Medical-Legal Partnership Projects enhance patient care

Patricia Nogelo, clinical social worker, YNHCH; Alice Rosenthal; and Ada Fenick, MD, consult on a patient’s legal needs that might require MLPP intervention.

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In 2013, Yale New Haven Hospital partnered with the state-wide Center for Children’s Advocacy, a nonprofit that protects the legal rights of children suffering from abuse, neglect or lack of access to critical services.

That opened the door for a Medical-Legal Partnership Project (MLPP) office at Yale New Haven Children’s Hospital that has enhanced pediatric care and had long-lasting impacts on patients and providers. 

The MLPP brings together representatives from health care, public health and legal services to uncover and resolve legal issues affecting children’s health. Common concerns include housing and utility issues, disability and basic needs benefits, Medicaid and HUSKY disputes and education rights. The MLPP also addresses broader issues, including transportation and poor housing conditions that discriminate against the region’s most vulnerable populations. 

“A person’s health is determined by many things, including housing and access to education, benefits and food,” said Ada Fenick, MD, MLPP medical site director and a YNHCH Pediatric Primary Care Center pediatrician.

In the past four years, the MLPP has received more than 1,200 referrals, said Alice Rosenthal, the MLPP attorney onsite at the hospital, who works closely with YNHCH physicians, other healthcare providers and social services staff. Of the referrals, 6 percent required full MLPP legal representation on the family’s behalf, and nearly 20 percent involved in-depth consultations in which Rosenthal worked directly with patients and their providers to intervene and resolve legal issues affecting the child’s health. In most cases, the MLPP provided consultation to healthcare providers, who were then able to work with their patients. 

“This approach builds the providers’ capacity to screen and identify legal issues that harm their patients’ health,” Rosenthal said. “They learn how to effectively intervene or refer patients to services.” 

“Before the MLPP, medical providers might have been hesitant to screen and identify patients for socioeconomic obstacles,” said William Aseltyne, senior vice president and general counsel, YNHH. “Now they feel comfortable because they know there’s a legal resource readily available.” 

In addition to consulting with providers, the MLPP has held more than 100 presentations at YNHCH and Yale School of Medicine and coordinated annual “Keep the Power On” utility clinics for New Haven and Bridgeport families at risk of having electric and gas services terminated. 

The pediatric MLPP’s success has led to similar projects at YNHH, including the Transitions MLPP, for adults in the Primary Care Center, and the Palliative Care MLPP, for patients with life-threatening illnesses. All of the MLPPs are supported by Yale Law School through student externships.

The MLPP is funded by the hospital, a grant from the law firm of Wiggin and Dana and community support. For more information, contact Alice Rosenthal, 203-688-0113 or [email protected].