PC2075: Addressing Unmet Social Needs and Social Risks—parent Reported Outcomes and Impact from a Medical Legal Partnership

Background: Legal needs often reflect unmet social needs, which comprise up to 60% of individual health. Screening for social determinants of health can unmask unmet social and legal needs. Medical legal partnerships (MLPs) are situated to address multiple unmet social and legal needs. However, lack of data on utility of MLPs can be a barrier to sustained use.

Methods: We conducted a qualitative cross-sectional study of a medical legal pilot program at a tertiary children’s hospital to evaluate the experiences and outcomes of parents referred to an MLP with an emphasis on health impact. Parents of children who were referred to an MLP were invited to participate in a semi-structured interview about their experience. Interviews were transcribed verbatim and coded by two raters, with discrepancies resolved by consensus. The study was approved by the Institution’s IRB.

Results: Multiple reasons emerged for referral to MLPs including education issues (Participant 2, Participant 14), housing issues (Participant 10, Participant 14), public benefits (Participant 3, Participant 15), disability rights (Participant 2, Participant 16), and health insurance (Participant 17, Participant 15). Individuals were connected to the MLP through the Children’s Hospital. Some parents reflected that this trusted entity helped, “I was on the family advisory board. . .at Lurie. . . I saw [someone] that I used to work with. . . I was telling her the story [and she] referred me to legal.” (Participant 2). The majority of parents described no perceived delay in connecting to the MLP (Participant 18, Participant 19). Parents also described that MLP staff quickly understood their problem, “[The] person at the legal services organization knew exactly what I needed as soon as I relayed information to her.” (Participant 13). Outcomes from MLP referrals varied (Table 1). In some cases, no legal remedy was available (Participant 2). In other cases, there was timely resolution of the legal issue (Participant 3). Other parents noted that involvement taught them skills for the future (Participant 13). Respondents also commented on variable impact on health (Table 1). Some noted no specific health impact (Participant 20), while others noted positive direct (Participant 16), and indirect (Participant 10) health impact. Parents overall described their interaction with the MLP as positive (Table 1), that there was value in sharing their story (Participant 2), that involvement in the MLP made their issue visible (Participant 20), and made them feel validated (Participant 20).

Conclusion: MLPs are an important mechanism to address social determinants of health. In many situations, MLPs are able to resolve unmet social needs through legal remedies. Even when legal remedies are not available, MLPs may play an important role in elevating awareness of social risks. MLPs can have both direct and indirect positive impacts on health.