Permanency Planning

The client families that legal services attorney Emily Roscia visits in idyllic New York suburbs are faced with making worst-case decisions about a future in which a parent may die of AIDS. It's a practice area known as permanency planning, and the lawyers who do it deal with all aspects of the non-medical side of the disease, from arranging for health care proxies and drawing up wills to helping plan how clients will provide for their children.

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Attorney Emily Roscia makes house calls. The families she sees in New York’s Westchester and Putnam counties — places that summon visions of summer barbecues, Cub Scout troops and leafy cul-de-sacs — are faced with making worst-case decisions about a future in which a parent may die of AIDS. Lawyers have an ironic name for this practice area: permanency planning. “It’s tough, I’m a pretty emotional person,” said Roscia, 29, a graduate of City University of New York School of Law and a staff attorney for Legal Services of the Hudson Valley. “They call me by my first name,” she said of her clients — mothers and fathers whose health and money have run out. “I like it that way. I speak to them regular — no legal jargon.” Beyond the daily excruciation of their disease, the concerns of Roscia’s clients are many: How do I provide for my children? How do I keep a roof over my head? What do I do about credit card debt? How do I qualify for Social Security disability benefits? How do I make a simple will? How do I arrange for a health care proxy? Roscia and veteran Legal Services attorney Mary Mahoney take their cases from the Hawthorne office of Volunteers of America, specifically through a program known by the acronym Legacy (Legally Entrusted Guardians for AIDS-affected Children and Youth), which currently assists 38 families. Volunteers is a national, nonprofit agency providing outreach programs for abused and neglected children, troubled youth, the frail and elderly, the disabled and the homeless. The organization’s metropolitan New York chapter, with an annual budget of $86 million, is the largest affiliate in the country. “We work very closely with Volunteers on the cases we get,” said Mahoney, 45, a graduate of Northeastern University School of Law in Boston. “They do a lot of the legwork and social work it takes for people who have chronic illness.” Chief among the Legacy case workers in the Hawthorne office is Catherine Gonzales, 31, a former paralegal for the Bronx district attorney. “I’d always planned on a law career,” said the John Jay College graduate. “But once I got into social service, I decided to stay.” “When I came here, I thought Catherine was an attorney,” said Brad Cauthen, program director at the Hawthorne office and Gonzales’ supervisor. “She’s the one working with the medical agencies and the landlords and all the bureaucrats.” EMOTIONAL SUPPORT This is besides Gonzales working through her clients’ feelings of shame. Clients such as Robin Gibbs, 43, a single mother of three with multiple legal needs as the result of her illness, controlled by medications. “I was in deep denial. I had my insides coming out of me in a terrible, nasty way,” said Gibbs, who was hospitalized for long periods and remains too weak to care for her family on a daily basis. Legal Services found Gibbs an apartment in Yonkers and a home and guardian for her three children. “I said to myself, How am I going to tell people? What are they going to think of me?” Mahoney, who has worked in permanency planning for more than a decade, said Gibbs’ denial process is common. “Often when clients come to us, even though they seem ready, it can take months or sometimes years to help them through to what they need,” said Mahoney. “Many times, they haven’t even told their families yet. “The natural plan for any parent, of course, is to live as long as you can and see your children grow up,” she said. “With all the new treatments, that’s becoming possible. When I started back in ’93, I’d have four and five and six clients die every month. That’s a rarity now. Yet still, you have to prepare for the possibility you might not make it.” BENEFITS HARDER TO GET While the mortality rate has dropped for AIDS patients in the past decade, Mahoney said, the rate of HIV infection — the virus that leads to AIDS — has remained relatively unchanged. In obtaining disability benefits, Roscia said this has made her work more difficult. “The standard is pretty high,” she said. “With all the new medications and people living longer, you now have to demonstrate recurrent infections and severe weight loss.” But to Gibbs, living longer through better chemistry means “vomiting, diarrhea, headaches, too many pills that look like a bunch of jelly beans and sometimes I feel like I’m going to die every time I go to sleep.” Her comfort, she said, has come from lawyers. “Lawyers helped me with a lot of things, basically with my kids,” said Gibbs. “None of my family members are here [in New York]. The lawyers go to court with me. They helped get a place that would take all three of my kids. I was so stressed out. I didn’t want the state to get them.” To Mahoney, “It’s a wonderful thing to be able to help people make a plan, and take some of their fears away, including the biggest one — that your children will be lost without you.” There is little material reward for such work, said Roscia. Previous to her low-salaried position at Legal Services, she worked for a Manhattan personal injury firm to gain courtroom experience. The pay was significantly better. It bothers Roscia that she lives, for the time being, at her parents’ home in Westchester. She often thinks of big-firm associate income, “And I ask myself all the time, Why am I here at Legal Services? “The answer is always the same,” she said. “I just can’t do something every day that doesn’t involve some kind of social justice.”

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