Rice retires after two decades of leadership in Health Justice Clinic, 28 years on faculty

Clinical Professor Allison Rice has long garnered praise from students, colleagues, and clients for superb teaching and leadership in the Health Justice Clinic, dedicated advocacy on behalf of people living with HIV, AIDS, cancer, and other illnesses, nuanced grasp of health care policy, and kindness. But many also note that Rice, who retired in June after two decades as supervising attorney and then director of the Health Justice Clinic, never wanted to hear that praise.

“Allison has never, ever sought recognition for what she was doing,” says Colin W. Brown Clinical Professor Emerita of Law Carolyn McAllaster, the founding director of the clinic in which students learn to serve the legal needs of low-income clients facing serious health conditions and health care challenges. “It’s a remarkable characteristic.”

A Long Island, N.Y., native and graduate of Colgate University, Rice found her calling in poverty law when enrolled in a clinic at Boston University School of Law, where she earned her JD. She started her career in 1984 as a staff attorney at Legal Services of Southern Piedmont in Charlotte, N.C., where she focused largely on housing and domestic violence matters and later served as managing attorney. She joined the Duke faculty in 1994 as one of the first cohort of full-time instructors of Legal Analysis, Research and Writing, helping to cement the strength of the Law School’s writing program and later ensuring that excellent written advocacy was part of her clinic students’ toolkits. Over her tenure at Duke she also taught Ethics and co-founded the HIV/AIDS Policy Clinic.

For Rice, the real power of the clinical experience lies in taking law students out of their bubbles of privilege and connecting them with people who face very different challenges, needs, and social obstacles. She says providing that “experience of proximity” was her primary pedagogical goal as she taught students to craft clients’ wills and end-of-life directives, help them secure medical benefits, or pursue claims of employment discrimination related to their conditions.

“You’ve got to be up close to people to know what their lives are like to both think about solving problems for individuals and to look at what the policy needs to be,” she says. “In a poverty-focused clinic, you get an open door into a different part of the work that most Duke Law students haven’t experienced.”

Rice’s students say she continually stressed the importance of listening carefully to their clients, treating each with respect, compassion, and empathy, and stepping back to consider what systemic forces might be in play.

“Allison really challenged you to think about what’s going on in this person’s life — what are they experiencing, and what systems are they working through?” says David Gardner ’20, who worked with Rice over three semesters in the clinic and as co-president of the student-run Cancer Pro Bono Project, for which she was the faculty advisor. Gardner says that approach, which included asking whether and how systems in which clients are struggling should change, is invaluable to his current practice as an attorney in the Disability Rights Section of the Civil Rights Division at the U.S. Department of Justice.

In addition to facilitating their direct service to clients, Rice involved her students in cutting-edge policy advocacy on a range of matters on which she has been engaged at the state and national levels. She has also been an influential mentor to many, particularly to those hoping to craft public interest careers.

Bethany Lilly ’12, now executive director, public policy at the Leukemia and Lymphoma Society, says Rice remains an inspiration as she works to improve health care access for people with chronic conditions and disabilities. “It can be incredibly hard to keep going in the face of the extreme odds and when victories are small and few and far between,” says Lilly. “But Allison’s unshakable conviction and commitment to the work she did and the work’s importance to the people we served has always guided my own commitment.”

A trusted and dedicated counsellor

Rice’s evident commitment routinely earned her trust — and deep affection — from clinic clients, says Clinical Professor Hannah Demeritt ’04, the clinic’s supervising attorney since 2011. “Allison’s clients feel her dedication. She really cares about them as whole people and doesn’t see them as ‘cases.’”

Adds McAllaster: “She had clients who weren’t clients of the clinic anymore but were ‘lifers’ for her. They would just call her when they needed advice or when they had a problem.” Whenever the clinic was unable to take on a particular matter, Rice would try to connect the individual in need of assistance with representation or other resources.

Rice’s ethos of client service was also central to her teaching. She routinely pointed out to her students the importance of narrative in developing the solution to any problem.

“You have to really understand the individual and their values, and it takes a lot of listening to do that,” she says. “The real work is hearing the story and helping the client think about what it is they want, hearing what they want, and being able to counsel them when you hear what their story, their family situation, and their values are, about what choices to make.”

Says former student Lilly: “Allison always reminded us that even the smallest changes could matter a lot to a client. I recall making changes to one client’s will that seemed fairly minor and Allison telling me that they mattered to him and so they needed to matter to me, too. I also recall her care for a client whose case had no good remedy beyond ensuring he felt heard and that someone cared that his privacy rights had been violated.”

Rice says she found her work with students on behalf of clients seeking disability benefits to be particularly gratifying, especially those marginalized by substance abuse, homelessness, and HIV, who faced considerable challenges engaging with care. Their cases are hard to win given regulations that disallow benefits if substance use materially contributes to a claimant’s disability, and are generally avoided by private attorneys who work on contingency.

“Over the years, we’ve been able to work collaboratively with the providers and the case managers to work around those rules,” she says “And we’ve been able to get these clients some stability in terms of getting disability and Medicaid to cover insurance.”

In addition to her “inspiring” students and colleagues, Rice says she’s grateful for the support of clinic partners in the medical and care community for marginalized clients with HIV. “At Duke and UNC and a lot of other clinics we deal with, there is an embrace of really stigmatized, vulnerable patients,” she says. “We’ve worked and developed relationships with them over the years to really kind of double-, triple-, and quadruple-team it. It’s that little village that sometimes is what can take these clients over the finish line.”

