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By: The MLPC Staff
Catherine Chen, Fernando Cosio, Deja Ostrowski, & Dina Shek
Imagine this scenario.
A newspaper sits folded on the waiting room chair at a community health center, with the following headlines in English and large font: “STATE EVICTION MORATORIUM” and “Here’s How to Apply for the New Rent Relief Program.” Meanwhile, inside the exam room, Mom tells her daughter’s doctor through an interpreter, “I’m going to be evicted if I don’t pay all this rent from these six months. I’m not sure what to do.” The doctor pulls out her tablet. “Let’s talk with a lawyer.” The physician also provides a short infographic translated into Chuukese about the eviction moratorium and what it means.
The case above illustrates a common client case story, where community members face daunting barriers to accessing benefits or asserting their legal rights. Our Medical-Legal Partnership (“MLP”) is built around this reality. Embedded in a community health center, MLP lawyers are on hand for warm-handoff or immediate personal referrals from our doctors, who are skilled at “issue spotting” by screening for health-harming legal needs, known to us as “social determinants of health.” Our model builds on public health concepts that acknowledge racism, gender discrimination, and other social barriers impact wellbeing more than genetics. Most importantly, the MLP model of legal services is founded on a legal practice of working with the community to confront and change systems of power that stigmatize and delegitimize community expertise. Our work requires us to make an explicit and detailed commitment to meeting and challenging implicit and explicit biases, particularly those about Pacific Islanders, and putting community leadership at the center of our work.
For the last twelve years, the William S. Richardson School of Law’s MLP for Children (“MLPC”) has collaborated with the Kōkua Kalihi Valley Comprehensive Family Services (“KKV”), a community health center.KKV provides free, on-site, direct legal services for KKV’s patients, nearly a third of whom identify as Micronesian. MLPC and KKV also work alongside Micronesian communities to address systemic advocacy needs.
The case we examine in this article may seem like a straightforward report of a legal violation that only requires providing a client with tailored legal information and program information. However, a deeper inspection reveals the far-reaching consequences of the pandemic for our clients and demonstrates the importance of messaging and collaborating alongside communities who are not often prioritized. Additionally, we clearly see how, specific to Pacific Islander communities in Hawaiʻi, advocacy that goes beyond simple legal service provision and works to uplift community partnerships is most needed.
Moments later, after telling her physician through an interpreter that she is facing a threat of eviction, Mom is sitting in front of the tablet in the MLPC office with a lawyer and law student intern talking to her on the tablet. The doctor nods encouragingly and then leaves to give them privacy. Mom starts to tell her story with the assistance of a KKV Chuukese interpreter. Mom explains that she lives in a public housing facility with her three young children. Shortly after the beginning of the pandemic, her husband abandoned the household without notice for unknown reasons. As a result of his sudden departure, Mom sustained serious distress and financial difficulty, as he was previously the primary breadwinner of the family and the main source of income for rent purposes. MLPC conducts a brief domestic violence (“DV”) screening and assesses that Mom feels safe, but deeply frustrated and saddened due to the abandonment. Due to challenges caused by COVID-19 and concerns Mom had about her eligibility for the program as a Lawful Permanent Resident (a status she obtained through the marriage to her husband), she was unable to provide housing management with household change information in a timely manner. As a result of these circumstances, her rent amount continued to increase due to circumstances beyond her control.
The MLPC lawyer, through an interpreter, explains to Mom that under normal circumstances, a tenant of a public housing complex can report household changes of income directly to their housing project management to amend their normal monthly rent payments, as rents are calculated based on the total monthly income of the household. During the pandemic, as many offices closed for in-person visits and clients faced employment interruptions, MLPC heard questions from the community on how to document business previously conducted in person. Thus, MLPC created a form to assist clients with self-advocacy and documentation when they report changes in household income to management. Due to the high needs, the MLPC made this form available to prospective clients through their healthcare providers. Here, MLPC provides this form to Mom, discusses rent adjustments, and confirms that her immigration status did not affect her family’s housing or rental assistance eligibility, and Mom could confidently interact with housing staff. However, many problems would end up requiring more formal legal intervention due to the unprecedented challenges that tenants faced.
While a cursory review of the client intake may suggest that the case requires only a light touch by providing legal information about reporting changes in household composition and program eligibility for immigrants, MLPC has learned that navigation of even seemingly straightforward eligibility requirements can require legal advocacy. Importantly, when faced with the overwhelming and unprecedented challenges of the pandemic, many immigrant populations seek advice and support from already trusted community partners such as their physicians and community health centers.
Three weeks later, Mom is back at the MLPC office, interpreter at her side and papers in her hands. She explains what happened. Armed with information from MLPC for self-advocacy from the last meeting, Mom had informed management of the sudden change in her household. However, as often happens, even basic eligibility reviews can reveal additional challenges. Even after doing everything right, Mom had to return to the community health center to ask for more sophisticated legal assistance. Mom nods as the lawyer asks if she had told the housing project about her husband leaving. “They are telling me I need a signed affidavit from my husband to show the change in household to get the rent changed. I don’t know where he has been for months. How am I supposed to obtain this or make him sign this?”
Many of our clients come to us after much of their self-advocacy efforts hit areas that seem impossible to navigate such as preparing an affidavit, which takes time and resources to complete and notarize. In this situation, not knowing the general whereabouts of her ex-husband created a futile, if not impossible, requirement considering that he had not been in contact with the family for several weeks. This client did her best to contact family members to complete the affidavit requirement and document what seemed nearly impossible. The housing management also failed to assess this client for domestic violence and offer her appropriate alternatives before sending Mom to contact her absent ex-husband.
