MLP Network Resource Library

Article on the medical-legal advocacy screening questionnaire (MASQ) developed and studied by the Family Advocates of Central Massachusetts in Worcester, MA.

Development of a Brief Questionnaire to Identify Families in Need of Legal Advocacy to Improve Child Health.  Ambulatory Pediatrics 2008; 8:266–269. David Keller, MD; Nathan Jones, MD; Judith A. Savageau, MPH; Suzanne B. Cashman, ScD

Article concludes that children’s asthma is associated with reduced parental employment among single parents and increased welfare receipt among single- and 2-parent families. These associations with children’s asthma may have implications for policy makers interested in increasing employment and decreasing welfare use.

CITATION:
The Association of Childhood Asthma with Parental Employment and Welfare Receipt. Journal of the American Medical Women’s Association.  Winter 2002.  LA Smith, JL Hatcher & R Wertheimer.

Dr. Diane Pappas, medical director of the Child Health Advocacy Program in Charlottesville, VA, reflects on lessons learned as the physician champion of a medical-legal partnership.

Article examines advocacy as part of residency training:

There is a place for advocacy training in pediatric residencies if the focus is on learning techniques that make one more effective in supporting a cause or causes.

CITATION:
Advocacy is Not a Specialty.  Archives of Pediatric and Adolescent Medicine.  2005; 159:892.  AB Bergman.

Article discusses teaching future doctors and lawyers to work together and uses the joint medical and law school course offered to Roger Williams School of Law and Brown Medical School students as an example.

Allies not Adversaries. Teaching Collaboration to the Next Generation of Doctors and Lawyers to Address Social Inequality. Journal of Health Care Law & Policy. September 2008; 11: 249-294. Elizabeth Tobin Tyler.

Study concluded that welfare recipients and applicants with chronically ill children face substantial barriers to employment, including high child health care use rates and missed work. The welfare reform reauthorization scheduled to occur later in 2002 should address
the implications of chronic child illness for parental employment.

CITATION:
Employment Barriers Among Welfare Recipients and Applicants with Chronically Ill Children.  American Journal of Public Health.   2002; 92 (9): 1453-1457.   LA Smith, D Romero, PR Wood, NS Wampler, W Chavkin & PH Wise.

ABSTRACT:

Urban children and families reported a significant burden of healthrelated social problems yet infrequent pediatric screening or referral for these problems. Of families who reported receiving referrals, a majority contacted the recommended agencies and found them helpful. This study also demonstrates the feasibility of using a computer-based questionnaire to identify health-related social problems in a routine outpatient clinic setting.

CITATION:
Families’ Health Related Social Problems and Missed Referral Opportunities.  Pediatrics. 2007; 119; e1332-e1341.  Eric Fleegler, et. al.

Paper authored by McDermott, Will & Emery, LLP and MLP | Boston which addresses a number of common questions regarding medical-legal partnership site operations, describes the principal legal considerations for each, and makes a number of general recommendations.

ABSTRACT:

This medical–legal model is taking hold in resource-poor settings or resource-poor countries, including support from a new initiative through the Soros-funded Open Society Institute. Its benefits should have ripple effects well beyond the health and well-being of individual families and children. Firstly, collaboration among lawyers and healthcare providers constituency for related efforts ranging from human rights campaigns to legislative advocacy. Secondly, identifying and dealing with violations of laws that emanate from a human rights framework will add teeth to those laws and that framework. This in turn will ultimately promote a wider embracing of the rule of law as a universal standard.

CITATION:
From Principle to Practice: Moving from Human Rights to Legal Rights to Ensure Child Health.  Arch Dis Child.   2007; 91: 100-101.  B Zuckerman, E Lawton & S Morton.

White paper on how medical-legal partnerships can utilize health care recovery dollars as a funding strategy.

Doctors are in a position to provide valuable testimony to state and national legislatures while lawyers often understand the best audience to hear their message.  As a result, medical-legal partnerships are in a unique place to organize legislative advocacy efforts.   In this article, former Boston Medical Center Chief Pediatric Resident Marie Clark shares her experience of testifying before the Massachusetts State Legislature.

