On August 14, the Institute for Child Success convened a briefing for congressional staff on Pay for Success, how it can be used to scale successful early childhood programs, and about pending legislation in the field. The briefing was convened in partnership with Representatives Young's and Delaney’s offices, and both Harvard's SIB Lab and Third Sector Capital Partners joined us to add their invaluable perspectives. About 40 staffers in attendance represented a balanced mix of offices representing both Republicans and Democrats, from both the House and the Senate, as well as some non-congressional groups and agencies.
By Keller Anne Ruble, Associate Director of Policy Research
Healthcare delivery systems are facing multifaceted and complex challenges: seeking to improve public health while reducing costs. One recent shift in how hospitals and health centers address the “both-and” is through Medical Legal Partnerships. Medical Legal Partnerships (MLPs) offer a unique value: rather than a medical professional treating a patient’s symptoms alone, doctors scan for any environmental causes of health care concerns and “prescribe” a legal-aid attorney to leverage legal services to address those root causes. In a new paper, we explore the power and possibility of MLPs to improve child and family well-being.
MLPs represent a cross-disciplinary approach to integrated healthcare, proven to improve child and family health and economic outcomes. At MLPs, civil ‘legal aid’ lawyers embed into the health care institution. Hundreds of hospitals and health centers across the country are employing the MLP approach it goes beyond treating symptoms to address root contextual causes that limit child and family health and well-being. Through a holistic approach, MLPs foster immediate and long-term health while removing barriers to supporting healthy child development and healthy families.
Why are doctors concerned with what goes on outside the exam room? Healthcare access and genetics are only a small component of overall health. It is estimated that the majority of what influences our overall health are the social, environmental, and behavioral factors we experience, often referred to as our Social Determinants of Health. These are the conditions and contexts in which children grow and develop that influence their overall health and quality of life. The Social Determinants of Health (SDOH) have a bigger impact on population health than do genes and access to medical care and can be categorized into several key domains:
Remarkably, one key factor missing from these SDOH is the law. The legal system plays a strong role in overall health, and MLPs fill an important gap in the legal system for patients. Dr. Laura Lividitis notes, “Low-income American families typically have 2 to 3 unmet legal needs. Virtually all of these needs are directly or proximally connected to health status.”
America today is experiencing a “Justice Gap”: there is only one legal aid attorney for every 6,415 persons in poverty, many of whom do not have the means to advocate for themselves when legal issues occur. Families may not know their rights in certain situations; beyond immediate health care delivery, the MLP approach represents, “a starting point for thinking about the role of law in creating health systems and environments that are premised on-and can help create-health equity.” The American Academy of Pediatrics recommends MLP intervention as one avenue to respond to a child’s SDOH needs.
Because of their tremendous value to patient and population health, Medical Legal Partnerships are spreading quickly throughout the country. Want to learn more about MLPs and how their intervention supports young child development? Download our new paper, Medical-Legal Partnerships and Child Development, which outlines the structure, services, and outcomes associated with MLPs, explores the growth and utilization of MLPs in South Carolina to inform other efforts, and identifies opportunities to strengthen MLP service delivery for improved public health.