Take Two Lawyers and Call Me in the Morning

A child in public housing may be able to get treatment for her asthma, but her doctor can’t force her landlord to remove the black mold that’s causing it. Likewise, a lawyer can’t provide treatment for a senior living with cystic fibrosis, but she can fight to ensure his utilities stay on so he can keep his medications refrigerated. For people in poverty, legal issues can exacerbate health problems, and health issues can trigger legal problems.

To improve health outcomes and legal outcomes, both sides need to connect health care with patients’ broader social needs. To that end, health care providers and social service providers are teaming up to address the social determinants of health and poverty – such as income, housing, education, and employment, with Medical-legal partnerships. MLPs — the topic of LAF’s latest Brownbag Roundtable—are a prime example. In addition to helping patients and communities become healthier, MLPs reduce healthcare spending for high-need, high-use patients and improve reimbursement rates for clinical services, meaning that medical providers have more resources to help more people.

“As lawyers, we’re often frustrated that despite the best legal outcomes we can accomplish, our clients are still trapped in poverty because of chronic illness. Physicians and other medical providers we’ve talked to share that same frustration—that despite their best efforts, their patients are trapped in poor health because of factors beyond their control,” Trey Daly, Director of LAF’s Public Benefits Practice Group, explained at the Brownbag Roundtable last week. “MLPs bring together those two important roles in the lives of low-income Chicagoans, to find creative solutions that deal with both their legal and medical problems.”

The Health Justice Project, LAF’s flagship MLP, is a partnership between LAF, Erie Family Health Center, and Loyola University School of Law. “The providers at Erie understand social determinants of health, which makes them good at spotting legal issues, especially when a patient maybe didn’t even know their problem was a legal issue,” says Amelia Piazza, LAF’s MLP Project Coordinator. About half of the referrals come from doctors; while the rest come from a variety of other providers, including nurses, case managers, and behavioral health specialists. “We work to identify health-harming legal issues early, before they become critical. That way we can engage in preventative lawyering to help people stabilize their situation before they seek help through traditional means, after they’ve already lost their utilities or are facing eviction,” explains Alice Setrini, LAF’s MLP Supervisory Attorney.

Another perk of these partnerships is they enable LAF to reach populations that are harder to reach through traditional avenues. Of the clients that went through LAF’s regular intake process so far this year, only 7% speak Spanish as their preferred language—far less than the actual proportion of Spanish-speaking residents of Cook County. But since a large portion of Erie patients are Spanish speakers, more than 40% of patients they’ve referred this year speak Spanish as their preferred language.

LAF also hosts MLPs with Rush’s Road Home Program, a partnership with Rush’s Center for Veterans and their Families that aims to increase patient access to Veteran-specific public benefit, and partners with Howard Brown Health Clinic and Provident Hospital in efforts to bring legal aid to the traditionally underserved HIV/AIDS community on Chicago’s south side. LAF’s newest MLP, Health Forward/Salud Adelante, launched just this year. It’s an innovative partnership is with Cook County Health and Hospitals System and the Chicago Department of Public Health, and it started taking referrals in March.

Thanks to all who joined us for this informative presentation on MLPs at LAF, and how they are closing the health justice gap, one patient of a time.

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