Collaborating for better care

Article author Blake Windsor, MD

Edited by Jonathan Markowitz, MD, FAAP James Stallworth, MD, FAAP

SCLS attorney Kirby Mitchell meets with an adult patient needing legal assistance.

The reality that social determinants of health need to be addressed with help beyond the medical field led to the creation in 2016 of the Medical Legal Partnership (MLP) in the Upstate between what is now Prisma Health, Furman University and South Carolina Legal Services (SCLS). A year later, a similar partnership developed in the Midlands called CHAMPS (Carolina Health Advocates Medicolegal PartnerShip), which partners with Prisma Health, the University of South Carolina School of Medicine Columbia, University of South Carolina School of Law and SCLS. Both the MLP in Greenville and CHAMPS serve vulnerable patient populations to reduce health-harming legal barriers, increase access to healthcare and improve overall community health. At its core, these services merge legal and clinical solutions to identify and address potential health risks, remove civil legal barriers, and help disadvantaged families find new pathways for success.

Greenville’s program aids pediatric and geriatric clients while CHAMPS focuses on pediatrics only. Both help families in need – free of charge – navigate the cumbersome legal and healthcare systems that so many face.

“A lot of wonderful low-income families have very serious and widely varying health-harming civil legal needs,” said Kirby Mitchell, an SCLS attorney who directs Greenville’s MLP. “These needs can and do include all kinds of issues, ranging from employment law and public benefits to education and family law. We are determined to be holistic and responsive to patient needs and meet the families where they are.”

In one example, a 1-year-old with cystic fibrosis was repeatedly admitted to the hospital with trouble breathing and lung infections. The MLP attorney successfully challenged the landlord over a mold-infested apartment, and the landlord was forced to move the family and provide new tiles and air filters. As a result, the child’s breathing improved and hospital admissions dropped.

In another case, a baby discharged from the neonatal ICU continued to need complex round-the-clock care. When Medicaid cut the approved hours, the CHAMPS attorney successfully appealed the denial – the infant received the care needed and a return stay in the hospital was prevented.

Emily Suski, LLM, JD, MSW, CHAMPS legal director “Providers have always recognized these issues,” said Emily Suski, CHAMPS legal director. “Now they have a place to go for help for patients who have been improperly denied services.”

She added, “We’re grateful for the strong support we get from our healthcare partners. We couldn’t get the effective results we do without our working together.”

Kerry Sease, MD, MPH, Medical Director of Prisma Health Accountable Communities and of the Bradshaw Institute for Community Child Health & Advocacy in the Upstate, said that as health systems move toward routine screening for increased vulnerability and the social drivers of health, collaborative relationships with local services are needed to address identified concerns.

“Such programs represent one very important collaboration,” Dr. Sease said. “I practice pediatrics at a different level now by addressing legal needs connected to the child’s health and ultimately improving the overall health of the family unit.”

The MLP in Greenville is available to all geriatric and pediatric providers at Prisma Health. To make a referral for pediatrics, click here. (To make a referral for geriatrics, click here.)

For assistance in the Midlands from CHAMPS, pediatric providers and staff can call or direct patients to call 803-777-9243 or 803-777-2278.

Greenville’s Medical Legal Partnership – the first of its kind in South Carolina – celebrated 1,000 referrals from Prisma Health providers in March 2021. In addition to SCLS, both graduate and undergraduate students from Furman University play a partnership role by observing and participating in discussions around patients’ needs, both in the exam room and the conference room.

Benefits of the program have shown: • MLP patients report lower levels of stress • MLP patients with chronic illnesses have fewer hospital admissions • Healthcare service costs decrease for high-need, high-cost patients who would typically go to the hospital • MLP patients are more likely to take their medication as instructed

• Clinical services are more frequently reimbursed by public and private payers, resulting in healthcare system savings

“We are proud of the impact this program has had on our community and the families we have helped,” said Catie Buckingham, LBSW, program director of Medical Legal Partnership with Prisma Heath and Furman University. “We hope our referring physicians and providers will share in this success, celebrate this milestone with us, and help continue the great work for many years to come.”

During the program’s first full year of operation, an MLP intern from Furman University gathers information from a family at Greenville’s Center for Developmental Services, a network of care providers (including Prisma Health) for those with special needs.