Collecting Outcome Data on Limited Services: A Case Study of Atlanta Legal Aid Society’s Enhanced Services Project

Introduction

Limited service cases make up approximately three-quarters of the reported cases closed by LSC grantees in a given year.[fn]In 2016, limited service cases made up 76 percent of all cases served. See Oh, M. L. Lee, S. John. 2017. LSC by the Numbers: The Data Underlying Legal Aid Programs (2016). Legal Services Corporation, Washington, D.C.[/fn] However, little is currently known about the outcomes of these cases.

Limited service cases are closed with Case Service Report (CSR) Handbook closing codes A (“counsel and advice”)[fn]In the 2017 CSR Handbook, case closure A corresponds to “Counsel and Advice” cases: “a case closed in which the program provided legal advice to an eligible client should be closed as Counsel and Advice (e.g., the advocate ascertained and reviewed relevant facts, exercised judgment in interpreting the particular facts presented by the client and in applying the relevant law to the facts presented, and counseled the client concerning his or her legal problem).”[/fn] and B (“limited action”).[fn]In the 2017 CSR Handbook, case closure B corresponds to “Limited Action” cases: “a case closed in which the program took limited action(s) on behalf of an eligible client that addressed the client’s legal problem that is not so complex or extended as to meet the requirements for CSR Category L should be closed as Limited Action. Examples include: communications by letter, telephone, or other means to a third party; preparation of a simple legal document such as a routine will or power of attorney; or legal assistance to a pro se client that involves assistance with preparation of court or other legal documents.”[/fn] These are cases in which an attorney or case handler provides legal advice or takes some limited action on behalf of a client but does not provide extended legal services. Because there is no extended interaction with these clients, LSC grantees usually do not know if the assistance the client receives is helpful.

In May 2015, the Atlanta Legal Aid Society launched its Enhanced Services Project (ESP) to address this challenge. ESP leverages pro bono attorneys to follow up with clients who receive some type of limited service to provide additional assistance until the client’s issue is resolved and, through this extended engagement, pro bono attorneys learn about and can record the outcomes related to the case.

In addition to providing a mechanism for tracking and documenting outcomes, ESP increases the likelihood of positive outcomes for clients by providing follow-up support.

This case study offers an overview of ESP, focusing on the following topics:

  • Program background
  • How ESP works
  • How outcomes are recorded
  • Resources needed for successful implementation
  • Benefits of ESP
  • Lessons learned from Atlanta Legal Aid’s experience

Program Background

The Atlanta Legal Aid ESP model emerged from an initial study of outcomes from legal advice provided through the Georgia Senior Legal Hotline—a cooperative project between Atlanta Legal Aid, the Georgia Division of Aging Services, and the Georgia Legal Services Program—which found that many seniors were not acting on the advice given to them and, therefore, were not experiencing successful outcomes. It became clear to staff that clients often needed additional support to achieve success. LSC-eligible clients are often dealing with a myriad of issues and, in this context, even the smallest of challenges can impede a client’s ability to act on the advice they are given. A common example is that of a senior not receiving Supplemental Nutrition Assistance Program (SNAP) benefits they are eligible for because they never turned in their SNAP application. An attorney might have advised them to apply for SNAP, but if the client misplaces the application or cannot find a stamp when it is time to mail it, that application might never get turned in and the client might never get access to the public benefits for which they are eligible.

ESP Fast Figures

2015: The year Atlanta Legal Aid launched ESP.

877: The number of limited service cases to receive follow-up services through ESP in 2016.

80 percent: The estimated proportion of Atlanta Legal Aid cases that are limited service.

10: The number of pro bono attorneys typically volunteering with ESP during a given week.

