Fall 2019
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The Docket
What's Inside:

  • Protecting Immigrants' Health Care Rights in a Time of Crisis

  • Mental Health Advocacy Program for Kids Expands

  • Staff Spotlight - Deborah Steinberg

  • 24th Annual Benefit Breakfast - November 19th - Featured Speaker Roz Chast!

  • New Board and Staff Members

  • Cy Pres Awards Can Support Health Care Justice
Dear Friends,

Already in 2019, our growing team has provided legal assistance to help more than 880 clients across Massachusetts overcome obstacles to health care due to the generosity of our supporters.

In this edition of The Docket , we are very pleased to share major developments in our work on behalf of immigrants as well as children with unmet mental health needs. We are also happy to introduce you to several new HLA staff and board members.

With appreciation,

Matt Selig
Executive Director
Protecting Immigrants'
Health Care Rights
in a Time of Crisis

HLA Plays Role in National Class Action to Block Harmful Trump Administration Policy
HLA is responding to this time of crisis for low-income immigrants in Massachusetts and throughout our country through our Immigrant Health Care Access Initiative. Our work includes key support for national lawsuits against the Trump administration, individual representation already this year of nearly 200 immigrant families blocked from accessing health care, and dozens of training programs to help providers and advocates understand the shifting policy environment and ensure that low-income immigrants can access vital health care services.

Fighting Against The New 'Public Charge' Rule

HLA has been hard at work since the Trump Administration first leaked a sweeping regulatory change last year redefining the longstanding meaning of “Public Charge” found in the Immigration and Nationality Act. The final Rule was published in August and provides that immigrants could be deemed a Public Charge and denied status for receiving even small amounts of public benefits, such as Medicaid, food stamps or housing assistance.
In September 2019, HLA and Foley Hoag filed jointly authored amicus briefs in lawsuits challenging the Rule across multiple jurisdictions on behalf of HLA and 23 other legal services, advocacy and public health organizations. Our brief called out the devastating impact the Rule would have on not just immigrants, but on all of us.
Just two weeks ago, on October 11th, federal judges in New York, Washington and Maryland issued nationwide preliminary injunctions barring the Rule from going into effect. Courts in California and Illinois also issued limited-scope injunctions, indicating that the plaintiffs were likely to succeed on the merits of their claims. In support of its ruling, the Eastern District of Washington specifically cited HLA’s and Foley Hoag’s amicus brief.
Under well-established agency interpretation of the term “Public Charge”, only an immigrant who is primarily dependent on the government for subsistence could be declared a Public Charge. This draconian policy change, originally set to take effect on October 15, 2019, used possible immigration consequences to frighten low-income immigrants away from health benefits for which they are eligible . E xperts estimate that the new Public Charge Rule could discourage as many as 77,000 low-income Massachusetts immigrants from seeking health care out of fear for adverse immigration consequences. While the preliminary injunctions provide a temporary reprieve, the fight is not over. HLA expects to file amicus briefs in appeals of the recent decisions and will continue to work until the rule is permanently enjoined.
We will continue fighting to permanently invalidate the Rule as part of our overall efforts to enable low-income immigrants to receive health care while they pursue the American dream amid the daily, prejudicial assault on immigrants' health and safety by the federal Administration.
Representing Low-Income Immigrant Families Every Day
Already in 2019, HLA attorneys have provided legal assistance to more than 180 immigrant clients who are striving to get ahead but struggling to access health care due to a range of systemic barriers. Our clients live in cities and towns from Pittsfield in the Berkshires to Sandwich on the Cape.
One crucial ally in our work to assist immigrants with low-income in accessing health care is Beth Israel Deaconess Medical Center (BIDMC), a member of Beth Israel Lahey Health (BILH). HLA and BIDMC have formed a collaboration in which BIDMC clinical staff systematically identify immigrant patients who lack health insurance coverage for needed services. Then, HLA's Immigrant Health Care Access Initiative Director Andrew Cohen works directly with BIDMC staff and immigrants who are BIDMC patients to navigate the complex rules governing health insurance eligibility for immigrants. Due to the intricate nature of these rules, many Massachusetts residents who are not U.S. citizens are initially provided with limited health benefits despite possibly qualifying for comprehensive coverage. Attorney Cohen is regularly able to work with BIDMC staff and his clients to secure the health benefits his clients need to access health services. Andrew has also conducted several trainings on health coverage eligibility for BIDMC staff. HLA is actively seeking to create similar initiatives with other health care providers.

