Investing in Legal Aid to Promote Individual and Population Health Moderator: Mary McClymont, President, Public Welfare Foundation Jim Sandman, President, Legal Services Corporation Wendy Yallowitz, Program Officer for Vulnerable Populations, Robert Wood Johnson Foundation Stacey Barbas, Senior Program Officer for Health, The Kresge Foundation Woody Thorne, Vice President, Community Affairs at Southern Illinois Healthcare Ellen Lawton, Director, National Center for Medical-Legal Partnership
Report available online at: www.publicwelfare.org/NaturalAllies.pdf
Webinar Overview Moderator – Mary McClymont, President, Public Welfare Foundation Speakers Jim Sandman, Ellen Lawton, Wendy Yallowitz, Stacey Barbas, Woody Thorne, Director, President, Program Officer for Senior Program Vice President, Legal Services National Center Vulnerable Populations, Officer for Health, Community Affairs Corporation for Medical-Legal Robert Wood Johnson The Kresge at Southern Illinois Partnership Foundation Foundation Healthcare
Today’s Agenda Speaker Discussion – 35 minutes Audience Q&A – 25 minutes
What is the Legal Services Corporation? • Established by an Act of Congress in 1974 to fund civil legal aid programs covering the United States • Funding comes entirely from a congressional appropriation • Supports 134 independent legal aid programs, with more than 800 offices serving every county in every state, and the territories • The backbone of the civil legal aid system
Overview of Funding for Legal Aid • 19% reduction in LSC funding since 2010 • Second largest funding source reduced by 75% • Other current funding sources are precarious • Funding per eligible client has declined • Need at an all-time high
50 million Americans need legal care to be healthy. 1 in 6 Americans live in poverty. And every single one has a civil legal problem that negatively affects their health. Department of Health Policy
Legal problems are health problems. Social Determinant of Health Common Legal Problem Lack of basic resources Families wrongfully denied food supports and educational benefits Physical environment Children living in housing with mold or rodents, in clear violation of housing laws Lack of access to insurance Seniors wrongfully denied long-term care coverage Department of Health Policy
Medical-Legal Partnership A healthcare delivery model that integrates legal care directly into patient health care to address and prevent health-harming legal needs. Department of Health Policy
MLP Across the U.S. 36 States 136 Hospitals 145 Health Centers 107 Legal Aid Agencies Department of Health Policy
Robert Wood Johnson Foundation’s Vulnerable Populations’ Portfolio Much of the Foundation’s work is based on the fact that the health of all Americans, particularly the health of the most vulnerable people in our society, is influenced significantly by factors outside of the health care system. These factors are social determinants of health.
Working Together = Culture of Health Medical practitioners can make a huge impact by gaining a deeper understanding of the social determinants of health (SDOH) and of how many SDOH have legal underpinnings.
Overview Kresge is a $3 billion private, national foundation that works to expand opportunities for vulnerable people living in America’s cities. Through the work of our programs and partners, residents can improve their life circumstances and join the economic mainstream. December 5, 2013 GIH Webinar 14
Health Program Reducing health disparities by addressing conditions that lead to poor health outcomes. HEALTHY ENVIRONMENTS COMMUNITY HEALTH Investing in efforts that PARTNERSHIPS address key determinants Improving community health of health: by encouraging cross ‐ sector collaboration and the Housing integration of community Transportation & the Built health strategies into health Environment care, especially the primary care safety net. Food Systems December 5, 2013 GIH Webiinar 15
