How Public Health Departments and Medical-Legal Partnerships Can Collaborate to Strengthen Community Health Efforts
July 12, 2019
In a previous blog post, I described how medical-legal partnership (MLP) attorneys are ideally situated to identify and define the contours of specific legal issues affecting a community’s health. Their extraordinary insight into health-harming legal issues comes from their position on the front lines: their daily work reveals how specific gaps in the law, implementation errors, or enforcement failures directly contribute to specific adverse health outcomes experienced by their clients. MLPs may also play an important role in informing, guiding, and effectuating strategic legal changes to improve health at the population level.
In addition to working with MLPs on public health law and policy initiatives, there are many additional opportunities for public health departments and MLPs to collaborate on a day-to-day basis. Here are a few examples from across the country.
- Public health data can help guide MLPs to address the most pressing and prevalent health problems in the highest-need neighborhoods and among the most vulnerable populations. State and local health departments routinely collect and analyze data about their communities’ health. They may obtain and integrate data from other governmental sources as well, such as housing code violation data collected by a municipal enforcement agency. In aggregate, this data can inform MLP planning processes to ensure that resources are targeted to maximize impact. For example, consider how this MLP/public health collaboration in Worcester, Massachusetts used city public health data to inform asthma initiatives. The Chicago Department of Public Health similarly contributed to priority setting by Health Forward / Salud Adelante, an MLP formed in partnership with Legal Aid Chicago (formerly LAF) and Cook County Health & Hospital System.
- Local health departments may serve as primary partners in launching MLPs. For example, the Los Angeles County Department of Health Services launched Whole Person Care-Los Angeles (WPC-LA), which leverages Medicaid funding to deliver coordinated health and social services to six specific populations, including “Homeless High-Risk, Justice-Involved High-Risk, Mental Health High-Risk, Perinatal High-Risk, Substance Use Disorder (SUD) High-Risk, and Medically High-Risk.” The health services department partnered with a local legal services organization to create an MLP as a key component of the WPC-LA program. The MLP provides a range of legal services to promote WPC-LA participants’ health and well-being.
- Public health departments may play a convening role to facilitate collaboration among MLPs and other community partners. For example, Harris County Public Health (HCPH) (Texas) co-leads a coalition of local MLPs and cross-sector partners aimed at increasing local MLP capacity and impact. The health department is also a founding partner and now part of the backbone committee for the Texas Medical Legal Partnership Coalition – a statewide MLP coalition and resource network to support public health law and policy change in other Texas communities.
- Public health and other local governmental agencies can work with MLPs to help target and improve enforcement efforts. For example, the Cincinnati Child Health-Law Partnership (Child HeLP)—a partnership between Cincinnati Children’s primary care clinics and the Legal Aid Society of Greater Cincinnati—worked with city health and building authorities to address a cluster of poor quality housing identified through MLP referrals. The buildings were subject to multiple previously unaddressed city code violations and health orders.
- A public health department partner may play a key role in collecting and analyzing data to evaluate MLP effectiveness and, in turn, support program expansion. For example, the Delaware Division of Public Health (DPH) partnered with Community Legal Aid Society, Inc., to develop an MLP focused on providing free legal services to high-risk pregnant women participating in the state’s Healthy Women Healthy Babies (HWHB) program. The MLP began as a pilot study in one county and, after finding statistically significant results from that pilot study, the MLP was expanded to include all HWHB sites throughout the state, postpartum women up to 6 months, and participants of the Nurse Family Partnership statewide. Later, the MLP was further expanded to one county’s Healthy Families America (up to 2 years postpartum) home visiting program.
This post was prepared by Colleen Healy Boufides, Deputy Director, Network for Public Health Law – Mid-States Region Office.
The Network provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.