One Doctor's Vision
Not every illness has a biological cause. A family forced to choose between food and heat in the winter months cannot be treated with a prescription or a vaccination. Healthcare providers at hospitals and health centers serving low-income patients face this dilemma every day. It is often these unmet legal needs that repeatedly force families into their doctor’s office, and it is often legal barriers that prevent them from getting healthy. Yet traditional healthcare is ill equipped to treat these underlying causes of poor health.
In 1993, Boston Medical Center’s then Chief of Pediatrics Dr. Barry Zuckerman was frustrated sending sick children home to apartments with mold and without heat, only to see them return again and again not having responded to medical treatments. Dr. Zuckerman recognized that a lawyer could help patients navigate the complex legal systems that hold solutions to many social determinants of health—income supports for food insecure families, utility shut-off protection during cold winter months, and mold removal from the home of asthmatic children. Together, a doctor and a lawyer had the best chance of keeping patients healthy. He founded Medical-Legal Partnership | Boston, the first medical-legal partnership in the country.
There is a history of patient and policy level collaboration between medicine, law and public health. Legal services were part of care for HIV / AIDS patients as early as the 1980s, and tobacco laws are an example of policies enacted with a specific public health focus. Yet, the medical-legal partnership model is unique because it bridges the patient to population level interventions and adds a level of institutional systems change, while integrating health and legal services as a means to longer-term, more effective solutions to health problems.
The National Center is Formed
Following an article in The New York Times and amidst growing demand from institutions interested in developing medical-legal partnerships in their communities, the National Center for Medical-Legal Partnership was founded in 2006 at Boston Medical Center. Between 2006-2012, NCMLP helped 250 healthcare institutions develop MLPs.
By 2011, the growth of the MLP movement demanded a new approach. NCMLP, which had been primarily engaged in individual technical assistance to healthcare and legal institutions, transitioned its focus to: (1) Promoting policy change at the institutional, local & national level; (2) Building the evidence base for medical-legal partnership; and, (3) Growing & supporting the MLP Network to achieve sustainability.
In July 2012, a Transitional Board of Directors moved NCMLP to the Department of Health Policy at the George Washington University School of Public Health and Health Services. The Department of Health Policy has been at the forefront of innovative, cross-cutting health policy research and education for 15 years, and provides an ideal home for NCMLP to scale MLP nationally.
National Reach and Endorsements
Today, more than 275 hospitals and health centers include MLP and legal care as a standard part of patient healthcare and serve more than 54,000 people every year. What started as an intervention for children has expanded to help the elderly, veterans, pregnant women and people with chronic illnesses, and has proven effective in a variety of settings from rural health centers to urban hospitals. MLP improves patient health, saves healthcare institutions money and improves the clinical workforce.
MLP has been recognized by the American Bar Association, the American Medical Association, the American Academy of Pediatrics, the Agency for Healthcare Research and Quality, and The White House Champions of Change. The model has been featured in dozens of news articles, including The New York Times, The Washington Post, The Los Angeles Times and The Boston Globe.
I found out then I finally had someone who was going to help me. When I found out that they were handling it, when they were doing the talking, I was more relaxed. I could sleep better and deal with other things that were going on.
Melissa King, Chicago MLPC client