It’s the difference between treating a symptom or delivering a cure for a root cause — especially when it comes to the overall health of a community.
When the Legal Aid Society of Cleveland formed its first Medical-Legal Partnership (MLP) with MetroHealth back in 2003 it was the first in the State of Ohio and only the fourth in the nation.
The idea was to embed attorneys directly into a health care system to serve patients with legal issues so they could then help medical professionals and their patients address issues that have a direct impact on patient health, including unsafe housing, employment concerns or challenges accessing public benefits.
Based on the premise that individual’s health is determined by a lot more than excellent health care, (which we have in abundance in Northeast Ohio) it’s also shaped by environment, where someone lives, works, plays and learns. Indeed, it’s estimated by the National Center for Medical Legal Partnership that 60% of a person’s health is determined by other social factors, including income, health insurance, housing, education, employment, legal status and personal and family security. Other sources estimate that environment can shape up to 80% of a person’s health.
Low-income and other vulnerable communities have less access to basic needs and opportunities because of the ways in which deep-rooted, inequitable systems and practices shape their environments. In turn, people in these communities do not have an equal opportunity to thrive or reach their optimal health.
Obviously, it wasn’t long before this innovative model of community care proved so successful at providing positive outcomes that it was duplicated in various forms across the nation. Today, MLPs exist in 450 health organizations across 49 states and Washington D.C. And the Legal Aid Society of Cleveland’s MLP program continues to spread its wings to new hospitals and new demographics.
“We’re adding our fifth attorney at MetroHealth who will focus on helping patients and their family members with opioid use disorder,” says Katie Feldman, managing attorney of the Health and Opportunity Practice Group of the Legal Aid Society of Cleveland. “We have also been able to expand our practice from just MetroHealth’s pediatrics department at their main campus to several of MetroHealth’s Community Health Centers as well as to other health care organizations like the UH Rainbow Ahuja Center for Women & Children and Cleveland Clinic Pediatrics.”
As of press time, Attorney Lauren Hamilton was already working on-site and accepting referrals at MetroHealth, says Feldman.
While Legal Aid’s MLP is adding new staff, the patient populations served by the MLP have also been expanding, says Feldman.
“When we started our first MLP back in 2003, we were focused on pediatrics at just one location,” she says. “But now we are serving other populations like seniors, pregnant patients and others who get their health care at certain community health centers.”
“Our MLP evolved from being mostly a pediatric focused population, but Metro saw a need beyond pediatrics,” says Kathryn Plummer, director of proposals and grants for the MetroHealth Foundation. “This allowed us to pilot into different populations, including Spanish speaking communities, because Metro serves a very large Hispanic population.”
“But we are still very much involved with pediatrics and have been focusing recently on households with younger patients from birth through one-year old,” adds Feldman. “We’ve been increasing that, in addition to all the other populations we serve.”
While all of its offices are physically located in Cuyahoga County, the MLP’s reach extends to serve patients from Lake, Geauga, Ashtabula and Lorain counties.
So how do patients and clients get free legal help?
First of all, you have to qualify as being lower income based on a formula that factors in household income with household size. Usually, a person starts the income evaluation process through Legal Aid’s intake system.
“Most referrals come through physicians and social workers from within the health care system — those are the two largest populations providing referrals,” says Karen Cook, director of Healthy Families and Thriving Communities within MetroHealth’s Institute for H.O.P.E. (an acronym that stands for Health, Opportunity, Partnership and Empowerment). “They are in a position where they are engaging directly with the patient and understand their circumstances. The Legal Aid Society has done a great job of educating our staff here about what might be a legal issue to look out for and then help the patient make a connection with an attorney.”
That spirit of cooperation is a cornerstone of the MLP model. The medical side of the partnership helps navigate people to social services and organizations, while the legal side of the partnership
helps specifically with legal issues.
While the MLP does not handle criminal matters, it does help patients handle very fundamental necessities like housing, access to education, employment and issues related to income.
“We have helped people facing evictions or other housing conditions that are impacting their family’s or child’s health, like lead abatement,” says Feldman. “We will get involved when a landlord isn’t properly maintaining their property. We will also get involved in cases where a family is seeking special education services from a school district, or with people who have lost or been denied important benefits, like SNAP (the USDA Supplemental Nutrition Assistance Program).”
“The MLP works so well and has lasted so long because of the close alignment of the MetroHealth and Legal Aid missions,” adds Feldman, explaining the relationship between medical and legal components. “We have a shared commitment to not only serve our community, but to partner with our community. Both organizations work together on ensuring the sustainability of the MLP and on identifying areas of joint advocacy that impact the health of our patient-clients.”
Founded in 1905, the Legal Aid Society of Cleveland, has built a reputation for serving the underserved in our area as advocates for people who have low incomes, but still need access to legal representation. With a mission to secure justice, equity and access for people with low incomes, Legal Aid uses the power of the law to improve safety and health, promote education and economic security, secure stable and decent housing and improve accountability and accessibility of government and justice systems.
By solving fundamental problems for those with low incomes, the Legal Aid Society of Cleveland removes barriers to opportunity and helps people achieve greater stability.
