Charity Scott: Teacher, Mentor, Collaborator, Interdisciplinarian

Charity Scott brought health law to Georgia State College of Law in the fall of 1987. Through her faculty appointment, along with her boundless energy and intellectual curiosity, she set herself on an odyssey. She began by teaching a single general health law class. This beginning led to the development of a full curriculum in the field, complete with experiential learning opportunities and a certificate in health law program. In addition to creating learning and career opportunities in health law for law students, her development of the Center for Health, Law and Society created academic opportunities for leading health law faculty.

To Charity, health law was an interdisciplinary pursuit. From the outset, she established herself within the medical, medical education, and bioethics communities in Atlanta. To expand her understanding of the interface of law, medicine, and ethics, she spent a six-month sabbatical in the Neonatal Intensive Care Unit at Grady Health System. Around the same time, she began mentoring a former student who wanted to create a legal aid law office inside of Grady to address the legal needs of her clients more effectively. These experiences spurred Charity to create a medical-legal partnership.

Despite numerous roadblocks, Charity’s persistence and passion resulted in the formation of the Health Law Partnership (HeLP) in July 2004.¹ HeLP is an interdisciplinary collaboration to address health-harming legal problems affecting the health and well-being of low-income children.² At its inception, HeLP was one of ten medical-legal partnerships in the country.

Charity was committed to exposing the next generation of lawyers, physicians, social workers, and ethicists to the benefits of interdisciplinary thinking and problem-solving. To that end, she spearheaded the development of an in-house clinic at the law school, the HeLP Legal Services Clinic. The following tribute describes Charity’s career contributions to health law at Georgia State Law and beyond, and her role in creating the HeLP Legal Services Clinic.

Joining the Faculty

As she embarked on her academic journey at Georgia State Law in 1987, little did anyone realize that this marked the dawn of a comprehensive health law education and research program at the law school. Charity infused the faculty with energy and a deep commitment to legal education. Her dedication to her role as an educator was evident from the start, as she brought energy, passion, in-depth knowledge, and devotion to the classroom. She became very popular with students, particularly with those interested in health law and those who came to law school with backgrounds in health. Charity had an engaging, inclusive teaching style and a genuine interest in the growth and development of her students.

Charity inspired and challenged students to think critically, engage deeply with the material presented during class, and make meaningful contributions to the field. Her mentorship and guidance nurtured countless students, lawyers, researchers, and young faculty.

Developing a Comprehensive Health Law Curriculum

From the start, Charity had a vision. She recognized the need for and interest in developing specialized health law curricula. Throughout her tenure at Georgia State Law, Charity recognized and understood the evolving health law landscape and adjusted to it. She took the initiative to develop a range of health law courses beyond the general survey course in health law she first taught upon her arrival at Georgia State Law. In a time when the importance of health law was burgeoning, Charity recognized the need for future lawyers to have specialized knowledge and skills to navigate the complex intersection of health care and the law. She was fond of saying that health law embraced all areas of law — constitutional law, contracts, torts, administrative law, bioethics, corporate law, intellectual property — to name a few.

Charity designed courses that were both academically rigorous and practical. She pushed the boundaries of traditional legal education by incorporating interdisciplinary perspectives because the challenges and demands of health law demanded a multifaceted approach.³ Her courses became incubators for new ideas and identified career pathways for students. Her offerings grew to include health law quality and access, financing and delivery, bioethics, and public health law. Charity connected her courses to real-world healthcare issues. This approach prepared students for transition into the field of health law upon graduation. Her teaching went beyond the classroom to include mentoring, research opportunities, and health-related experiential learning opportunities for interested students.

Many of Charity’s students went on to excel in various health law fields, including working at major law firms and the Centers for Disease Control and Prevention, entering academia, including medical schools, or becoming counsel for hospitals and healthcare companies. She planted the seeds of curiosity and the drive for excellence in her students, empowering them to tackle complex issues and contribute to the betterment of society.

Through the development of her array of health law courses, she not only helped shape the present state of health law education but also laid the groundwork for future development. Her energy and passion drew other faculty in health law to Georgia State Law. Charity sought leading academics in health law and sold them on the advantages of moving to Atlanta and joining Georgia State Law faculty. She nurtured their adjustment and mentored their scholarship. She supported the career development of many health law faculty⁴ who now are national and international experts in their fields of health law.

With this faculty expansion, the offerings in health law expanded to include courses such as biotechnology, human subjects research, HIV/AIDs, and food and drug law. Her legacy lives on in the countless legal professionals she inspired and the transformative impact she had on health and society.