Through experimentation following the initial study of outcomes of senior hotline cases, Atlanta Legal Aid staff realized that they could greatly improve the likelihood of clients’ success by providing them with modest follow-up support over the phone. In the case of the SNAP applications, for example, they found that sending a stamped, addressed envelope to the client and following up by phone within two weeks made a significant difference in the likelihood that a client would submit their application and begin receiving benefits. Atlanta Legal Aid formalized the lessons learned from these initial efforts into a new service offering called the Enhanced Services Project. Atlanta Legal Aid officially launched ESP in May 2015, offering the service only to senior hotline clients at first. Since then, they have expanded ESP to other specialized units and offices gradually. By the end of 2017, it will be a standard part of the Atlanta Legal Aid approach to providing legal assistance across all offices and units.

In 2015, Atlanta Legal Aid attorneys assigned 436 limited service cases for follow-up through ESP and successfully provided this support for 315 cases (clients for another 121 cases were either unreachable or declined follow-up support). The number of cases receiving ESP follow-up has grown as ESP has expanded to more units and offices. In 2016, 877 cases were assigned ESP follow-up support and 580 successfully received it. Atlanta Legal Aid expects to assign more than 1,000 cases for ESP follow-up in 2017 (as of October, 928 cases had been assigned ESP follow-up with 729 successfully receiving it). There is great potential for continued growth of the program, as limited service cases account for approximately four out of every five of the estimated 20,000 cases Atlanta Legal Aid closes in a typical year.

How ESP Works

ESP Volunteers

Most of the follow-up contact and support provided to clients through ESP is conducted by pro bono attorneys. At any given time, Atlanta Legal Aid has about 10 ESP pro bono attorneys. The “core” of these volunteers are five retired attorneys who have given long-term commitments to the program. These retired attorneys typically devote 5 to 10 hours per week to ESP work. The other pro bono attorneys who volunteer with ESP typically commit to shorter terms (e.g., six months), so there is naturally more turnover among them. These pro bono attorneys are often recent transplants to the Atlanta area looking to get involved in the legal community or corporate lawyers seeking experience with non-corporate clients and ways to contribute to their community. Atlanta Legal Aid has recently begun engaging other types of volunteers, including law students and paralegals who are looking for opportunities to work with clients and gain experience.

Engaging Retired and Emerging Attorneys

Retired attorneys represent the core ESP volunteers and dedicate 5 to 10 hours per week and long-term commitments to the program.

Law students and paralegals are new types of volunteers and typically have shorter commitments.

Atlanta Legal Aid originally envisioned ESP being staffed primarily by retired, pro bono attorneys, but has adapted this expectation in light of two developments. First, they realized that there was not as large of a market of retired attorneys looking for volunteer opportunities as they thought. Second, they have found that the program can be easily adapted to accommodate shorter-term volunteers with proper coordination and management.

Currently, there is no standard procedure for recruiting ESP pro bono attorneys and other volunteers. Most are connected to the program through existing networks in the legal community, including law schools. Some also learn about the program through Atlanta Legal Aid’s website or other publications. An estimated 30 pro bono attorneys and several law students and paralegals have volunteered in the program since its inception in 2015.

ESP-Eligible Cases

Atlanta Legal Aid has determined that some types of cases are more likely than others to benefit from the type of support volunteers can provide through ESP. In general, the types of cases eligible for ESP are cases that involve legal forms (e.g., wills, powers of attorney, advance directives), applications for public benefits (e.g., SNAP, Medicaid, unemployment), and other cases that follow straightforward processes. These types of cases are ripe for ESP follow-up because they involve formal processes and procedures without much variance between cases, making it easy for pro bono attorneys—and other volunteers—to provide helpful follow-up even when they do not have firsthand familiarity with the client’s case. In determining which types of cases will be eligible for ESP, ESP coordinators also take into account the extent to which it can provide resources and protocols to support volunteers’ work in a given area.

The list of case types eligible for ESP follow-up is always evolving. ESP coordinators adapt the list based on input and feedback from staff attorneys and volunteers. The two most common ways a new type of case gets added to the list are:

a)      A staff attorney petitions for a new type of case to be added because they have noticed their clients need additional support that they are not able to provide due to resource constraints.

b)      ESP is expanded to a new office or specialized unit and the staff attorneys from that office/unit identify a type of case that is particularly common in their practice and ask that it be added.

