Saint Luke’s Hospital establishes medical-legal partnership to meet more patient needs
Lawyers now a vital component of the health care team, help patients deal with legal problems that directly or indirectly harm their health
What if the problem is that her apartment is infested with mold to a degree that it does not meet housing code standards? Is there anything that doctors and the hospital can do about that?
At Saint Luke’s Hospital of Kansas City the answer to that question is now yes, thanks to an innovative Medical-Legal Partnership between the hospital and Legal Aid of Western Missouri. Established with a $150,000 grant awarded by the Homer McWilliams Memorial Hospital Trust and distributed by the Saint Luke’s Hospital Foundation, the partnership is dealing with a wide variety of issues that impact patient well-being.
“Our indigent patients often are uninsured or very under-insured, and are dealing with a lot of societal issues that affect their health,” said Director of Risk Management Bonnie Johnson, a lawyer and registered nurse. “If they’re worried about having a place to sleep tonight, getting a meal today, or getting abused when they go home, those worries can divert them from taking their asthma medicine. If we can eliminate some of those issues from their plate, then they will be better able to focus on their health care.”
Saint Luke’s Medical-Legal Partnership (MLP) is modeled after similar programs that have succeeded in improving the health of indigent patients around the country since 1993. The partnerships integrate lawyers as a vital component of the health care team, to help patients deal with legal problems that directly or indirectly harm their health. The concept has earned the backing of groups such as the American Hospital Association, American Bar Association, American Medical Association and American Academy of Pediatrics.
Saint Luke’s medical-legal partner is Legal Aid of Western Missouri. Legal Aid began its first MLP in Kansas City in 2007. Since that time, the program has expanded to other hospitals and clinics, but this is Legal Aid’s first partnership to involve legal staff working full-time at a medical site. Saint Luke’s has contracted with Legal Aid for the full-time, on-site services of attorney Amber Cutler and Ben Summers, a paralegal.
“We’re trying to catch legal and social issues before they reach crisis level,” Cutler said. “We’re trying to come up with creative solutions.”
The Saint Luke’s Medical-Legal Partnership is based on a model known as I-HELP. I stands for income and insurance issues; H is for housing issues; E is for ensuring patient safety in domestic situations; L is for legal status; and P is for power of attorney and guardianship.
“We do a lot of housing counseling,”
In cases of asthmatic patients living in mold-infested homes, an attorney or paralegal in the medical-legal partnership can take steps to see that patient dwellings are brought up to housing code standards for mold remediation.
Another major issue for indigent patients is obtaining health coverage through programs such as Medicaid. “If we can help patients obtain Medicaid coverage, they’re more likely to receive regular care rather than just come to the emergency room when they get sick,” Cutler said. “That’s going to improve the patient’s health.”
Cutler said the partnership takes a holistic view toward patients. “For example, we may agree to represent a disabled individual with an appeal for Social Security benefits. During the course of representation, we may also assist with an appeal for Medicaid health insurance. If we are successful, the patient gains an income source to secure stable housing and health insurance to obtain ongoing treatment improving his or her overall health. If we see a patient who’s been referred to us by the social worker for one legal issue, we do a screening to see if there are other legal needs. On average, low–income Americans have two to three unmet legal needs.”
Patients usually are referred to the program by hospital social workers, but the program’s eyes and ears extend to virtually everyone at Saint Luke’s. “We’re telling the hospitalists and the other staff if they see a legal issue or a quasi-legal issue, they should refer it to the social worker, and the social worker will refer it to us,” Cutler said.
Cutler estimates that the partnership could work on 500 legal issues involving Saint Luke’s patients this year. And if need be, she and paralegal Summers can draw on the expertise of other Legal Aid attorneys, as well as private attorneys who donate their services to Legal Aid.
The medical-legal partnership program is now limited to Saint Luke’s Hospital near the Country Club Plaza, but it could be expanded to other Saint Luke’s facilities if demand warrants it.
Mark Litzler, executive director of the Saint Luke’s Hospital Foundation, said he expects the Medical-Legal Partnership to receive additional funding from the Homer McWilliams Trust to operate through 2013. At that point, depending on the success of the partnership, the hospital could choose to absorb the program and continue operating it indefinitely.
“I think there’s sufficient demand and that the results will speak for themselves, and observers will see that this is a valuable program that warrants being sustained,” Litzler said. “The notion of taking care of uninsured patients is something that affects Saint Luke’s and all the hospitals in the community. It takes novel approaches to figure out new ways to help solve that problem. It’s not going away.”
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Saint Luke's Health System based in Kansas City, Mo., consists of 11 area hospitals in northwest Missouri and eastern Kansas, and several primary and specialty care practices. We provide a range of inpatient, outpatient and home care services.