Creating the Center for Law, Health, and Society

Charity’s leadership extended beyond the classroom. Her passion for educating the broader legal and health communities, both locally and nationally, led to the creation of the Center for Law, Health & Society. This far-sighted initiative was designed to foster interdisciplinary engagement among faculty and professionals from other fields. Through the center, she hoped to reduce the silos that exist among legal, medical, and ethical problems because solutions to complex health-related issues require a multi-disciplinary approach.

Charity’s guidance in developing the center forged opportunities for groundbreaking discussions, presentations by renowned leaders, and innovative problem-solving, particularly in legislative-related issues. She challenged the status quo and drove health care and legal reforms. Through the center, faculty proposed and approved innovative programs for students, such as developing and coaching health law moot court teams, developing the health law certificate program, and providing targeted mentoring and advisement.

Over time, the center became the incubator for the development of the expanding health law curriculum. It also served as a springboard for members of the center to engage nationally and internationally. The center rose in prominence among other such law school-based programs. Perhaps one of the most noteworthy developments was attracting significant grant-funded collaborative research, by attracting law faculty who engaged in grant-funded, interdisciplinary empirical research — a new development in legal research.⁵

Charity’s leadership extended beyond the classroom. Her passion for educating the broader legal and health communities, both locally and nationally, led to the creation of the Center for Law, Health & Society. This far-sighted initiative was designed to foster interdisciplinary engagement among faculty and professionals from other fields. Through the center, she hoped to reduce the silos that exist among legal, medical, and ethical problems because solutions to complex health-related issues require a multi-disciplinary approach.

Bringing Life to the Health Law Partnership (HeLP)

Perhaps the most remarkable and transformative initiative spear-headed by Charity was her design, development, and implementation of the Health Law Partnership (HeLP). HeLP was brought to life in July 2004 with one attorney employed by Georgia State Law and a hospital-based office that had no furniture. HeLP was designed to be an interdisciplinary collaboration among Children’s Healthcare of Atlanta (a pediatric healthcare system), Georgia State University College of Law, and Atlanta Legal Aid Society to address health-harming legal problems affecting the health and well-being of low-income children treated at Children’s and their families. Charity’s vision for HeLP was that it would (1) serve the legal needs of children; (2) provide interdisciplinary educational experiences for students in law, medicine, ethics, public health, and social work; (3) address systemic issues through upstream advocacy; (4) and engage in research and meaningful program evaluation. Over the intervening nineteen years, the three partners have sustained HeLP and supported growth and expansion in the delivery of services.

HeLP would not exist without Charity’s drive to see that it came to fruition. While she started the push to create HeLP in the early 1990s, it took thirteen years to find a willing health care partner. She developed program plans, printed materials, and talking points. She made numerous formal presentations to area hospital leaders about adding a lawyer for patients to the healthcare team. This was a novel idea, and many health care leaders she approached were concerned about having lawyers who were not employed by the institution having access to patients and providers. After Grady Hospital declined to establish a partnership, Charity’s persistence paid off when an inspired general counsel at Children’s viewed the concept of a medical-legal partnership as a win-win for patients, their families, and the hospital.⁶

Charity’s tenacity and her belief that a good idea is a good idea brought HeLP to fruition, albeit after thirteen years of presentations and cajoling. Identifying the right, willing healthcare provider was key. She sought seed funding, encouraged the executive director of Atlanta Legal Aid to contribute legal support for the initiative, and convinced the general counsel for Children’s to educate the institution’s leaders about HeLP and its benefits. The partners understood that adding lawyers to the health care team was good both for patients and their families, and also for the health care team. Charity’s leadership and advocacy were instrumental in gaining essential support and cooperation from providers and lawyers to institutionalize HeLP.

Charity believed that having lawyers an elevator ride away from low-income patients and families experiencing health-harming legal needs was an operational imperative. For hospitalized patients or those attending clinic appointments at Children’s facilities, having ready access to a lawyer facilitated the connection between the health care team, the patient, and the lawyer. In setting up HeLP, she insisted that lawyer office space be provided at each of Children’s three hospital locations. This was no mean task, as no hospital has adequate space, and securing dedicated space for HeLP was a major accomplishment. As the partnership grew, more attorneys were hired to serve patients, and the partnership fulfilled its goals for all four components.