The table below presents the list of cases currently eligible for ESP follow-up.

Types of Cases Eligible for ESP Follow-Up

SNAP/food stamps

Landlord-tenant

TANF

Fair Debt Collections Practice Act

Wills/power of attorney/advanced directives

Home loan modifications

Medicaid/Medicare Savings Program

Unemployment

Social Security

Guardianships

SSDI/SSI

ACA/medical coverage

 

Assigning Cases for ESP Follow-Up

When closing a limited service case on an ESP-eligible topic, staff attorneys can decide whether to flag it for ESP follow-up. There are no formal rules governing this decision, but the general principle guiding the decision is whether the attorney thinks the client’s case would benefit from the type of follow-up volunteers can provide. This includes consideration of, for example, whether the client shows signs that they might not be able to act on the advice they were given by themselves. It also includes consideration of whether interaction with the client would prove to be a rewarding experience for the volunteer. If, for example, a client has shown signs of being verbally aggressive or otherwise difficult to work with, their case is less likely to be assigned follow-up through ESP.

It is important to note that an additional consideration is language. Because there are only English-speaking ESP volunteers (currently at least), the cases of non-English-speaking clients are not currently assigned ESP follow-up. As ESP attracts a more diverse set of volunteers with other language skills in the future, this will change.

When closing a limited service case, staff attorneys can flag any ESP-eligible cases for follow-up in the case management system in one of two ways:

a)      If the client’s original case was related to an ESP-eligible topic (e.g., an application for TANF), then the staff attorney closes the case and flags it for follow-up by ESP volunteers.

b)      If the client’s original case was related to a non-ESP-eligible topic (e.g., divorce), but the staff attorney has also recommended the client take action in an area that is ESP-eligible (e.g., home loan modification), then the staff attorney indicates that the client needs follow-up on another matter. ESP coordinators then open and close a new case for the ESP-eligible topic, which is then followed up on by ESP volunteers.

When flagging a case for follow-up, staff attorneys can provide additional instructions or context by adding notes in the case management system. Once a case is flagged for ESP follow-up, the case is put into the ESP queue and all related follow-up is managed by ESP coordinators and volunteers. Atlanta Legal Aid has learned that it is helpful for staff attorneys to tell clients that a colleague will follow up with them to see if they have any additional questions about their case at a later date.

Screen in case management system in which staff attorneys flag a case for follow-up and indicate the reasons follow-up is needed.

 

While the vast majority of ESP cases originate from staff attorneys’ regular casework and the senior hotline, it should be noted that attorneys can also assign cases for ESP follow-up through other legal aid pathways facilitated by Atlanta Legal Aid such as their “Saturday Attorney” events and other special events and clinics. Cases entering the ESP queue with these origins typically require an additional screening step to ensure they are LSC-eligible.

Timing of Follow-Up

The timing of follow-up is carefully planned. The staff attorney assigning the case for ESP indicates the timing for the initial follow-up contact and, after each interaction, volunteers indicate the timing for additional contact. The timing for ESP follow-up is case- and client-specific, depending on the type of case and the type of additional support required. For example, if someone has just recently submitted an application for Medicaid, their case would likely be marked for follow-up in 45 days, which is when the client will likely have received an eligibility decision and a volunteer can help them determine next steps regarding how to access their benefits or how to appeal a decision.

Screen in case management system in which volunteers record follow-up status. If volunteers are unable to reach a client, or the client needs additional follow-up, the volunteer can schedule the next follow-up call.

 

Providing Follow-Up

Cases are ordered in the ESP queue within the case management system based on the dates assigned to them for follow-up. Pro bono attorneys and other volunteers are based at Atlanta Legal Aid’s central office in downtown Atlanta, where the ESP coordinators are also based. Upon arrival, the ESP coordinator gives the volunteer a list of clients to call. Volunteers are trained on what to say and what type of advice and support to provide. Their primary task is to reiterate the advice provided by the original staff attorney, but the volunteers also answer clients’ questions, clarify points of confusion, and identify other simple ways to help the clients get to the next step in their process. This might involve providing information such as phone numbers and addresses for agencies they need to contact, sending them a form letter or an application, or directing them to other resources.

