Welcome to the Health Justice Clinic. We are looking forward to working with you this semester.
Our first class is Tuesday, August 27, from 4:00 until 5:50. The first few weeks are very busy as we get you oriented and trained to serve your clients. You’ll have forms to fill out, extra meetings to attend, sign-ups, and trainings. It’s important for you to attend to these tasks in a timely manner. We have a checklist to help you keep track of everything.
Drop/add: We will be making case assignments the first week of the semester. For this reason, we need to know asap if you are thinking of dropping the course.
Email: Throughout the semester, you’ll need to keep close watch on your Duke email. We use email constantly to communicate about the class and your client representation. You will not be able to keep up your professional obligations if you do not check your email several times daily. Your responsiveness to clinic communications will also be taken into account in your grade. Because we will often communicate by email about specific client matters, please do not forward your Duke email to another account, such as gmail.
Course Materials: Course readings and forms are contained in the Clinic Binder, which will be available both electronically and in hard copy in the clinic pod.
Out of Class Activities:
- You should have received an email from Allison that includes the information below:
- Office hours/Supervision meetings: http://tinyurl.com/OfficeHours-Supervision-SignUp. (Sign up for one supervision meeting and 6 office hours). Office hours & supervision meetings begin the week of 8/27. Note that you will have your first meeting before our first clinic class.
- Student Schedule: http://tinyurl.com/Health-Justice-Student-Sched (add your schedule so we can find you if we need you)(there is also a paper form on which you are asked to put your schedule).
- Computer encryption: https://law.duke.edu/actech/signup/ (required if you want to do client work on your personal laptop). Encryption time slots are available the first two weeks of the semester.
- Computer (Clio) training: http://tinyurl.com/Clio-Training-Sign-Up (1-hour training on our client database, Clio)
- Office orientation: Sandra Pettiford, our office administrator, will give you a tour and orientation which takes about 20 minutes. You should sign up in the clinic office or by emailing Sandra
- Forms: You will receive a stack of forms in your mail folder. With the exception of the State Bar Forms, these forms should be filled out and turned in by Monday, August 26, at 4:30. (Drop off at Allison's office, 2188).
- State Bar Form & Rules: You will be certified under the North Carolina student practice rules, which requires that you complete the State Bar Form and read the NC Rules Governing Practical Training of Law Students (placed in your mail folder with forms), and North Carolina Rules of Professional Conduct 2019
Clinic Intensive: Friday, September 6, 9:00 - 4:30. Breakfast and lunch provided. The day will include a visit to the Duke Infectious Disease Clinic and Duke Cancer Center.
We usually take a road trip or two to meet with clients in HIV clinics outside the Triangle. The trips are a great way to help you quickly gain confidence and experience. All travel and client time is counted toward your clinic hours. For each trip, one of the Supervising Attorneys takes a group of about 3-8 students to interview new clients and to prepare and execute documents such as a Power of Attorney, Health Care Power of Attorney, Living Will, Standby Guardianship Designation. We also do intakes for Wills. We are scheduled for a road trip on Friday, September 27, to an HIV medical clinic in Hickory, North Carolina.
Journal due Dates:
Journals are due on the following Tuesdays: 9/10; 10/1; 10/29; 11/19 and a final entry by the end of the semester. Please submit the journals by email to both Allison & Hannah, by 8 am on the due date. Final journal is due before your end of semester exit interview. See Journal Memo.
Quiz Due Dates:
There are three quizzes that are meant to help test your knowledge. All are due on Fridays.
Readings & Assignments
NOTE: There may be some changes to reading assignments as we go along. Please check back each week for the most up to date information.
Clinic Binder Sections:
Advance Directives Manuscript
Advance Directives Articles, Statutes and Forms
Planning for Children (Standby Guardianship) Manuscript
Standby Guardianship Forms
Social Security Readings
Social Security Law
Social Security Forms
Tuesday, August 27: Course Introduction & Advance Directives
- Course Requirements
- Journal Memo
- Advance Directives Manuscript
- Advance Forms (Browse)
These are primarily for reference - you may need to read some of these to answer questions on the quiz due Friday.
-NCGS Chapter 32C, Powers of Attorneys
-NCGS Chapter 32A Health Care Powers of Attorney and
-NCGS 90-320 et seq, Living Wills (Right to a Natural Death)
- Michelle Andrews, Kaiser Health News, "Despite Gains in Advance Directives, Study Finds More Intensive End-of-life Cancer Care, July 21, 2015 (In Advance Directives Articles, Statutes, and Forms)
- NPR, August 16, 2015: Though Not a Death Sentence, HIV/AIDS Still Holds a Powerful Stigma
- Washington Post, November 24, 2017, "'I don't feel like I'm a threat anymore.' New HIV guidelines are changing lives"
For review after class, you can watch these slide shows
- Part 2 (Power of Attorney)
- Advance Directives Slides (POA and HCPOA/LW)
Friday, August 30
DUE by email to ALLISON, 8 am: Advance Directives Quiz
Monday, September 2 (Labor Day)
We are available to do supervision meetings on Labor Day, even though it's a holiday. If you have a Monday supervision meeting, let Allison & Hannah know whether you need to reschedule.