Public Health Legal Services

One of the partnership’s primary aims is to assist children and their families with health-harming legal needs. HeLP attorneys represent families with an array of legal issues affecting the patients’ ability to benefit from the delivery of health care services. These include obtaining Supplemental Security Benefits (SSI) for disabled children; addressing housing issues, transportation challenges, food insecurity, and forging stronger family relationships.

HeLP was and remains designed to do more than address the current legal issue facing the family. A goal continues to be to empower families to better advocate for themselves in addressing future challenges. For example, this involves counseling families on improving communication with landlords to address problems and taking appropriate steps to protect SSI benefits. HeLP lawyers want to equip families with the skills and confidence to address future challenges effectively.

Interdisciplinary Education

When HeLP was created, the vision for collaboration included an interdisciplinary educational component. Fulfilling the educational component of HeLP entailed creating a new experiential learning opportunity within the law school, the HeLP Legal Services Clinic, and hiring and supporting new clinical faculty.⁷ Charity secured initial funding to support the creation of the clinic, and the law school hired its first two clinical faculty members to design the clinic and its curriculum. The HeLP Clinic grew to include learning for students in law, medicine, ethics, public health, and social work.⁸ In addition to the education taking place at the law school, the lawyers of HeLP, employed by Atlanta Legal Aid, offer learning opportunities at the hospital offices of HeLP for students in medicine, social work, and bioethics. Over time, the educational offerings have become so robust that students in other disciplines, particularly medicine, including some enrolled in out-of-state schools, have sought to participate in the available electives.

Systemic Advocacy

From its inception, HeLP has used systemic advocacy to address the health and well-being of children at the policy level by addressing systemic issues through upstream advocacy.⁹ Although federal restrictions on federally-funded legal aid programs prevented HeLP lawyers employed by Atlanta Legal Aid from engaging in systemic advocacy, Charity recognized the experiential learning opportunity these systemic issues created for training students in policy development and advocacy. She spearheaded the approval of a two-semester law school course known as health legislation and advocacy, taught by Sylvia Caley.¹⁰ Students in law, medicine, and social work worked with non-profit community partners, such as Children’s, the Medical Association of Georgia, Georgians for a Healthy Future, and other health advocacy organizations to research and propose solutions for health-harming issues requiring a systemic approach. Students obtained experience in reading legislation, drafting legislation, and observing first-hand the legislative process during the Georgia General Assembly sessions. They also gained experience in researching best and promising practices and policies from other states and organizations with substantive expertise. Many of the students who enrolled in this class were interested in non-traditional legal jobs after graduation. Several students have gone on to be legislators, lobbyists, and policymakers. The course is now a single semester, taught by two graduates who participated in the course as students.

Research and Program Evaluation

Research and program evaluation were a key element of HeLP since its inception.¹¹ Charity participated in the design of a research program that surveyed families, providers, and students regarding the services of HeLP, their experiences with the program, and the needs of individuals. She secured initial Georgia State University Institutional Review Board (IRB) approval for this research endeavor. The IRB had never received an application from the law school. She also secured approval and funding to contract with an independent researcher to engage in HeLP’s program evaluation. The researcher subsequently joined the staff of the Georgia Health Policy Center and provides ongoing support for the research component. Data and findings from the research component have been used to make programmatic improvements, to attract funding and continued support, to establish best practices, to serve as a model for other programs, and to engage in research and publication.¹²

Charity’s role in the development of HeLP stands as an example of her commitment to improving the lives of vulnerable populations. She envisioned the practical approach — addressing the current legal needs of patients and families — along with upstream thinking — interdisciplinary education to prepare the next generation of healthcare providers and lawyers and systemic advocacy with all efforts supported by a robust evaluation component.

Creating the HeLP Advisory Council

Several months prior to the actual formation of HeLP, Charity convened the first meeting of the Health Law Partnership Advisory Council. While it was intended that HeLP would exist as a true partnership, the partners understood the benefit of advice and counsel from leading health law and medical experts in the community. The council assisted in creating buy-in. Among other things, advisory council members obtained trademark protection for HeLP and its logo. Members of the council also performed the legal work to create the Health Law Partnership Foundation. The non-profit foundation serves as a fund-raising vehicle for HeLP. To this day, the Advisory Council serves as a sounding board, think tank, champion, and fund-raising arm for HeLP.

Conclusion

Charity Scott’s contributions to the field of health law, legal education, interdisciplinary collaboration, social change, and effective problem-solving are immeasurable. Charity was a Renaissance woman — she left an indelible imprint on a generation of new health lawyers and young physicians.