Screen in case management system in which volunteers record whether clients have received materials or followed advice, and the type of follow-up support volunteers provided on the call.

 

Almost all ESP follow-up is conducted by phone. Atlanta Legal Aid is currently experimenting with conducting some in-person follow-up for cases that require more hands-on assistance like filling out paperwork for powers of attorney, wills, and advance directives. Pro bono attorneys have begun offering some clients the option of going to the central office to work with them in-person to fill out these forms.

Recording Case Notes and Outcomes

The case management system is a central hub for recording case notes and outcomes. Volunteers review past case history notes in the case management system before contacting clients. This orients them to what advice has been given, what actions have been taken, and what additional support might be needed. After each attempt at follow-up with a client, volunteers record additional case history notes based on their interaction with the client and update the follow-up status using one of the following categories:

  • Client declined
  • All follow-up is complete
  • Unable to reach client
  • Sent back to staff
  • Documents need to be re-sent
  • Follow-up pending

If follow-up is complete, volunteers are prompted to record the conclusion of the follow-up activities and to record any outcomes using a pre-populated list of potential outcomes for that type of case. This process is described in more detail below in the “How outcomes are recorded” section.

Program Management and Coordination

While staffed primarily by volunteers, ESP requires hands-on coordination from staff. Staff members provide the structure necessary for this volunteer operation to work and work well. Atlanta Legal Aid has two staff members with dedicated ESP roles:

  • ESP paralegal. Atlanta Legal Aid has a paralegal who is responsible for coordinating volunteers’ schedules, managing the queue of follow-up cases, and doing initial quality checks to make sure case notes have been properly recorded.
  • ESP manager. Currently, the ESP manager is an attorney who oversees all pro bono attorney work at Atlanta Legal Aid. She provides direction to ESP as a whole, collaborates with staff attorneys on ESP-related matters, develops ESP-related trainings and resources for staff and volunteers, and manages all ESP volunteers and the ESP paralegal. The ESP manager is also the final check for data quality assurance. Once follow-up for a case has concluded, she reviews the case notes and outcome indicators to make sure the case file is complete and accurate.

Ensuring Data Quality

Volunteer training and staff oversight of outcome reporting have been important to ensure data quality.

How Outcomes are Recorded

Once ESP follow-up is complete, volunteers indicate one of four possible conclusions and record any associated outcomes.

The possible conclusions are:

  • Client was unable to follow advice
  • Client was not successful
  • Client was successful
  • Client benefited in some other way
  • Client received agency referral

Screen in case management system in which volunteers record the conclusion of follow-up.

 

If the client was successful, the volunteer is prompted to record the outcomes of the case, if any. They select the relevant outcomes from a list that is pre-populated based on the case type. For example, for a case related to landlord-tenant issues, a possible outcome is that housing was obtained or retained for at least 30 days. Where relevant, additional fields are provided to facilitate the recording of quantifiable outcomes such as dollar amount in benefits received.

Screen in case management system in which volunteers record outcomes for successful clients. This example shows the possible outcomes for a client with a Medicare case.

 

A full list of the possible outcomes by case type can be found in the Appendix. It should be noted that there is also an “other outcomes” field where volunteers can specify outcomes that do not appear in the pre-populated list. Staff members monitor what types of outcomes get entered into this field and have made additions to the pre-populated list as appropriate. Additions are rare; for example, since launching ESP, they have added two outcomes to the list of possible outcomes.

Ensuring that outcomes are recorded and done so accurately by volunteers has been a challenge. They offer training and resources to help volunteers navigate the data entry process and offer support as needed. ESP coordinators decided to put the ultimate responsibility for ensuring outcomes are recorded appropriately on ESP staff members rather than on the volunteers. As mentioned above, the ESP paralegal is the first check on case notes and outcome data entry, and the ESP manager conducts the final quality assurance check on each case once follow-up is complete. They are usually able to reconcile the records based on case history notes and follow up with volunteers to clarify certain cases when necessary.