ABSTRACT:

The United States is a highly mobile society, with family relocation rates double those of Great Britain and Germany. The objective of this study was to describe the impact of frequent family moves on reported rates of delay in growth or development, learning disorders, school failure and frequent behavioral problems in U.S. school-age children.

CITATION:
Impact of Family Relocation on Children's Growth, Development, School Function, and Behavior.  The Journal of the American Medical Association.  September 15, 1993; 270(11).  David Wood, MD, MPH, et. al.

In the effort to create effective policies and programs to address social disparities in health, allies outside the health sector are crucial.  Letter to the editor highlights the inclusion of attorneys as part of the public health team.

CITATION:
It Takes Lawyers to Deliver Health Care.  American Journal of Public Health.  2005; 95: 245 - 249.  ME Northridge.

Debra J. Wolf, an attorney at LegalHealth, describes disclosure requirements under the Family and Medical Leave Act (FMLA), and the American with Disabilities Act (ADA), and protection against workplace discrimination for individuals with cancer or other chronic illnesses.

CITATION:
Know Your Legal Rights in the Workplace. Coping with Cancer. May/June 2009; 23(3): 32. Debra Wolf.

ABSTRACT:

This study examined the knowledge of and application for health-related welfare program provisions among beneficiaries with children who have chronic conditions. Welfare beneficiaries with children who have chronic conditions show limited knowledge and use of program provisions, placing them at risk for penalties or benefit termination.

CITATION:
Knowledge of Welfare Reform Program Provisions Among Families of Children with Chronic Conditions.  American Journal of Public Health.  2002; 92 (2):228-230.  LA Smith, PH Wise, NS Wampler.

ABSTRACT:

Medical professionals are becoming more deeply aware that a child’s environment as much as, or even more than, biological and genetic factors can affect her health. One such environmental determinant of health is the condition of the housing where a child lives. All states and most localities have laws governing the conditions of residential property. Lawyers, by advocating proper enforcement of these laws, ensure that housing is safe and sanitary—and thus help children grow up healthy.

CITATION:
Lawyers and Doctors Partner for Healthy Housing.  Clearinghouse Review Journal of Poverty Law and Policy.  2005; 3.  M Cherayil, D Oliveira, M Sandel & E Tohn.

ABSTRACT:

Doctors and lawyers are learning to put aside their preconceived notions of each other’s profession and work together for the mutual benefit of their patients/clients. In the last five years, medical-legal partnerships in hospitals and health facilities have grown significantly throughout the country. These collaborations have proven effective in combating selective socio-economic impediments to health, relieving the anxiety that often accompanies a chronic health condition, and improving quality of life for vulnerable adults and children. This new partnership benefits patients, hospitals and both of these professions.

CITATION:
Lawyers and Doctors Working Together: A Formidable Team.  The Health Lawyer.  October 2007; 20 (1): 33-36.  Randye Retkin, Esq., Julie Brandfield, Esq., Ellen Lawton, Esq., Barry Zuckerman, MD and Deanna DeFrancesco.

LegalHealth article highlights the cost-effectiveness of medical-legal partnerships, citing the money that legal clinics can save hospitals through revenue producing services, particularly around insurance and benefits.

Article offers overview and innovations of the medical-legal partnership model.

CITATION:
Medical-Legal Partnerships: From Surgery to Prevention?  Management Information Exchange Journal.  Spring 2007; 1-7.  Ellen Lawton.

Comment in The Lancet on medical-legal partnership.

Doctors, especially those who care for patients on low incomes, are frustrated that their patients' health is adversely affected by social determinants. For those patients with an acute or chronic illness, social determinants undercut the effectiveness of the burgeoning number of drugs and other treatments. Although this problem is usually considered a public-health issue, experience in the USA and abroad suggests a new way to transform the health-care system to address these social determinants.

CITATION:
Medical-Legal Partnerships: Transforming Healthcare. The Lancet. 8 November 2008; 372(9650): 1615-1617. Zuckerman, B, Sandel, M, Lawton, E, Morton, S.

Journal of Public Health Management and Practice article highlights medical-legal partnership as an intervention that improves health and reduces disparities. An excerpt:

The Medical-Legal Partnership model developed by the Boston Medical Center shows
promise for improving care and enhancing the management of disease...The addition of
lawyers to the medical team can promote health, prevent disease, and address barriers to
the effective care and management of illness by screening patients and their families for
social problems that can affect their medical care, assisting in the resolution of specific
social problems and enhancing the effectiveness of advocacy by the entire healthcare
team.

