Health and wellness attorney Deborah J. Rotenberg was raised by healthcare providers.
"My father's a physician, and my mother's a nurse," Rotenberg explained. "So I'm very comfortable in hospitals; I'm comfortable with gore and guts. That stuff doesn't bother me."
Earning a living as a lawyer wasn't something that initially appealed to Rotenberg, and her first real jobs after completing her undergraduate degree were in politics, working for members of the state legislature. In fact, it wasn't until she started speaking regularly with constituents - while working at a state senator's district office - that the notion of a career in the law first took root.
"I handled anything someone called about. It was my job to answer their questions, and I loved it. I loved helping people," Rotenberg recalled. "But some problems needed to be referred to a lawyer, and I didn't like that feeling. I didn't like not being able to help them all the way, so I decided I needed to be a lawyer."
Rotenberg graduated from UC Hastings College of Law in 2005 and began work soon after in the public health section at the Office of Legislative Counsel. From there, she moved on to a boutique firm that specialized in healthcare regulatory compliance and later worked for nearly five years at the Planned Parenthood Affiliates of California.
"It was a wonderful job," Rotenberg said. "And I really fell in love with clinics and reproductive health care providers."
But it was also during that time when she recognized there were many attorneys who work with medical groups and hospitals, but very few who represent the many primary care community clinics across the state.
"They provide culturally competent and comprehensive primary care services to individuals who often have a hard time accessing healthcare for a number of reasons," Rotenberg explained. "Community clinics are required to see patients regardless of income or insurance status, and most community clinics are required to provide or at least facilitate the provision of the full scope of primary care services. It's a one-stop shop model, which makes them different from your doctor's office or a hospital. They're just critical to our healthcare delivery in California, and yet there aren't a lot of lawyers who specialize in serving that type of provider."
Rotenberg struck out on her own in 2017, looking to provide legal assistance specifically for these community clinics, assisting them with everything from licensing to permitting, advising on compliance, providing risk assessments as well as helping them enroll with MediCal, Medicare and other payer programs.
Rotenberg soon found, however, that these community clinics also needed help with things like business formation advice and tax issues - areas of focus pretty far outside her practice specialty. She did, however, know an attorney who could answer those questions with terrific expertise - Gabriel S. García. The two were introduced in 2017, and Rotenberg said she soon found herself relying more and more on García's extensive corporate and tax law knowledge.
"I started calling him so frequently that I think he got the sense that he either needed to go into business with me or change his number," Rotenberg said with a laugh. "Fortunately, he went into business with me."
The duo launched Sacramento-based DJR Garcia, APC in January 2021 and now assist more than 200 community health clinics across the state with everything from licensure and enrollment to regulatory compliance, business transactions, tax planning and reproductive health law.
García graduated from UC Berkeley School of Law in 2004, and he completed an LLM in Taxation at Georgetown before clerking at the U.S. Tax Court for Judge Maurice Foley. He later handled Silicon Valley startup issues and mergers and acquisitions for Jones Day before moving into the healthcare space. And much of the work he's doing today at DJR Garcia lands outside of what might be considered traditional health and wellness law.
"We have clients on the central coast, for example, that did an affordable housing, medical clinic, dental clinic mixed-use property that was donated by their county," García explained. "That was exceptionally interesting and moved far beyond just pure medical services. Giving legal advice there was more like what you'd see in a traditional real estate transaction, and I've really enjoyed doing that type of stuff in my career. And to be able to do it for some health centers that we represent was great."
Home today to four attorneys, DJR Garcia also represents more than 100 clinics across the state that provide abortion and family planning services, according to Rotenberg, who said the U.S. Supreme Court's recent ruling in Dobbs v. Jackson Women's Health Organization has raised new liability concerns for many of those clients.
"There are millions of women in this country now that don't have access to abortion providers in their home state, and now to access those services, they must travel outside of their state," Rotenberg explained. "Given the way some of these laws are written in states where abortion is banned or heavily restricted, there's the potential that it could impose some liability for providers here in California, depending on exactly how services are rendered to those out-of-state patients."
Rotenberg said she's been busy working with clinic clients who provide abortion services on comprehensive liability risk assessment, trying to make sure they are fully informed, but she noted there aren't always black-and-white answers in this environment of fast-moving legal change.
"Obviously, providers who work for community clinics - and abortion providers in particular - they very much want to help. It's in their nature to help," Rotenberg said. "Being told they have to limit their ability to help someone who is very much in need of assistance is not information they want to hear."
Rotenberg noted that some states' laws prohibiting or restricting access to abortion impose criminal liability for anybody who assists someone from that state with an abortion.
"I know there are concerted efforts to make those laws extend beyond those states and into other states where abortion is perfectly legal - like here in California," she added. "So helping providers navigate those risks has been a new challenge since Dobbs."
Inverness attorney Beth H. Parker, who serves as outside general counsel for a number of the community clinics DJR Garcia now represents, described Rotenberg as "an absolutely spectacular regulatory attorney."
"She cares deeply about the patients we serve and ensuring they receive the same access to health care that patients who have private insurance often take for granted," Parker said. "And she also feels passionately about the healthcare providers, who've chosen to serve low income and more vulnerable patients. ... And knowing they want to provide the best patient service possible, she - as opposed to other lawyers, who sometimes only tell you all the reasons you can't do something - she definitely has more of a yes perspective and is also always trying to come up with creative solutions."