Resources Needed

Volunteers and Office Space

The most important resource necessary for carrying out this type of follow-up effort is a set of volunteers to do the important work of following up with clients, reiterating advice, listening to their concerns, and identifying ways to facilitate successful outcomes. ESP coordinators have found that pro bono attorneys who volunteer primarily because they like interacting with clients and helping people are most likely to succeed in the role. In contrast, they have found that pro bono attorneys who are more interested in litigation and challenging legal cases are not likely to find the ESP volunteer experience satisfying.

In addition, the volunteers need desk space, phones, and access to a computer to access the case management system.

Staffing Considerations

As discussed above, Atlanta Legal Aid has two staff members with official ESP roles: an ESP paralegal who is solely dedicated to ESP and an ESP manager, an experienced attorney who manages ESP as part of her larger role managing the broader pro bono program in the organization. The ESP manager’s experience as an attorney is key as it facilitates communication with both the staff attorneys and pro bono attorneys and helps her understand and anticipate ways to make the program work better for both parties. Another important quality for a staff member in this role is to be familiar with social services, public benefits, and other resources available to lower-income clients.

Case Management System

Pursuing a model like ESP requires a robust case management system that is adaptable to meet the needs and structure of a given organization’s approach to follow-up. Atlanta Legal Aid uses Legal Server and adapted the activity log feature to create a queue for follow-up and facilitate extended case history notes and outcome recording. It is important to note that Legal Server’s pre-screen feature would be more easily adapted to support a follow-up program by phone. Indeed, had Atlanta Legal Aid not been using that feature to manage cases from the senior hotline, they would have used it for ESP. Other case management systems used by LSC grantees should also be adaptable for these purposes.

Screenshot showing the queue for client follow-up.

 

Legal aid organizations pursuing a similar project to the ESP model will need someone on staff who understands how to adapt the case management system. Atlanta Legal Aid has a long-term staff member who understands Legal Server, who played a major role in developing the components used for ESP, and who continues to tweak and adapt the system to make it more user-friendly for both staff attorneys and volunteers to facilitate their work with clients and their ability to record outcomes.

The Benefits of ESP

ESP increases the chances limited service clients will experience successful outcomes.

Comparing data from a study of limited service outcomes before offering ESP with the results from recent data among ESP cases, Atlanta Legal Aid has seen the success rate for limited service cases increase from 50 percent to 90 percent. This is the principal reason it has continued to invest in ESP and will soon expand it to all of its offices. Atlanta Legal Aid sees ESP as a way to ensure that the limited services its staff attorneys are able to provide are acted upon and have a chance of improving their clients’ lives.

Benefits of ESP

  • Increases likelihood of successful outcomes to limited service cases.
  • Informs service delivery.
  • Facilitates documentation of limited service case outcomes.
  • Engages community members through volunteer opportunities.

The insights gathered through ESP shape the delivery of legal aid services.

The very existence of ESP is evidence of how insights emerging from a follow-up investigation into the outcomes of limited service cases can inform service delivery. ESP is now an established part of the way Atlanta Legal Aid approaches service delivery for limited service cases, and it continues to produce insights that shape the way both staff attorneys and volunteers provide legal assistance.

Through feedback from ESP pro bono attorneys, for example, staff learned that clients seeking adult guardianship were facing significant difficulties advancing their cases in probate court. Previously, Atlanta Legal Aid had only offered limited services for these types of cases because it was assumed that probate court was “pro se friendly” and clients could navigate the process on their own. Armed with new insights into the challenges clients were experiencing in certain counties, staff attorneys have adapted their approach and offer extended service in some cases.

