The Legal-Social Work Collaborative: Working Together to Serve Bay Area Clients

The Youth and Education Law Project (YELP), one of the founding practices at Stanford Law School’s Mills Legal Clinic (MLC), provides direct special education and school discipline representation for Bay Area youth and their families. In any given case, YELP’s advocacy may include representing students in expulsion proceedings, attending Individualized Education Program (IEP) meetings, and/or advocating for various school services and accommodations.

In October 2018, YELP’s capacity to meet MLC’s goal of holistic client-centered representation was greatly expanded through the establishment of the Legal-Social Work Collaborative, which aims to provide a multi-disciplinary approach to client advocacy. The Collaborative pairs MLC’s four direct service practices—Community Law, Criminal Defense, Immigrants’ Rights, and YELP—with practitioners in the field of social work. Certified law students and social work interns work in interdisciplinary teams to provide comprehensive support to systems-impacted clients.

The potential benefits of such collaboration are readily apparent in a typical school discipline case. While YELP traditionally assists in expulsion proceedings, a social work partner can provide insight into the youth’s interactions with the juvenile justice system, wraparound supports including mental health counseling, and other relevant services. Furthermore, the social work partner can help identify instances when the behavior leading to expulsion is not simply “acting out,” but it is instead a manifestation of a health condition.

One recent case highlights the benefits of the Collaborative. In the spring of 2018, YELP began representing a student in juvenile hall when it became apparent that the student faced a number of medical and cognitive challenges. With an IQ in the low-average range, the student struggled to obtain comprehensive diagnoses and access appropriate services. Over the course of the past two years, three different YELP teams worked with the student on their educationally related goals.

While YELP’s initial advocacy focused on the student’s educational needs post-juvenile justice system involvement, working with the Collaborative allowed us to pursue broader goals. This included applying for training and vocational services from the state Department of Developmental Service’s local regional center[1]. Although the student was initially denied, upon appeal they were deemed eligible.

The team, involving members of the Collaborative, learned a great deal from this advocacy, including that (1) working together to question black-and-white answers can enable more nuanced understandings; (2) proper diagnoses are key and can be difficult to obtain, and; (3) students involved in many systems can benefit from interdisciplinary coordination, like the Legal-Social Work Collaborative. We plan to integrate these lessons (and others that we will no doubt learn during the ongoing partnership) to better advocate for all students seeking equal and appropriate educational opportunities.

Lesson #1: Working Together to Question Black and White Answers Enables Nuanced Understandings

In order to be eligible for regional center support, an individual must meet the requirements in one of five categories: Intellectual Disability; Cerebral Palsy; Epilepsy; Autism; and a fifth catch-all category, a condition that is closely related to or requires treatment similar to an individual with an Intellectual Disability. Our client’s complex medical and cognitive needs fell into the oftentimes vague fifth category.

Because our client has an IQ above 70, they are considered outside the range for a prototypical Intellectual Disability, despite his clear developmental needs. Assessing an individual who does not fall within well-defined categories necessitates a deeper understanding of how their complex medical and cognitive conditions may result in functional limitations that severely impact their daily life, even if their cognitive capacity is above an arbitrary IQ cut-off point.

Our team firmly believed our client was eligible for services and decided to question the denial of eligibility by compiling the client’s complex educational, psychological, and medical records to advocate for regional center eligibility. Specifically, we compiled evidence demonstrating that the student’s functional limitations necessitated treatment supports similar to those required by an individual with an Intellectual Disability. Our team counseled the client and their family about the available options. Because of the complexity of our client’s case, an appeal would be a long shot. However, our team—along with the client and their family—believed an appeal would nonetheless be worthwhile to pursue. The social work team helped prepare the legal team to represent the client by providing critical understanding of exactly how the regional center had not considered the full record. Thankfully, the effort (and the risk) paid off. Upon further review, the regional center reconsidered its position and granted our client eligibility based in part on our filing and in-person advocacy. Given the responsibilities accepted by the state of California under the Lanterman Developmental Disabilities Services Act,[2]regional center services will be a lifelong benefit for the client.

