Legal-medical partnerships: A path to improving health outcomes
Legal advocates working with health care teams through partnerships can provide much-needed support for vulnerable families.
Legal services sometimes can be as important as medical care for improving the health of children living in poverty.
Legal advocates working with health care teams through medical-legal partnerships help provide legal services to vulnerable families, according to a new report in Health Affairs. For example, advocates could compel a landlord to remove mold, pests and other allergy triggers from the home.
Through such services, families referred to medical-legal partnerships may experience greater access to healthy housing, food, income and educational resources. Medical-legal partnerships also may enable more use of preventive services and less family stress. Approximately half of all low- to moderate-income households are estimated to have at least one unrecognized legal need and could benefit from legal advocacy.
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A recent study evaluated Child HeLP, a medical-legal partnership run through Cincinnati Children’s Hospital Medical Center primary care centers. Researchers compared referred children with matched controls who were seen concurrently but not referred.
“Medical-legal partnerships connect physicians and other medical professionals to the true `attorneys of the poor’ — legal aid advocates working to address social needs amenable to legal remedies,” they said. “We found that a referral to Child HeLP resulted in a significantly greater reduction in hospitalizations in the year after referral than what would have occurred had no referral taken place. To our knowledge, this is the first time that this type of intervention has been linked to a reduction in acute care use. This finding has implications for upstream interventions, clinical care and financing.”
Social needs intervention also has implications for clinical care delivery. The American Academy of Pediatrics recommends routine social needs screening and, when possible, implementation of integrated needs-focused programs. Medical-legal partnerships are one such integrated program, bringing the expertise of legal advocates into the clinical environment.
“We suspect that the decrease in hospitalizations identified in our analyses was driven by the ability of advocates to address acute needs or challenges and, when possible, to confront root causes of ill health,” researchers said.
Although the study focused on children, brokers and employers may want to consider how similar partnerships may be able to improve health outcomes in the workplace, as workers may face financial or family issues at home.
“Children seen in primary care whose families were referred to legal advocates had a significantly greater reduction in hospitalizations in the subsequent year than those who had not been referred,” the study concluded. “Implementing medical-legal partnerships in health-care settings could improve outcomes and bring value to pediatric care.”
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