Reducing the Justice Gap and Improving Health through Medical–Legal Partnerships

Keene, Danya E.; Murillo, Sascha; Benfer, Emily A.; Rosenthal, Alice; Fenick, Ada M.

doi:10.1080/01947648.2020.1816233

Cited by 9 publications

(8 citation statements)

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“…Moreover, improvements to interpreter services in the outpatient settings can produce more efficacious and efficient patient care, as well as reduce malpractice claims [ 51 ]. Additional legal and social services have demonstrated reductions in overall system costs [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Diverse community leaders’ perspectives about quality primary healthcare and healthcare measurement: qualitative community-based participatory research

Culhane‐Pera

Pergament

Kasouaher

et al. 2021

Int J Equity Health

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Background Healthcare quality measurements in the United States illustrate disparities by racial/ethnic group, socio-economic class, and geographic location. Redressing healthcare inequities, including measurement of and reimbursement for healthcare quality, requires partnering with communities historically excluded from decision-making. Quality healthcare is measured according to insurers, professional organizations and government agencies, with little input from diverse communities. This community-based participatory research study aimed to amplify the voices of community leaders from seven diverse urban communities in Minneapolis-Saint Paul Minnesota, view quality healthcare and financial reimbursement based on quality metric scores. Methods A Community Engagement Team consisting of one community member from each of seven urban communities —Black/African American, Lesbian-Gay-Bisexual-Transgender-Queer-Two Spirit, Hmong, Latino/a/x, Native American, Somali, and White—and two community-based researchers conducted listening sessions with 20 community leaders about quality primary healthcare. Transcripts were inductively analyzed and major themes were identified. Results Listening sessions produced three major themes, with recommended actions for primary care clinics. #1: Quality Clinics Utilize Structures and Processes that Support Healthcare Equity. #2: Quality Clinics Offer Effective Relationships, Education, and Health Promotion. #3: Funding Based on Current Quality Measures Perpetuates Health Inequities. Conclusion Community leaders identified ideal characteristics of quality primary healthcare, most of which are not currently measured. They expressed concern that linking clinic payment with quality metrics without considering social and structural determinants of health perpetuates social injustice in healthcare.

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Section: Discussionmentioning

confidence: 99%

Diverse community leaders’ perspectives about quality primary healthcare and healthcare measurement: qualitative community-based participatory research

Culhane‐Pera

Pergament

Kasouaher

et al. 2021

Int J Equity Health

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“…As such, there is a need for interventions like MLPs, which can simultaneously address multiple social needs. However, the difference between civil legal aid needs and civil legal aid service provision, referred to as the "justice gap," persists due to inadequate funding for civil legal aid, including MLPs [31,32]. Several national organizations, including the American Bar Association, the American Academy of Pediatrics, the American Medical Association, and the Agency for Healthcare Research and Quality, support and promote the MLP model [33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Better Together: A Descriptive Analysis of a Medical-Legal Partnership in Western North Carolina

Cené¹,

Buys²,

Clark³

et al. 2022

North Carolina Medical Journal

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background The medical-legal partnership (MLP) is an innovative and proven-effective approach to addressing health-harming social needs that have legal remedies (e.g., housing concerns, intimate partner violence). Yet, few MLPs exist within outpatient primary care practices and in rural settings. methods We describe the impact of an MLP between Pisgah Legal Services and the Mountain Area Health Education Center, which serves rural North Carolina counties, over a 24-month period. results Overall, 629 cases were referred to the MLP. Three hundred seventy cases were opened and investigated by a lawyer. Three hundred sixty-four cases were closed (i.e., a resolution was reached), yielding 808 outcomes, with an average of 2.2 outcomes per case. Domestic violence/family law and housing were the main socio-legal concerns addressed by the MLP. Eighty-six (24%) of cases included at least 1 representation outcome; the success rate in representation cases was 90%. limitations We did not examine the impact of the MLP on patient health outcomes, nor did we have comparative outcomes data for similar individuals with unmet social needs but who did not receive MLP services. conclusions The MLP was successful in helping to address multiple social needs faced by patients that contribute to worse health status and outcomes. Monetary benefits to patients were $309,902 plus an additional $174,733 from tax returns and the Earned Income Tax Credit. The MLP lawyer provided education and training to support clinicians, learners, and community organizations. These data highlight the benefits of collaboration between health professionals and lawyers in advancing equity by addressing unmet social needs.

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“…Moreover, improvements to interpreter services in the outpatient settings can produce more e cacious and e cient patient care, as well as reduce malpractice claims [49]. Additional legal and social services have demonstrated reductions in overall system costs [50,51].…”

Section: Discussionmentioning

confidence: 99%

Diverse Community Leaders’ Perspectives About Quality Primary Healthcare and Healthcare Measurement: Qualitative Community-based Participatory Research

Culhane‐Pera

Pergament²,

Kasouaher

et al. 2021

Preprint

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BackgroundHealthcare quality measurements in the United States illustrate disparities by racial/ethnic group, socio-economic class, and geographic location. Redressing healthcare inequities, including measurement of and reimbursement for healthcare quality, requires partnering with communities historically excluded from decision-making. Quality healthcare is measured according to insurers, professional organizations and government agencies, with little input from diverse communities. This community-based participatory research study aimed to amplify the voices of community leaders from seven diverse urban communities in Minneapolis-Saint Paul Minnesota, view quality healthcare and financial reimbursement based on quality metric scores.MethodsA Community Engagement Team consisting of one community member from each of seven urban communities —Black/African American, Lesbian-Gay-Bisexual-Transgender-Queer-Two Spirit, Hmong, Latino/a/x, Native American, Somali, and White—and two community-based researchers conducted listening sessions with 20 community leaders about quality primary healthcare. Transcripts were inductively analyzed and major themes were identified.ResultsListening sessions produced three major themes, with recommended actions for primary care clinics. #1: Quality Clinics Utilize Structures and Processes that Support Healthcare Equity #2: Quality Clinics Offer Effective Relationships, Education, and Health Promotion#3: Funding Based on Current Quality Measures Perpetuates Health InequitiesConclusionCommunity leaders identified ideal characteristics of quality primary healthcare, most of which are not currently measured. They expressed concern that linking clinic payment with quality metrics without considering social and structural determinants of health perpetuates social injustice in healthcare.

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Reducing the Justice Gap and Improving Health through Medical–Legal Partnerships

Cited by 9 publications

References 0 publications

Diverse community leaders’ perspectives about quality primary healthcare and healthcare measurement: qualitative community-based participatory research

Diverse community leaders’ perspectives about quality primary healthcare and healthcare measurement: qualitative community-based participatory research

Better Together: A Descriptive Analysis of a Medical-Legal Partnership in Western North Carolina

Diverse Community Leaders’ Perspectives About Quality Primary Healthcare and Healthcare Measurement: Qualitative Community-based Participatory Research

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