Similarly, through ESP, Atlanta Legal Aid has learned that they can help clients achieve important, intermediate outcomes in landlord-tenant cases and have started offering more limited service assistance in this area. Previously, these were low-priority cases and not often accepted by attorneys because under Georgia state law, tenants who have not paid their rent have no real defense, and it was presumed that even if staff attorneys helped them, they would not be successful. Through follow-up for some limited service landlord-tenant cases, however, Atlanta Legal Aid learned that they could help clients achieve intermediate outcomes such as successfully negotiating favorable move-out dates, identifying alternate housing, and understanding the process and the importance of taking pictures of the property and turning in the keys to protect themselves from potential additional complications. Because they have observed clients benefiting from the provision of legal assistance through limited service on landlord-tenant cases, Atlanta Legal Aid has begun accepting more of these cases.

More generally, ESP provides Atlanta Legal Aid a window into what is and is not working both in terms of its own legal service delivery and in terms of challenges and trends in the courts and agencies their clients interact with. This allows them to think through what kind of support it can provide to help improve the likelihood of success among both limited and extended service clients.

The documentation of outcomes provides evidence of effectiveness for both internal and external stakeholders.

The data collected through ESP on outcomes from limited service cases has helped Atlanta Legal Aid demonstrate to funders and other external stakeholders the impact their legal assistance is having on clients’ lives. What is perhaps more surprising, however, is that these data have also been instrumental in demonstrating the value of limited service to internal stakeholders. The cases that often receive limited service rather than extended service are less “interesting” cases—in a legal sense—and are often not cases related to high-priority areas. By collecting data on the outcomes from limited service cases through ESP, Atlanta Legal Aid has been able to document the impact of limited service. This evidence of effectiveness has helped legal aid attorneys see the value this type of legal assistance can bring their clients.

Insights from ESP have led to the identification of new outcomes to track.

Through their extended interactions with clients receiving limited service, ESP volunteers have helped the organization identify new outcomes to track. Two new outcomes have been added as a result of insights gathered through ESP. One outcome is the attainment of adult guardianship. The other is related to cases involving debt and collections: elimination of harassing phone calls. Previously, Atlanta Legal Aid was tracking more traditional outcomes like debt elimination or protection of equity. Through ESP follow-up work, volunteers learned that even when these more traditional outcomes were not achieved, clients’ lives were improved because they were able to successfully end harassing phone calls from collectors. Staff attorneys had always been providing advice to clients on how to manage and end this harassment, but they never knew that clients were successful in achieving because they did not have extended interactions with them.

ESP is a “win-win” for volunteers and the legal aid organization.

Participating in ESP has many benefits for volunteers, especially retired attorneys. It is a way for them to stay engaged in the legal community, an avenue for “giving back” and contributing to the community, and a social opportunity to build camaraderie with other volunteers. Additionally, it provides retired attorneys the opportunity to fulfill their continuing legal education (CLE) requirements through participation in legal-aid-sponsored trainings and similar types of events.

Beyond the direct service pro bono attorneys provide to limited service clients, their participation in ESP has additional benefits for Atlanta Legal Aid as an organization. Their very presence in the central office benefits staff attorneys and other staff members who are able to learn from more experienced colleagues. Engaging retired attorneys is also a way to keep well-networked stakeholders engaged and invested in the organization, which can have the indirect benefit of maintaining the organization’s reputation and aiding fundraising efforts.

Lessons Learned

Reduce the burden on staff attorneys.

When ESP coordinators instituted a new protocol for flagging cases for ESP follow-up in the case management system, they realized they had low buy-in from staff attorneys partly because ESP coordinators were asking them to take extra steps to assign cases for ESP follow-up. Recognizing this barrier, the ESP coordinators adapted the system so that the only step attorneys had to take was to check a box when closing a case. This increased buy-in and participation among staff attorneys.

Be mindful of organizational culture and implement the program accordingly.

