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Rural medical-legal partnership and advocacy: a three-year follow-up study.

An Evidence-Based Practice

Description

This study aimed at reviewing a Health and Law Collaborative Partnership between a hospital and a legal aid organization that created a health care legal navigator system which referred patients to pro bono legal aid, thereby facilitating legal solutions to health-related problems including: Social Security and Medicaid benefits, power of attorney rights, property or housing dispute resolution, wills, medication benefits, employment benefits, divorce, and child support.

The intervention cost is $321 per client and $270 per case based on an investment
of $115,438 by the hospital partner.

Goal / Mission

Medical-legal partnerships perform advocacy services for vulnerable and under-served populations. These populations are typically burdened disproportionately by legal and medical problems. This study aimed to examine the effectiveness and sustainability of a rural medical-legal partnership (MLP).

Impact

The rural medical-legal partnership continued to show social and financial impacts, such as health care recovery dollars (319% return on investment between 2007 and 2009), Social Security benefits, family law services, and end-of-life guidance.

Results / Accomplishments

Of 372 closed cases, 42.7% resulted in clients receiving legal advice and/or referrals to legal assistance. Local health care providers collected $296,704 in adjusted Medicaid reimbursement ($10,597 on average for 28 clients that obtained benefits), yielding a 149% return on the hospital’s investment in the program. Clients had $1,177,844 of billed health care services covered by Medicaid ($42,066 on average for 28 clients).

About this Promising Practice

Organization(s)
The OASIS Institute
Primary Contact
James Teufel, MPH, PhD
OASIS Institute
7710 Carondelet, Suite 125
Saint Louis, MO 63105
(314) 862-2933
jteufel@oasisnet.org
Topics
Economy
Economy / Government Assistance
Economy / Poverty
Organization(s)
The OASIS Institute
Source
https://www.ncbi.nlm.nih.gov/pubmed/22643618
Geographic Type
Rural
Location
southern Illinois
For more details
https://muse.jhu.edu/article/474050
https://www.ncbi.nlm.nih.gov/pubmed/22643618

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
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