Invested in healthy housing as part of quality care? Experiencing “fixing fatigue”? Read on . . .December-2022-MLPB-Newsletter
By: Kate Gannon – Law & Policy Consultant, MLPB
December 20, 2022
One of the most fulfilling parts of my work at MLPB is supporting helping professionals who have answered a deep-seated call to care for others. As a Law & Policy Consultant, I have the privilege of participating in interdisciplinary team meetings where I further MLPB’s mission of spotlighting legal rights and protections that can be leveraged to increase the wellbeing of those served. Together, we engage with legal problem-solving. While I relish the highs that I have the privilege to witness, I also sit with my colleagues in the lows. Often, these lows are referred to as compassion fatigue, the burden shouldered by those who seemingly “care too much.” But perhaps it’s time to rethink this description?
Earlier this year, I attended a presentation led by Dr. Christina Bethell, Director of the Child and Adolescent Health Measurement Initiative and Professor at the Johns Hopkins Bloomberg School of Public Health, during the second annual HOPE Summit. Dr. Bethell planted a seed that for me has since grown into a personal maxim, “Compassion fatigue is a misnomer.” It is not the caring or the connecting that brings us down, it’s the inability to eliminate the suffering, a heavy symptom that Dr. Bethell has aptly retitled “fixing fatigue.”
Essentially, care teams are in the business of bearing witness to the suffering of others. They also are human. They feel empathy, often deeply understanding and identifying with the pain felt by those they support. By their nature, they take steps to try to alleviate some of that pain. As Dr. Bethell explained, the discomfort comes not from engaging in those compassionate acts, but from the empty feeling that remains when care team members realize they cannot eliminate the suffering, or “fix” things. It’s been described by some of my colleagues as a kind of profound powerlessness.
I want to offer my human-centered colleagues who seemingly “care too much” the same relief that Dr. Bethell gave to me: We don’t have compassion fatigue. A simple act of compassion, even just taking a moment to listen, is a human connection that is as important for the giver as it is for the receiver. (For instance, a clinical trial demonstrated that oncology patients who received just 40 seconds of compassionate physician care were significantly less anxious.1 Meanwhile, a study of medical students showed that delivering compassionate care increased overall staff wellbeing.2) However, we may have fixing fatigue, an exhaustion for which the cure is not less compassion, but leaning into compassion as both an act of kindness to the people we serve and to ourselves.
- Thomas MR, Dyrbye LN, Huntington JL, et al. How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med. 2007;22(2):177-183. doi:10.1007/s11606-006-0039-6.
- Fogarty, LA, et al. Can 40 seconds of compassion reduce patient anxiety? Journal of Clinical Oncology. 1999; 17(1), 371-9.
Who’s a community visionary?November-2022-newsletter
Amy Copperman to lead MLPB’s next chapter of impact
Amy Copperman, a seasoned and creative access to justice system-builder, will take the helm at MLPB in early January 2023. Since 2015, Copperman has led AmeriCorps Legal Advocates of Massachusetts (ALA-MA), an innovative state-wide program that deploys national service corps members — most of whom are not licensed attorneys — to advance access to justice in the Commonwealth. Before joining ALA-MA, Copperman was a healthy eating educator operating in several settings and a staff attorney at the Massachusetts Law Reform Institute (MLRI). At MLRI, she specialized in housing law and policy and democratizing access to justice for people impacted by housing instability and homelessness.
. . . in a case that will impact Massachusetts tenants challenging unhealthy housing conditions
Nationally, most tenants are unrepresented in eviction proceedings, legal cases that can catapult families into homelessness. Currently, the Massachusetts Supreme Judicial Court is considering Jason Dacey v. Sandy Burgess, a case that could impact the health and well-being of residential tenants across the Commonwealth.
What’s Dacey v. Burgess?
In this case, a family experiencing a pest infestation sought injunctive relief – basically, asking for an order from the court saying to the landlord “fix things immediately!” – from the Northeast Housing Court. Ultimately, after concluding a court-referred mediation process, but not after a summary process proceeding (a kind of hearing that has long been required by law before any eviction can occur), the landlord tried to evict the family. They challenged the eviction, but it was upheld by the Northeast Housing Court. The family is appealing that decision, and the Supreme Judicial Court – the highest court in Massachusetts – is preparing to make a ruling.
Why is this important?
