An Introduction to Medical Legal Partnerships
The work that legal service organizations do for our clients goes beyond the courtroom. We improve living conditions, increase income, and keep utilities connected. We have a direct impact on the health of the people we help. Medical professionals are our natural allies, since their patients come to them looking for relief from medical conditions that may have social or legal causes.
Medical Legal Partnerships began in 1993 when doctors at Boston Medical Center traced cases of chronic pediatric asthma to housing that was making children sick. They reached out to civil legal aid, who helped improve the asthma by improving housing for the families. The most common Medical Legal Partnership model has an attorney on site at a medical center who works with medical team members. Medical Legal Partnerships prioritize legal needs according to the IHELP method. We concentrate on Income, Housing, Employment, Legal Status and Personal Stability because these are areas where our legal work can be most effective in improving health. However, attorneys will often focus on one at-risk population, or on one or two legal issues in a population, in order to control the number of clients. The ultimate goal is integration into a medical system. Legal partners want medical staff to be able to identify a legal need and feel comfortable calling the attorney to help.
North Penn Legal Service’s Medical Legal Project is located at Lehigh Valley Health Network at 17th and Chew Streets in Allentown, the old Allentown Hospital. The location is ideal because the hospital serves a large local, low-income population. The hospital has a strong Community Health program, so many patients already seek help at the hospital when they have nonmedical needs like SNAP applications and utility shutoffs. Many of our clients are new to legal services. Others are repeat legal service clients who are relieved that they can walk to our office instead of taking a bus to Bethlehem, or that they can visit us after a medical appointment they already have. We encourage existing clients to drop by to ask questions. That policy makes for hectic Monday mornings, but it allows us to provide holistic legal help for a variety of legal issues and sometimes provide information that prevents a legal issue from becoming acute.
Our Medical Legal Project has one full-time attorney and one part-time paralegal. We receive referrals in-person, via email, and through EPIC, the hospital’s electronic medical database. In our first year we handled 267 cases covering 38 different legal categories. In our second year, we are narrowing our focus to helping clients with housing and income related legal issues. We hope to have a stronger effect on health by assisting clients with these most basic needs. LVHN has hired a Community Health Worker, whose focus is on housing needs and makes home visits to assess health and housing needs. The CWA and MLP cross-refer patients/clients to each other, so that someone facing a housing crisis has the support they need, in the home or in the courtroom.
We have worked with clients facing eviction, foreclosure, termination of benefits, utility shut offs and family law problems. As an example, we were referred a patient, who was being treated for several conditions, including high blood pressure that was difficult to manage. Marta was facing eviction from a rental unit. She did not pay the rent because there were serious repairs that the landlord refused to make. These included a wall that fell down, roof damage causing ceilings to leak, faulty electrical wires, and other safety issues.
The property manager filed an eviction when the rent was two months behind. They had by that time received our advocate’s letter, but did not make repairs until our advocate spoke with them about the seriousness of the situation. In the third month they made the repairs requested. By the time of the court hearing, the client had found a new place to live. The court in the eviction case decided that the client only owed one month’s rent, because the needed repairs made the property partially uninhabitable for a significant period of time.
Eviction itself can be a cause of poverty, because having the eviction on record may make it more difficult to find clean and decent rental housing.*
The parties agreed to terminate the lease and the client was able to move to a new place, prepared with a self-help manual for tenants. Marta was able to use the rent money she had privately escrowed for the costs of security deposit and first month’s rent in her new place. She came into the office after the move and shared that she had been to her doctor and was very pleased because her blood pressure had finally stabilized.
Medical Legal Partnerships are a good way for attorneys to help clients in a holistic manner where they are. Medical staff help by identifying issues, but also by providing needed letters or medical information that can help manifest legal solutions. At our Medical Legal Project, we are working to help people in ways that will improve their health most effectively. We are also integrating ourselves more thoroughly into the hospital where we practice. We believe that patient lives and health will improve because of our actions.
A special thank you to Lehigh Valley Health Network for partnering with us for our Medical Legal Partnership in Allentown.