Medical-Legal Partnership Investments National Nursing Centers Consortium - Philadelphia, PA 2013 – 2016 Integrating Legal Services into Nurse-Managed Primary Care DNA People’s Legal Services - Window Rock, AZ 2011 – 2014 Development of an MLP program model practice for Indian Health Services across the nation George Washington University - Washington, DC 2011 – 2015 Expanding the capacity of local and regional MLPs in policy, evaluation and program activities December 5, 2013 GIH Webinar 16
Southern Illinois Healthcare Illinois St. Louis Clinton Wabash Missouri 57 St. Clair Wayne Edwards 64 Jefferson Washington Monroe Perry Evansville Randolph White Hamilton Franklin Jackson Indiana Gallatin Williamson Saline Mississippi River Key Hardin Pope Union Johnson 16- County Market Area 2011 Population: 339,563 Ohio River Cape Girardeau Pulaski SIH Hospitals Massac Alexander SIH Affiliates Kentucky Paducah
Figure 1. Summary of Medical Legal Partnership of Southern Illinois (MLPSI) investments, referrals, and outcomes. Closed Cases (n=2125) Closed Cases (n=2125) Funding Health Funding Health Funding Health Funding Health Care Partner* Care Partner* Positive Outcomes (n=1237) Positive Outcomes (n=1237) Care Partner Care Partner Medicaid Benefit Medicaid Benefit Medicaid Return Medicaid Return Medical Benefits Medical Benefits To Partner To Partner on Investment on Investment (n = 149) (n = 149) ($1,308,450) and ($1,308,450) and >$2,000,000 >$2,000,000 ($897,137) or ($897,137) or Its Clients Its Clients (218%) (218%) Social Social Social Security Social Security ($5,930,165) ($5,930,165) Security Security Benefits Benefits (n = 138) (n = 138) and Social and Social Service Service Power of Power of Funding Health Funding Health Legal Assistance Legal Assistance Benefits Benefits Attorney or Will Attorney or Will Care Partner Care Partner Partner Partner (n = 145) (n = 145) Reviews Cases and Reviews Cases and Funds Legal Funds Legal Divorce or Divorce or Personal, Personal, Assistance Partner Assistance Partner Implements Legal Implements Legal Child Support Child Support Financial, and Financial, and Solutions Solutions ($411,313) ($411,313) (n = 29) (n = 29) Health Benefits Health Benefits Visitation, Guardian, Visitation, Guardian, or Child Custody or Child Custody (n = 28) (n = 28) Referring Organizations Referring Organizations Property or Property or Legal Assistance Partners Legal Assistance Partners Make Referrals to Legal Assistance Partner (n=2141) Make Referrals to Legal Assistance Partner (n=2141) Housing Housing (n = 14) (n = 14) Makes Referrals to Outside Makes Referrals to Outside Funding Funding Federally Federally Rural Rural Health Care Health Care Qualified Qualified Health Health Food Assistance Food Assistance Health Health Partner Partner University University Pro Bono Pro Bono Clinic Clinic (n = 12) (n = 12) Center Center (n = 1449) (n = 1449) (n = 98) (n = 98) Law Clinic Law Clinic Attorneys Attorneys (n = 235) (n = 235) (n = 141) (n = 141) (n = 21) (n = 21) Other Issues Other Issues Social, Human Social, Human University University Other or Other or (n = 14) (n = 14) LOLLAF LOLLAF Other Other or or Health Health Unknown Unknown Aging Aging Services Services (n = 96) (n = 96) Branch Branch Services Services Legal Advice Legal Advice Services Services (n = 85) (n = 85) (n = 12) (n = 12) (n = 5) (n = 5) and/or Referral and/or Referral (n = 178) (n = 178) (n = 708) (n = 708)
Here’s What Grantmakers Can Do Now Identify grantmaking programs that could achieve improved outcomes and reach their goals more efficiently by adding civil legal aid partners. Identify and eliminate unintended barriers that can prevent legal aid providers from becoming grantees and subgrantees. Invite current grantees to investigate collaborations with legal advocates for those they serve. Partner with state IOLTA funders www.ambar.org/IOLTADirectory to identify legal aid programs that match your funding priorities. Provide general support for the legal aid groups that serve your own communities. Learn more about legal aid and areas of need by visiting: ‐ American Bar Association >> www.ambar.org/sclaidinitiatives ‐ Legal Services Corporation >> www.lsc.gov ‐ National Legal Aid and Defender Association >> www.nlada.org/civil ‐ National Center for State Courts >> www.ncsc.org/atj
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