Federal Funding Helps Revive N.H.'s Medical-Legal Partnership

Apr 13, 2016

People living in poverty are often at greater risk for serious health problems. And for many, legal problems can be a contributing factor to those medical issues.

The National Center for Medical-Legal Partnership estimates one in six Americans have at least one civil legal problem that negatively affects their health.

A medical-legal partnership here in New Hampshire ended in 2011 in part due to state budget cuts, but is now up and running again.

  Cheryl Steinberg is senior law project director for New Hampshire Legal Assistance.

She oversaw the original partnership and joined NHPR’s Morning Edition to talk about the efforts behind getting it going again.

How does the partnership work?

New Hampshire Legal Assistance, which is a civil legal aid program, partners with health care centers, particularly right now with the Manchester Community Health Center, to work with their patients to help provide legal services that impact their health.

Can you give us examples of cases that come up?

A conditions problem in an apartment, for example. So if a child has asthma and the landlord refuses to fix problems such as mold or other irritants in the apartment, it’s the landlord’s responsibility to rectify and they refuse to do so, we can come in and try to get those problems resolved for them. We also help people with fighting illegal evictions, housing discrimination issues, people with disabilities who are entitled to accommodations in their apartments, we do all those kinds of things.

Are these cases where people simply aren’t aware of their rights?

That’s correct. One of the big aspects of this project is to inform health care providers of the different areas that could be benefited by legal interventions that might be affecting their patients. We train the medical providers to help increase their awareness of the problems as well so they can make appropriate referrals to us.

If people's legal problems that impact their health are addressed, the idea is they will remain healthier, and will not have to go to the doctor, or the hospital as frequently.

How is it funded?

The federal Health Resources Services Administration, or HRSA, recently found that legal services was an appropriate service to fund through federally-qualified health care centers. Manchester Community Health Center, who’s our current partner, applied for that funding and received it. We also were very fortunate recently to get a grant from the Bean Foundation. There are a few other grant opportunities we’re seeking out.

Has this type of program become more common across the country?

Yes, I believe there’s somewhere over 300 different medical-legal partnerships over the country now. The National Center for Medical-Legal Partnership is doing research on this, and some preliminary findings are that the legal services we provide reduces stress, helps people take medications on a more regular basis, and reduces hospital admissions for people with chronic illnesses, just to name a few things.

So you see these people coming in less for medical issues?

Exactly. If people's legal problems that impact their health are addressed, the idea is they will remain healthier, and will not have to go to the doctor, or the hospital as frequently.

The idea being to save money in the long run?

Absolutely.

How are potential clients identified?

As I mentioned before, we try to train health care providers so they can identify these problems. So the way it’s working right now in Manchester, there’s a good number of social workers and case managers, they’re really the key people in this, they will talk to their clients and see if they need any legal help. If they do, they make a referral to us. We actually have someone on site at the health center a half day one day a week to meet with clients and talk to the health care providers if they have questions.

How far does this legal counseling go? Are you helping them maneuver through the court system?

Well, all of our services are free. And we provide a whole range of services. It can be as simple as providing information referrals to other places if it’s something we don’t handle, counsel and advice, all the way up to full representation in court.

I know there are plans for the program to expand to the Ammonoosuc Community Health Center in the North Country. Where does that stand?

That health center has received some funding as well. They have hired a paralegal and we are partnering with them to get their program up and going.