Five Things the Civil Legal Aid Community Can Learn from Medical-Legal Partnership
By Jim Sandman*
(This article was originally published on the National Center for Medical-Legal Partnership blog "Bridging the Divide: Trends, Topics and Tips in Medical-Legal Partnership".)
Medical-legal partnerships are one of the most important developments in the delivery of civil legal services in the last twenty years. They represent the kind of innovation and entrepreneurship our community needs. There are currently 48 federally-funded civil legal aid agencies that have formally partnered with healthcare institutions, and I’d like to see that number grow.
I draw five important lessons from medical-legal partnerships:
1. Meet clients where they are.
Research from Rebecca Sandefur and the American Bar Foundation shows that the majority of people with a civil legal problem – 78% – do not seek outside help. A big reason why is that people often do not recognize their problems as being legal in nature. There are also significant barriers, like transportation, that keep people from making it to legal aid offices.
Medical-legal partnerships bring civil legal aid on-site at healthcare institutions where people in our community go to seek help for other issues. MLPs not only help clients by co-locating healthcare and civil legal aid services, they provide the opportunity to reach people who would never identify their legal problems as legal. We in the civil legal aid community should embrace this strategy and take our services to the other places in the community where people go for help.
2. Never limit the service by the label the client has given it. Learn how to think like a client, not like a lawyer.
Law school trains us to think in a very specific way that can benefit our clients when we are advocating for them. But that same training can create barriers to reaching clients. Civil legal aid is set up to reach those clients who have self-identified their problems as legal and come to legal aid’s door.
Medical-legal partnerships teach us that people often seek medical treatment for problems that have a legal component. They are seeking help; they just aren’t seeking legal help. Lawyers who work at medical-legal partnerships have learned to ask different screening questions and work with healthcare providers to ask about basic needs in a way that will detect legal problems the client has not identified as legal. Lawyers need to learn how not to think like lawyers and instead to think like our clients. We in legal aid need to ask ourselves how our clients frame their problems and where they go for treatment.
3. When it comes to data, more is more. And other sectors have data we can use.
Medical-legal partnerships provide access to more data about clients’ circumstances. The more we know about our clients, the better we will be able to help address their problems. Medical data can support appeals for insurance, public benefits, and housing subsidies. When a civil legal aid office has a strong partnership with a healthcare institution, this additional information and expertise becomes more readily available, allowing attorneys to better represent their clients. This concept is not limited to health information. Partnerships with other organizations serving legal aid clients can open the door to new information that helps us achieve better legal outcomes for clients.
4. More data leads to systemic solutions, which helps more people.
One of the best ways to extend civil legal aid’s limited resources and reach a larger number of clients is to address chronic problems with systemic solutions. Medical-legal partnerships do this by sharing health and legal data that identify patterns of need. For example, data on asthma admissions can help detect substandard housing clusters. Identifying and addressing these types of problems require data and expertise that neither the healthcare or civil legal aid community has alone.
Systemic solutions not only expand the reach of our limited resources, they are more attractive to funders, including government funders. Civil legal aid can look to other sectors – transportation, education, urban planning – to identify opportunities to share our individual knowledge about our communities and to collaborate on policy solutions.
5. Cross sector partnerships open up new sources of funding and additional funding from old sources.
Medical-legal partnerships take civil legal aid and reframe it as a healthcare intervention – as something that can improve the health and well-being of communities. Medical-legal partnerships have started to open up new sources of funding for civil legal aid – from health centers and hospitals that have contributed funding to civil legal aid attorneys who work on-site in their clinics, from healthcare foundations that support the work of these partnerships, and from federal healthcare grants to support civil legal aid.
As we think about strategies for bringing new monetary support to civil legal aid, we need to expand beyond our traditional funding sources. Partnerships with healthcare and other sectors create possibilities for innovations and new relationships that can lead to additional funding.
As we look to the future of civil legal aid, we must enlist new allies for our work. We need to leave our offices and go into the community to find new partners and new ways of doing business.
* Jim Sandman is President of the Legal Services Corporation, the federal funder of civil legal aid in the United States.