Professor heads Pediatric Advocacy Initiative


By Sheila Pursglove
Legal News

As she wrapped up her undergrad studies at the University of Chicago, Anne Schroth was torn between joining the Peace Corps or studying law.

“I naively thought they were similar endeavors — working for justice to make the world a better place,” says Schroth, a clinical professor of law at the University of Michigan Law School.

“I was in for a rude awakening when I arrived at Harvard Law School but I’ve managed to maintain my original goal to use the law to improve the lives of the marginalized and underserved members of our society.”

In 1997, Schroth helped start the Michigan Poverty Law Program (MPLP), a partnership between the law lchool and Legal Services of South Central Michigan, funded in part by the
Michigan State Bar Foundation and the Legal Services Corp.

She has been the law lchool’s liaison to MPLP since its inception and — until this year — her clinic had been co-located with the offices of MPLP.

A fan of clinical education since Harvard, Schroth was thrilled with the opportunity presented by U-M.

“Practicing law collaboratively is — in my view —the best way to learn and explore the substantive law, ethical dilemmas, and professional development that lawyers deal with every day,”
she says. “Working with students is incredibly rewarding as we watch them develop their own personae, confidence and identity as attorneys, through real work with real clients. The students are incredibly bright and committed, so working here has the added benefit of working with such talented and fun students.”

Schroth enjoys the dynamic of each semester unfolding differently, with new cases, clients, and students.

“I’m very lucky to be able to work in this laboratory where we practice law under a microscope and have the time to reflect and debrief our work — time that most lawyers rarely have once they enter the world of legal practice.” Schroth is director of the U-M Pediatric Advocacy Initiative (PAI), a partnership between lawyers and health care providers — including social workers, nurses, and doctors — that provides free legal services to low-income families who have children with medical issues complicated by social and legal problems. This model of legal services delivery provides a holistic approach.

“We connect with the patient families through their health care providers, where they get physical, emotional, psychological — and, now, legal — assistance,” she says. “We also reach families who are under such stress — emotional, psychological, economic, and social — that they may never have the resources to seek legal assistance however much they are entitled to it. Through our partnership, we can provide access to justice for these families and reach communities and individuals chronically underserved by social and legal services.”

PAI launched in 2004 with two U-M health care provider partners — the pediatric social work team at C.S. Mott Children’s Hospital and Ypsilanti Pediatrics at the Ypsilanti Health Center. 
PAI now serves both the pediatrics and family practices of Ypsilanti Health Center, added the Maternal Infant Health Program at Mott, and also established partnerships with The Corner Health Center and the Maternal Infant Health Program of the Washtenaw County Department of Public Health. 

“Each of these health care sites reaches specific populations and communities that I wanted to reach with PAI services, communities where our most vulnerable clients face the most challenging barriers to optimal health outcomes,” Schroth says.

Mott’s pediatric social work team is the most frequent referring partner, sending PAI diverse and complex issues. The two Maternal Infant Health Programs support Medicaid eligible women with high-risk pregnancies, with the county MIHP including home-based services.

“With these partnerships, we reach many extremely vulnerable immigrant and non-English-speaking families who are often so isolated that they would never be able to seek out legal assistance even if they knew it was available,” Schroth says.

A high percentage of Medicaid recipients had already made the pediatricians and social workers at Ypsilanti Pediatrics dedicated advocates for their patients in the tangled bureaucracies faced by families living in poverty, Schroth says.

“The legal services offered by the PAI were a welcome addition to their available resources and helps to diversify our reach into the low-income communities of Washtenaw County.”
The Corner Health Center’s team of family practice physicians, pediatricians, psychiatrists, certified nurse-midwives and nurse practitioners helps young people from ages 12-21.

“Their multi-disciplinary model made it an especially appealing partner, where we could reach uniquely isolated teens and provide another resource accessible at their trusted healthcare site,” Schroth says. 

Since the Corner is a clinic site for U-M Health System residents, the partnership is reinforced by the PAI training curriculum presented four times annually to U-M pediatric residents. 
Law students come to the PAI with all kinds of future goals and career plans but usually with the goal of working with real clients who have real problems, Schroth says.

“Our students gain invaluable experience working in the PAI’s innovative legal service delivery model where they are challenged to meet their clients as they find them — distracted, vulnerable, stressed — identify viable legal solutions to their presenting issues, and enlist their collaboration in resolving these issues.”

In addition to gaining legal skills in interviewing, counseling, research and writing, and oral advocacy, students gain less obvious skills like empathy, creative problem solving and patience.

Frustration with overwhelming bureaucracies and tangled administrative muddles turns to elation when determination and persistence pays off and they achieve their clients’ goals, Schroth says.

PAI’s varied poverty law practice exposes students to diverse areas, including family law, special education, public benefits, housing, and consumer law.

Some of the work is preventive advocacy, avoiding litigation before crisis hits.

More traditional cases involve contested litigation or administrative advocacy. Students and staff also provide community training sessions for medical provider partners.

Prior to joining the U-M faculty, Schroth was an associate with Bernabei & Katz, a plaintiffs’ civil rights law firm in Washington, D.C.

She then became a staff attorney with AYUDA in D.C., with challenging and rewarding work representing immigrant and refugee victims of domestic violence.

“My clients were predominantly immigrants and refugees from Central America who were facing often overwhelming barriers, involving language, immigration issues, financial stresses, employment issues, and — in addition to all those challenges — were also subjected to devastating emotional and physical abuse by an intimate partner,” she says. “Helping these vulnerable individuals navigate the unfamiliar and intimidating court system and successfully establish stability for themselves and their children was great work.”

She also worked on systemic issues facing clients, the most satisfying of which was working on many committees and work groups that eventually formed a new domestic violence court in D.C.

“I’ve never figured out why it’s true, but the court system in D.C. was much more ‘user-friendly’ for non-English-speaking litigants and for domestic violence victims than I’ve found here, so seeking help from the courts was usually an empowering and liberating experience for my clients.”