Rajan worked to improve health and education outcomes of low-income children with sickle cell disease (SCD) by leading an innovative effort to understand and meet their interrelated medical, social, and legal needs.
Need Addressed By Project
More than a quarter of low-income children have a chronic illness. For children with sickle cell disease (SCD), which primarily affects African-Americans, historical and structural racism negatively affects health. SCD receives nine times less funding per person for research and social support than comparable diseases affecting white Americans. Best medical practices for SCD have been disseminated and followed at much lower rates than best practices for other diseases. Children with SCD face challenges to their health in multiple contexts. Detrimental social factors such as education, housing, and income security can adversely affect health even more than access to health care. Studies have shown, for example, that students with SCD are routinely denied basic accommodations to stay healthy and that the severity of their condition is not believed by schools. Integrated medical, social, and legal services foster better health outcomes for children with SCD.
During his Fellowship, Rajan has:
- Partnered with pediatric hematologists and social workers at two Boston hospitals to develop and implement a comprehensive social-legal screening and referral system
- Conducted a formal Institutional Review Board-approved study at both hospitals to examine the effectiveness of the screening/referral system and to detect relationships between social-legal needs, health outcomes, and health care costs
- Represented 55 clients who have children with SCD
- Provided brief services and advice to 175 clients
- Persuaded the Breathe Easy at Home program, a collaboration of Boston city agencies, to add SCD to the list of disorders to which they give priority status during housing inspections
- Coordinated the effort among local and national physician groups to comment on regulations proposed by the Social Security Administration that would harm patients with SCD
- Produced educational materials customized for various audiences—families, physicians, teachers, and government agencies—to explain accommodation requirements for children with SCD in K-12 schools, colleges, public housing, and other contexts
- Raised awareness of SCD issues through community education
- Helped form a parent-led SCD advocacy group within the Greater Boston Sickle Cell Disease Association
Many argue against universal access to healthcare, but few if any argue against universal access to justice—yet, there is only one lawyer for every 6,415 low-income individuals in the United States.
Rajan Anthony Sonik
Paul established a medical-legal partnership with Massachusetts General Hospital–Chelsea Healthcare Center to provide effective educational advocacy to children who were at risk for school exclusion or who faced barriers to equitable educational access.
Need Addressed By Project
Despite substantial strides in recent years, schoolchildren in Chelsea and neighboring communities continue to face a variety of challenges that threaten their long-term educational outcomes. Approximately 90% of students in Chelsea come from low-income families and are classified as “high needs” by the state, nearly half of Chelsea residents are foreign-born, and four out of five students speak a first language other than English. Each of these figures represents the highest rate in Massachusetts, contributing in part to the second-highest dropout rate in the state, the lowest graduation rate for students with disabilities, and an out-of-school suspension rate approximately twice the state average. No legal aid organization focuses specifically on educational advocacy in Chelsea, presenting a significant gap in legal services that this project seeks to fill.
In the past two years, Paul has:
- Provided full legal representation to over seventy low-income clients in a variety of legal
disputes with schools. He helped one client with significant disabilities secure school district funding of a private transition program after graduation, resulting in the client securing his first competitive employment and gaining the confidence to live independently.
- Worked onsite at MGH-Chelsea two days a week throughout his Fellowship, providing easily accessible legal information, consultations, and referrals to over 300 patients and families.
- Filed administrative complaints resulting in significant improvements to school district
policies relating to bullying intervention and prevention.
- Leveraged the expertise of experts in developmental pediatrics to negotiate improved services and a 150% increase in early education instructional time for all of a school district’s children diagnosed with Down Syndrome.
- Conducted training workshops for parents and providers regarding self-advocacy strategies in special education, school discipline, bullying, and other education law topics.
Where are they now?
Now that the Fellowship is complete, Paul plans to:
- Join the U.S. Department of Education’s Office for Civil Rights as an attorney in the Boston regional office.
- Continue working to ensure equal access to education through the enforcement of federal civil rights laws in educational institutions throughout New England.
Matt helped low-income people fight debt collection abuses, and works towards a fresh start for all consumers.
Debt collectors are some of the heaviest users of state court systems nationwide. In Massachusetts, they file over half of all civil cases. Despite this, very few lawyers are working with consumers to fight for their rights against industry players who do not comply with the law. It is a common misconception that there are no defenses that consumers can raise in debt collection cases; but Matt worked with his clients to raise meritorious defenses and counterclaims that can often save consumers thousands of dollars.
In the past two years, Matt has:
- Provided representation to over 400 individuals in debt collection actions.
- Given presentations to numerous community groups on consumer’s fair debt collection rights.
- Successfully advocated as a part of a coalition for changes to court rules for debt collection cases that are favorable to consumers.
- Helped to form a statewide coalition of consumer advocates dedicated to reaching 100% access to justice for people with consumer debt issues.
Now that the Fellowship is complete, Matt plans to:
- Continue representing consumers in debt collection lawyer for the day programs.
- Serve as the Project manager for pilot programs focusing on assuring 100% access to justice for low-income consumers in Massachusetts.
- Work as an attorney at Greater Boston Legal Services representing consumers in fair debt collection, auto fraud, student loans, bankruptcy, and other consumer matters.
Deborah combats pervasive barriers to mental health care by providing direct legal services, community outreach, and advocacy for low-income residents of Massachusetts.
Thousands of low-income Massachusetts residents every year are inequitably denied or limited access to mental health services. More than half of individuals with mental health, substance use, and co-occurring disorders face significant barriers to obtaining care, such as enrolling in comprehensive insurance plans, finding providers, and accessing medically necessary treatment and services. The existing mental health parity laws and health care consumer protections are ineffective and insufficient to meet the needs of this vulnerable population. Furthermore, these laws and regulations are inaccessible, especially for people with mental disabilities, without adequate legal representation.
In the past year, Deborah has:
- Advised or represented over 100 low-income residents of Massachusetts with mental health conditions facing denials of medically necessary services, barriers to comprehensive health insurance coverage, and unaffordable medical debt;
- Secured approximately $300,000 in health care services received or medical debt eliminated; and
- Collaborated with 24 advocacy organizations and local providers of mental health services to identify violations of mental health parity and advocacy opportunities to improve access to mental health care.
In the next year, Deborah plans to:
- Continue representing low-income residents of Massachusetts resolve barriers to mental health care;
- Increase advocacy efforts to strengthen mental health parity laws and regulations; and
- Work with pro bono attorneys to assist and represent additional clients.