From MLPB’s brief:
Through our work, MLPB is reminded daily of how poor housing conditions and lack of affordable housing stock exacerbate health inequities, which in turn contribute to harmful health disparities impacting residents of the Commonwealth. Against this backdrop, the Northeast Housing Court’s ruling in Dacey is extremely troubling. Absent a reversal, Dacey functionally strips tenants in the Commonwealth of a longstanding affirmative pathway to assert their rights to healthy housing: injunctive relief in connection with enforcement of the State Sanitary Code. Linking a tenant’s assertion of their fair housing and code enforcement rights to a potential eviction outcome is especially likely to spur increased housing instability and homelessness among renters with lower incomes and renters of color.
Attorneys for both sides presented their oral arguments to the SJC on December 5, 2022. The parties and other stakeholders now await a decision.
To read MLPB’s Amicus Brief Letter and for more information on Dacey v. Burgess:
Are you there yet? The next frontier of whole person, whole family, whole community health . . .MLPB-October-2022-Newsletter
Legal Problem-Solving & Flourishing:
Wisdom for Perinatal and Early Childhood
By: Samantha Morton – CEO, MLPB
September 29, 2022
Nationally, significant resources and energy are being dedicated to:
- screening families for barriers to concrete supports (sometimes called health-related social needs in the healthcare context); and
- strengthening referral protocols to assure successful “hand-offs” of families to community-based resources.
However, less attention has been paid to problem-solving strategies that assure families can secure the resources and legal protections they seek, especially when those resources are bound up in complex and intimidating laws, policies, and legal/court processes.
Whether a family is navigating access to familiar resources (like food, housing, utility service, unemployment, health insurance and transportation) or more nuanced legal protections (like reasonable accommodation in school or housing, freedom from violence through restraining orders and asylum, or strengthened family unity through a range of family law and immigration law processes), all concrete supports/social needs are embedded in law and policy. This means that the problem-solving “toolbox” assembled and replenished by perinatal and early childhood systems calls for tools that align with the architecture of law and policy.
Over the last decade, several organizations have been innovating at the intersection of early childhood/health and flourishing/access to justice. Inspired by this work and the evidence it is generating, in 2021 MLPB invited three partner communities to create a national Learning Community with us: First 5 Orange County; the Rhode Island Department of Health Office of Family Visiting; and Smart from the Start. This planning process was made possible by generous support from The JPB Foundation, which in recent years has invested in early childhood innovations that advance goal-concordant care.
The three communities collectively reflect structural and geographic diversity as well as “early adopter” cultures relating to legal-problem-solving.
Local liaison teams assembled diverse ambassadors to the Learning Community’s two active bodies, a Planning Advisory Committee and a Content Advisory Committee. The work of these Committees:
- Facilitated 140 responses to a first-ever multi-state survey on early childhood sector perspectives on legal problem-solving;
- Prioritized three topics for a pilot Unlocking Access training series (Immigration Status, Family Court Involvement and Educational Access), on which MLPB later delivered customized training series in each partner community;
- Generated insights that will advance the field through preliminary, formative research that was subject to Institutional Review Board oversight; and
- Produced a Handbook being released publicly today, September 29, 2022.
The Learning Community’s Handbook confirms that – in addition to external collaborations with public interest law resources – systems themselves can engage with legal problem-solving in a range of scope-of-practice-aligned ways. So a system can fill their toolbox with existing assets, while also expanding their toolbox through external partnerships. It’s not either/or!
What does a rights-based system of care look like? According to the Learning Community, it’s one that elevates these legal problem-solving functions in its partnerships with families:
- Direct legal services (representation) that takes different forms/intensities
- Rights education that supports people to assert their power
- Coaching on system navigation and strategies to reduce barriers to resources and legal protections
- Facilitating coordinated hand-offs to responsive resources
- Clear expectation management about the responsiveness of specific resources, and how a particular decision could generate trade-offs or unintended consequences
- Community organizing
A rights-based system of care also is attuned to two conditions, the absence of which can render legal problem-solving – really any problem-solving efforts with families – unsuccessful from the start:
- Communication and relationships that promote the building and maintenance of trust with families:
- Communication and operations that account for the language diversity of families.
These are big ideas, and systems need guidance in moving from theory to practice. That’s why the Handbook features nine (9) tools for system-builders to use when exploring (or integrating) legal problem-solving as an element of care.
Interested in learning more about how legal problem-solving can strengthen your community of care? Join us today at 2pm EST / 11am PST for Legal Problem-Solving & Flourishing: Wisdom for Perinatal and Early Childhood System-Builders!
