Materials for this week:
- Case discussion developed by Scott Crain JD
- Medical-Legal Partnership in Primary Care – Health Affairs 2010
- Outcomes of Medical-Legal Partnership to Help Children – Journal of Health Care for the Poor and Underserved, 2013
- Washington MLP – see Resources for letter templates available
Take-home points regarding Medical-Legal Partnerships (MLP):
- History of the MLP model: The MLP model was first started at Boston Medical Center over 20 years ago and has been gaining in reach and availability. Hundreds of formal MLPs now exist in health care settings. Research has demonstrated their effectiveness in improving outcomes in primary care.
- Why we need MLPs: Given that more than 20% of children live in poverty in the US and close to 40% live in near poverty, pediatricians can best address the needs of the whole child by engaging with multi-disciplinary teams including legal professionals and social work to advocate for our patients. While we cannot know the intricacies of benefit eligibility, we can screen for needs and refer. Approximately 50% of all low to moderate- income households are estimated to have at least one unmet legal need (e.g., public benefit denial or unsafe housing, access to education services, etc).
- Use a screening tool to assess need: Use the I-HELP mnemonic (Income, Housing, Education/ Employment, Legal Status, and Personal and Family Stability and Safety) to help screen for needs.
- MLPs can address social determinants of health: In one study, families referred to an MLP showed increased access to health care, food, and income resources; two- thirds reported improved child health and well- being. An important note about legal services provided by the Washington MLP: it does not handle malpractice, criminal issues, personal injury or other fee-generating cases, or other civil legal cases where a referral for services is readily available elsewhere. They do not handle immigration-related legal issues, but do work closely with and refer to the Northwest Immigrant Rights Project.
- Residents can be instrumental in MLPs: One study documented that residents made over 40% of the referrals in a pediatric continuity clinic. Patients of residents at Seattle Children’s are eligible to have referral to the MLP, in addition to the partner clinics involved.
Here’s to advocating and teaching others to advocate!