Justice Changes Everything: Medical-Legal Partnerships for Holistic Health

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Maria suffered severe abuse from her partner and escaped to the street with her toddler. She ended up in the emergency room and her child went into foster care.

A year later, when Maria was stabilized and she was reunited with her child, the child’s father filed a custody action. Maria’s primary care physician referred Maria to Legal Aid staff attorney, Luke Grundman.

Grundman is available on site at Hennepin County Medical Centers’ (HCMC) Whittier Clinic through Legal Aid’s first Medical-Legal Partnership (MLP), established in 2013, thanks to the foresight and financial assistance of HCMC. He represented Maria in family court. The referee awarded Maria sole legal and physical custody and child support, with conditioned parenting time for the father.

An MLP serves as a pipeline between two broad networks. Clinic staff knows what kind of help their patients need in order to become healthy and stay that way. Legal Aid attorneys can draw on a wealth of information from colleagues to seek solutions.

The success of Legal Aid’s partnership with Whittier Clinic led to a second partnership in St. Cloud. CentraCare Clinic welcomed Legal Aid on site in 2015, with the MLP funded by a Blue Cross/Blue Shield grant. Legal Aid’s initial goal at CentraCare was to see at least five referrals in the first three months, but they exceeded that goal in the first month. In 2016, a St. Thomas fellowship enabled Legal Aid’s St. Cloud office to expand the CentraCare partnership to four of their rural clinics.

“Holistic care is the joy of this job,” says staff attorney Heidi Hovis, who heads up the CentraCare MLP. “As lawyers, our goal is to solve legal problems. But as MLP partners, our goal is to improve our clients’ health. The patient’s problem may not be legally complex, but for the patient it’s an insurmountable barrier.”

Meanwhile, the Whittier Clinic in Minneapolis continues to fine-tune the MLP connection. Doctors can now make referrals directly from the exam room via the clinic’s electronic system.

“I get a lot of referrals from doctors with just a word or two to describe the person’s legal issues,” says Grundman. “I figure things out on a basic level, identify the legal need and decide what to do about it.”

Grundman receives 25-35 referrals per month. He can’t possibly handle all of the cases that come his way, so part of the job is deciding where his services make the most sense. Those patients he can’t help himself, he refers to Legal Aid’s downtown office.

“When I look at a case, I check to see if there’s a specific health benefit to be gained,” he says. “If you look closely at any of our clients, you can make a connection between the legal service we provide and their health, but sometimes it’s a much clearer path.”

David is a Whittier patient with a chronic condition that causes severe back pain. His doctor prescribed two-hour hot tub soaks several times a week – nearly impossible without a bathtub in the home. David submitted a request to Minneapolis Public Housing Authority (MPHA) over a year ago asking to be moved to a unit with a bathtub. His request was denied. When Grundman helped David submit a new request with a supportive letter from a nurse practitioner at the clinic, the transfer was granted within a week.

In this case, a lawyer was exactly what the doctor ordered.

 

Pat Schmatz

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