Because of its organizational culture, Atlanta Legal Aid approached the development and implementation of ESP gradually and with an emphasis on fostering buy-in among stakeholders, particularly staff attorneys. They have expanded ESP over the course of three years, typically expanding to one new office or specialized unit every few months since it first launched in May 2015. With each expansion, ESP coordinators give a presentation to explain the goals of the program, how it works, and the impact it has had. They also view this as the beginning of an important dialogue with staff attorneys to understand any questions or concerns and to identify ways to facilitate their participation in the program. This often involves creating new ESP-eligible case categories and developing the necessary materials—letter templates and resource guides, among others—necessary to help volunteers provide follow-up on that topic.

Atlanta Legal Aid has implemented ESP this way because it works for their organization. It is possible that another organization could implement the program through a more top-down approach. For example, an organization could create a committee dedicated to designing the program and issuing guidance on its implementation in the organization.

Help staff attorneys see the value in addressing less urgent, lower priority issues.

Staff attorneys are often focused on helping clients address urgent legal matters. Helping clients with less pressing issues—such as applying for SNAP—is not always viewed as a top priority. Through its ESP work and the collection of related outcome data, Atlanta Legal Aid has shown that assistance through limited service can bring real value to clients’ lives.

Build in quality assurance processes for data entry by volunteers.

Volunteers—especially pro bono, retired attorneys—may not have data entry experience. To address this challenge, ESP coordinators have built in quality control processes to make sure case notes are up-to-date and outcomes are recorded accurately.

Set expectations with clients.

Clients can be confused by follow-up calls from ESP volunteers if they have not been told to expect them. Atlanta Legal Aid has learned that it is important for staff attorneys to tell clients that another attorney from the organization will follow up with them to see if they need any additional help on the issue at hand.

Adapt, adapt, adapt.

One of the main themes emerging from Atlanta Legal Aid’s experience with ESP is the need to adapt continuously in order to make the program successful. ESP coordinators adapted the processes and case management system to address the needs of staff attorneys when they learned about barriers to participating. They adapted ESP so that they can engage short-term volunteers in addition to long-term volunteers. They adapted the case management system to make it easier for volunteers to enter notes and outcomes in real time while talking to clients. ESP coordinators have accepted that facilitating a successful program with so many different stakeholders will require ongoing feedback and adaptation. It has become part of the model and, given the real benefits to Atlanta Legal Aid clients and low-cost investment as an organization, continually adapting ESP has been worth it.

Methodological Note

The Legal Services Corporation (LSC) contracted with NORC at the University of Chicago (NORC) to conduct a case study of the Enhanced Services Project (ESP) at Atlanta Legal Aid. The case study was informed by a review of Atlanta Legal Aid’s Enhanced Services Project reports, trainings, and other program-related materials as well as information gathered through semi-structured, in-person interviews with Atlanta Legal Aid staff and pro bono attorneys in Atlanta on September 14, 2017.

 

Appendix

ESP Possible Outcomes

Case type

Apply for Medicaid/Medicare Savings Program and/or Source, NOW/COMP waiver

  • Access to mental health care/medication
  • Appropriate discharge planning obtained
  • Forced medication avoided
  • Home/community-based services benefits obtained or retained
  • Medical debt eliminated
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown; $500)
  • Money follows the person benefits secured
  • Other health benefits

Apply for guardianship

  • Adoption of children
  • Advanced directive prepared
  • Custody/visitation arrangement obtained
  • Guardianship of minor obtained/retained
  • Guardianship/conservatorship of adult obtained
  • Individual education plan obtained
  • Legitimation/paternity established
  • Medical coverage received/retained (unknown; $500)
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown; $500)

Send FDCPA letter

  • Consumer debt
  • Elimination of harassing phone calls
  • Equity in home saved
  • Garnishment or attachment
  • Homes protected from foreclosure
  • Housing obtained/retained for 30+ days
  • Medical debt eliminated
  • Other consumer benefit
  • Other housing benefit
  • Other mortgage debt eliminated
  • Percent decrease in monthly mortgage payment
  • Policy change affecting a group