Training Others to Navigate the Health Care System Themselves

Lack of health care access for low-income immigrants is such a widespread and worsening problem that HLA is asked to conduct more trainings on this topic than any other. Already in 2019, Attorney Cohen and other HLA staff have conducted more than 25 trainings around the state for immigrants, clinicians, attorneys, and advocates on the Public Charge Rule and other barriers to immigrant health care access.
HLA greatly appreciates targeted grants for our Immigrant Health Care Access Initiative from the Fish Family Foundation , Massachusetts Bar Foundation , MetroWest Health Foundation , and the Tomfohrde Foundation . T he Klarman Family Foundation , the Blue Cross Blue Shield of Massachusetts Foundation and the Nord Family Foundation provide generous operating support which also makes this program possible along with contributions from hundreds of corporate and individual supporters.
HLA's Mental Health Advocacy Program for Kids Expands
Program that diverts kids from juvenile courts and im proves their mental health now has attorneys based in 7 MA counties
This summer, state legislators and Governor Charlie Baker approved a major investment in HLA's Mental Health Advocacy Program for Kids (MHAP for Kids) that will help hundreds of at-risk youth across the state receive needed mental health care. Powered by $500,000 in the state's fiscal year '20 budget, MHAP for Kids now has attorneys based in seven counties - Bristol, Essex, Hampden, Middlesex, Norfolk, Suffolk, and Worcester. The attorney s are located in Department of Children and Families’ (DCF) Family Resource Centers (FRCs) in the cities of New Bedford, Lynn, Holyoke, Lowell, Quincy, Boston, and Worcester, respectively. We invite you to read the bios of our new MHAP for Kids staff lower in this newsletter, including our attorneys in Holyoke, Quincy, and Worcester, and our MHAP for Kids Intake Coordinator and Paralegal.

These attorneys provide free legal assistance to low-income youth struggling to cope with substantial unmet mental health needs and facing steep challenges as a result. Our lawyers ensure children receive appropriate services from schools, state agencies, and health insurance plans. These attorneys also share the FRCs’ mission of diverting kids from the juvenile justice system to appropriate community-based services. HLA is working hard to secure resources to expand MHAP for Kids statewide, so we are able to serve every child who needs our program's assistance.
HLA is deeply grateful to Governor Baker and the entire Legislature for their support of MHAP for Kids. In the Legislature, we owe enormous thanks to Senate President Karen Spilka, House Speaker Robert DeLeo, Senate Ways and Means Committee Chair Michael Rodrigues, and House Ways and Means Committee Chair Aaron Michlewitz for their strong support for MHAP for Kids and dedication to children with mental health needs.

HLA is especially thankful to Senate Ways and Means Committee Vice Chair Cindy Friedman for her impeccable leadership in the budget process to secure funding in this year's budget to expand MHAP for Kids and her unyielding commitment to mental health access.

We also greatly appreciate the vital role played by House Chair Kay Khan of the Joint Committee on Children, Families and Persons with Disabilities in championing funding for MHAP for Kids in the House of Representatives and all she does to protect vulnerable children in Massachusetts.
MHAP for Kids, an evidence-based program, is fortunate to have support from a broad range of stakeholders in the mental health, judicial, and educational systems. HLA is grateful to the FRCs that host and strongly support our MHAP for Kids attorneys. The agencies that operate these FRCs are: Bay State Community Services (Quincy/Norfolk County), Centerboard (Lynn/Essex County), Enlace de Familias (Holyoke/Hampden County), The Home for Little Wanderers (Boston/Suffolk County) NFI, Inc. (Lowell/Middlesex County), The United Way of Greater New Bedford (New Bedford/Bristol County), and You, Inc. (Worcester/Worcester County). Also, Boston Children's Hospital, Health Care for All, the Massachusetts Association for Mental Health, the Massachusetts Society for the Prevention of Cruelty to Children, and the Parent/Professional Advocacy League, as members of the Children's Mental Health Campaign, played essential roles in this summer's MHAP for Kids expansion and we are enormous grateful for their efforts on this and many other issues involving children's access to mental health services.

Data from a two-year study of MHAP for Kids by the Boston University School of Public Health found that the program improves children's and parents' mental health, children's school attendance, and family functioning, while decreasing psychiatric inpatient hospitalizations , emergency department visits, and court involvement. These outcomes result in significant cost-saving for the state while substantially improving the lives of children and their families.

