A Question of Quality
It is not enough merely to
offer legal services. In an era of scarce resources, advocates must
assure the provision of high-quality help. Introducing the QUALITY
MATRIX, a new service model to help providers (and funders) get the
most bang for their legal aid buck.
The
American legal services community teems with diverse views, passionately
held and energetically debated. On some issues, however, consensus is
broad and deep. We all agree that legal aid programs exist to provide
assistance to clients without the financial resources to get the legal
help they need. We agree that the assistance advocates provide must be
of high quality. And we agree that our clients deserve the best that our
profession requires—namely, advocacy that is competent, zealous, and
diligent (the obligation of every lawyer, as codified in the American
Bar Association’s Model Rules and Model Code.) “Legal assistance”
is a misnomer if it does not give the help-seeker a reasonable chance to
obtain a fair outcome in our civil justice system.
However,
the question becomes more complex when we begin to think about what
constitutes “quality” in legal services. Our profession suggests
that a law-school degree and bar passage can prepare attorneys to
practice law, but those who have practiced for many years know too well
that a bare-bones legal education does not assure skill and competence.
Similarly, our profession’s ethical codes and values do not resolve
this issue; after all, what does it mean to be competent, zealous, and
diligent when scores of needy clients are in the waiting room reminding
us that we have far too few resources to serve all those with important
legal needs?
Lawyers
sometimes assert that “quality” legal representation cannot be
defined because it is so dependent on context, suggesting we needn’t
worry about our inability to define quality because “we know it when
we see it.” Not only is this view illogical—How can we “know”
when we “see” something that defies definition?—it is a
potentially harmful cop-out given current budgetary realities. We are
operating in an age in which our funders require evidence that we are
making the highest and best use of the resources we do have as a
condition of continued funding.
Besides,
other professions have made progress in defining quality. In doing so,
they have been able to act in systematic ways to produce and assure it.
Health care professionals, among others, have tackled the quality
problem forthrightly. The Institute for Healthcare Improvement reports
the findings of its broad-based movement to improve the quality of
health-care delivery at www.ihi.org.
We know of no similar effort under way in the law. That is why we, as
legal services professionals, have a unique opportunity to begin an
important conversation about how the definition of quality “legal
care.”
If
other professions can do it, we can surely do the same. We can begin to
identify indicators of quality. We can make quality an important
national agenda item. And we can begin to hold ourselves accountable to
the criteria and standards that emerge from our discussion, for the sake
of the tens of millions of Americans who rely on us for justice.
WELCOME
TO THE MATRIX
To
start a conversation that will move a quality agenda, we need to unpack
its possible meanings. Fortunately, there is now a large body of
literature that points to a variety of indicators of quality, including
some commonly accepted standards for civil legal services delivery (such
as the ABA Standing Committee on Legal Aid and Indigent Defendants
Standards and LSC Performance Criteria).
Rather
than trying to debate and assess whether one approach is superior to
others, we have begun to think broadly about indicators that make up
what we will call a “quality matrix.” We doubt that there is a
single, undisputed best approach to achieving quality. Alternatively, if
we hone in on quality from a number of perspectives, we may find that
powerful synergies emerge that will allow staff, management, and funders
to evaluate and validate quality from a broad base.
Here,
then, is our first attempt to identify the core components of a
“quality matrix” for legal services providers:
Good
case management systems.
Such systems make it easy for advocates to document case activity and
client contacts, to avoid administrative duplication, to keep important
client information up to date, to secure client documents and funds, to
move cases in a timely fashion, to document the outcomes of legal work,
and to provide the reports and data required by funders.
HIGHLY
Competent staff.
In a quality legal services program, management endeavors to hire and
retain a core of experienced advocates, while less-experienced staff
receive training, mentoring, and supervision by more experienced
attorneys. A quality program offers support for ongoing professional
development, and employee performance is regularly evaluated in light of
qualitative and quantitative service goals. Weaknesses are promptly
addressed so that staff members have every opportunity to meet high
performance standards.
Peer
review and learning.
In a quality program, systems should be instituted for peer assessment
and review of casework. Managers are actively involved in case review,
using the process as a tool for developing enhanced approaches to
case-handling. Training and skills development is multifaceted—and
includes internal and external workshops, as well as the use of experts
from other programs. A consistent seminar agenda ensures that all staff
stay current on policy changes and developments in major areas of client
service.
Sufficient
resources to support excellent practice.
