The Equivalent of Nurse Practitioners
By Albert B. Kelly
One thing that the delivery of legal services in this
country has in common with healthcare is the fact that too many individuals and
families simply can’t afford it. The impact is hardest on those with low and
moderate incomes. In terms of healthcare it comes down to cost- whether paying
for insurance or the care itself. As for legal representation, unless it’s a
criminal matter requiring a court-appointed attorney, many people dealing with
civil matters are forced to go it alone and the consequences can be enormous
even though the matter may seem minor.
As for healthcare, one encouraging development is the use of
nurse practitioners. According to some estimates, Americans now make over 900
million visits each year to nurse practitioners and they’ll be an even larger
presence in healthcare in the years ahead. Nurse practitioners are more
accessible and affordable than doctors and while not doctors; they diagnose
illness, treat patients, order tests and administer or prescribe medications.
In New Jersey, nurse practitioners can prescribe medication under a
collaboration protocol with a physician.
My point in mentioning nurse practitioners is to show how
critical they are in delivering much needed care to people in an affordable
way. This stands in contrast to what is available for those needing legal representation
on noncriminal matters. One area that comes to mind is that of evictions which
recently began to receive long overdue attention with the publication in 2016
of “Evicted; Poverty and Profit in the
American City” by Matthew Desmond.
From his research, Mr. Desmond went on to found the Eviction
Lab in 2017 with Princeton University which includes a nationwide database with
stats on evictions and information on key issues surrounding evictions. One
thing that emerges from Mr. Desmond’s work is the idea that those facing
eviction, given what’s at stake, should have the right to an attorney even if
they can’t afford one and that’s where the idea of having the legal equivalent of
a nurse practitioner comes into play.
While one answer to that problem at first glance is a
paralegal, I’m not sure that paralegals currently have the same ability to do
in the legal realm what nurse practitioners do in healthcare. New Jersey does
not regulate paralegals with respect to training and education and while New
Jersey does have some voluntary certifications via the New Jersey Certified
Paralegal credential from the South New Jersey Paralegal Association, it’s not
the same thing.
This is by no means minimizing the work done by paralegals
in the current framework, but a suggestion that given the stakes involved in
many noncriminal matters, we need to consider expanding the role of paralegals in
evictions and other civil matters of consequence in much the way the healthcare
industry uses nurse practitioners to meet needs through uniform credentialing and
training for paralegals who desire it in order to address the unmet needs in
our courtrooms.
Just looking at evictions, consider that the rates of
eviction drop when a defendant has legal representation. According to J. Brian
Charles, who wrote on the issue for the magazine “Governing”, a pilot project providing
lawyers in a section New York City saw the rate of eviction drop 27%. In Philadelphia,
it was estimated that a yearly investment of $3.2 million to provide counsel
for those facing eviction would save the city some $45 million per year.
Such numbers certainly wouldn’t be as dramatic in Bridgeton
where in 2016, there were 677 eviction filings nor in Cumberland County, which
saw 3,003 filings that same year. Locally I’m not making a judgement as to
whether any single eviction filing was warranted nor am I making a value
judgement about tenants and landlords, but I am saying that eviction has
serious consequences and if the courts are the forum to consider the monetary
and business interests of the one side, then legal representation should be available
or at least affordable to advocate for the interests of the other.
So it is for other potential consequences that are either
avoided or lessened by those of us with the money and means to have representation
in court should the need arise whether we’re facing the loss of employment,
driving privileges, appealing the denial of benefits, custody of children or
visitation, credit worthiness, and more. The difference between those who bear
the full weight of such consequences and those who don’t often comes down to having
an advocate in court.