MHAP for Kids is supported by both public and private investment. We are enormously grateful for generous targeted grants from several private funders including a lead grant from The Peter and Elizabeth C. Tower Foundation, The Fish Family Foundation, The Cabot Family Charitable Trust, The Ludcke Foundation, The Beveridge Family Foundation, The Gardiner Howland Shaw Foundation, The Charles H. Hall Foundation and The Bennett Family Foundation .
We are also grateful for the strong financial support for MHAP for Kids by state agencies: The Department of Children and Families, The Massachusetts Attorney General's Office, The Massachusetts Health Policy Commission (through a subgrant from Community Care Cooperative) and The Massachusetts Probation Service .

T he Klarman Family Foundation , the Blue Cross Blue Shield of Massachusetts Foundation and the Nord Family Foundation provide generous operating support which also makes this program possible

Significant financial support for this work has also been provided by Boston Children's Hospital and Hagens Berman Sobol Shapiro LLP and many more corporate and individual HLA supporters.
Staff Spotlight: Deborah Steinberg
Equal Justice Works Fellow
A Lifelong Passion for Mental Health Parity
In the fall of 2018, Deborah (Deb) Steinberg joined HLA as an Equal Justice Works Fellow, sponsored by Fidelity Investments and Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C. Deb designed her two-year fellowship to combat the legal and inequitable barriers people with mental health, substance use, and co-occurring disorders face when trying to access health care.

A Lifelong Passion for Mental Health Parity

Growing up in Needham, MA, Deb was surrounded by a wave of suicides during her middle and high school years and saw too much suffering among her peers that she knew she wanted to ameliorate. Rather than feeling helpless by the vast unmet needs for mental health treatment, Deb started volunteering with Samaritans Suicide Prevention Helpline at the age of 16, and she went to college at Vassar to pursue a bachelor’s degree in psychology. Once at Vassar, Deb became involved in student government, rising from the president of her dorm to the president of the student body by her senior year. Her campaigns always centered around improving access to mental health care for students and expanding the school’s public service in the greater community.

Upon graduation, she started working in the Office of Patient Protection (OPP) at the Health Policy Commission. While facilitating the external appeal process for individuals who were denied health care services by their insurance companies, she came across appeals that were filed by attorneys from Health Law Advocates. These appeals were so much stronger and more comprehensive than those filed by consumers themselves, and they were much more likely to succeed. As much as Deb loved her work at OPP, Deb was drawn to the plights of the consumers, especially those with mental health conditions, and she dreamed of joining the team of attorneys at HLA who were fighting for these individuals. So Deb went to Georgetown University Law Center to pursue her passion for public interest law with a focus on access to health care. She interned with the U.S. Department of Health and Human Services and with the National Health Law Program (NHeLP) among many other extracurricular volunteer work and pro bono projects, but she remained committed to returning to Massachusetts to help fight for mental health parity in her home state.

Deb’s First Year at HLA

Deb has already advised or represented more than 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 $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. Deb has drafted legislation to improve mental health parity laws in Massachusetts and has been instrumental in advocating for regulatory changes and sub-regulatory guidance that further expand affordable access to mental health care.

In the year ahead, Deb is excited to continue representing low-income residents of Massachusetts in resolving barriers to mental health care while increasing advocacy efforts to strengthen access to these services.
HLA's 24th Annual Benefit Breakfast
Coming up on November 19th!
With Featured Speaker: Roz Chast, Cartoonist for The New Yorker
Tuesday, November 19, 2019
7:00am - Networking Hour
8:00am - Program

Sheraton Boston Hotel
39 Dalton Street
Boston, MA 02199

On Tuesday, November 19th, HLA will hold its 24th Annual Benefit Breakfast! Over more than two decades, the Benefit Breakfast has grown to welcome nearly 900 lawyers, advocates, and health care professionals to raise funds for HLA. Funds raised go directly to providing free legal assistance to low-income health care consumers in Massachusetts, educating consumers and advocates, and advocating for just policies that benefit our communities.

We are delighted to welcome Roz Chast, acclaimed cartoonist for The New Yorker, as this year's featured speaker!

So please join us for the Networking Hour, starting at 7:00am, and take a seat for breakfast and a show at 8:00am!

