Medical Legal Partnerships in South Carolina Kirby Mitchell Senior Litigation Attorney, South Carolina Legal Services and Dr. Charles Hatcher, III, M.D Greenville Hospital System May 16, 2015

“There is more to health than healthcare.” “The goal of healthcare reform is to reform the system. The goal to improve health requires different questions and different answers.” (Poverty, Health and Law: Edited by: Tyler, Lawton, Conroy, Sandel, and Zuckerman).

SOCIAL DETERMINANTS OF HEALTH(CARE) Evidence shows ‘vulnerable populations’: suffer disproportionate share of chronic illness. do not receive adequate primary care. experience multiple social conditions that complicate the delivery of high quality healthcare.

‘Legal problems’ are often immediately experienced by the patient /client as health problems……: Families wrongfully denied food, housing, or income supports. Children living in substandard housing in violation of housing laws. Young adults with disabilities are denied disability / educational / health benefits.

…..and many of these health problems have legal solutions….: Social factors influence development & severity of disease. Inconsistent program implementation results in denials of benefits / services. Many social factors are remediable by enforcement of existing laws and regulations… but currently aren’t remedied, due to lack of enforcement / resources / etc.

….and thus: Medical - Legal Partnership (MLP) Build a healthcare team able to identify, treat and prevent health-harming legal needs for patients, clinics, and populations.

Please enjoy this obligatory symbolic marriage of law’s scales o’ justice + medicine’s caduceus / rod o’ Asclepius.. = MLP, baby!

What is a MLP? Early doctor + legal aid partnerships can be traced back to the 1960’s. First true MLP was formed in 1993 Boston Medical Center Greater Boston Legal Services Formed to address housing sanitation for children with asthma “Explosion” of MLPs across U.S. since early 2000’s Dr. Barry S. Zuckerman, MD (photo below) credited as founder of MLP movement.

What is a MLP? Currently established in 262 healthcare institutions in 36 states. 135 Hospitals 127 Health Centers 35 Health Schools 127 Legal Aid Agencies 46 Law Schools 70 Pro Bono Partners

MLP Joint Goals Provide integrated & collaborative medical & legal care. Enhance patient access to legal protections and benefits. Diminish legal barriers to health and promote long-term well-being.

Hmmm, interesting… what is the best resource for more MLP information? www.medical-legalpartnership.org National Center for Medical Legal Partnership at the Milken Institute School of Public Health at George Washington University, Washington, D.C. (formed in 2006; at GW since 2013) Mission: “To mainstream an integrated medical-legal approach to health and health care for people and populations.”

What is a MLP?

What about our neighbors? Georgia’s MLP… HEALTHCARE PARTNERS LEGAL PARTNERS Children’s Healthcare of Atlanta — Egleston, Hughes Spalding & Scottish Rite Atlanta Legal Aid Society, Inc. Emory University School of Law Children’s Healthcare of Atlanta Community Clinics Georgia State University College of Law Emory University School of Medicine Morehouse School of Medicine

…North Carolina’s MLP… HEALTHCARE PARTNERS LEGAL PARTNERS Carolinas Health Care System Duke University School of Law Duke Children’s Hospital & Health Center and Duke Primary Care for Children Legal Aid of North Carolina — Charlotte Legal Aid of North Carolina — Durham Duke University School of Medicine, Pediatrics Residency Program Legal Aid of North Carolina — Greensboro Legal Aid of North Carolina — Winston-Salem FirstHealth of the Carolinas Legal Aid of North Carolina, Inc. — Pittsboro Guilford Child Health at Wendover, Triad Adult and Pediatric Medicine Legal Aid of North Carolina, Inc. — Statewide Legal Services of Southern Piedmont, Inc. Lincoln Community Health Center Pisgah Legal Services Mission Hospitals University of North Carolina School of Law Pro Bono Program North Carolina Children’s Hospital University of North Carolina, Lineberger Comprehensive Cancer Center, NC Cancer Hospital Wake Forest University School of Law Wake Forest Baptist Health Downtown Health Plaza Wake Forest Baptist Health Pediatrics—Winston East Wake Forest School of Medicine, Pediatric Residency Program Wake Forest University Baptist Medical Center Wake Forest University School of Medicine Western North Carolina Community Health Services

…What about a South Carolina MLP. well, we are working on it… …What about a South Carolina MLP? well, we are working on it… ! 3 possible partners in G’ville… P

What about a South Carolina MLP? Initial possible focus of this pilot GHS-FU-legal aid MLP project: Families w/adolescents struggling with Autism Spectrum Disorders (ASDs) Our idea: Insure the necessary support is in place and remove the legal barriers for the critical transition of care prior to the age of majority (18) Guardianship / Conservatorship Supplemental Security Income (SSI) Social Security Disability Insurance/Disabled Adult Child Benefits (SSDI) Health insurance Transition health care needs Child support Academic support / IEP representation

Possible Location for this possible GHS-FU-legal aid pilot MLP project? Center for Developmental Services (CDS) Unique partnership linking Upstate at-risk individuals and families with multi-disciplinary services Clarity Family Connection Greenville County Schools Kidnetics Wonder Center

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Thank you to: GHS’s Dr. Nancy Powers, M. D. and Dr. Charles Hatcher, M Thank you to: GHS’s Dr. Nancy Powers, M.D. and Dr. Charles Hatcher, M.D. for their work on these presentation materials. Want to talk to someone at GHS about MLP? Nancy R. Powers, MD, FAAP Assistant Clinical Professor Developmental Behavioral Pediatrics Children’s Hospital Outpatient Center Greenville Health System 200 Patewood Drive, Greenville, SC 29615 Office: (864) 454-5115 Npowers@ghs.org

Want to talk to someone at Furman about MLP? Eli V. Hestermann, Ph.D. Executive Director of Undergraduate Students and Studies, Greenville Health System Executive Director of Health Education and Associate Professor of Biology, Furman University, Greenville, SC 29601 Eli.Hestermann@furman.edu

South Carolina Legal Services Want to talk to someone at South Carolina Legal Services (SCLS) about MLP? Andrea E. Loney, Esquire Executive Director South Carolina Legal Services 2109 Bull Street Columbia, SC  29201 (803) 744-4179 (803) 744-4184 (Fax) andrealoney@sclegal.org

Any questions / comments / ideas / suggestions / help about MLPs? Thank you! Any questions / comments / ideas / suggestions / help about MLPs? Kirby Mitchell Senior Litigation Attorney South Carolina Legal Services 701 South Main Street Greenville, SC 29601 (864) 679-3247 kirbymitchell@sclegal.org