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Medical-Legal Partnerships (MLPs)

Improving the health and quality of life of children with disabilities requires not only medical intervention, but also supports related to social, educational, and environmental demands. Clinicians serving individuals with disabilities are often the first to recognize environmental factors that affect health outcomes. Yet many of the problems with the greatest impact on the health of these children are, in fact, legal problems (e.g., denial of public benefits and failure to provide an appropriate educational program). The need for legal assistance in resolving these issues has created a new interface between medicine and law, one in which advocates and attorneys have become vital members of the new interdisciplinary healthcare team through medical-legal partnerships (MLPs).

A growing number of these MLPs have made legal care part of quality, basic healthcare, and have successfully integrated advocates and attorneys into the healthcare team. The medical-legal partnership model, which began at Boston Medical Center in 1993, has been adopted by 282 healthcare institutions across the country. Advocates and attorneys in medical-legal partnerships work with healthcare professionals to provide legal care at the patient, clinic, and systemic levels. They work with clinicians to recognize and address health-harming legal needs such as poor housing conditions or a denial of services to which a patient is legally entitled. Medical-Legal Partnerships strengthen the ability of clinical practices to respond to chronic legal problems incorporating advocacy tools into the clinical model.  In addition, they work to leverage the twin expertise of health and legal professionals to improve local, state, and federal laws and regulations that impact the health of vulnerable populations.

Project HEAL (Health, Education, Advocacy, and Law) is a community-based program of the Maryland Center for Developmental Disabilities at Kennedy Krieger Institute in Baltimore. Despite the national MLP movement, Project HEAL remains the only comprehensive MLP in Maryland. Project HEAL exclusively serves children with intellectual disabilities, developmental disabilities, and mental health concerns in matters specifically related to the child’s disability (e.g., special education matters, Supplemental Security Income appeals, and simple family law matters).

Since its inception in 2005, Project HEAL advocates and attorneys have provided confidential and comprehensive advocacy and legal services to thousands of patients through a multifaceted approach. Services include representation (i.e., attorney-client relationship in a civil legal matter); limited representation (i.e., brief advice, document review, information and resources, pro bono referrals); case consultations with healthcare professionals, trainees, and educators; professional training for healthcare professionals, trainees, and educators; community trainings for consumers and families; community outreach; mentoring; and legislative advocacy.

Access to the vast knowledge of Project HEAL advocates and attorneys has been invaluable to the clinicians at Kennedy Krieger Institute and beyond. In eight years, Project HEAL attorneys have provided 1,600 case consultations to healthcare professionals. Project HEAL attorneys have also reached 1,575 healthcare professionals through more than 75 professional trainings addressing a variety of civil legal topics, including special education law, public benefits, guardianship and less restrictive alternatives to guardianship, and discipline for students with disabilities. The high demand for trainings and consultation with Project HEAL staff suggests that in an effort to meet the complex needs of their patients, healthcare professionals desire and benefit from resources on social, educational, and occupational legal issues affecting individuals with disabilities.

Through access to Project HEAL advocates and attorneys, clinicians and families can more effectively navigate the complex systems in which individuals with disabilities live, work, and learn. Between 2005 and 2013, Project HEAL attorneys have represented over 480 low-income families and children with disabilities, with 93 percent of the cases involving special education matters. The incorporation of advocacy and legal services directly into the pediatric clinical setting provides an innovative and efficient mechanism to improve outcomes for children with disabilities, especially for those families who might not otherwise have access to legal services. Legal advocacy within the clinical setting ensures that comprehensive recommendations are implemented effectively in the home, school, and community, further contributing to the overall health and improved quality of life of the children and families we serve.

This article was written by Alison Zisser, PhD, a post-doctoral fellow within the Department of Behavioral Psychology at Kennedy Krieger Institute, who volunteered more than 90 hours with Project HEAL. 

For more information about medical-legal partnerships, please visit the National Center for Medical-Legal Partnership at http://www.medical-legalpartnership.org/
For more information about Project HEAL, please call 443-923-4416.

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