In questioning what originally felt like a final decision by the regional center, our team learned that by taking a calculated risk—even one considered a longshot—we (joyfully) surprised even ourselves. We learned that a “no” is not necessarily a final decision; a critical interpretation of the rules can provide flexibility and avenues of negotiation to explore. By asking clarifying questions, we learned to better understand the differences between a true, fully considered “no” and a “no” at which the issuer can be persuaded take a second look.

Lesson #2: Proper Diagnoses are Key, Albeit Difficult to Obtain

Even seasoned professionals can fall prey to the false notion that disabilities—developmental disabilities in particular—are visible in some way, clearly defined, and/or present themselves early in a child’s life.  While the Diagnostic and Statistical Manual of Mental Disorders[3] can give the impression that disabilities fall into clean categories, individual students’ cases are often far more complex. Thus, it is challenging for individuals to obtain accurate and comprehensive diagnoses. Without such diagnoses, these same individuals are unable to obtain needed services and supports.

Pairing certified law students and social work interns has enabled us to better identify and evaluate potential experts, interpret and critique expert reports, and understand procedural shortcomings of evaluations. In this student’s case, many of the medical and educational files were filled with incomplete, conflicting, and ever-changing diagnoses. Interpreting this record required a combination of skills at the intersection of law and social work. The student’s challenges had, at various points, been labeled everything from Autism Spectrum Disorder to Attention-Deficit/Hyperactivity Disorder. Thus, the social work team arranged a comprehensive neuropsychological assessment of the student that provided diagnostic clarification and concrete recommendations. Our joint team also reached out to the examiners to better understand what they had or had not seen in this student’s case, arming ourselves with the most accurate and up-to-date information about the student’s condition.

Despite the lack of clear answers in the record, the team was able, through this joint advocacy, to persuasively illustrate the student’s full set of challenges to the regional center to appeal their eligibility determination. Combined with its own evaluations, this enabled the regional center to accept this student as a lifelong client. The importance of this approval should not be underestimated, especially in a complex case as our client’s situation presented.

Lesson #3: Case Coordination is a Constant Challenge, but a Worthwhile One

Raising a non-neurotypical child imposes many demands on our clients and their resources. For many of these clients, their challenges are compounded by the need to coordinate care across multiple social and educational agencies, including school districts, IEP teams, social welfare resources, housing supports, health care providers, and even legal advocates, such as YELP. While the supports that each service provides are vital, each agency has its own set of policies—involving separate meetings, correspondence, and paperwork. When compounded by time constraints, economic stressors, language barriers, and/or family turmoil—realities facing many clients—the challenges of coordination can become overwhelming to our families.

YELP’s partnership with the Collaborative has proven invaluable in easing this burden for our clients. Social work interns have jumped in to affirmatively help families coordinate their time and engagement across service providers, ensuring accountability from agencies to collectively meet our clients’ complex needs. And, as in this case, the Collaborative has proven critical in connecting clients to outside agencies like regional centers that can provide lifetime case management support long after our representation has concluded. 

Holistic Collaboration Serves to Benefit Lawyers, Social Workers, and Clients Alike

As exemplified through this case and with countless other YELP clients, the Legal-Social Work Collaborative has proven invaluable. Only together can we understand and impact the many non-educational factors that would otherwise reinforce or undercut the educational advocacy we pursue. Beyond improving advocacy for our clients, this collaboration provides valuable pedagogical experiences for YELP and its students—the lessons our team has learned through our multidisciplinary interactions will undoubtedly make us better lawyers and social workers moving forward.

 

[1] Regional centers are state and federally-funded nonprofits designed to support individuals with disabilities. They are intended to help these individuals and their families in locating and developing services to fit their needs. California’s 21 state regional centers serve 300,000 individuals. Golden Gate Regional Center, http://www.ggrc.org/about-us/history (last visited Apr. 16, 2020).

[2] Lanterman Developmental Disabilities Services Act, 1977 Cal. Legis. Serv. Ch. 1252 § 550 (A.B. 846) (codified at CAL. WELF. & INST. CODE § 4502(a) (2019)).

[3] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013).