Legal & Medical Partnership for Families (LAMP) Law Student Training

LAMP Hours and Location LAMP Wednesdays from 2:00 to 5:00 p.m., two students work together Downtown Health Clinic at 1020 N. 12 th Street (12 th and State), just 4 blocks from the law school. (Just as a point of reference, this is where the Wells St. parking structure is located.)

DHC Families’ Common Obstacles Low Income Family Immigration Nutritional Supports Health Insurance Domestic Violence Child CareDisability Income Supports Education Housing & Homelessness

Prevalence of Unmet Legal Needs is High  Nearly two-thirds of low-income households in urban families were found to have unmet legal needs.  Legal help for low-income families is limited, publicly funded legal aid agencies turn away up to 60% of cases due to lack of resources.  Nearly 80% lower-income households with significant legal problems have no choice but to deal with their predicaments without any professional help. Source: Wisconsin’s Unmet Legal Needs. Access to Justice Committee, State Bar of Wisconsin, 2007

Medical Legal Partnerships - MLPs  Draws on strengths of two powerful professions to reduce health disparities for vulnerable populations by addressing the social determinants of health  Provides collaboration between clinicians & lawyers to ensure that the basic needs of families are met  Trusted relationships between healthcare providers and families allow for screening of unmet legal needs that impact family health. Founded, Dr. Barry Zuckerman, Chief of Pediatrics, Boston University School of Medicine/Boston Medical Center, 1993

6 180 sites, only 14 states without a site MLP Network, 2010

LAMP Goal To develop and implement a medical-legal advocacy model at the Downtown Health Center, Martin Luther King Heritage Health Center, and Isaac Coggs Health Center to improve the health and social stability for Milwaukee’s low- income children.

LAMP Partners Since 2004

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Downtown Health Center (DHC) Social Work Data  De-identified data analysis of 420 DHC Social Work referrals,  Legal counsel and/or intervention could have resolved the adverse condition in 90% [N=379] of social work referrals  41 referrals [10%] would not have benefited from legal consultation DHC Patients’ Suggested Legal Needs Domains N=379 % Health Insurance9224% Child Abuse/Neglect6317% Education (Special)5213% Other (criminal, asthma)4712% Housing3710% Family Law349% Public Benefits195% Disability185% Domestic Violence133% Employment31% Immigration11% DHC Patients’ Suggested Legal Needs DomainsN=379% Health Insurance9224% Child Abuse/Neglect6317% Education (Special)5213% Other (criminal, asthma)4712% Housing3710% Family Law349% Public Benefits195% Disability185% Domestic Violence133% Employment31% Immigration11%

Patient Gender of LAMP Referrals at the Downtown Health Center N=20 Legend: Over half (61%) of the LAMP Referrals at the DHC are from female patients. Male patients comprise 39% of the total referrals.

Percent of the Race/Ethnicity of LAMP Referrals at the Downtown Health Center N=20 Legend: The demographic data obtained from the LAMP Referral Form is consistent with the overall demographics of the Downtown Health Center [70% African-American, 12% Hispanic, and 12% White].

Percent of LAMP Screening Questions by Domain at the Downtown Health Center N=72 Percent (%) Referrals Legend: Of the patients/clients screened for LAMP referrals at the Downtown Health Center, the most common domains for legal services identified are: Housing (43%), Public Benefits (17%), Income (17%), and Employment (10%). The domains of Disability, Education, and Intimate Partner Violence were each less than 10% of LAMP referrals.

Percent of Reasons for LAMP Referrals by Domain at the Downtown Health Center N=20 Percent (%) Referrals Legend: Of the 6 domains used to categorize the Reasons for Referrals to LAMP legal services at the Downtown Health Center the most common are: Family (50%; includes Family Law, and Legal Guardian), Housing (25%), Disability (15%), and Other (10%; Health Care Concerns). Education and Employment were not represented amongst Reasons for the recent LAMP Referrals.

