What Are Medical Legal Partnerships

In rural areas, it can be difficult to identify patients with legal and social needs that may impact their health and well-being. Healthcare systems that implement MLPs should provide healthcare providers and employees with training on these services, including best practices for connecting patients to MLP services. 6 Cohen 2010 – Cohen E, Fullerton DF, Retkin R, et al. Medical-legal partnership: Working with lawyers to identify and addressing health inequalities. Journal of General Internal Medicine. 2010;25(Suppl 2):136-139. A: Absolutely! The National Center for Medical-Legal Partnership hosts webinars on a variety of topics. You can also network with colleagues at MLP meetings at national meetings and participate in learning networks that we share in our newsletter. We also host a biannual Medical-Legal Partnership Summit, which brings together hundreds of executives from the health, legal and public health sectors and is the largest training and meeting on forensic pathology in the country. 19 Pettignano 2011* – Pettignano R, Caley SB, Bliss LR.

Medico-legal partnership: impact on sickle cell patients. Paediatrics. 2011;128(6):e1482-e1488. 9 Sege 2015* – Sege R, Preer G, Morton SJ et al. Medical-Legal Strategies to Improve Infant Health Care: A Randomized Trial. Paediatrics. 2015;136(1):97-106. We want every healthcare organization in the United States to use legal services as a standard part of how they respond to social needs.

The National Centre for Forensic Partnership leads education, research and technical support efforts to achieve this goal. The Washington Medical-Legal Partnership is an example of a long-standing MLP; Since its establishment in 200834, it has provided direct legal assistance to 2,200 people and trained 2,000 health care and social workers in legal representation. Medical-Legal Partnership Boston is another MLP that provides training, coaching and technical support to interested organizations.35 UF Health Senior Medical-Legal Partnership, a partnership between the University of Florida Health and Three Rivers Legal Services, Inc., provides free, confidential legal advice to low-income elderly patients in 17 counties in north-central Florida.36 Q: How does an MLP differ when a doctor, nurse or social worker refers a patient to a civil legal aid agency for help with a legal problem? Medico-legal partnerships (MLPs) integrate legal services into healthcare facilities such as hospitals, health services, and behavioral health care facilities1. Health care providers refer patients to local legal assistance, which may include legal aid lawyers, pro bono lawyers, as well as law professors and students.3 Patients are usually screened for legal in waiting rooms;4, 5, 6 Electronic health records (EHRs) may also ask providers to look for legal requirements7. As needs are identified, legal service providers work with health care providers and patients to address concerns related to housing, food assistance and supplies, and social services. Social workers, who are often on site, can also provide counselling.4, 5, 6 Some MLPs focus on specific patient populations or conditions, such as low-income or pregnant women, or asthma patients1. MLPs can be funded by hospitals or health systems, health foundations, federal legal aid, law schools, businesses, or state governments.3 Rising Sun is a government-qualified health centre that serves a diverse, low-income immigrant and refugee population. The Rising Sun MLP`s location in Philadelphia`s Olney neighborhood allows CLS to reach a deeply underserved community.

The highly immigrant and limited English-speaking patient population faces a number of legal issues, including difficulties accessing health care. CLS advocates have helped many Rising Sun patients access Medicaid so they can seek treatment for serious illnesses such as epilepsy and cancer. The AHEAD Medical-Legal Partnership Patient and Community Health Survey provides a core set of questions that assess the impact of legal interventions on a patient`s perception of health and the quality of services received from an MLP. The survey is designed to be broadly applicable to different intervention models and details specific administrative instructions for pre- and post-survey investigations. 1 Regenstein 2018* – Regenstein M, Trott J, Williamson A, Theiss J. Address the social determinants of health through medical-legal partnerships. Health service. 2018;37(3):378-385.

