2019-20 TOW #17: Medical-legal partnership

Next week’s topic is the Medical –Legal Partnership model, a collaboration to allow patients/families to access legal support. We are fortunate to have our own MLP in Washington originally formed as a partnership which included Harborview, Odessa Brown and local attorneys. The current Washington MLP directors are our own amazing Drs. Ben Danielson and Brian Johnston and SCH director Annette Quayle. Scott Crain JD was the first attorney with MLP in WA and now supports statewide advocacy through NW Justice Project.

Materials for this week:

Take-home points regarding Medical-Legal Partnerships (MLP):

  1. 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.
  2. 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).
  3. 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.
  4. 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.
  5. 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!

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