A highly effective policy advocate

In 2022, Rice became the second recipient of the Legal Services Justice Award from the National LGBTQ+ Bar Association, which recognizes a practitioner whose work on behalf of low-income, marginalized members of the LGBTQ+ and HIV+ communities has advanced the cause of justice and equity with excellence and compassion. And in 2018, she received the American Bar Association’s Alexander D. Forger Award for Sustained Excellence in the Provision of HIV Legal Services and Advocacy, in recognition of both her direct service to clients and her engagement in statewide and national policy research and advocacy focused on health care access.

Among Rice’s achievements in collaboration with students: monitoring and evaluating health plans offered through the Affordable Care Act with respect to their suitability for people living with HIV and publishing an annual guide for caregivers’ use; studying insurance assistance programs offered by AIDS Drug Assistance Projects (ADAP) and lobbying North Carolina policymakers both for an expansion of health insurance cost assistance in the state’s ADAP and applying Medicaid funds to such non-medical needs as food, shelter, and transportation that can affect health; and educating stakeholders in the HIV community about control measures designed to reduce transmission and HIV criminalization. Many such initiatives have been in partnership with the North Carolina AIDS Action Network (NCAAN), which Rice and McAllaster helped found in 2010.

Rice, along with McAllaster, helped draft revisions to North Carolina’s control measures that went into effect in 2018 that reflect scientific advances in HIV treatment and removed stigmatizing language. She continues to be engaged in efforts to ensure that insurers meet their obligations to cover prophylactic medication regimens that help prevent HIV transmission.

“For everyone living with HIV in North Carolina, your life [today] was likely changed in some way or other because of Allison’s work, be it having more freedom because those criminal laws are changed, because you have insurance, or because the AIDS Drug Assistance Program is fully funded,” said Lee Storrow, the former executive director of NCAAN.

“I’ve learned from Allison that if you tackle things that seem impossible, you can master them with enough dedication and passion, and that few problems that we encounter in our work are too complex to solve, even when they seem too complex on their face.” 

—  Clinical Professor Hannah Demeritt ’04 

Rice also engaged her students in health justice policy advocacy, such as a successful 2021 effort to secure coverage for gender-affirming facial feminization surgeries for transgender individuals by Blue Cross Blue Shield of North Carolina. Along with the current clinic faculty, she is continuing to advocate for expanding coverage of gender-affirming care further in accordance with standards set by the World Professional Association of Transgender Health.

In 2020, Rice co-chaired a subcommittee of national experts who contributed recommendations for closing the justice gap as it relates to health, a part of the American Academy of Arts and Sciences “Making Justice Accessible” project. The health subcommittee’s three key recommendations involved the increased use of medical-legal partnerships to promote a broad definition of health that incorporates its social determinants, facilitate effective and efficient collaboration in solving civil justice problems, and expand sources of revenue for helping to solve health-related legal problems.

A beloved mentor, colleague, and friend

For students and colleagues alike, Rice has been a stalwart and supportive colleague, a cherished friend, and an inspiring mentor.

McAllaster highlights the many tasks Rice took on outside of the Health Justice Clinic, such as training students in the Cancer Pro Bono Project how to prepare powers of attorney and health care powers of attorney and training all students newly enrolled in the Law School’s clinics — about 100 each semester — how to use the clinical case management software.

Demerrit, who was one of Rice’s early clinical students, calls herself fortunate to have later had the opportunity to practice with her.

“I’ve learned from Allison that if you tackle things that seem impossible, you can master them with enough dedication and passion, and that few problems that we encounter in our work are too complex to solve, even when they seem too complex on their face,” says Demeritt, who also recalls the encouragement Rice gave her when, as a student, she faced her first standby guardianship hearing. “And I can’t imagine a more supportive co-worker. You can bring your ‘whole self’ to work and she brought her whole self to work. I think her authenticity is one of her great traits, too. That’s why students love her.”

Lilly describes Rice as a “calm, guiding mentor” on her clinic cases who never hesitated to offer blunt assessments of specific situations or share her outrage over outdated laws and incompetent bureaucracies. “I use things that I learned in the clinic almost every day,” she says. “Not only the importance of understanding the needs and wants of the people I represent, but everything about the Affordable Care Act. It’s knowledge that got me one of my first jobs in D.C. and that I rely on every time I need to draft comments on the law or come up with a policy solution in the health care space.”

Edward Gonzales ’22, whose clinic experience included working with Rice on securing coverage for a client’s facial feminization surgery after a sex change, lauds her career-long dedication to fighting stigma and discrimination against people living with HIV: “As a gay man at Duke Law it was incredibly inspiring getting to see how Allison’s work has positively affected countless queer men and women in North Carolina.”

“She’s a really great friend,” adds Gardner, recalling her outreach when a gas explosion in downtown Durham displaced him temporarily from his apartment, and the support she offered him and others for their goals of entering public service and public interest law.

“I saw her, not only with myself, but with so many other law students really take the time to talk through what worried them, what steps they could take, how she could be supportive. She’s much too humble to say it, but she really has made such an impact with so many students.”

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Spring 2023
Volume 42 No. 1