Join us on Sep. 29 for a live event!
|Are you an early childhood system-builder invested in new strategies that promote health, wellbeing and flourishing for all children and families? Interested in how to fill or expand your toolbox?|
|Legal Problem-Solving Principles & Practices for the Early Childhood Sector: Handbook Release!|
|Thursday, September 29 |
2-3pm EST / 11a-12n PST
|We’ll be hosting a virtual conversation about how early childhood system-builders can incorporate legal problem-solving into their work. Hear from a panel of remarkable colleagues and be the first to get our new handbook!|
Additional event details to follow right after Labor Day!
|In early October, we’ll be at the Root Cause Coalition’s Annual National Summit on the Social Determinants of Health, alongside our valued colleague and First 5 Orange County ambassador Ana Page. |
Stop by our poster presentation: Embracing Legal Problem-Solving to Address SDOH: Lessons from an Early Childhood-based Learning Community.
We’d love to connect and hear what’s on your mind!
|And join us in November for important dialogues about legal problem-solving and early childhood flourishing at the 30th Annual A View From All Sides Conference, New England’s premier family support conference (hosted by The Children’s Trust) as well as the APHA 2022 Annual Meeting & Expo.|
|30th Annual A View From All Sides Conference||APHA 2022 Annual Meeting & Expo|
|Nov. 2-3, 2022 | Framingham, MA & virtual||Nov. 6-9, 2022 | Boston, MA|
|Learn more / register||Learn more / register|
|Legal partnering in an Emergency Medicine context |
High Touch, High Trust: Using Community Health Advocates And Lawyers To Address ED High Utilizers (The American Journal of Emergency Medicine, Aug. 1, 2022) Link offers free access to article through 10/15/22
|More evidence of DULCE impact! |
Benefits Of A Universal Intervention In Pediatric Medical Homes To Identify And Address Health-Related Social Needs: An Observational Cohort Study (Academic Pediatrics, Jul. 18, 2022) Subscription required
|Cancer health disparities and legal partnering|
Patient navigation to address sociolegal barriers for patients with cancer: A comparative-effectiveness study (Cancer, Jul. 1, 2022)
|Legal partnering as part of a Family Medicine residency program |
From HRSA Grant To A Medical Practice: Improving Care For Children And Adolescents In A Family Residency Clinic (Rhode Island Medical Journal, May
Top Story: The Health Benefits of Paid Sick Leave
- State Mandatory Paid Sick Leave Associated With A Decline In Emergency Department Use In The US, 2011-19 (Health Affairs, Aug. 2022) Subscription required
Access to Justice, Civil Rights & Health
- A Need For Disability Data Justice (Health Affairs Forefront, Aug. 22, 2022)
- The Impact Of COVID-19 On The Health Of Incarcerated Older Adults In California State Prisons (Health Affairs, Aug. 2022) Subscription required
Climate, Environmental Justice & Health
- Air Pollution Is Responsible For Premature Deaths In Every Massachusetts City And Town (The Boston Globe, Aug. 8, 2022)
Food Security & Health
- Qualifying Mass. Restaurants Will Soon Be Able To Accept Government SNAP Benefits For Prepared Meals (Worcester Business Journal, Aug. 22, 2022)
Health Inequities & Care Transformation
- Understanding Patients’ Interest In Assistance With Social Risks Identified In Health Care Settings (American Journal Of Preventive Medicine, Sep. 2022)
- Evolving Issues In Designing Local, Whole-Person Care Management Programs In Medicaid (Manatt Health, Aug. 28, 2022)
- Lessons From Five Years Of The CMS Accountable Health Communities Model (Health Affairs Forefront, Aug. 8, 2022)
- To Advance A National Health And Equity Infrastructure, Measure Drivers Of Health (Health Affairs Forefront, Jul. 1, 2022)
Housing & Health
- Something Better Than A Tent For The Homeless (The New York Times, Aug. 24, 2022)
- Tents May Be Gone From Mass. And Cass, But A Humanitarian Crisis Remains (The Boston Globe, Aug. 15, 2022)
- Criminal Background Checks May Be Banned In N.Y.C Housing Applications (The New York Times, Aug. 9, 2022)
- Examining Health Care Access And Health Of Children Living In Homes Subsidized By The Low-Income Housing Tax Credit (Health Affairs, Jun. 2022) Subscription required