Q&A with Brooke Nelson

Brooke Nelson, LMSW, LCSW

Title:  Medical Social Worker
Organization:  Children’s Mercy Hospital and Clinics
Years in Social Work Practice: Practicing as a social worker for 6 years post Master’s Degree, total of 8 years after Bachelor’s Degree
MLP Affiliation:  Medical-Legal Partnership at Legal Aid of Western Missouri
How were you introduced to MLP?  In November 2007 by Dr. Jeffrey Colvin our Physician Champion

Q: How does working with a legal team help you do your job?

A: Working with a medical-legal partnership here at Children's Mercy has made me a more effective social worker. It allows me to connect families with an incredibly valuable resource that they were not able to access easily before this program came to our hospital.
Most of the cases I refer to the Medical-Legal Partnership have good outcomes, or the Medical-Legal Partnership is able to give the family guidance, which is very helpful for families when they cannot afford an attorney.

A lot of my families have barriers to accessing resources.  Whether they're legal resources or medical resources or community resources, they have barriers, such as transportation barriers or language barriers or educational barriers.  So I think this program has definitely allowed families to get connected to resources all in one place, like one-stop shopping.

Q: Describe the first case you referred to Medical-Legal Partnership.

A: It was a child who had a tracheostomy and some pretty complex medical needs. The boy and his family lived in Section 8 housing, and he kept being readmitted to the hospital multiple times for respiratory problems. The medical team couldn't figure out why he was being readmitted to the hospital so many times.

We found out the home was leaking and that the walls were moldy.  For months the family had been trying to get their landlord to make repairs or let the family end their lease.  But the landlord had ignored or missed all of his appointments with the family.

That's where I got involved, and I referred them to the Medical-Legal Partnership at Children's Mercy.  When the mom started working with the attorney, through Legal Aid of Western Missouri, she informed her landlord that she had a lawyer.  That very same day, the attorney was able to get the landlord to release them from their Section 8 lease.  They moved within a couple weeks.

Since that night, the boy has rarely needed to be hospitalized.

This family did not have reliable transportation, they had no way of affording an attorney, and I really feel like this program made a definite difference in their lives.   That was my first case, which allowed me to really, truly believe in this program.

Q: Since then, what have been a couple of the most memorable cases you've referred?

A: I had a family with a child who had severe asthma.  He was hospitalized, and during the hospitalization his mom went home to pick up some clothing, and there was a sign on her door that said that she had been evicted.  The lock had been changed.  She was incredibly panicked. She came back to the hospital frustrated and angry.  I immediately referred her to the medical-legal partnership, and they made a couple of phone calls and were able to revoke the eviction.  Eventually they assisted her in moving.

I had a child seen in the Urgent Care Center at Children's Mercy due to concerns of physical abuse. During my assessment with the mother I was able to determine that were some pretty significant concerns of domestic violence, dating back years. That day I was able to refer her to the Medical-Legal Partnership to assist her in obtaining a restraining order and to work on a divorce and custody arrangement.  Since then, she's relocated, a custody arrangement was made and they're all safe and protected. And all of that happened very quickly because of the severity of the abuse.

Q: What role do social workers play in the Medical-Legal Partnership at Legal Aid of Western Missouri?

A: Social workers serve a vital role in medical-legal partnerships.  We are fortunate to have a very large social work department at Children’s Mercy.  We have more than 100 social workers throughout the Children's Mercy system, and that allows us to be the main referral source for this program.  The social workers at Children’s Mercy are not only the main referral source for the program, but are also responsible for ensuring that families know about the program and have access to legal services no matter what their situation is.

During their patient evaluations doctors will ask a few questions to determine what the social needs of the family are, and then they connect the families to us.  We complete a more thorough psychosocial assessment and refer the families to the medical-legal partnership if we identify any type of legal needs as well as to other community resources as needed.