By Nikole Nelson and Rishi Manchanda

Stanley is a 78-year-old grandfather doing something he never imagined he would at this age: raising four grandchildren, all under age 10. Their parents struggled with substance abuse and couldn’t properly care for them. Stanley’s retirement savings and Social Security aren’t enough to cover the expenses of this bigger household, so he’s had to cut back—taking less of his prescribed medication for high blood pressure and diabetes. Sometimes he skips meals and isn’t able to buy snacks or clothes that his grandchildren need. He applied for SNAP (food stamps) and Medicaid benefits months ago, but recently received notice that he didn’t qualify. His house is now in foreclosure. The stress is compromising his already fragile health. 

What looks like a health and finance problem for Stanley’s family can actually trace its source to something deeper: the inability to access legal help. There are often laws and policies meant to help with such struggles, which means health problems like Stanley’s often have a legal solution—or they should, if only legal help were accessible. But for this family and millions like them, legal solutions are out of reach, so their health and financial problems persist.

The size of this civil justice crisis is enormous. In the U.S., an estimated 120 million civil legal needs go unmet in any given year. For low-income communities, the latest Legal Services Corporation’s Justice Gap Study found that 92% of civil justice needs are unmet. These are stunning numbers with devastating consequences that impact the ability to fight wrongful evictions or foreclosures, stop illegal wage garnishing, ensure access to public benefits, obtain mandated insurance coverage for prescribed care, secure family safety for domestic violence survivors, arrange guardianship paperwork to enroll a child in school—and more. If you are accused of a crime, the government will provide a lawyer if you can’t afford one. But for civil matters like these, you have no such right.

The results of these unmet legal needs show up in chronic health conditions and crises that could be avoided with proper legal support.

Most often the response to this crisis is to increase the availability of free lawyers through legal aid, pro bono service, and medical-legal partnerships (MLP). Without question, these solutions are critically important and impactful. But the civil justice gap is far greater than these interventions can cover alone—and it’s only growing wider as federal policies slash healthcare funding, gut SNAP, and send vast communities of immigrants and LGBTQ+ patients into retreat from services and care. The size of this crisis requires us to radically expand the supply of legal helpers, and do so in a way that makes them more accessible to those in need and aims to improve health. 

This is where the emerging community justice workers movement is showing promise.  Community justice workers are frontline helpers trained to give timely, critical legal help on everyday issues. They can be shelter volunteers, community health workers, or other trusted advocates who are cross-trained to provide critical legal help to those who need it most. And they are a crucial part of the multipart approach that this crisis demands: more MLPs, more lawyers positioned to serve low-income communities, and a workforce of justice workers connected with health care and public health.

What would that kind of help mean to Stanley? With the help of a justice worker, Stanley could challenge the decision denying him SNAP and Medicaid benefits and get the support he needs to feed his grandchildren and cover his healthcare expenses. A justice worker could help assure that he doesn’t lose his home to foreclosure, even connecting him with an MLP or legal-aid lawyer if needed. A justice worker could make the difference between keeping Stanley’s grandchildren with him or sending them into foster care.

Healthcare and public health have a critical role to play to support and scale this solution. Learn more about how community justice workers work, why they’re essential to health—and what health care can do to grow their numbers—through this FAQ.

What do community justice workers do, and how are they different from medical-legal partnership?

Typically, MLPs embed lawyers as members of the health care team. Community justice workers expand this practice by training people who are not lawyers to provide simple legal help, typically in a team-based fashion with lawyers.    

This approach is inspired by the successful model of community health workers, promotores, and peer navigators—who become part of the healthcare ecosystem to help address health needs. Justice workers are often trusted community members who people turn to in times of crisis. They might work primarily as community health aides, pastors, or food bank case managers or volunteers, but they are trained to spot and solve specific legal problems that affect people in their setting.

For example, a food bank volunteer might be trained as a justice worker to appeal SNAP benefits that were wrongly denied or withheld. This is not a theoretical example. In Alaska, a recent study found that community justice workers secured more than $23 million in SNAP benefits that otherwise would not have been distributed. An advocate at a domestic violence shelter could be certified to accompany a survivor to court to get a protective order or child support. Trained staff at a senior center could help file an appeal for someone who wrongly lost Medicaid coverage or found it would not cover the prescription their doctor wrote. A housing shelter worker could send a letter to a landlord demanding legally needed repairs or to a court to prevent wrongful eviction.

To do this work, community justice workers receive targeted training in specific areas of law relevant to the people they serve. This way, they can address health-related legal needs affordably, at the right time, and through a trusted source.

Why is the need urgent and growing?

Recent federal policies make civil justice needs acute. Billions of dollars in Medicaid cuts in H.R. 1, otherwise known as the “Big Beautiful Bill,” stand to force healthcare service cutbacks and accelerate hospital closures. An estimated 11.8 million people are likely to lose health insurance under the bill, while many have already lost SNAP food support. 

