[Congressional Record Volume 147, Number 71 (Tuesday, May 22, 2001)]
[Senate]
[Page S5433]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  COMMENDING BOSTON MEDICAL CENTER AND DR. BARRY ZUCKERMAN FOR THEIR 
                  ADVOCACY ON BEHALF OF POOR CHILDREN

  Mr. KENNEDY. Mr. President, for the past 8 years, the Boston Medical 
Center has had a unique program in place to give legal help to 
disadvantaged children and their families. Under the leadership of Dr. 
Barry Zuckerman, the hospital's chief of pediatrics, the Family 
Advocacy Program was established to fight the legal and administrative 
problems that doctors often face when trying to improve children's 
health in ways that ``pills and surgery cannot.'' Dr. Zuckerman 
believes that we must impact the whole child. As he puts it, ``you 
can't separate out a child's organ functions from the rest of his body 
and the context of his environment.'' That is why at Boston Medical 
Center, the hospital that treats more poor people than any other in 
Massachusetts, Dr. Zuckerman and fellow pediatricians decided to get 
their own lawyers to advocate on behalf of these poor children and 
families.
  The three lawyers in the program do what they can to pressure 
negligent landlords to improve living conditions, help families apply 
for food stamps, pressure insurance companies to pay for baby formula 
and other things to help prevent child illness. Recently, the New York 
Times did a story on the program, recognizing the good it has done for 
the disadvantaged families of Massachusetts. I ask unanimous consent 
that the article be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                [From the New York Times, May 16, 2001]

           Boston Medical Center Turns to Lawyers for a Cure

                          (By Carey Goldberg)

       BOSTON, May 15--A doctor gets very tired of this kind of 
     thing: sending a child with asthma home to an apartment full 
     of roaches and mold; telling the parents of an anemic toddler 
     to buy more and healthier food when they clearly do not have 
     a cent; seeing babies who live in unheated apartments come in 
     again and again with lung ailments.
       At Boston Medical Center, the hospital that treats more 
     poor people than any other in Massachusetts, pediatricians 
     got so tired of it that they decided to try a radical 
     solution: getting their own lawyers.
       That is, a staff of three lawyers, right in the hospital--
     and on ``walk-in Mondays,'' right in the pediatrics clinic--
     now fights the legal and administrative battles that the 
     doctors deem necessary to improve children's health in ways 
     that pills and surgery cannot. The program, which goes far 
     beyond the social work that hospitals customarily provide, is 
     all but unique nationwide, but doctors here say they hope it 
     becomes a model.
       ``We're trying to think out of the box,'' said Dr. Barry 
     Zuckerman, the hospital's chief of pediatrics. ``I want an 
     impact on the whole child, since you can't separate out a 
     child's organ functions from the rest of his body and the 
     context of his environment.''
       That means that the lawyers of the Family Advocacy Program 
     at the hospitals do things like pressuring recalcitrant 
     landlords, helping families apply for food stamps and 
     persuading insurance companies to pay for baby formula. With 
     more than 300 referrals a year, they cannot go to court much, 
     but they can help poor families navigate the administrative 
     byways. And they can help doctors make phone calls or write 
     letters to get their small patients what they need.
       Among other things, ``we help doctors put things in 
     legalese,'' said Ellen Lawton, a staff lawyer and project 
     director. ``They don't teach that in medical school.''
       That helps the doctors, and the doctors help the lawyers 
     through the medical heft they can throw behind a legal or 
     administrative request.
       When a doctor writes a letter about a child's need for, 
     say, special education classes or a mold-free apartment, 
     ``it's not as confrontational,'' Ms. Lawton said. ``It's 
     like, `This is what the kids need for their health,' and 
     who's going to argue with that?''
       The Boston Medical Center lawyers knew of just one other 
     full-fledged program like theirs, a new one in Hartford run 
     at Connecticut Children's Medical Center, in partnership with 
     the Center for Children's Advocacy at the University of 
     Connecticut Law School. There, said the advocacy center's 
     director, Martha Stone, ``it took a while for medical 
     personnel to exactly understand the concept of the medical-
     legal partnership project, because lawyers make people 
     nervous.''
       ``So,'' Ms. Stone said, ``they had to overcome the bias 
     that we were in there looking at malpractice issues. We were 
     in there doing poverty issues which would affect health 
     outcomes. So it's taken a lot of education on the part of the 
     lawyer to have the medical staff understand.''
       At Boston Medical Center, where the Family Advocacy Program 
     has run since 1993, the program is well accepted by now but 
     is still exploring ways to help poor families and looking for 
     ways to expand. The walk-in lawyers' hours began just this 
     winter, for example, and have found plenty of takers.
       One recent Monday, the mother of a diabetic girl stopped in 
     to see Pamela C. Tames, a staff lawyer, about an 
     administrative hearing scheduled for the next day on whether 
     her daughter should qualify for federal disability money. The 
     girl's diabetes was still poorly regulated, said the mother, 
     who would not let her name be used, and she frequently had to 
     miss school and stay in bed when her blood-sugar levels went 
     bad. The mother, who is on welfare, had no lawyer of her own 
     and had been denied requests for disability.
       ``They say being diabetic is not a disability,'' she said, 
     ``I think it is a disability if a mother has to stay at home 
     and come get the child from school if the child constantly 
     gets sick.''
       She came to the law clinic, the mother said, ``because I 
     need to know how to represent my case.''
       Ms. Tames told her how, beginning with the suggestion that 
     she get an extension from the judge so she could present her 
     case better.
       In many ways, the lawyers at the medical center act as 
     typical legal services lawyers, but they describe various 
     forms of synergy with the doctors they help. For one thing, 
     doctors, they say, have become more willing to ask patients 
     questions like, ``Do you have enough food?'' now that they 
     have lawyers who can help if the answer is no.
       Before, Ms. Lawton said, ``they didn't want to screen for 
     something they could do nothing about.''
       The Family Advocacy Program said its director, Jean Zotter, 
     is meant to work as preventive medicine; it can catch 
     problems early because patients' families are more likely to 
     confide troubles to doctors than to agency bureaucrats, and 
     to trust the information they receive in a clinic, she said.
       ``Traditional medicine can treat the effects of poverty,'' 
     Ms. Zotter said, ``but this is a program that hopes to 
     intervene so that poverty won't have the effects it has on 
     children's health.''
       The greatest challenge for would-be imitators of the 
     program, its lawyers say, is probably getting financing for 
     such a hybrid organism. The Boston program costs about 
     $175,000 a year; it is paid for mainly by city money for 
     welfare-to-work transitions, because it helps many families 
     trying to cross that bridge. The Connecticut program, which 
     has one staff lawyer, got a three-year, $260,000 grant from 
     the Hartford Foundation for Public Giving.
       But Dr. Zuckerman has been known to unleash national 
     phenomena before. He founded Reach Out and Read, a program 
     beloved of the Clinton and Bush White Houses alike, which 
     makes books a part of pediatric care. It gives children a new 
     book at each checkup and has spread to hundreds of pediatric 
     clinics around the country.
       ``I don't see what I'm doing with these nontraditional 
     programs as just add-ons,'' Dr. Zuckerman said. ``What I'm 
     trying to do is change pediatric care so it can have more of 
     an impact.''

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