Percent of Common Child Health Concerns for LAMP Referrals at the Downtown Health Center N = 65 Legend: The most common Child Health Concerns amongst the LAMP patient/client population at the Downtown Health Center are: Physical Health (62%; includes Abdominal Pain, Allergic Rhinitis, Asthma, Dental Caries, Prematurity, and Vision Problems) Behavioral Health (29%; includes ADHD, Anxiety, Behavioral Problems, Developmental Delay, and School Problems) and Reproductive Health (9%; includes Venereal Disease, Contraceptive Management, Dys Uterine Bleed, Exposure to Venereal Diseases, and Health Sex Counsel).

Percent of LAMP Legal Case Categories at the Downtown Health Center N=20 Percent (%) Referrals Legend: Of the 9 domains used to categorize each Legal Case at the DHC the most common are: Family (55%; includes Guardianship/Adoption/Foster, Domestic Violence, Custody/Placement/Visitation, and Child Support), Housing (25%; Landlord/Tenant), Public Benefits (15%; Social Security Disability Insurance (SSDI) and Supplemental Security Income ( SSI), and Other (5%; Power of Attorney/Wills). Civil Rights, Consumer Law, Criminal, Employment, and Immigration were not represented amongst the recent Legal Cases at the DHC.

Case Status of LAMP Referrals at the DHC N=20 Legend: The majority (92%) of all referrals to LAMP Lawyers at the Downtown Health Center received some form of Direct Legal Service— Information/Education, Brief Advice and Consultation, and/or Referral.

Downtown Health Center: A Two-Week Process WEEK ONE Student staff LAMP table in clinic lobby. Makes DHC patients aware of LAMP clinic. Student reviews Form A-1 with potential LAMP clients and helps clients identify legal issues appropriate for LAMP Client completes Form A-1 and gives to provider during medical visit Medical provider completes Form A-2 and gives to Pam Ramsey to follow up Pam Ramsey completes Form B1 and Form G. Pam then makes LAMP clinic appointment for client (ideally scheduled for Week 2). WEEK TWO Attorney and Student review client information for current clinic appointments. Review Form B1. Student and Attorney meet with client. Student explains and provides Form C. During client conference, attorney and student complete Form B2. During client conference, student completes Forms D and E. At the end of the conference, student provides Form H with self-addressed stamped envelope to client. After the conference, student completes LAMP Stats Form in SharePoint or paper Form I

Accessing SharePoint After this training, you will receive an invitation by to join the LAMP SharePoint site. Use your MULS credentials to log into the site. When you are off-campus (ie: at DHC), you will need to enter the following before your username: Marqnet\ Notice the weird slash! This is a backslash (found above the “Enter” key.) It is not the slash we usually use.

Using SharePoint

Family Case Story Mother of two Medical provider identified bed bug bites on children. Bed bugs determined to be in carpet Landlord refused to do any repairs Mother withheld rent LAMP referral Mother was given legal advice on withholding rent and informed that her case did not qualify. Attorney assisted her in petitioning for an inspection by Dept. of Neighborhood Services. Landlord was required to institute pest control of the apartment.

Family Case Story Developmentally delayed mother of newborn Confided in medical provider. Dad would not pay child support or consent to paternity. Mom was unsure of what to do after initial Social Security Disability claim denied. LAMP referral Mother was given legal assistance filing paternity order. Pro Bono representation for Social Security Disability benefits appeal secured.

Family Case Story Mother of child w/disabilities Concerned about a traffic ticket. After discussion, mom indicated that her husband was recently killed in a workplace accident. Concerned about guardianship of her daughter if something were to happen to her. LAMP referral Drafted basic will with guardianship provision for mother, as well as durable power of attorney for healthcare.

Family Case Story Mother of five children, one with significant development delays Adult child’s disability benefits were terminated by Social Security upon turning 19. LAMP referral Attorney explained process for a termination of benefits appeal. Attorney made appointment for the mother to see a Legal Action attorney at no cost for ongoing representation.

Discussion & Questions