Agreement provides in-hospital legal guidance to patients and caregivers; experiential learning for law students

Case Western Reserve University School of Law and University Hospitals Rainbow Babies & Children’s Hospital (UH Rainbow) have formed a Medical-Legal Partnership (MLP) to guide families and other caregivers of pediatric patients on non-medical legal issues affecting children’s health.

The MLP will provide education and training, advocacy and individual representation on issues that impact children’s health, but are beyond the scope of clinical care.

The MLP is part of Case Western Reserve’s top-ranked Law-Medicine Center’s innovative experiential education curriculum. It is also one part of a visionary set of programs that are being piloted by UH in advance of the opening of the new UH Rainbow Center for Women and Children.

The MLP will start at the Rainbow Ambulatory Practice in its current location on the UH main campus, and will then serve families on-site when the new center opens.  The MLP will initially focus on families in the Smooth Transitions into Adulthood with UH Rainbow (STAR) Clinic, a unique multidisciplinary clinic designed to support families of youth with Autism Spectrum Disorder, and transition into assisting patients with legal matters varying widely, from guardianship hearings to providing a child special-education services due to a disability.

University Hospitals (UH) is a national leader in population health, providing patient-centered care that acknowledges that patients may have non-medical challenges that directly impact their health, which the MLP is designed to facilitate.

This collaborative MLP is the latest effort by University Hospitals to address its patients’ needs that may be barriers to getting care or maintaining their health outside of the hospital. It also reflects a commitment of the Milton A. Kramer Law Clinic Center at Case Western Reserve’s law school to serve the community’s unmet legal needs.

Photo of Laura McNally-Levine

Laura McNally-Levine

Laura McNally-Levine, a law professor and director of the Kramer Law Clinic Center, and Marie Clark, MD, a developmental-behavioral pediatrician at UH Rainbow and the MLP medical director, co-developed the MLP with key stakeholders at both UH Rainbow and CWRU’s law and medical schools.

“With the MLP, we’re not making clients come to us, we’re going to them in the health-care setting,” McNally-Levine said.

The Kramer Clinic allows students to engage in experiential opportunities in various areas of law. Through its Health Law Clinic, third-year law students can represent children and adults in administrative and court proceedings under faculty supervision. McNally-Levine said 14 law students have enrolled to handle health-law matters in the fall semester and can participate in the law school’s first MLP.

“We are excited about the launch of this MLP, as it aligns with the law school’s commitment to develop a broad range of experiential education opportunities for our students,” said Jessica Berg, law school dean and professor of bioethics and public health. “The MLP will provide legal services to some of the most vulnerable members of the Cleveland community.”

According to The National Center for Medical-Legal Partnership, 294 health-care institutions in 41 states have developed MLPs to help people with health concerns who need legal advice.

Clark previously trained at Boston Medical Center, home of the nation’s first MLP and later worked to develop a MLP in a previous position in Pittsburgh. In addition to her current position at UH Rainbow, Clark is also an assistant professor of pediatrics at Case Western Reserve’s School of Medicine.

Clark’s mentor, Claudia Hoyen, MD, was instrumental as UH Rainbow’s director of pediatric innovation in helping to envision how the program could enhance efforts to address social determinants of health at UH Rainbow. Hoyen, an associate professor of pediatrics, held an Ohio MedTAPP grant through the Case Western Reserve School of Medicine that funded their work on the project.

Clark said she was excited about being able to support patients and families in ways not previously possible at UH Rainbow.

“We can treat only so much with the arsenal of medical tools available to us,” Clark said. “At some point, we need to address the underlying causes of patients’ disorders. When we screen for health-harming legal needs, like poor-quality housing and inadequate access to appropriate educational resources, we are now able to refer families to lawyers who are passionate about these issues.”

Clark and McNally-Levine will train caregivers at UH Rainbow to work with patients within the hospital, and law students in turn will work with the medical personnel. The law students will have an opportunity to learn more about how a children’s hospital serves patients.

“We are most excited to work with our colleagues at the law school to benefit our patients and families,” Hoyen said, “but we also want to foster the academic and research potential of our partnership. Creating multidisciplinary teams of learners—medical students, residents and fellows—along with law students presents a special opportunity.”

Due to the great success of other MLPs across the country and the clear evidence-based need for these services, Clark and McNally-Levine are already planning for program expansion by looking for additional funding and innovative community collaborators to help fulfill a vision and reach as many families as possible.

This article was originally published Sept. 5, 2017.