If you're interested in becoming a sponsor or purchasing tickets, please contact Emily Tabor at etabor@hla-inc.org or 617.275.2881.
HLA Board and Staff News
Please join us in welcoming the following additions to our fantastic Board and Staff

New HLA Board Members
Ugonma (Ugo) Chukwueke was elected to HLA's Board of Directors in March. Dr. Chukwueke has appointments as a Medical Oncologist at Dana-Farber Cancer Institute and as a Neurologist with Brigham and Women's Hospital. Ugo has a personal and research interest in improving access to oncological care in minority and underserved populations. She received her MD from Wake Forest University School of Medicine, a Masters in Public Health from Harvard T.H. Chan School of Public Health, and a Masters in Biotechnology and a B.A. from Johns Hopkins University.
Dennis Heaphy was also elected to HLA's Board of Directors in March. Mr. Heaphy is a Healthcare Policy Analyst with the Disability Policy Consortium, a position he has served in for more than a decade. Dennis has also held positions as a Program Coordinator with the Department of Public Health and as an Adjunct Faculty Member at Emmanuel College. Dennis hold Masters degrees in Divinity and Public Health from Boston University, a Masters in Education from Harvard University, and a B.A. from Boston University.

New HLA Staff Members
Torie Argus joined HLA in September as our Mental Health Advocacy Program for Kids Staff Attorney in Worcester. Prior to joining HLA, Torie represented children with disability-related discipline and/or bullying issues as an education law attorney. Torie earned a Bachelor of Arts and Master of Education from the University of Notre Dame. While working towards her graduate degree, Torie taught 4 th grade which inspired her passion for juvenile justice and educational law. She graduated from Boston College Law School where she was recognized as a Public Interest Fellow and Curtin Public Interest Scholar.
Michaela MacQuarrie joined HLA in September as the Paralegal for the Mental Health Advocacy Program for Kids. Previously, she served in AmeriCorps' New American Integration Program as an Immigration Case Manager at Action for Boston Community Development where she assisted low-income residents with citizenship applications. Additionally, Michaela has worked to support children as a teaching fellow in the Holyoke Public Schools and as an academic mentor at a non-profit organization for students in Buenos Aires. She earned her B.A. in Sociology from the University of Massachusetts Amherst.
Marina Millison joined HLA in August as our new Legal Fellow through AmeriCorps. Marina graduated from the University of Florida Levin College of Law in 2019. During her time at UF Law, Marina was both a General Editor and the Executive Acquisitions Editor of the Journal of Law and Public Policy. She worked for several legal aid organizations in Florida prior to and during law school, including as a Florida Bar Foundation Summer Fellow. She received her B.A. in English from the University of South Florida.
David Satin joined HLA in October as our Mental Health Advocacy Program for Kids Staff Attorney in Quincy. For the past year, David has served as an Associate in a law firm's Education Law Group. Previously, he was a Trial Attorney for more than two years with the Children and Family Law Division of the Public Defender's Office. Before receiving his law degree from Northeastern University, David was an Applied Behavioral Analysis Counselor for three years. He received his undergraduate degree, magna cum laude from the University of Massachusetts Amherst.
Mara Shulman joined HLA in August as our Staff Attorney based in Holyoke for our Mental Health Advocacy Program for Kids, Before joining HLA, Mara worked for five years as a court-appointed attorney in Hampden and Hampshire Counties with a focus on representing youth in delinquency proceedings. Before studying law as a Public Interest Scholar at Western New England University, Mara received a Master’s Degree in Sustainable Development from the School for International Training and a Bachelor’s Degree in English and Spanish Literature from Smith College.
Hannah Singer joined HLA in September as the Intake Coordinator for our Mental Health Advocacy Program for Kids. Hannah served previously as an AmeriCorps Legal Advocate of Massachusetts with the Volunteer Lawyers Project (VLP). With the VLP Hannah assisted hundreds of low-income clients with poverty law issues. She also has served a judicial internship with the Honorable John B. Beliveau, District Court Judge for Androscoggin County (Maine). She graduated from Bates College with a Bachelor's Degree in Sociology.
Cy Pres Awards Can Support
Health Care Justice

Over the years, cy pres awards have made a significant difference in HLA's ability to help low-income consumers access health care and defend consumers' rights. These funds serve as a vital revenue source that support HLA's efforts along with the individual and corporate contributions, grants and contracts. Please contact HLA's Executive Director Matt Selig at 617-275-2986 or selig@hla-inc.org if you are interested in nominating HLA for a cy pres award. Thank you for considering us!
Health Law Advocates
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