Law students are easing the way for cancer patients

An innovative partnership between UB Law School and Roswell Park Cancer Institute aims to make life easier for patients by addressing legal problems that arise all too often after a cancer diagnosis.

Through the initiative, called LegalCare, students in the Law School’s Health Justice Law & Policy Clinic will counsel patients on issues that include employment law, guardianship arrangements, housing law and advance planning for end-of-life care.

“Unfortunately, people with cancer end up accumulating a lifetime of legal issues in a very short period of time,” says Danielle Pelfrey Duryea, the visiting clinical assistant professor who teaches the Law School clinic. “Maybe the boss can’t accommodate your chemo schedule and so you lose your job, you don’t have enough to eat, you may face eviction or foreclosure on your house.” Timely legal help, she says, can forestall these problems and eliminate the stressful burdens on patients who should be focusing on fighting their disease.

LegalCare builds on a successful arrangement between the hospital and Neighborhood Legal Services, whose attorneys serve low-income patients without charge. “We felt there was room to grow this medical-legal partnership,” Duryea says. “Roswell treats 5,000 patients a year. There are so many people who don’t qualify for free legal services, but they can’t afford a lawyer.”

Medical-legal partnerships are becoming more common as hospitals increasingly adopt a “whole person” treatment model, recognizing that a variety of life stressors can harm their patients’ health. Such an approach has support under the Affordable Care Act, which ties fee payments to hospitals’ overall outcomes and measures of population health.

Duryea says studies have shown that when doctors and other members of the health care team have such a resource in the hospital, they are much more likely to ask their patients about problems that might have legal solutions. About 100 medical-legal partnerships exist across the country, but this is one of only a handful that include a law school clinic.

Duryea’s students in the Health Justice Law & Policy Clinic designed a model for how to handle legal cases in conjunction with other providers: Neighborhood Legal Services, the Erie County Volunteer Lawyers Project and Legal Services for the Elderly, Disabled or Disadvantaged of Western New York. Clinical students will conduct initial interviews with patients needing help, then perform legal triage, deciding where the case will be best placed.

Beyond the immediate, practical help the students can provide to patients at Roswell Park, Duryea says, the experience imparts important lessons about the practice of law. “They’re learning a lot about legal issues because they’re talking to a real range of people,” she says. “What I’m helping them to learn are judgment and decision-making skills. It’s not a skill like cross-examination, but it is so important to practicing law.”

Jennifer Scharf, ’05, Roswell Park’s associate general counsel, says the legal issues presented by patients sometimes arise quickly, leaving them short on time to arrange legal counsel on their own. “The students can handle emergencies, of course, but they can also handle bigger-picture issues that patients didn’t realize they needed an attorney for,” says Scharf, who also teaches trial technique at the Law School as an adjunct professor.

The UB Law students will conduct intake interviews, learn to tease out concerns that have a legal solution and work to resolve them. Those patient concerns, Scharf says, anagram to IHELP: insurance, housing and eviction, education and employment, legal status or immigration, and personal planning such as advance directives, powers of attorney and wills. “Those are the issues that most affect people’s health care or are affected by health care,” she says. Less run-of-the-mill issues will be tackled with the help of specialists from the Western New York legal community.

Before joining the Law School faculty last fall, Duryea practiced litigation with Ropes & Gray in Boston. There she managed a vast medical-legal partnership that became a firm-within-the-firm, organizing the work of about 100 lawyers and paralegals in the working-class Dorchester neighborhood.

“It was such a great experience and really a true partnership,” she says. “We created a free legal service in five practice areas, working with every patient who was referred to us by a clinician. Over four years, we did not turn away a single patient who was referred to us for lack of someone to help them.”

She also has served on the advisory board of the National Center for Medical-Legal Partnership.

“From Roswell’s perspective, we are so fortunate to have the Law School as a collaborator,” Scharf says. “To have Danielle’s expertise here in our community is really quite incredible for us.”