Tuesday, September 3, Wills, HIV 101
Wills Readings, from Binder/Linked:
Wills Exhibits from binder, including statutes, forms, client education materials. Skim the statutes -- they are for your reference. You will need to refer to the statutes to answer one or more of the Wills Quiz questions.
Plain English Translations to help you talk with your clients about documents
- BEFORE CLASS -- View Wills Lecture (Panopto) (Wills powerpoint to go with Lecture)
Friday, September 6
Wills Quiz Due - Email to Hannah
Clinic Intensive, 9:00 - 4:30
HIV/Cancer Background & Health Disparities, Interviewing
- We will have a joint session with all clinics students in the morning. Then we'll grab bag lunches and head over to Duke Hospital for visits to the Duke Infectious Diseases Clinic and Duke Cancer Center. We'll return in the afternoon to discuss the readings on HIV/Cancer background and disparities, and also do an interviewing exercise.
Readings: (distributed in hard copy also)
Readings on HIV & Cancer Context: (All of the items below are linked in one file)
- Otis Webb Brawley, M.D., Chief Complaint (from How We Do Harm) – READ this one thoroughly– it’s very compelling
- North Carolina Health News, High Death Rates in Cancer ‘Hotspots’ Across NC, Aug 2016
- Yabroff, Journal of Clinical Oncology, Financial Hardship Associated with Cancer in the US (focus on the conclusions and discussion – don’t worry about the methodology), Jan 20, 2016
- Chino, JAMA Oncology, My Unfortunate Introduction Into the Financial Toxicity of Cancer Care in America – March Forth, Dec 7, 2017
CDC HIV Fact Sheets
- HIV 101
- HIV and AIDS in America: A Snapshot
- HIV in the Southern United States
- Internalized HIV-Related Stigma
- Ila Mulasi, MD, New England Journal of Medicine, The Scarlet Virus, June 7, 2018
- Lambda Legal: HIV Stigma and Discrimination in the U.S., Nov 2010Center for HIV Law and Policy, Routes,
- Risks and Realities of HIV Transmission and Care, Current Scientific Knowledge and Medical Treatment
- American Cancer Society, Cancer Facts & Figures 2019 - 1-28 & 52-55 (skim)
Brief reading on interviewing (to be posted)
Tuesday, September 10 -- Disability 1 & Working with Clients with Serious Illness,
Guest Speaker, Vickie Leff, MSW, LCSW, Duke Palliative Care
Journal 1 - Email to Hannah and Allison
Disability Readings from Binder (or see links above):
"Disability Readings," Section, pp. 1- 17
- The Determination of Disability within the Social Security System
- Tom Bush, Chart: The Two Disability Programs & Diagram of Sequential Evaluation
- Medicaid and Persons with Disabilities
"Social Security Law" Section, pp. 3-4
- Definition of Disability: § 404.1513 Medical and other evidence of your impairment(s)
- Evaluation of Disability: § 404.1520(b) Evaluation of disability in general
Wednesday, September 11 - Friday, September 13 -- Simulated Interviews
With a partner, you will interview a simulated documents client (Allison or Hannah). You will receive feedback immediately after the interview. Afterwards, you will review a recording of the interview and give yourself feedback.
Sign up here
Before the interview, we recommend you review these readings:
- Cochran, DiPippa & Peters, The Counselor-at-Law: A Collaborative Approach to Client Interviewing and counseling, Chapters 3-4.
- Plain English Translations to help you talk with your clients about documents
You may also find it helpful to review this recording of mock documents interview: Jacob Whiteside interview
Friday, September 13
Due to Hannah by 8:00 am - Disability Quiz
Tuesday, September 17 - Power of Attorney Interview & Disability 2
Power of Attorney Interview
In most of the simulated interviews, we didn't get to the Power of Attorney part of the interview. We'll do a group power of attorney interview in class, with your client "Sheila." We'll also discuss your questions about interviewing. The Documents Explanation exercise, which had originally been scheduled for today, has been moved to next week.
