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  • Criminalization

Court fines are financial punishments assessed by a judge upon conviction, and court fees are charges that defendants must pay to recoup justice system costs. For people who have the ability to pay, these charges may be a minor inconvenience; however, for those who don’t have the means, they can represent significant burdens that trigger more serious consequences such as exacerbating economic inequality, prolonged involvement with the criminal justice system, driver’s license suspension, voting restrictions, and damaged credit. Furthermore, people with legal debt are more likely to have other types of debt as well, particularly medical debt. Black and Hispanic adults, low-income adults, and people with less education have been shown to be disproportionately affected by legal expenses.

This letter can be used to advocate for your patient who is at risk of having court fines or fees imposed, and whose physical or mental health would be adversely impacted as a result. If your patient has an upcoming court date, it is likely that they will be mandated to pay court costs, fines, and/or fees. If your patient has not hired an attorney, they have more than likely been appointed an attorney from the Public Defender office. The patient should give this letter to the attorney. 

Example language to use in the letter:

Please list the medical and mental health conditions that you believe incarceration would exacerbate. It is reasonable to list the patient’s entire medical history here. For example:

  • “hypertension, chronic kidney disease, head and neck cancer, and depression.”
  • “post-traumatic stress disorder, bipolar disorder, type II diabetes, rheumatoid arthritis.”

Please describe any improvements the patient has made to their overall health or life. This is your opportunity to describe your patient’s strengths.For example:

  • “(Patient name) has recently done a remarkable job of “adhering to appointments and medications, exercising, and eating healthier.”
  • “(Patient name) has recently done a remarkable job of “taking medications, caring for family members, and remaining in recovery from substance use.”


  1. Preventing Court Fines Letter Template

Next steps

Instruct your patient to take this letter to his/her/their attorney, who will then determine whether and how to present it to the judge. 

In our experience, these letters are most effective when:

  • The letter is directly submitted to the judge in a one-on-one meeting or, if this is not possible,
  • The letter is placed in the patient’s file for review by the judge during court