Even staff with appropriate skills cannot produce quality service
without access to funds to support case-handling needs (e.g. experts,
depositions), online research, adequate libraries, translation services
for clients who do not speak English, and administrative support.
Therefore, resource development is a critical aspect of a quality legal
services program.
Consistently
strong outcomes for clients.
Helping our clients achieve meaningful access to the civil justice
system is our ultimate goal and the reason legal services programs
exist. Sometimes this involves fending off a potentially adverse
situation, other times it means securing positive outcomes for our
clients, and still others it means simply affording our clients an
opportunity to give voice to the grievances they experience. It is not
unusual for a quality legal aid program to accomplish all of these goals
simultaneously. Increasingly, programs are seeking to document the
impact their services have on clients’ lives; indeed, many legal
services providers are doing pioneering work in this realm.
common
approach for measuring outcomes.
While efforts to document the ultimate impact of service on our clients
should be encouraged, we can all do something even easier. We should
embark on a common effort to document the legal outcome achieved when
representation is concluded. While this will not completely identify the
benefits of service, such information will offer a foundation upon which
other measures can be calculated and determined. Over time, these
measured outcomes, combined with other key indicators, will allow
profiles of office performance to emerge in a program’s main areas of
practice. This outcome information will then be the subject of
discussion, comparison, and efforts to improve.
Client
Satisfaction.
Quality programs measure client satisfaction using a wide variety of
tools, including inputs, surveys, focus groups, and information from
secondary reporters such as community service agencies.
THE
EXPANDED MATRIX
Most
of the initial categories of our quality matrix are familiar and widely
discussed in legal services literature. However, the inclusion of more
cutting-edge, quality components may be essential to effectively
maximizing scarce resources.
Thus,
other components of our legal services quality matrix include:
Client
choice and involvement.
The 1974 statute authorizing the creation of the Legal Services
Corporation states that the “availability of legal services has
reaffirmed faith in our government and laws.” Indeed, the legal
services community has long cherished the goal of client empowerment. A
quality provider will offer services in such a way that clients feel
more confident in their ability to use our legal system. Some clients,
however, for a variety of reasons are reluctant to utilize the services
of a legal aid office. High-quality programs recognize that reality and
develop alternative ways to reach clients. Using the services of the
private bar has demonstrable benefits, including giving clients some
choice in their provider.
Community
partnerships and support.
This component of the quality matrix involves a program’s willingness
and ability to partner with other legal services, social services, and
justice providers to create an integrated, coordinated, and
comprehensive legal services delivery system that benefits clients.
A
diverse workforce.
Quality providers aspire to have a diverse staff from top professional
positions to support staff. This requires effective recruitment and
retention policies. Staff diversity is particularly important where the
clientele served is particularly diverse.
Accessibility.
Quality programs provide all prospective clients an equal opportunity to
access assistance. Despite the fact that legal services may not
ultimately be provided in a given instance, quality providers take steps
to reasonably ensure that all those requesting assistance are dealt with
promptly, courteously, and offered whatever advice, referrals, or other
information that may be of value.
Efficient
and cost-effective use of resources.
Clients should get the help they need delivered in the most
cost-effective and efficient way. If a client has a straightforward
legal need, the skill and experience of the advocate should be
appropriate to the need. Experienced and skilled staff should be working
on the more complex and demanding cases and projects. If assisted pro se
services or the services of a lay advocate can meet a client’s needs,
office staffing and resource allocation should reflect this. Effective
use of program resources also involves coordination with all of the
legal services providers in the area. The national legal services
community now has a diverse funding base, and while this diversity
offers opportunities, it also requires greater coordination in order to
assure the most effective use of all available resources.
Best
practices and comparative peer review.
In our system of decentralized and highly diverse providers, great ideas
and approaches to quality can be in place in one office and unknown in
another. A program that pushes for high quality needs to know what its
peer programs are accomplishing and be open to adopting approaches that
have proven successful elsewhere. Such exchanges of “best practices”
are critically important to achieving a high-quality legal services
system.