- Disablity 2 Readings:
Slides: Disability 2
"Disability Readings", pp. 39-62
- Health Justice Project Social Security Protocols (you may skim this for class, but must read it carefully when working on your disability case)
- Guidelines for Reviewing and Charting Medical Records
- Medical Chart Example
- Factual Investigation - Essential Information
- Using Affidavits in Disability Cases
"Disability Readings," pp. 63-87 (please note that TOC is incorrect - but these page numbers refer to those printed on the document and are accurate)
- Tom Bush, Social Security Practice - RFC and Medical-Vocational Guidelines, pp. 63-70
- Cessations/CDRs, pp. 81-83; 87
Skim --pp. 71-80
- Vocational Terms Quick References
- DOT Materials (pay special attention to Sample Entry, p. 75)
"Social Security Law," pp. 7-9; pp. 57-60 (please note that TOC is incorrect - but these page numbers refer to those printed on the document and are accurate)
- § 404.1525 Listing of Impairments in appendix II
- Adult Disability Listings (browse Cancer (13.00), HIV (14.00) and Mental Health (12.00) Listings)
- § 404.1527 Evaluating opinion evidence
- § 404.1528 Symptoms, signs, and laboratory findings
- § 404.1529 How we evaluate symptoms, including pain
SSR 96-4p: Symptoms, Medically Determinable Physical and Mental Impairments,
and Exertional and Nonexertional limitations
"Social Security Law," pp.10-14; pp. 15-23; pp. 35-43
- § 404.1545 Your Residual Functional Capacity
- § 404.1562 Medical-vocational profiles showing an inability to make an adjustment to other work
- § 404.1564 Your education as a vocational factor
- § 404.1565 Your work experience as a vocational factor
- § 404.1566 Work which exists in the national economy
- § 404.1567 Physical exertion requirements
- § 404.1568 Skill requirements
- Appendix II: Medical-Vocational Guidelines (“The GRIDS”) (browse and plot your client)
- POMS DI 90070.050–DAA Material Determinations
- POMS DI 25020.010 Mental Limitations
Browse -- "Social Security Forms," Skim these forms, pp. 9-50; pp. 71-82; pp. 86-93 (please note that TOC is incorrect - but these page numbers refer to those printed on the document and are accurate)
- Disability Interview Form Part I, II (skim and consider why we are asking these questions)
- Doctor/Therapist Questionnaires (browse)
- Social Security Disability Report Appeal (form SSA-3441)
Tuesday, September 24 -- Documents Explanation & Case Rounds
Documents Explanation Exercise:
You will be given a prepared set of documents prior to class. Please review these documents and be prepared to explain them to your "client" and answer her questions.
Choose a case to present to your classmates. You'll each have about 15 minutes to tell us briefly about your chosen case and have a little discussion/brainstorming as needed.
Tuesday, October 1 - Theory of a Disability Case
Journal 2 due - email to Hannah and Allison
In this class, we will work as a group to develop a theory of a disability case. You will review a client file and apply the five step sequential evaluation. You will complete the five-step sequential evaluation for the client, and turn in your analysis before class.
We will organize our discussion around the five steps. Bring your notes to class to facilitate discussion
- -Client disability file - saved in Clio under the "case" "AIDS Training"
- - Review Social Security disability listings, grids, vocational materials, and law to consider possible theories for the client's case.
-POMS - Medical-Vocational Terms, Physical Limitations, Mental Limitations, (Binder, SS Law)
-Components of the Definition Trailer (Binder, Social Security Readings, pp. 77-79)
- -Social Security Forms, Case Theory Worksheet, p. 65
Week of October 7 - Fall Break
Tuesday, October 15 - Standby Guardianship
- Video Lectures -- look at these before class:
Overview of Care & Custody of Minors
Standby Guardianship Video - Part 1
- Standby Guardianship Video - Part 2
- To accompany the video lectures: Standby Guardianship powerpoint.
Readings, from the Clinic Binder - Standby Guardianship Forms
Manuscript: Permanancy Planning for Children of HIV Infected Parents
Standby Guardian Flow Chart
Standby Guardian Checklist
Checklist of Planning Considerations
- Standby Guardianship Brochure
Browse Standby Guardian Forms
Browse the statute, NCGS 35A-1370, Standby Guardians for Minor Children which is included in the materials. If you have a standby guardianship case, you will need to read this carefully.
Tuesday, October 22 -- Case Rounds - Clients and Empathy
Prepare a 1-2 page discussion of one of your clients and the role of empathy/compassion. Post to the "Health Justice Training" case in Clio by 5:00 pm on Monday, October 21. For class, read the posts from classmates.
Tuesday, October 29 - Confidentiality & Discrimination
- Journal 3 due - Email to Hannah and Allison
N.C. Gen. Stat. 130A-143 (Confidentiality)
N.C. Gen. Stat. 130A-25 (Enforcement)
Privacy: Hall v Post.
HIPAA consumer summary;
HIPPA Privacy Rule detailed summary (Lengthy - browse if interested)
HHS Office of Civil Rights - Health Information Privacy Enforcement Examples Involving HIV
Browse: Pro Public Series on Medical Privacy
Read Small-Scale violations of Medical Privacy Often Cause the Most Harm
N.C. Gen. Stat. 130A-148(i) (NC HIV Discrimination)
N.C. Gen. Stat. 168A Persons with Disabilities Protection Act
Americans with Disabilities Act
US Department of Justice, ADA and HIV/AIDS
ADA - Selected Sections (browse if interested)
Department of Justice HIV/AIDS enforcement actions
Family and Medical Leave Act
- Department of Labor Fact Sheet #28, FMLA
Tuesday, November 5 - Case Rounds
Tuesday, November 12 - TBA
Tuesday, November 19 - TBA
Journal 4 due - Email by 8 am