Achieving better health outcomes with a little legal help
In the 1990s, Boston Medical Center began noticing pediatric patients being treated for asthma were not showing signs of improvement after treatment. The healthcare team learned that children were returning to homes overtaken by mold and other infestations where landlords had disregarded health codes. Since the team knew they could not provide a prescription to treat the patient’s housing conditions, they reached out to seek legal assistance for the patients, and thus began the nation’s first ever medical-legal partnership.
LMH Health implemented a similar program in 2016 in conjunction with the University of Kansas School of Law, creating the KU School of Law Medical-Legal Partnership at LMH Health. The program, which is supported in part by gifts to the LMH Health Foundation in 2022, provides free legal services to qualified patients who have legal needs affecting their health. Since the KU MLP opened, the medical-legal partnership has received more than 1,500 referrals involving 1,900 legal needs for patients. Referrals come from providers and staff at any of LMH Health’s facilities who have spotted a health-harming legal need.
Juliann Morland DaVee
Juliann Morland DaVee, managing attorney for the KU School of Law Medical-Legal Partnership at LMH Health, said it’s not just the work her and legal interns have done on many different cases, but the success stories that continue to remind her and the team why the work they do is incredibly important.
“We had a recent case with a possible eviction. We learned a patient and their family were being evicted from a home that had no heat and no hot water,” Morland DaVee said. “Alongside this, they were also in the process of applying for disability. The medical-legal partnership team was able to step in and work with the landlord to allow them several more months of time.”
She said because they were able to get back and several months of future rental assistance, the family did not have to worry about eviction or what was owed. Quality of life and housing is important and the team worked to ensure there would be heat and hot water restored to the property as well.
“You don’t have to explain how it affects patient outcomes when they are going back to a home with no heat in the depths of winter and no hot water in a pandemic,” Morland DaVee said. “By addressing those legal issues, it all connects and ties back to improved patient care. This is an incredible example of how the medical-legal partnership can, and does, help patients right here in Lawrence.”
Lumen Mulligan, Earl B. Shurtz Research Professor and supervisor for the KU School of Law Medical-Legal Partnership at LMH Health, said that medical problems are often, in part, legal problems.
“Patient health outcomes can often improve if patients have a protection from abuse order, access to safe housing, can appeal a denial of food stamp benefits, can access medical-leave benefits or expunge outdated court records that are currently preventing employment,” he said. “Medical-legal partnerships help healthcare providers diagnose and cure these problems for patients.”
Mulligan said that above all, the KU MLP ensures that patients lead healthier lives. This may mean that they help by preventing utility companies from disconnecting power so patients can be discharged into a safe home, appealing a denial of Medicaid Qualified Medicare Beneficiary Plans, obtaining Medicaid coverage, ensuring patients have sufficient food upon discharge, seeking proper guardians for patients in need of stewardship and helping expunge now stale minor criminal records.
“As these examples demonstrate, having medical teams and legal teams working closely together through this partnership allows us to more thoroughly address a patient’s whole health,” said Morland DaVee. “Also, by providing access to legal services within a healthcare setting, it often makes it possible for patients to see their doctor and lawyer in the same visit. This is a crucial benefit for many who would not otherwise have access to services to address their legal needs, transportation to get to a legal appointment, or for some, even a safe phone number or address to otherwise communicate their legal needs to an attorney.”
Sheryle D’Amico, LMH Health senior vice president of strategic integration, said this partnership has been incredibly invaluable to LMH Health.
“For patients in need, the program helps ‘close the gap’ by offering legal services that ultimately support the pursuit of the best possible clinical outcome for that patient,” she said. “The feedback from providers and patients has been simply amazing.”
The partnership between the KU School of Law and LMH Health not only benefits a patient’s health, but the community and the hospital as well. For example, by helping patients get insurance benefits, the medical-legal partnership can improve a patient’s access to healthcare, coverage of care and reduce uncompensated care for the hospital.
“When we address these legal/social determinants of health, the MLP is often able to prevent future health issues and even help reduce emergency room and hospital visits,” Morland DaVee said. Both she and Mulligan agreed that patients can often leave the hospital sooner when they are returning to a safe home and work environment that the MLP helped to procure.
COVID-19 has had an effect on many aspects of business and care over the past few months. Morland DaVee said thanks to technology and the strong support of the staff at the KU School of Law and LMH Health, the KU MLP has continued to accept referrals and provide legal assistance without interruption.
“We continue to get referrals on guardianships, benefits and insurance questions, protection orders, advance directive needs, housing concerns, and many other types of legal needs” she said. “In addition, the medical-legal partnership is uniquely positioned to be able to educate both providers and patients on a broader level regarding legal issues members in our community are facing due to the COVID-19 pandemic.”
Morland DaVee said her parents have been veterinarians for over 50 years so she grew up surrounded by the practice of medicine and the power and hope that it can offer patients and communities.
“I actually attended the KU Law School because of its strong international law program, which would build on my previous degrees,” she said. “However, halfway through law school I interned with the medical-legal partnership program and have been practicing law in medical-legal partnerships ever since. Medical-legal partnerships are a perfect nexus that allow me to combine my respect for medicine with the practice of law. Also, I love to serve others and love to help solve problems, and I’m privileged to get to do both for a living.”
She said it is humbling as an attorney to know the legal work she gets to do every day through the medical-legal partnership improves health outcomes for her patients. Not only is Morland DaVee honored to be able to serve her patient-clients’ legal needs, but that she gets to walk alongside them and provide support through the very difficult legal and medical situations they are facing.
“I truly enjoy working with providers to find solutions to help improve patients’ health,” she said. “I am proud to be partnered with such an amazing healthcare team made up of some of the most dedicated and compassionate people that I have had the privilege to meet.”
Morland DaVee emphasized that addressing unmet legal needs is essential to a person’s health. She said KU Law and LMH Health’s collaboration through the medical-legal partnership has been crucial to improving many patient health outcomes.
“I am extremely thankful to the administrations at LMH Health and KU Law, the care coordination department and the KU MLP advisory committee, who work together to provide the underlying support that allows the KU School of Law Medical-Legal Partnership at LMH Health to serve patients,” Morland DaVee said. “I am blessed to be part of the KU MLP and am grateful to those that saw the need for this program and made sure it became a reality. I am proud to be partnered with a health system that understands the need to treat the whole person and I am thankful to LMH Health for allowing the KU MLP to work alongside them in their mission to do just that.”
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As part of LMH Health’s commitment to better serve all populations in our community, we are increasing our focus on health equity. Our goal is to directly address social determinants of health through education and community partnerships. But we need your help!
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