BREATHING
LIFE INTO THE MATRIX
Legal
services providers and those who fund their work each have essential, if
different, roles in ensuring quality. In a nutshell, while funders can
set the framework for quality, providers make it real. In the final
analysis, quality must be designed and validated at the local level. But
while funder and provider roles are different, they are also
interdependent. Funders provide money to legal services but are
generally not involved in the day-to-day provision of assistance. They
normally do not have direct control over the quality of services
provided by their recipients. However, using their financial resources
to support and influence advocates, funders can impact the quality
question by:
•
Directing grantees to focus on a definable, quality agenda;
•
Insisting that providers evaluate themselves (looking to the components
of the quality matrix);
•
Developing standards for funding a quality infrastructure (e.g., use of
technology, a baseline case reporting system, a best practices exchange
and reporting system);
•
Sponsoring objective, credible research on delivery and quality
approaches so that programs have better information and a better basis
for choosing service approaches;
•
Promoting and supporting intra-program consultation around best
practices (e.g., where a program has developed a good system of
performance review, ask staff from that program to consult with other
programs);
•
Investigating and making available to grantees information and
approaches that have worked in other fields;
•
Investigating and reporting to providers on the best research tools,
online services, and case management systems, and wherever possible, by
negotiating best prices from those vendors preferred by providers;
•
Challenging programs to integrate multiple aspects of the quality matrix
into their work and evaluating provider progress on their quality
agenda;
•
Documenting which components of the quality matrix are most valued by
high-performing programs, and based on program-validated experience,
assisting other grantees in incorporating similar approaches;
•
Assuring providers that honestly assessing and addressing weaknesses
will be viewed positively and will result in support and assistance.
While
the funder’s role is important, it is obvious that only providers can
produce quality service. Resources, support, and framework from funders
is essential, but without genuine support at the program level for an
active, quality-focused agenda, it will be difficult to achieve
broad-based program quality.
The
ultimate goal is for funders and providers to work together to
continually elaborate and refine the quality matrix—to breathe life
into it. Particular program needs, client demographics, and other
factors will make some categories of the matrix more valuable to some
programs than others. All components of the quality matrix need not be
present to have a high-performing program, but many components will be
in operation in most quality legal aid operations.
The
matrix itself is no more than a tool, reminding us that quality has many
aspects and helping us maintain a balance among its important
components. For example, if a program chooses to focus on
efficiency—defined as low operating costs or a low cost-per-case—it
might decide to eliminate neighborhood outreach offices or provide only
hotline advice services. This approach would neglect client needs for
more extended service and might negatively impact quality goals of
equity and access. At the other extreme, a program that defines quality
by putting a high premium on staff experience and competency might find
out that it is hard to operate an economically efficient legal services
program. A mix of better-paid, experienced staff with less-experienced,
well-supervised staff might offer both competence and cost-effectiveness
consistent with a range of client needs.
The
key would seem to be balance. Providers must be mindful of the broad
parameters of the quality matrix while choosing the priorities on which
to focus—and against which they are willing to be evaluated. Funders
must understand that managers at the program level make decisions every
day that will impact, positively or negatively, their ability to address
components of the quality matrix.
In
the final analysis, the pursuit of a quality agenda is best understood
not as a “goal” for which there can be found universal agreement but
as a way of redefining the agenda. By laying out a quality agenda, the
funder indicates its aspirational priorities. But achieving these
priorities—bringing them from aspiration to reality—can only be
realized by providers as part of a process in which the balance of
emphasis among matrix components shifts over time.
QUALITY
CONCLUSIONS
Achieving
high quality throughout the legal services delivery system will not be
easy. Obviously, in a system in which only 20 percent of our client base
is served, additional resources are essential. But the case for more
funding can be better made by demonstrating that we are using every dime
of what is currently available in the most efficient and effective way.
We must be able to demonstrate that we are acting as wisely as any corps
of advocates can, given current constraints, in delivering high-quality
services to as many clients as possible. With solid documentation of our
current activities, we can know a lot more about who is being turned
away. Then we will have information on what might have been accomplished
with additional resources—crucial data to present to potential
funders.
In
issuing a call for a national conversation on quality within the legal
services community, we are acutely aware that our current challenges and
past history may conspire to undermine the acceptance of the
funder/provider partnerships and the provider/provider collaborations
crucial to driving higher quality. Let’s be mindful of this reality as
a way to keep it from happening.
Although
the past is beyond our control, we can write a different future in the
years ahead—a future whose history will reflect expansion,
effectiveness, efficiency, and most importantly, high quality. A future
in which every client who comes to us gets the very best we have to
offer.
Jeanne
Charn is a lecturer at Harvard Law School, director of the Bellow-Sacks
Access to Civil Legal Services Project, and director of the Hale and
Dorr Legal Services Center of Harvard Law School.
Randi Youells is Legal
Services Corporation’s Vice President of Programs. |