In a Shifting Legal Landscape, Health Law Clinic Continues to Adapt to Clients' Needs

Attorney Bob Holub an Health Law Clinic members

Clinic instructor Mary Frances Charlton; students Mike Srstka, Megan Mackie and Tex Pasley; and instructor Amy Walters '09 are helping low-income clients with legal needs related to their health.

January 23, 2017

At times, health care documents can look like they're written in Swahili. Other times, not so much.

Third-year law student Tex Pasley, a participant in the University of Virginia School of Law's Health Law Clinic, recently won an Affordable Care Act case on behalf of a client who didn't reapply for an income-based discount in his benefits in time, because he didn't receive a notice and application in the only language he can read — Swahili.  Providing documents in the language a person understands is one of the requirements of the law.

"We said under the language-access provisions under the Affordable Care Act, he should have received information in his native language," Pasley said. "His income met the level for the subsidies."

Though he could hardly afford it, the man faithfully kept making his government insurance payments, even though the amount rose from around $16 a month to around $200 a month.

But once the clinic challenged the error, the benefit was reinstated "relatively quickly," Pasley said.

The case is just one example of how the clinic responds to the diverse and often changing needs of its clients. It's unclear how the apparent dismantling of the Affordable Care Act will affect clients in the new year, but the clinic — a collaboration with the Legal Aid Justice Center — will continue to try to help every applicant who comes through the door and qualifies for assistance.

Through the clinic, students represent low-income clients in a variety of health-related legal matters. The hands-on course gives students experience filing benefits claims, responding to Social Security overpayments, and drafting wills, advanced directives and powers of attorney, among other legal tasks.

The problem of accidental overpayments currently fills much of the clinic's time.

"The Social Security Administration says, 'Oops! We paid you too much,' because either you earned too much income that month, or you weren't actually disabled that month, or something like that," said Amy Walters '09, an attorney at the center. "So all of the sudden you owe $20,000 — or whatever the amount might be."

Walters teaches the clinic with Mary Frances Charlton, an LAJC staff attorney and its Affordable Care Act coordinator.

Mike Srstka, a third-year law student, said part of the job in handling overpayments is being a master of document review and rounding up paperwork.

"You have to look at bank statements, and then you and the client have to explain everything," Srstka said.

Megan Mackie, a second-year law student, said sometimes clients have multiple needs. A woman's father, for example, was sick and needed end-of-life legal planning. The woman herself was facing bankruptcy, and worried what would happen if she inherits her father's house, given her financial situation.

Mackie said she had to figure out what she could indeed help with, and what other issues she would have to refer to outside counsel.

"We have a certain expertise in this office, but it's not going to encompass every issue a client is going to have," she said.

Walters and Charlton said the clinic is a smart choice for second- and third-year students interested in client and witness interviews, factual development, legal research, preparation of documents and pleadings, and negotiation and advocacy.

"This a great clinic for second-year students because you don't need a third-year practice license," Charlton said.

But students who do have their third-year license may be able to use it, for example, in general district court to represent a client in a medical debt collections case.

“So I think this is a great clinic for either 2Ls or 3Ls," she said.

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