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Targeting Legal Needs to Improve Health

Essential hospitals serve communities challenged by several social determinants of health. For many patients and families, social and economic needs also can have a legal component. Medical-legal partnerships (MLP) integrate legal service providers into health care teams to meet these needs.

Patients commonly seek assistance with:

  • government program benefits (e.g., Medicaid, Social Security income, and the Supplemental Nutrition Assistance Program);
  • evictions and housing court;
  • utility shut-offs;
  • employment disputes; and
  • immigration status challenges.

Evidence shows health is attributed 50 percent to social and economic factors, leaving the 71 percent of low-income households experiencing at least one civil legal problem in 2017 at a higher risk for negative effects on mental, emotional, or physical health. Thus, medical-legal partnerships are powerful resources for essential hospitals, which care for the nation’s vulnerable populations.

About 350 hospitals and health centers across 46 states operate a medical-legal partnership, including association member NYC Health + Hospitals (NYC H+H), in New York, the country’s largest municipal health system. The health system partners with LegalHealth, a division of the New York Legal Assistance Group dedicated to combating social and economic injustice for vulnerable populations.

LegalHealth supports patients at onsite no-cost legal clinics and trains health system staff to recognize legal issues. In 2018, LegalHealth handled more than 9,800 new matters and 7,200 patients referred by health care professionals from hospitals across New York City.

The most prevalent legal issues facing patients at NYC H+H include immigration, public benefits, and housing. An integrated process in the health system’s electronic appointment system easily refers patients to one of 15 legal clinics. Several legal clinics also have a hotline to schedule an appointment and offer self-refer or walk-in appointments for patients with immigration issues.

The partnership between NYC H+H and LegalHealth offers a rich case study for other essential hospitals to learn about leadership buy-in, culture change, training, staffing, financial return on investment, and data reporting related to integrating a medical-legal partnership into the health system.

To learn more about medical-legal partnerships, read A System-Level Approach to Addressing Health-Harming Legal and Social Needs: A Case Study of the NYC Health + Hospitals and LegalHealth Medical-Legal Partnership. For more information about essential hospitals’ work to target social determinants of health, visit essentialcommunities.org.

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About the Author

Hannah Lambalot is a program assistant at America's Essential Hospitals.

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