Medical Legal Partnership · 2018-04-10 · Engaging with providers •Trainings •Legal case...
Transcript of Medical Legal Partnership · 2018-04-10 · Engaging with providers •Trainings •Legal case...
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Rachel Arnold, JD, MPH
Laura Russell, JD
Medical Legal Partnership of Oregon
Medical Legal PartnershipBetter Health Through Legal Advocacy
Robert Trachtenberg, MS
OSHU Family Medicine at Richmond
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Based on the premise that legal problems are health problems
A patient care model that aims to improve the health and well-being of vulnerable patients and populations by integrating legal professionals into the health care setting to identify and address health-harming legal problems.
Approach involves individual patient legal interventions as well as policy interventions aimed at improving population health.
What is Medical Legal Partnership (MLP)?
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Health is largely determined by social factors
Denials of insurance, cash benefits, social security, disability
Evictions, habitability, utility shut-offs
Secure specialized education services (IEP), employment discrimination, worker rights
Veteran status, criminal/credit histories, asylum, immigration status
Restraining orders, domestic violence, custody, guardianship, conservatorship
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Benefits of MLP
• Leads to healthier patients
• Leads to more effective health care team
• Creates healthier communities
• Can lead to health care cost savings
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MLPs across the Nation
• Nearly every state in the U.S.• 155 Hospitals• 139 Health Centers• 34 Health Schools• 126 Legal Aid Agencies• 52 Law Schools• 64 Pro Bono Partners
http://medical-legalpartnership.org/brief-health-center-operations/
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MLP Mission Moment
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MLP in Oregon
First MLP in Oregon opened August 2016 (OHSU Richmond Clinic)• Initial Partnership between Richmond Clinic and Health Share of Oregon
Second MLP established in Sweet Home; partnership between Samaritan Health and Linn-Benton Legal Aid
Interest across the state: Corvallis, Eugene, Southern Oregon, various efforts in Portland metro region
Medical Legal Partnership of Oregon (MLPO)• Nonprofit organization designed to support MLPs statewide
• Focused on education, technical assistance and operational support, research and evaluation and advocacy
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Duration: 1-Year Pilot, began August 24, 2016• Now into year 2
Initial Partners: The Richmond Clinic, Health Share of Oregon, Law Students (Lewis & Clark), and Medical Students (OHSU)
Target Population: High-need patients
Research: Utilization & medical record review
Goals: Demonstrate improved patient health outcomes and reduced health care costs
Richmond Clinic Program
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MLP on-site hours: Wednesdays & Fridays from 1pm-4pm
Legal staff: 1 supervising attorney, 2 volunteer support attorneys, 1 law student
Referral process: Richmond Clinic provider/staff identify patient and refer to legal team; patients primarily referred by behavioral health
Funding: The Richmond Clinic & Health Share of Oregon (in year 1)
Program Operations
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Number of Clients Served in 1st year: 170 patients; initial goal: 50 patients
Number of legal issues: 234 distinct legal issues
Training: Trained approximately 100 health care team members on health-harming legal issues
Richmond Clinic MLP—By the Numbers
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Richmond Clinic MLP Legal Issues
2%
1%
3%3%
5%1%
6%Employment
20%Family Law
1%
19%Housing
10%Legal Status
4%
2%
13%SSI/SSDI
5%3%Bankruptcy
Cash benefits
Child Care
Criminal
Consumer Debt
Domestic Violence
Employment
Family Law
Food Stamps
Housing
Legal Status
Medicaid/Insurance
Power of Attorney
Small Claims
SSI/SSDI
Tort
Trusts/Wills
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OHSU Family Medicine Clinic
Federally Qualified Health Center
33 Providers 14,962 patients
79% of patients below 200% of poverty
60% below 100% of poverty
Richmond Clinic: A Closer Look
76%
7%
8%
6%
1%1% 1%
2016 Patient Race/Ethnicity
Non-Hispanic White
Hispanic/Latino Ethnicity
Black/African American
Asian
American Indian/Alaska Native 1
Native Hawaiian / Other PacificIslander 1
More than one race
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Engaging with providers• Trainings
• Legal case feedback
• Direct provider engagement
Provider satisfaction- feedback from providers and staff about MLP
Year 2: Greater integration• Increased integration- Social Determinants of Health Coordinator
Transforming Practice at Richmond Clinic
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Contracting • Connecting health care providers to legal providers
Planning and development of new MLPs
Provider trainings
Sharing best practices
Research
Services of MLPO