Without legal help, the resulting problems go unresolved, even as people’s health suffers. Many people don’t realize these are legal needs; they consider them life problems without clear solutions. Community justice workers can help identify them. For instance, there are many exemptions to the work requirements recently added to SNAP and Medicaid. A growing evidence base indicates that justice workers can help people understand whether they qualify for such exemptions and get them approved, or help people prove they have satisfied the requirements if there is a mistake. As such, community justice workers can play an important role in multipronged efforts to maintain enrollment and eligibility for Medicaid and SNAP benefits and to improve affordability for lower income communities. 

People should not lose their health care or food access over paperwork. Many common legal challenges are difficult for a layperson to tackle but resolvable by someone with the basic training that community justice workers receive.

How widely available are community justice worker services now?

State laws that prohibit the “unauthorized practice of law” can present a hurdle to community justice workers, as they generally prevent anyone who is not a lawyer from giving legal help. Frontline Justice is helping states modify those laws to allow critical justice worker assistance, akin to the changes made to health policy to open the door to community health workers. 

Momentum for wider adoption of the community justice worker model is building. Thirteen states and the District of Columbia have already adopted or officially proposed justice-worker-friendly policies, with 20 more considering it. These policies allow justice workers to provide a wide variety of legal help, including matters of eviction, public benefits, probate, domestic violence protective orders, debt-relief, and other areas.

Even prominent national legal organizations—including the American Bar Association and the National Conference of State Supreme Court Justices—have formally urged states to consider this change. As recognition of justice workers’ impact grows, this is a pivotal time for the support of two more crucial sectors: health care and public health.

What should health care and public health do to expand opportunities for community justice workers to improve health?

In people’s lives, there are no boundaries between legal problems and health problems. So we need to cross the boundaries between legal care and health care to create effective solutions.

Healthcare and public health leaders can play an essential role in building the needed policies and infrastructure to bring community justice worker services to scale. Steps for leaders across sectors include:

• Become a champion of community justice workers. To begin, tap existing resources to understand the legal needs gap and the potential for justice workers more deeply, or consider joining Frontline Justice’s Groundwork platform to connect and collaborate with fellow supporters.
• Become a community justice “mentor.” Healthcare and public health professionals can serve as mentors to community justice workers through a model adapted from clinical champion frameworks already proven in primary care, pairing a designated primary care provider with a specialist. Designated providers—including clinical social workers, care managers, or public health nurses—can pair with justice workers to provide health-context input on legal matters. Mentors can also provide targeted didactic content that upskills justice workers in the health dimensions of common legal problems. (Health systems and FQHCs already engaged in MLPs have a ready-made infrastructure for justice worker mentorship.) The mentor’s role is to serve as the clinical or public health anchor in a bidirectional relationship: helping justice workers understand how specific legal problems manifest as health risk, triage which cases warrant escalation, and provide the health-system credibility and connectivity that helps justice workers close the civil justice gap and improve health outcomes for patients.
• Invest in training and partnership. Health systems, managed care plans, FQHCs, and public health agencies can invest in justice worker capacity through several concrete channels. One, cross-training existing community health workers to function as justice workers, too—adding legal navigation competencies to their existing SDOH skills—is the fastest path to scale access to justice. For example, adding a legal navigation competency to CHW training curricula—in partnership with organizations like Frontline Justice—can create a hybrid workforce capable of addressing both health and legal dimensions of unmet social needs. Two, embedding civil legal needs screening into EHR workflows and care management programs creates the referral infrastructure that connects patients to MLP, legal aid, and justice worker services at the right moment. Three, nonprofit hospitals and managed care plans can direct community benefit funding and community reinvestments, respectively, toward justice worker programs that address the legal determinants of needs documented in community health needs assessments. And four, health systems operating under value-based contracts can make the ROI case to payers and ACOs that justice worker services—by preventing evictions, maintaining benefit coverage, and securing food access—reduce emergency utilization and improve chronic disease control. Frontline Justice’s Groundwork platform and HealthBegins’ content and resources offer practical entry points for healthcare and public health leaders ready to act.

• Help build the evidence base: A growing body of evidence indicates that trained non-lawyers providing civil legal assistance can handle a defined scope of legal matters safely and effectively and improve legal outcomes (e.g. benefits secured, evictions prevented). Early adopters and researchers in health care and public health can contribute meaningfully to building this evidence base, examining how community justice workers improve health outcomes by increasing access to justice. 

• Use your influence to advocate for policy change. Health care holds sway as an essential service, a business, and a trusted expert. Leverage that influence to urge your city, state, and national governments to remove hurdles and open more pathways for community justice workers. For example, state medical and nursing associations, hospital associations, and health department directors can lend credibility to legislative efforts to remove “unauthorized practice of law” barriers by testifying to the health impact of civil legal needs—framing justice worker authorization as a public health measure, not merely a legal reform. Similarly, state health departments and boards of health can engage with state supreme court task forces and bar associations—the regulatory bodies shaping justice worker authorization—to provide health-sector input on scope, training standards, and oversight. 

The kinds of problems that led to Stanley’s health problems are not inevitable—or unsolvable. By building support and partnership for simple, affordable legal solutions that increase access to justice, we can improve health for the patients and communities who need it most.

Nikole Nelson is founding CEO of Frontline Justice. Rishi Manchanda is founder and CEO of HealthBegins.