12 Ryan 2012a* – Ryan AM, Kutob RM, Suther E, Hansen M, Sandel M. Pilot study on the impact of medico-legal partnership services on patients` perceived stress and well-being. Journal of Health Care for the Poor and Underserved. 2012;23(4):1536-1546. Early intervention to resolve legal issues contributes to improved health outcomes.4, 8, 11, 13, 14, 15, including mental health.4, 16 MLPs can improve health in the short and long term, in part by reducing stress and improving adherence to required medical treatment.4 MLPs can also improve patient well-being and increase the appropriate use of health services.8 MLPs have been shown to improve the health and well-being of children and families.11, 13 In children with asthma, MLPs can reduce emergency departments and hospitalizations.17 MLP participants report reduced stress11, 12 and improved well-being.11, 12 Q: Are there examples of training, screening tools or letters of intent that I can use as part of my medical-legal partnership? 34 WA MLP – Washington Medical-Legal Partnership (WA MLP). Work towards better health through legal advocacy. MLPs have been shown to increase patient convenience when using legal services10 and reduce the need for litigation by resolving legal issues through administrative or informal processes.16 MLPs have been shown to improve access to stable and affordable housing10 for populations such as veterans16, families of children with sickle cell disease19 and families of children with asthma17. By screening for energy insecurity8,10 and issuing certificates of medical need, MLPs can prevent utility closures and increase energy security, especially for families with vulnerable children.20 A study in Buffalo, New York, of an MLP serving cancer patients receiving palliative care suggests that MLPs could also receive emergency funding from the Low Income Home Energy Assistance Program (LIHEAP) to reduce heating costs.21 MLPs can also improve quality of life by providing legal support for patients` efforts to reduce domestic environmental risks such as pests, mold and other allergens.22, 23 A: The forensic partnership approach can be customized in a variety of settings. Medico-legal partnerships currently exist in 450 health organizations, including 163 HRSA-funded health centers, 37 pediatric hospitals, 29 VA medical centers, and a growing number of facilities serving older people. 4 Speldewinde 2015 – Speldewinde CA, Parsons I. Medico-Legal Partnerships: The Role of Mental Health Service Providers and Judicial Authorities in Developing a Coordinated Approach to Meeting the Legal Needs of Mental Health Clients in Regional and Rural Settings. Health in rural and remote areas.

2015;15(4):1-11. 11 Roses Valverde 2018* – Rosen Valverde JN, Backstrand J, Hills L, Tanuos H. Effects of medical-legal partnerships on parents` perceived stress: A pilot study. Behavioral medicine. June 2018. Medico-Legal Partnerships (MLPs) address legal issues that affect health, such as lack of heating, instability of shelters or food insecurity, by integrating legal experts into health teams. The MLP model ensures that lawyers can resolve issues before they become crises by working closely with healthcare teams. Together, these partners provide holistic medical and legal care to help children and families thrive. In an MLP, health systems, hospitals and clinics work with lawyers to screen patients for health-related social and legal needs, engage with legal counsel as needed, communicate and share data, and jointly set priorities that reflect the partnership`s mission. As of January 2019, there were medical-legal partnerships (MLPs) in 333 health organizations in 46 states30. The National Center for Medical-Legal Partnership (NCMLP) provides research and technical support services to organizations interested in establishing MLPs and provides a manual of guidelines on the evaluation of MLP30, 31. The NCMLP and the American Bar Association each maintain lists of MLP partners across the country.32, 33 Research shows that MLPs can have a positive impact on DSS control.

For example, MLPs have been shown to help improve housing conditions for asthma patients, improve mental health outcomes, and reduce health care costs. There is some evidence that MLPs, including those located in rural areas, have the potential to improve health outcomes and well-being by reducing health inequalities and improving the overall health system. Medico-legal partnerships have been found to reduce patient stress and improve engagement in health care and other social support services. Dr. Lisa Puglisi is an Assistant Professor of Medicine, Primary Care Physician and Director of the Transitions Clinic New Haven at Yale Primary Care Center, a program specializing in providing primary care and social services to individuals returning to the community after incarceration.