- Theresa Brabson, Esq, Legal Director, Legal Clinic for the Disabled, Philadelphia, PA
- Emily Jenkins, Esq, Staff Attorney, Legal Clinic for the Disabled, Philadelphia, PA
- Linda Peyton, Esq, Executive Director, Legal Clinic for the Disabled, Philadelphia, PA
Background: The Legal Clinic for the Disabled, a civil legal aid agency, has four Medical-Legal Partnerships (MLP) across seven diverse sites in low-income communities and developed best practices to implement and sustain MLPs. LCD’s partnership with St. Christopher’s Hospital for Children (SCHC) is a case example of MLP’s effectiveness. SCHC is in an epicenter of poverty where 66% of the children in the surrounding zip code live in poverty. SCHC and LCD established an MLP in 2011. The MLP embeds an attorney in SCHC’s primary care practice to address social determinants of health (SDoH) including housing and habitability, food insecurity, immigration, public benefits, domestic violence, and family law. Attorneys and healthcare personnel combine law and medicine to mitigate negative SDoH. Objective: Systematize screening in an outpatient practice to proactively identify legal issues and connect families with resources or immediate legal intervention to mitigate negative SDoH. Methods: Families received a 14-item SDoH screener during the visit. Providers reviewed the screeners, gave resources and/or referred to an onsite attorney. The attorney regularly trains healthcare staff on screening and substantive legal issues. Screening tools were collected and results compiled. Results: 39833 families were screened for unmet legal needs from August 2011 through December 2019. The number of screens increased each year (year 1=895, year 9=7591). Overall, 40% (10480) self-identified at least one unmet need. From 2011 to 2019, the rate of self-reported unmet need decreased (year 1= 74%, year 9 = 19%) while the service rate (legal assistance and/or resources) increased (year 1 = 27%, year 9 = 63%). Conclusions: The MLP successfully implemented SDoH screening in a busy outpatient practice. With this holistic approach, each team member’s role best utilizes time and capabilities. With efficient screening, triage, and referrals, many families have their issues addressed during the visit.
- Understand the innovative MLP model to address social determinants of health that are legal in nature.
- Identify common issues for low-income clients that are especially ripe for MLP intervention.
- Identify approaches to implementing and sustaining an MLP or similar interdisciplinary partnership to address social determinants of health.