Working in a medical-legal partnership is an invaluable opportunity for those who believe justice requires the leadership and engagement of disenfranchised people within the legal system. The Medical-Legal Partnership for Children in Hawai‘i (MLPCH) is a partnership between the William S. Richardson School of Law (University of Hawai‘i at Mānoa) and Kokua Kalihi Valley Comprehensive Family Services (KKV), a community health center that aims “to address and improve the social determinants of health that impact child and family well-being.” This year-round law school clinic provides free legal advocacy on-site at the health center for housing, public benefits, family law, civil rights, consumer protection, and other matters for low-income and mostly immigrant families in Hawai‘i.
Laying the Foundation
Dina Shek, legal director and cofounder of MLPCH, started by traveling across the country and learning firsthand about the medical-legal partnership model. But she felt it was vital for the first MLP site in Hawai‘i to address the root causes of those issues that so commonly plagued their clients. To this MLP model, Shek says, “we added a rebellious lawyering practice and a racial justice framework that centers community knowledge and power.” She adds that the core value behind their work is the belief that: “all people have the right and the capacity to lead themselves.” Meaningful systemic change is only possible when community voices, experiences, and solutions drive their work.
By recognizing race and culture, the MLPCH staff can build better connections with their clients, which enhances the trust necessary to build an effective lawyer-client relationship. Much of their success can be credited to their ability to connect with clients and their families on this level.
It is necessary to talk about how racism and implicit bias appear in communities to represent and advise a client adequately. MLPCH emphasizes self-advocacy and skills-building, which require an open dialogue with clients about how legacies of racism can land on their shoulders. For example, a client who self-advocates at an agency office often reports stories that reveal how racist narratives about immigrants and welfare recipients can and will show up in their interactions with agency staff. The staff at MLPCH become better lawyers when they talk honestly about what is going on in clients’ lives, build trust, and accurately issue spot when and how discrimination may be affecting clients.
Community Engagement Leads to Community Power
MLPCH’s outreach into the community is possible through KKV, a health center with a long history of meeting patients where they are. KKV provides comprehensive services beyond medical and dental care: food cultivation programs, youth bike programs, and Hawaiian and Pacific Islander cultural education, which enhance a sense of community and trust among clients, patients, and providers.
Community-based training sessions are the best entryway into communities. For example, MLPCH conducts Advocacy Academy workshops that go beyond traditional “know your rights” by employing hands-on learning (teaching note-taking and role-playing), exchanging knowledge (we learn from each other), and addressing policy lessons (not only what happens, but why). This mini law school—plus food and laughter—allows all participants to build their capacity and hone their advocacy skills.
The Practice of Justice
Justice is often framed as a legal win, and MLPCH urges us to expand this framework to envision legal solutions that are broader and longer lasting in their impact. Often, capacity building, advocacy training, and training power are most effective in working toward “the practice of justice.” Together with the communities MLPCH serves, it successfully advocated for federal Medicaid restoration for US-residing Micronesians, improved language access in Hawai‘i, and organized Micronesian ministers to address critical health, social, and legal needs during the pandemic. Law school clinical programs such as this can bridge legal representation with policy advocacy so that, ultimately, people and communities may lead themselves.