Mom continues onward with her story. To make matters worse, all of her children contracted COVID-19 after our last meeting three weeks ago. As the lone parent and sole caretaker, she was precluded from working as the children required constant care and supervision. Thankfully, the children recovered and no one else in the household subsequently contracted the virus. Yet, once the illnesses subsided, Mom still could not return to work (even on a limited and nominal part time basis) due to County restrictions and retail closures.
Over the next few months, the lawyers and law students at the MLPC get to know Mom’s story even more. The husband’s abandonment led to an avalanche of unexpected problems. It seemed as though she encountered one difficulty after another, and that there was no end in sight. “They cut off my food stamps,” she explains frustratedly. “I told the food stamp processing center about my changes in the household and they wanted an affidavit just the same. I sent in the same affidavit I gave to housing, but I’m cut off of food stamps. I tried to tell them I sent in the paperwork and should get my food stamps.” MLPC staff is able to respond quickly by sending consent forms to the health center, where Mom is able to use much needed printing and faxing capabilities. After a request for an administrative hearing at the Department of Human Services (“DHS”) to review Mom’s termination from food stamps, Mom and her children are restored to benefits only after formal legal intervention.
During the peak of the matter, Mom faces severe financial strain in excess of $10,000.00 and a termination of food benefits when she needs it most. In the end, she receives financial relief through a trusted relationship with her community health center and Pacific Islander and immigrant service providers. Just as we attorneys build on the trust that patients have with their doctors, these local non-profit service providers and health center programs were most effective in helping this family because of their prior, trusted relationships. The English-only online systems of the State and County were not navigable to a client who had no computer or internet access or had limited English proficiency (“LEP”)—ultimately proving to be not effective for this family. Familiar staff at Kalihi-based non-profits came through to provide significant financial support at a time when the larger municipal programs were overwhelmed.
Notwithstanding this help, Mom still allegedly owes several thousands of dollars due to charges that were incurred based on her ex-husband’s financial information, despite the fact that he has no intention of ever returning. Mom is protected from immediate eviction as there is a current eviction moratorium effective in the State for monetary-based evictions. For many clients, this moratorium is limited in its power, as their landlords continue to pressure and harass them to move out or find new ways to allege breaches of lease rules. The client here successfully sought legal assistance to advocate for this matter and to inquire about additional hardship provisions that she and her family may be eligible for as members of the local public housing community. What happens when the moratorium suddenly ends? How will this information be disseminated? What about all those who have not been lucky enough to receive help?
Unique to our program, MLPC also understands that in addition to direct legal services, policy work is essential. We must ensure that implementation of any new government program or regulation involves the community most affected. COVID-19 and our cases have revealed how extreme the disconnects are between policy and community, particularly for Pacific Islanders. For many, messages about services and assistance never penetrated the community. Legal messages, which were literal translations, did not address concerns regarding immigration status and may not have included culturally appropriate ways of dissemination. To assist in bridging this gap, MLPC continues to provide community training to Pacific Islander leaders and prepare written advocacy briefs on the importance of partnering with the community for culturally appropriate messaging. What has been most important to our work is recognizing that clients and communities turn to existing providers, even as for many people, the pandemic was the first time they needed to rely on government systems for support. MLPC works to equip and train leaders and organizations in Pacific Islander and immigrant communities with the tools to respond to issues and navigate complex legal and social systems. It is this level of community partnership that is necessary to make the promises of those English-language newspaper headlines—the promises of protections and assistance programs—a reality for Pacific Islander and other immigrant communities.
 Social Determinants of Health, Ctrs. For Disease Control & Prevention, https://www.cdc.gov/socialdeterminants/index.htm (last visited Apr. 3, 2021).
 Dina Shek & Alicia Turlington, Building a Patient-Centered Medical-Legal Home in Hawaii’s Kalihi Valley, 78 Haw. J. Med. & Pub. Health 55, 55–60 (June 2019).
 Medical-Legal Partnership for Children in Hawaii, Med.-Legal P’ship for Child. Haw., https://www.mlpchawaii.org/ (last visited Feb. 24, 2021).
 See At KKV Health Means Wholeness¸ Kōkua Kalihi Valley, https://www.kkv.net/ (last visited Feb. 24, 2021).
 See Medical-Legal Partnership, supra note 3.
 Haw. Code R. § 15-193-45 (LexisNexis 2001), http://hpha.hawaii.gov/documents/15-193.pdf.
 See Medical-Legal Partnership, supra note 3.
 Hawai’i Community Foundation, Kōkua Kalihi Valley: Keeping Kūpuna Holistically Healthy, at Home, Haw. Mag. (Jan. 1, 2021), https://www.hawaiimagazine.com/kokua-kalihi-valley/.
 See Haw. Rev. Stat. § 127A-30, amended by Haw. Governor’s Emergency Proclamation No. 18 (Feb. 12, 2021), https://governor.hawaii.gov/wp-content/uploads/2021/02/2102078-ATG_Eighteenth-Proclamation-Related-to-the-COVID-19-Emergency-distribution-signed.pdf.
 See Will Caron, Wrongful Eviction Suit Reaches Settlement, Laws. Equal Just. (Mar. 11, 2021), https://www.hiequaljustice.org/press-releases/wrongful-eviction-suit-reaches-settlement; see also Anita Hofschneider, Hawaii Lawmakers Mull Mediation to Prevent Mass Evictions After Moratorium Lifted, Civil Beat (Feb. 26, 2021), https://www.civilbeat.org/2021/02/hawaii-lawmakers-mull-mediation-to-prevent-mass-evictions-after-moratorium-lifted/.
 Just Neighborhoods: COVID 19 Preventing Illegal Evictions Plan MLP, Med.-Legal P’ship Child. Haw. (Sept. 1, 2020),https://www.mlpchawaii.org/advocacy-briefs.