Integrated Legal-Medical care at health centers

The National Center for Medical-Legal Partnership has a New issue brief on medical-legal partnership and health centers. Marsha Regenstein, PhD, Joel Teitelbaum, JD, LLM, Jessica Sharac, MSc, MPH, and Ei Phyu authored the piece “Medical-Legal Partnership and Health Centers: Addressing Patients’ Health-Harming Civil Legal Needs as Part of Primary Care.” You can download it as a PDF here.

The brief explores the link between social & economic issues — like income, housing, education, employment, legal status, and personal/family stability– and how civil legal aid and health care can combine to provide positive impact on these issues.

Civil legal aid becomes an ‘enabling services’ that allows people who have come in as medical patients to a health care facility to get the appropriate government services and support. Legal aid supplements and reinforces the medical care, by addressing root issues that have led to medical problems. Legal help in hospital help patients to deal with health-harming civil legal needs, like those around housing and utilities.

Medical-legal partnerships train clinicians and health care staff to know enough about the law to spot when a patient has a potential legal issue. Then this health care worker can hand the patient off to an in-house legal worker (who may be part-time or permanently at the facility) to get the legal support for their problem. Sometime the lawyer comes into the medical exam room, sometimes they may schedule a follow up off site.

The majority of patients seen at health centers are living at or below the poverty level, and because of this, they have unmet legal needs — related to housing, public benefits, education — that negatively impact their health. Medical-legal partnership is an approach to health that integrates the expertise of health care, public health and legal professionals and staff to address and prevent these health-harming civil legal needs for patients, clinics and populations. There are currently 60 FQHCs and Look-A-Like health centers that operate medical-legal partnerships with civil legal aid agencies across the United States. In the fall of 2014, HRSA released guidance, which clarified that civil legal aid services may be included in the range of enabling services that health centers may choose to provide to meet the primary care needs of their patients.

This issue brief explores the medical-legal partnership approach to health in the context of health centers. It is intended to help health centers understand the benefits – to patients and to their institutions – of partnerships with civil legal aid agencies, and to introduce additional resources that can help health centers implement these programs.