30 Years of PLA: When Healthcare and Legal Aid Work Together

This year, Philadelphia Legal Assistance is celebrating 30 years of advancing justice for low-income Philadelphians. As part of that celebration, we are sharing interviews, stories, and reflections that highlight the people and partnerships behind our work.  

We recently spoke with Nicky Ripley, who joined PLA's Medical Legal Community Partnership in 2025, about their experience serving clients at Health Center 10 and how this legal help can play an important role in improving health and well-being.

You’re a newer member of the Medical Legal Community Partnership team. What site are you currently based at, and what is it like working in that environment alongside healthcare providers?  

I am based at Health Center 10 in Northeast Philadelphia, which serves a medically underserved community. The patient population is especially diverse, and the high volume of walk-in visits keeps each day interesting. I enjoy working alongside a multidisciplinary team. It truly feels like a collaborative environment, and everyone has been welcoming. I have enjoyed getting to know the staff better.
 

How does your day to day work differ from a traditional legal setting since you are embedded in a medical or community health space?  

I have not spent much time in a traditional legal setting, so I may not be the best person to answer this question. That said, the culture, pace, and communication in a medical setting are definitely unique. I think the biggest difference is that I need to work around the schedules of both providers and patients.

On one hand, collaborating with clients' primary care providers can make scheduling and follow-through easier. It also improves communication with providers and helps streamline the collection of medical evidence. More broadly, the medical providers and my PLA predecessors at Health Center 10 have built a great deal of trust within the community, and I benefit from that every day.

On the other hand, the medical and legal needs of low-income clients can be complex and unpredictable. One of my primary responsibilities at Health Center 10 is to be available in person as a resource, which means being prepared for whatever comes through the door, regardless of what else I have planned. I enjoy that variety and pace, though. I have never had a boring day at HC10.
 

What are the most common legal issues that clients come to you with, for example housing, benefits, or family law?  

Most of my clients are dealing with issues related to some combination of the cost-of-living crisis, disability, and domestic abuse. I work with many single mothers and older women who are doing everything they can to support their households and communities, often without spousal support.

Many clients need assistance accessing medical insurance, Social Security benefits, and utility assistance programs. Because these programs have strict means-testing requirements, I spend much of my time helping clients demonstrate that they meet the eligibility criteria for benefits to which they are legally entitled.

Can you share an example of a case where resolving a legal issue had a direct impact on a client’s health or well being?  

The first client I met in person at PLA was a Supplemental Security Income  (SSI) applicant who was living in a shelter after leaving an abusive relationship. She was an older adult whose cognitive impairments affected her ability to understand and navigate the Social Security application process.

I worked closely with her and her healthcare providers to compile the necessary medical evidence and complete her functional report. We also provided financial counseling to help preserve her benefit eligibility while maintaining her independence. Her application was approved quickly, and she began receiving the maximum SSI benefit, along with back pay.

We then worked with her providers and the health center's benefits counselors to ensure that her Medicare coverage was established without any gaps. We are hopeful that these benefits will help her secure stable housing and, perhaps most importantly to her, regain custody of her beloved cat.
 

You handle a wide range of legal problems. How do you manage that variety and decide what to prioritize?  

It is rare that a patient leaves my office without some form of assistance, so my triage process involves determining what kind of assistance to provide and how much, depending on eligibility, capacity, and urgency.

Some clients just need to be heard, validated, and pointed in the right direction. Most clients' legal issues fall within our established priorities, so I usually prioritize cases based on deadlines and urgency. I also make time to ensure that lower-priority cases receive regular check-ins so they do not get neglected.

There are a lot of lists, spreadsheets, and calendar reminders involved. But the variety of legal issues I get to work on is one of the things I enjoy most about this position, especially because I have so many experienced colleagues to learn from in areas where I have less experience.
 

How do you collaborate with doctors, social workers, or other healthcare staff when identifying and addressing clients’ needs?  

All the staff at HC10 are great at identifying patients' legal issues and sending people my way. Even when their questions fall outside our practice areas, I would rather they be over-inclusive. I try to keep resource and referral printouts on hand for common issues we cannot assist with, such as immigration matters. For the most part, though, provider referrals are timely and relevant.

I mainly reach out to providers when I need medical certifications, physicians' letters, or disability-related evidence for clients. I can also consult them for medical opinions when evaluating eligibility for disability benefits, which is extremely valuable. Another, more informal benefit is the additional context they can provide about a patient's referral. Providers often have strong relationships with their patients, so their insights are especially helpful when I am preparing for an intake.

This collaboration is also a valuable resource when I lose contact with a client. Sometimes I cannot track someone down, so I will reach out to a member of their care team for an update. I can think of one occasion when a patient had told their provider that they would be visiting family outside the country. When I mentioned that I had not heard from the client in a while, the provider was able to share that information, which helped me plan accordingly.

Finally, in a community as diverse as HC10, the in-person interpreters are an incredible asset. Much of my work involves sensitive information that can be difficult for clients to discuss, especially when there is a language barrier, as there often is. These interpreters help clients feel more confident and comfortable, which ultimately leads to better communication and improved case outcomes.
 

What do you find most rewarding and most challenging about working in a medical legal partnership setting?

Staffing a walk-in office for anyone who needs legal assistance at a heavily utilized health center can be overwhelming. Sometimes, patients walk in with an emergency on days when I really need to focus on other work. Other times, I have to deliver difficult news or navigate language barriers while my technology is being frustrating. The work is unpredictable, chaotic, and often emotionally challenging.

However, the results of this work are very tangible for our clients, and their ongoing engagement with the health center means we usually get to interact with them consistently over long periods of time. We are able to see their lives improve as a result of our work. We can also help ensure they do not fall through the cracks after their case is concluded, which is relatively rare in legal aid.

Perhaps most importantly, we get to build and maintain relationships with the communities we serve. That is personally rewarding, but it also helps us provide more informed and effective services in the future.