ASKED & ANSWERED: Kathryn Smolinski on Legal Advocacy for People with Cancer

By Steve Thorpe

Legal News

When a patient receives a cancer diagnosis, in addition to new emotional and financial issues, legal issues can arise. Legal Advocacy for People with Cancer (LAPC) is a partnership between the Karmanos Cancer Center and the Wayne State University Law School. LAPC provides free legal information, resources, and representation to low-income cancer patients who otherwise would be unable to afford legal services. Attorney Kathryn Smolinski heads up the clinic.

Thorpe: Why a cancer law clinic?

Smolinski: A cancer diagnosis can bring on myriad legal problems. These problems are compounded when the individual has limited financial resources. Given the large population of low-income people in the Detroit area, many of whom get their cancer care at Karmanos, a partnership with Karmanos seemed like a perfect way to meet unmet legal needs. Legal help qualifying for Medicaid, disability, and other public benefits can help cancer patients obtain necessary treatment and medication for their overall care. Some individuals may need legal advice regarding their rights under the ADA and FMLA so they will not be afraid to take leave from work to attend chemotherapy and radiation treatments. The demands of cancer treatment are overwhelming for most individuals. They don't have the time or energy to track down free legal help from nonprofit legal aid offices or law firm pro bono programs. So a cancer law clinic that comes to them, where they already are receiving treatment on a regular basis, is invaluable.

Thorpe: What was the genesis of the program?

Smolinski: LAPC grew out of my 20 years' experience as an oncology social worker, combined with my desire to continue providing service to cancer patients and their families after my graduation from law school. I went to law school so I could broaden my advocacy toolbox. Upon graduation, I was awarded a national Equal Justice Works Fellowship to build a program where law students could be part of a cancer-focused medical-legal partnership (MLP). An MLP is a health care-delivery model where lawyers are integrated into the health care team. I brought the idea to David Moss, Director of Clinical Education at Wayne Law, and he loved it. We knew we wanted to provide service in Detroit, and Karmanos, being part of the Wayne State community, was the perfect partner.

Thorpe: What is a profile of a typical patient who might be helped?

Smolinski: This work is so interesting and rewarding because individuals are unique in their experiences with cancer and its treatment. Each referral brings new challenges and problems to solve. The amazing resiliency of the human spirit is ever present. All of our clients are adults, most of whom have very limited income and assets. They may be on public assistance or trying to access such programs. Most clients live in Detroit or the immediate surrounding area and are receiving treatment in Karmanos' outpatient clinics. We generally don't represent inpatients because they are too ill to focus on their legal issues. They need that time to focus on getting better.

Thorpe: What are some of the legal issues that might be faced by a cancer patient?

Smolinski: While most individuals will find themselves consulting an attorney at some point in their lives, cancer patients are especially in need. Because of the extensive impact cancer can have across all areas of an individual's life, LAPC offers legal assistance in five general areas, most easily remembered using the acronym I-HELP: Insurance, Housing, Employment, Long-Term Planning, and Public Benefits. Many of our clients have legal issues related to leaving work or returning to work, such as whether to disclose their illness to an employer and eligibility for medical leave, COBRA, and disability insurance benefits. Many of our clients need help planning for the future upon receiving a diagnosis of cancer. It is a very thoughtful time for them. Many clients ask LAPC to draft their wills, assist them in making plans for guardianship of their minor children, or draft advance directives to ensure their voice is heard when they become unable to speak for themselves.

Thorpe: How is the program staffed and funded?

Smolinski: Currently LAPC has one full-time attorney, administrative support through the Wayne Law clinics, supervisory support through Wayne Law faculty, and law students who intern in the clinic. Additionally, the program is extremely fortunate to have several Wayne Law alumni who serve on its pro-bono panel offering their valuable time, insight, wisdom and legal expertise to consult on or handle cases. Masters students in social work, through Wayne's School of Social Work, have been placed at LAPC to learn and provide support in its program design and evaluation.

LAPC was originally funded as a two-year fellowship through Equal Justice Works (EJW), a national organization that supports legal services for underserved individuals. EJW focuses on projects that fill unmet legal needs and, but for the fellowship, would not exist. Thanks to the generosity of Pfizer Inc., Jackson Lewis LLP, and Kaye Scholer LLP, LAPC's sponsors through EJW, this program received its initial funding. Jocelyn Benson, interim Dean of Wayne Law, recognizing LAPC's value to the community and Wayne's students, recently was successful in securing University funding to continue the program. Karmanos Cancer Center, as well, has designated funds to assist the program. Private donors have been kind to give to LAPC; the more that continue to do so, the broader LAPC can extend its service to the community and the education it provides to law students.

Thorpe: What is the future of the clinic?

Smolinski: Wayne Law is very excited to continue this program and expand its opportunities and services. The program thus far has been part of the Law School's Disability Law Clinic, be we look forward to spinning it off as a freestanding clinic that students can take for academic credit beginning in January 2014. In the future, LAPC hopes to offer interdisciplinary educational opportunities in partnership with Wayne's Schools of Medicine, Nursing, Social Work, and Pharmacy. Collaboration would create opportunities for law students to learn alongside health care students to improve health outcomes and advocate for health equity in the Detroit community. It would be an opportunity for students, before they launch into their professional careers, to recognize and support the unique and valuable role all disciplines have in caring for cancer patients.

Published: Tue, Aug 6, 2013