Moving Upstream: How Interventions That Address the Social Determinant of Health Can Improve Health and Reduce Disparities. Journal of Public Health Management Practices. November 2008; 14(6) Supplement: S8-S17. David R. Williams, et. al.

Guest columnist and attorney Karen G. Luther describes the important work of the Legal Aid for Children and Families program in the Oakland County Bar Association journal, LACHES.

Article examines the benefit of coordinated advocacy for domestic violence survivors and the issues of training, consultation and confidentiality for providers.

CITATION:
Partnering Providers and Advocates for Child Wellness and Family Stability.  Clinician Quarterly.  Fall 2007; 11(4): 4-5.  Anne E. Gillespie, JD and Betsy Groves, LICSW.

ABSTRACT:

The Dickinson School of Law of the Pennsylvania State University offers several specialized in-house legal clinics. This article focuses on the outreach services of the Elder Law and Consumer Protection Clinic and the Children’s Advocacy Clinic. These programs provide opportunities for law students to obtain practical experience in a thoughtful and reflective environment and engage the students in community outreach and public policy advocacy. This article reviews the development of the two clinical programs as vital components of an engaged university and further suggest how interdisciplinary collaboration helps to guide their growth.

CITATION:
Partners in Outreach and Advocacy: Interdisciplinary Opportunities in University-Based Legal Clinics.  Journal of Higher Education Outreach and Engagement.  2006; 11(4): 163-174.   Katherine C. Pearson, Lucy Johnston-Walsh.

ABSTRACT:

In this Article, the authors, two clinical law teachers and a social worker teaching in the clinic, wrestle with some persistent questions that arise in cross professional, interdisciplinary law practice. In the past decade much writing has praised the benefits of interdisciplinary legal practice, but many sympathetic skeptics have worried about the ethical implications of lawyers working with nonlawyers, such as social workers and mental health professionals. Those worries include the difference in advocacy stances between lawyers and other helping professionals, and the mandated reporting requirements that apply to helping professionals but usually not to lawyers. This Article addresses those concerns in a direct way, using social work as an exemplar for many kinds of interdisciplinary practices.

CITATION:
Professional Ethics in Interdisciplinary Collaboratives: Zeal, Paternalism and Mandated Reporting.   Clinical Law Review.  Spring 2007; 13: 659.   Alexis Anderson, Lynn Barenberg, Paul R. Tremblay.

ABSTRACT:

This article examines the prevalence of asthma among New York City households from 10 racial/ethnic groups, and it explores whether differential exposure to potentially adverse housing and neighborhood conditions helps to mediate observed disparities. After adjusting for household size, Puerto Rican households exhibit the highest levels of asthma, followed by other Hispanic and black households. Mexican, Chinese, and Asian Indian households exhibit the lowest levels of asthma. Results from multilevel logistic regression models indicate that exposure to deteriorated housing conditions and perceptions of low social cohesion in the neighborhood significantly elevate the odds of asthma. Controlling for these conditions along with household characteristics reduces the disproportionately high levels of asthma among Puerto Rican and black households, although they remain significantly higher than the level among white households.

CITATION:
Racial/Ethnic Differences in Asthma Prevalence: The Role of Housing and Neighborhood Environments. Journal of Health and Social Behavior. June 2008; 49: 131-145. Emily Rosenbaum.

Study concludes children whose families have applied for welfare and children who are uninsured are at high risk medically and may require additional services to improve health outcomes.

CITATION:
Relationships Between Welfare Status, Health Insurance Status, and Health Care Among Children with Asthma.  American Journal of Public Health.  2002; 92 (9): 1446-1452.  PR Wood, LA Smith, D Romero, P Bradshaw, PH Wise & W Chavkin.

Article discusses need to include social deteminants in social history screening of pediatric patients.

CITATION:
Revisiting the Social History for Child Health. Pediatrics. September 2007; 120: e734-e738. Chén Kenyon, Megan Sandel, Michael Silverstein, Alefiya Shakir and Barry Zuckerman.