a Basic Critical Health Need. The funding from the Ilene Beal Foundation comes at a perfect time and has provided the bridge between their original funding and this new funding structure. Your foundation’s generosity allowed us to continue this vital work and not end the program. This new grant does not, however, cover the entire cost of the MLP. I would ask that you consider doing a legacy grant to close that gap for the 5 year period that the Health Foundation has committed to the program. The cost to fully fund the program is approximately $91,000 per year so our ongoing request would be $16,000 annually.
I also want to let you know that Katie Condon, the MLP attorney that you are funding, was recognized last month by the Massachusetts Bar Association as their Access to Justice Rising Star at an awards ceremony in Boston. She was nominated by MWLS, the Medical Director at the Health Center and the facilitator of the MetroWest Health Leader Program at the MetroWest Health Foundation. This honor is richly deserved.
Sincerely,
Elizabeth A. Soulé
Elizabeth A. Soule
Executive Director
May 1, 2018
The Board of Trustees
The Ilene Beal Foundation
Fiduciary Trust Company
175 Federal Street, #16
Boston, MA 02110
RE: Update and Request for Continued Funding of Medical Legal Partnership
Dear Foundation Trustees:
I am writing to update you on the work of the Medical Legal Partnership (MLP) which you are funding between MetroWest Legal Services and the Edward M. Kennedy Community Health Center in Framingham. I would like to start by telling you how appreciative we are of your funding and the great work that MLP Attorney Katie Condon Grace is doing addressing the legal needs of the patients of the health center.
Over the past year, 80 patients/clients received direct legal representation through the MLP. Demographically, 37% of those served were age 19 or under; 58% were between the age of 20-59; and 5% were over the age of 60. 90% of those served were minorities. In terms of the legal issues presented by clients, the breakdown is as follows: 39% - immigration; 31% - family law/domestic violence; 12% - health care access; 9% - housing; 5% - government benefits; and 3% - education.
In addition the MLP Attorney provided 185 consultations to Community Health Workers, medical providers and behavioral health providers. These consultations resulted in referrals to the MLP attorney, clarification about the need for legal assistance, and guidance about how to assist patients whose issue had not risen to the level of being a legal need.
Finally, 4 trainings were given to 38 Health Center staff on legal issues faced by their patients so that they could better understand and spot legal issues that would be appropriate for referral to the MLP. 3 of the 4 trainings in the past year were given on various aspects of immigration including: 1) Immigration basics and updates on the implications of several Executive Orders issued by the Administration; 2) Immigration Know Your Rights for health care center providers and intake staff relating to their rights as a health center when Immigration officials come into the health center and request patient information; and 3) A training on Deferred Action for Childhood Arrivals (DACA) status and the implications of the Administration ending that program in March 2018. The fourth training was given as an overview of the MLP to new staff which included referral protocols, case acceptance criteria, and consultations.
The MLP attorney along with other immigration attorneys at MWLS also held a DACA clinic at the Health Center for those who needed to renew their status or apply for DACA status prior to the end of the program. This was well attended by many patients of the Health Center.
A number of external factors directed some of the work of the MLP over the past year. The hostile political climate caused great fear in the immigrant community which presented challenges to providing both health care and legal representation. They included: 1) patients/clients not coming to appointments for fear that ICE would show up at the Health Center and detain them; 2) Clients are leery about attending court proceedings for the same reason which means that they may not seek restraining orders if they are victims of domestic violence; may not attend family court hearings seeking child support or to enforce an existing child support order; and may not appear at an eviction hearing and thus become homeless; and 3) some legal cases are becoming more difficult due to changes in policies relative to the approval of Special Immigrant Juvenile Status applications by the current Administration.
A number of emerging needs were identified during the last year:
- MassHealth has been making frequent errors in placing undocumented immigrants in the correct coverage category. When applying for MassHealth, proof of identity is required. Many undocumented immigrants use their passport for this purpose. MassHealth has been erroneously using the passport as proof of immigration status which results in people being found eligible for MassHealth Connector Care when they are not. This results in people having no insurance coverage until the error can be corrected. The MLP attorney worked closely with the Senior Policy Analyst at MassHealth to negotiate a settlement whereby MassHealth has agreed to retain all enrollment staff so that they know that Passports are not to be used for proof of immigration status and only for purposes of proof of identity.