File overpayment waiver for SSI/Social Security

  • Food stamps/SNAP benefits secured
  • Homes protected from foreclosure
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown; $500)
  • Other income benefits
  • Overpayment waived
  • Policy change affecting a group
  • SS/SSD/SSI benefits secured/retained
  • TANF benefits secured/retained
  • Veteran’s benefits secured

Private landlord/tenant eviction

  • Consumer debt
  • Garnishment or attachment
  • Housing obtained/retained for 30+ days
  • Housing benefits secured (unknown Sec 8; $729 0-1BR; $789 2BR; $1069 3BR; $1166 4BR+)
  • Improved housing conditions received
  • Other consumer benefit
  • Other housing benefit
  • Policy change affecting a group

Apply for food stamps/SNAP

  • Food stamps/SNAP benefits secured
  • Homes protected from foreclosure
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown; $500)
  • Other income benefits
  • Overpayment waived
  • SS/SSD/SSI benefits secured/retained
  • TANF benefits secured/retained
  • Policy change affecting a group

Apply for TANF, Social Security retirement/disability, or SSI

  • Food stamps/SNAP benefits secured
  • Homes protected from foreclosure
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown, $500)
  • Other income benefits
  • Overpayment waived
  • SS/SSD/SSI benefits secured/retained
  • TANF benefits secured/retained
  • Policy change affecting a group

Apply for Affordable Care Act

  • Access to mental health care/medication
  • Appropriate discharge planning obtained
  • Forced medication avoided
  • Home/community-based services benefits obtained or retained
  • Medical debt eliminated
  • Medicare/Medicaid/Peachcare benefits obtained/retained (unknown; $500)
  • Money follows the person benefits secured
  • Other health benefits
  • Other mental health benefit
  • Policy change affecting a group
  • Skilled care/personal care benefits secured/retained
  • Skilled care/personal care placement secured/retained
  • Supportive housing services for disabled person obtained/retained
  • Supportive services for disabled person obtained/retained

Complete power of attorney and/or advance directive

  • Access to mental health care/medication
  • Advanced directive prepared
  • Appropriate discharge planning obtained
  • Consumer debt
  • Equity in home saved
  • Financial powers of attorney prepared
  • Homes protected from foreclosure
  • Housing obtained/retained for 30+ days
  • Last will and testament prepared
  • Medical coverage received/retained (unknown; $500)
  • Nomination of guardianship prepared
  • Other mortgage debt eliminated
  • Policy change affecting a group
  • Powers of attorney revoked
  • Probate assets protected
  • Real property title issue resolved
  • Skilled care/personal care placement secured/retained

Consult housing counselor to apply for loan modification

  • Consumer debt
  • Equity in home saved
  • Foreclosure sale prevented
  • Homes protected from foreclosure
  • Housing obtained/retained for 30+ days
  • Improved housing conditions received
  • Other housing benefit
  • Other mortgage debt eliminated
  • Other reduction in monthly payment
  • Percent decrease in monthly mortgage payment
  • Policy change affecting a group
  • Probate assets protected
  • Real property title issue resolved
  • Rental expense avoided (unknown; $729 0-1BR; $789 2BR, $1069 3BR, $1166 4BR+)
  • Utility service protection

Apply for unemployment benefits

  • Food stamps/SNAP benefits secured
  • Homes protected from foreclosure
  • Other income benefit
  • Overpayment waived
  • Policy change affecting a group
  • SS/SSD/SSI benefits secured/retained
  • TANF benefits secured/retained
  • Unemployment benefits secured (unknown; $1200 for 6 months)

Special wills referral

  • Advanced directive prepared
  • Consumer debt
  • Equity in home saved
  • Financial powers of attorney prepared
  • Homes protected from foreclosure
  • Last will and testament prepared
  • Medical coverage received/retained (unknown; $500)
  • Nomination of guardianship prepared
  • Other housing benefit
  • Other mortgage debt eliminated
  • Other reduction in monthly payment
  • Policy change affecting a group
  • Powers of attorney revoked
  • Probate assets protected
  • Real property title issue resolved
  • Skilled care/personal care placement secured/retained