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Legal Aid launches new medical-legal partnership with Summa Health
TRACEY BLAIR
Legal News Reporter
Published: July 30, 2021
Four years ago, Shannon Perkins became frustrated after meeting with a patient who was physically unable to leave an abusive environment.
“I called all around town and none of the agencies could help due to her disabilities,” said Perkins, director of behavioral science/associate director of the Summa Family Medicine Residency Program. “That really inspired me and my partners to try to do something about the big gap we have in care.”
That was the impetus for a new medical-legal partnership between Summa Family Medicine Center and Community Legal Aid, a non-profit law firm serving the legal needs of low-income individuals in central and northeast Ohio. The Women’s Health Center at Summa also has a similar partnership with Legal Aid.
Medical-legal partnerships, commonly called MLPs, combine the expertise of healthcare providers and legal advocates to address underlying social issues that contribute to poor health outcomes.
The Family Medicine Center partnership – which was launched in March – is a pilot program made possible by a $50,000 grant from Summa Women’s Health Philanthropy Circle.
“We did a patient screening process in February and there was a huge need,” Perkins said. “Forty percent of our patients had problems that could be helped with Legal Aid.”
The medical piece
The MLP will allow the center to help patients with health-harming legal needs like eviction, unsafe housing and domestic violence.
“Medical-legal partnerships are a proven way to positively impact the physical and mental health of families struggling with poverty,” Perkins said. “In our clinic, the big thing is pending evictions. We’ve had patients who were evicted from their housing and then ended up in the hospital because they had an exacerbation of a chronic health problem. Obviously, eviction is going to significantly impact a person’s health.
“We referred a man who lives in a boarding house who reported unsafe conditions in his housing. There was mold and cockroaches, and his landlord would not take any action to remove those things from his housing situation. Lead paint is another huge problem in our area, and a lot of our patients have chronic lung disease, diabetes, asthma or COPD. Living in environments like that can exacerbate health problems and also lead to hospitalizations. Interpersonal violence is another common situation where medical-legal partnerships are helpful to address.”
MLPS can also help children who are supposed to be getting an accommodation due to a disability at school but aren’t. Lack of access to food – such as when someone has their EBT cards terminated – is something else such programs can help with, Perkins added.
“We’re hoping we’ll be able to see lower hospitalizations and improvements in mental health and stress,” she said.
Perkins said although she’s a psychologist, she sometimes is unable to help clients with the tools she has.
“A lot of patients we take care of here struggle with poverty,” she said. “They’re struggling to get by. They don’t have the same access to healthcare, to transportation, and all those types of things.
“We do a pretty good job identifying the barriers our patients face. We ask a lot of questions. Do you have the money to pay for the prescription? Do you have a car to get the prescription? We find out what the barriers are, but sometimes we can’t do anything about the barriers. What can I do as a psychologist if a patient is being evicted from their home? There’s nothing I can do, so it’s wonderful now to have a lawyer on our team who can do something about it. Sometimes just advising a patient of their rights can go a long way. Other times they may have to take legal action in some way.”
The legal side
Marie Curry, managing attorney for the Health, Education, Advocacy, and Law (HEAL) project at Community Legal Aid, coordinates the necessary legal services when a patient is referred. These services can be a lifeline for clients who may not have realized that there are legal solutions to the problems that are contributing to their health challenges.
Besides MLPs, HEAL addresses larger, systemic problems in Summit County and across the state.
For instance, HEAL has been working with the Ohio Department of Medicaid, Summit County Public Health and The Pathways Community HUB Institute in Mansfield since 2018 to reduce Summit County’s unusually high infant mortality numbers.
According to Summa Health statistics, Akron zip codes 44320 and 44307 have some of the highest infant mortality rates in the state, where babies are more likely to die before their first birthday than in any other region.
“One of the things we know from research is spending any time at all in a shelter when you’re pregnant is associated with poor birth and infant vitality outcomes,” Curry said. “When we see a family or a mom at risk of homelessness – maybe she lost her place and is doubling up, or maybe she lost her job and her landlord is giving her a hard time.”
Black infant mortality numbers are especially high.
“From the research, even when you control for other factors, being a Black woman in our society adds a layer of environmental toxicness, so that if you’re living with that kind of stress all the time it creates an unhealthy environment for growing a baby and a level of stress post pregnancy as well. All of those things have some correlation w lower birth outcomes. It’s not so much babies are coming home and dying at home. The larger categorization of deaths are babies that never got out of the hospital. A big percentage are born premature. The interventions need to happen before birth. Early in pregnancy; before pregnancy.
“One of the biggest things to remember is that stress creates an environment that links to prematurity. Your body is just gunning the engine all the time when you’re stressed like that.”
Curry said MLPs can help foster a healthy pregnancy by reducing stress.
“You are able to stay housed, maintain food stamps or Medicaid or childcare dollars or we help you get your stimulus check or unemployment check that is getting hung up, or we help extract you from an abusive relationship,” she said.
Curry said she expects the need to grow for MLPs in the near future due to the main issues that have been laid bare by the pandemic – food security and housing security.
“We’re really worried about evictions skyrocketing, foreclosures skyrocketing,” she said. “But also medical care – if I get COVID is there paid leave for me to stay home for two days to get better?”
Meanwhile, Perkins said her team is working on how to parlay the one-year grant into a permanent program.
“My main goal is to make it sustainable and make it something that sticks around,” Perkins said. “Down the road, I envision having an attorney or paralegal on site at times for patients with the highest level of need and more challenges in their lives.”