- Children’s Medical Security Plan (CMSP): Many children covered under this program have been wrongly terminated from coverage. This issue is a result of a data breach at CMSP that resulted in many accounts be closed erroneously. The MLP attorney worked with many families to make sure that their children’s CMSP coverage was reinstated.
- Increase in Domestic Violence intakes: Many undocumented victims of domestic violence who have obtained initial restraining orders are seeking legal representation in restraining order extension hearings and contested family law cases. That being said, some cases do not make it past the advice stage because victims are concerned about their safety if they go to court because of the increased presence of ICE at courthouses. If a victim does not have a concern about ICE, they may worry that if their undocumented abuser is deported due to bringing them to court for child support, they will lose any income generated from that could be used for the family.
- School access: Undocumented non-English speaking children and parents are having trouble enrolling their children in school. This problem is due to the fact that they have trouble providing proof of residency. Many undocumented families do not have a written lease or other bills in their name that can be used to prove where they live. Many have oral agreements with landlords or other arrangements which are hard to document. A secondary reason for not wanting these children enrolled is that they bring down the MCAS scores of the school district.
The following is a vignette about a client helped through the MLP this year:
After her two teenage daughters informed her that they had been raped by acquaintances at a party, Catia did what any parent would do, she called the police and immediately took her daughters to the emergency room for necessary medical care. The closest emergency room at the time was in Rhode Island, so Catia took them there to be treated. Since her daughters had MassHealth, Catia assumed that their insurance would cover the medical emergency. After having to deal with the trauma and heartache over what had happened to her daughters, Catia received bills for the medical care the girls received in Rhode Island, totaling over $9,000.
Catia was distraught and unable to pay the bills with the small income she earned as a house cleaner. She sought assistance from a Community Health Worker at the Health Center who referred her through the Medical Legal Partnership to Katie Condon at MetroWest Legal Services. Attorney Condon discussed the matter with MassHealth to clarify coverage for out-of-state emergencies, and she researched other options for coverage. She helped Catia prepare and apply for coverage through the State of Rhode Island Crime Victim Compensation Fund. The program approved Catia’s application and they covered the medical bills for both daughters in full. Catia can now focus her attention on her daughters and their recovery, instead of worrying about how she will pay thousands of dollars in medical debt that resulted because her daughters were victims of crime.
As you can see, the MLP continues to be very busy with great demand for services and excellent results. I am also writing to you to request that you fund a second year of the MLP as previously discussed in the amount of $50,000. When we met to discuss funding for the MLP, you asked about plans for sustainability. I am pleased to let you know that the MetroWest Health Foundation, after recently completing a Strategic Plan, have decided to fund “Basic Critical Health Needs” by providing funding for 8 community partners for a 5 year period starting next year. They have determined that the Medical Legal Partnership is a Basic Critical Health Need. The funding from the Ilene Beal Foundation comes at a perfect time and has provided the bridge between their original funding and this new funding structure. Your foundation’s generosity allowed us to continue this vital work and not end the program. This new grant does not, however, cover the entire cost of the MLP. I would ask that you consider doing a legacy grant to close that gap for the 5 year period that the Health Foundation has committed to the program. The cost to fully fund the program is approximately $91,000 per year so our ongoing request would be $16,000 annually.
I also want to let you know that Katie Condon, the MLP attorney that you are funding, was recognized last month by the Massachusetts Bar Association as their Access to Justice Rising Star at an awards ceremony in Boston. She was nominated by MWLS, the Medical Director at the Health Center and the facilitator of the MetroWest Health Leader Program at the MetroWest Health Foundation. This honor is richly deserved.
Sincerely,
Elizabeth A. Soulé
Elizabeth A. Soule
Executive Director