KU Law Medical-Legal Partnership | Fall 2013
An overview of the Medical-Legal Partnership Clinic at the University of Kansas School of Law. MLP is a health care delivery model designed to integrate critical legal services into comprehensive patient care to address those health problems that may have a legal solution.
Medical-Legal Partnership Clinic at the University of Kansas School of Law There are nearly 50 million people living in poverty in the United States. In Kansas, that amounts to nearly 13% of the population, and in Wyandotte County, more than a quarter of all residents. A NETWORK OF SUPPORT Member of the National MLP Studies have shown that at any given time, low-income people have between 1-3 civil legal needs — for safe housing, access to health insurance and access to public benefits. Many of these legal problems are actually health problems. Network www.medical-legalpartnership.org WHAT IS MLP? 125 123 health centers legal aid agencies 26 36 34 hospitals The guiding principles of Medical-Legal Partnership (MLP) are that every person has the right to be healthy and have access to health care that will address the source of their health problems. u MLP is a health care delivery model that is designed to integrate critical legal services into comprehensive patient care to address those health problems that may have a legal solution. u medical schools The law school launched its MLP Clinic — the first MLP in Kansas — in January 2008. u The MLP Clinic provides free legal services to lowincome patients of the following health care partners: q The University of Kansas Medical Center, Kansas City, KS q JayDoc Free Clinic, Kansas City, KS q Health Care Access Clinic, Lawrence, KS u Law students participating in the MLP Clinic: q Provide legal representation to low-income patients. u residency law Member of the National programs schools MLP Network www.medical-legalpartnership.org Work collaboratively with health care partners to provide legal care that improves health at the patient, clinic and population levels. q Engage in interprofessional education and practice alongside medical, nursing, and pharmacy student colleagues to improve care for vulnerable patients. u Representation is focused on the following “I-HELP” priority areas in which legal services can have the greatest impact on the health of patients: q Income supports q Housing and utilities q Education and employment q Legal status (immigration) q Personal and family stability MEDICAL-LEGAL PARTNERSHIP CLINIC AT KU LAW 99 q KU Law Medical-Legal Partnership Clinic | November 2013 MLP & THE TRIPLE AIM Through its work, the MLP Clinic pursues the Triple Aim: Improving the patient experience of care, including quality & satisfaction Improving the health of populations 1 2 Reducing the per capita cost of health care 3 In addition to improving patient experience and health outcomes, the legal care the MLP Clinic provides can save money for both patients and health care providers. Successful appeals of denials of SSI and Medicaid can result in monthly payments and medical coverage for low-income patients and reimbursable expenses for health care providers. Immigrants with successful VAWA petitions or U or T Visa applications may be eligible for public benefits or work authorization for employment that provides health insurance. Patients living in stable housing free from domestic violence can focus on their health and compliance with prescribed treatment plans. Appropriate advance care planning, or guardianships when necessary, can improve care coordination and transitions for patients at the end of life. KU Law Medical-Legal Partnership Clinic | November 2013 SUCCESS STORY: MLP Clinic creates safe haven for refugee B orn and raised in the Congo, “Marianne” witnessed the murder of her son and countless war atrocities, only to suffer further abuses in a refugee camp. Things began to change when she was granted refugee status and moved to the United States. But this was just the first step on Marianne’s road to recovery. As a result of the trauma she faced in the Congo, Marianne had multiple physical disabilities and was diagnosed with both depressive and post-traumatic stress disorders. For several years, she received Medicaid insurance to cover her medical and mental health treatments and Supplemental Security Income (SSI), a program that helps individuals with a severe illness or disability. Marianne’s doctor knew her SSI benefits were quickly coming to an end and that as a refugee she would not be eligible for additional help unless she became a U.S. citizen. Normally, this is a problem that her doctor would not be able to treat. He was trained to help with Marianne’s physical recovery, not the citizenship process that would allow her to access the health care and public benefits crucial to her treatment. Fortunately, the doctor knew who to call. Marianne came to the MLP Clinic for help with her citizenship application. But there was a problem. Marianne spoke only French, and she needed to pass an English and civics test to apply for citizenship. Her physical disabilities made it impossible to attend English classes, and her mental health issues would make learning a second language nearly impossible. The MLP Clinic and the doctors treating Marianne worked together to obtain a disability waiver to request an exemption from the English and civics test. And the MLP Clinic also helped connect Marianne to a KU psychiatrist who could provide ongoing treatment for her mental health issues. Her Marianne recently participated in her naturalization ceremony, and now her SSI benefits are secure. Law students Andrew Zarda, left, and Ben McFarlane helped “Marianne” navigate the complex naturalization process through KU’s Medical-Legal Partnership Clinic. new psychiatrist completed an additional disability waiver to include with her citizenship application. In July 2013, Marianne became a citizen. With a safe and permanent home in the United States and secure SSI and Medicaid benefits, she will be able to keep food on her table and a roof over her head and continue to access high-quality medical and mental health treatment at KU to help on her road to recovery. CONNECT WITH KU’S MLP Katie Cronin, Director firstname.lastname@example.org | 913-588-3731 Delp Pavilion G060, Mailstop 4010 3901 Rainbow Blvd. Kansas City, KS 66160 www.law.ku.edu/mlpclinic On our website, learn more about the services we provide to our clients and the educational benefits of this program. KU Law Medical-Legal Partnership Clinic | November 2013 TESTIMONIAL: An indispensable model for medicine The patients we see in the Family Medicine clinic at the University of Kansas Medical Center have needs that go beyond the exam room and stem from their home environments and neighborhoods. So often, these needs have to be met before they can focus on the medical interventions we prescribe. In fact, these needs — related to financial stability, safety, housing, immigration, disability — have to be addressed before our medical therapies even have a chance to work. Many of the patients I treat are elderly or have been diagnosed with terminal illnesses. Over the last two years, the lawyers and law students at the MLP Clinic have helped my patients with advance care planning — drafting wills and establishing advanced directives and powers of attorney. For terminally ill patients, this means knowing that their voices will be heard when and if they cannot advocate for themselves. For their families, advanced care planning allows them to focus on the immediate needs of their loved ones, all the while knowing that they can express the wishes of their loved ones if needed. I cannot imagine practicing medicine anymore without legal services available on-site at the hospital to provide this kind of care to my patients. The MLP Clinic has also opened up a great learning opportunity for students. I am part of the Interprofessional Teaching Clinic that brings medicine, nursing, pharmacy, and health professions students together to participate in shared learning at the point of care. Students see patients as a team, and when they identify I-HELP issues, they consult with law students. In addition, law students now join “Studio Pop” a few times each semester. Studio Pop provides protected time for all of our students to reflect and I cannot imagine practicing medicine anymore without legal services available on-site at the hospital. JANA K. ZAUDKE, MD, MA Assistant Professor & Director of Family Medicine Inpatient Service University of Kansas Medical Center debrief on their weekly interactions with patients and brainstorm how they can improve patient care through their collaborative efforts. The student teams also take their services to the community, doing in-home visits with patients who have complex medical and legal issues. During Studio Pop, students gain insight into each other’s training and profession and respect for one another’s expertise. We learn how to talk with one another without using the jargon associated with each professional culture. In doing this, we have a chance to reach out to one another as human beings and professionals, all for the sake of a common goal — our patients. THANK YOU to our generous funding partners KU Law Medical-Legal Partnership Clinic | November 2013