? II. MLP Model III. Healthcare Providers Role in the MLP IV. What - - PDF document

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11/29/2018 Disclaimer Law: The views expressed in this presentation are When Medicine is Insufficient: the presenters own and do not reflect the Medical Legal-Partnerships view of any organizations I am affiliated with. The information

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11/29/2018 1 Law: When Medicine is Insufficient: Medical Legal-Partnerships

Caroline Wick, Esq. MSPH UCONN CE Finale December 14, 2018

Disclaimer

The views expressed in this presentation are the presenters’ own and do not reflect the view of any organizations I am affiliated with. The information included in this presentation should not be considered legal advice.

Disclosure Slide

  • Ms. Wick has no actual or potential conflict
  • f interest associated with this presentation.

Learning Objectives

  • 1. Recognize social-determinants of health
  • 2. Define the term “medical-legal

partnership”

  • 3. List qualities that make medical-legal

partnerships successful

Agenda

I. Social Determinants of Health

  • II. MLP Model
  • III. Healthcare Provider’s Role in the MLP
  • IV. What if your organization is not part of

an MLP?

  • V. Questions

?

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11/29/2018 2

  • I. Social Determinants of Health

Social Determinants of Health

The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.

http://www.who.int/social_determinants/sdh_definition/en/

Modifiable Contributors to Healthy Outcomes

80‐90%

Social Determinants of Health

10‐20%

Clinical Care

(Hood CM, et al. Am J Prev Med 2016;50(2):129-135)

  • Health-related behaviors
  • Socioeconomic factors
  • Environmental factors

Active Learning Question #1

Which of the following is a Social Determinant of Health that affects a patient’s cancer outcome? a) The patient’s genetic predisposition to breast cancer b) The patient’s access to public or private transportation c) The patient’s body’s resistance to the most effective treatment d) The patient’s body’s response to drug side effects from chemotherapy

  • II. Medical-Legal Partnership Model
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MLPs: An Idea Born of Frustration

  • Dr. Barry Zuckerman

?

  • Outside domain
  • Healthcare system overloaded
  • Effectiveness evidence?

Reasons Healthcare Providers May Not Want to Address SDoH

(Magnan, S. NAM Perspectives 2017.)

Medical Legal

Screening

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Medical Legal

Legal Assistance

8 MLP Core Elements

1) Formal agreement

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

8 MLP Core Elements

1) Formal agreement 2) Defined population

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

8 MLP Core Elements

1) Formal agreement 2) Defined population 3) Screening strategy

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

1) Formal agreement 2) Defined population 3) Screening strategy 4) Staffing

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

8 MLP Core Elements

1) Formal agreement 2) Defined population 3) Screening strategy 4) Staffing 5) “Lawyer in residence”

8 MLP Core Elements

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

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1) Formal agreement 2) Defined population 3) Screening strategy 4) Staffing 5) “Lawyer in residence” 6) Lawyer provided training

(Regenstein, M, et al. Health Aff. 2018;37(3):378‐385)

8 MLP Core Elements

1) Formal agreement 2) Defined population 3) Screening strategy 4) Staffing 5) “Lawyer in residence” 6) Lawyer provided training 7) Information sharing

8 MLP Core Elements

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

1) Formal agreement 2) Defined population 3) Screening strategy 4) Staffing 5) “Lawyer in residence” 6) Lawyer provided training 7) Information sharing 8) Designated resources

8 MLP Core Elements

(Regenstein, M, et al. Health Aff. 2018;37(3):378-385)

Active Learning Question #2

Which of these is not a MLP core element? a) “Lawyer in Residence” b) Information Sharing c) Lawyer Provided Training d) Policy advocacy

Policy Advocacy MLPs Today

https://medical-legalpartnership.org/partnerships/

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Evidence of MLPs’ Successes

(Tsai J, et al. Health Aff 2017;36(12)2195-2203)

  • IV. Healthcare Providers’ Role

in MLP Healthcare Providers’ Role in MLP

  • Note: Healthcare provider’s role will be

limited by patient-client’s wishes.

  • Referrals

Healthcare Providers’ Role in MLP

  • Referrals
  • Write letters

Healthcare Providers’ Role in MLP

  • Referrals
  • Write letters
  • Testify

Healthcare Providers’ Role in MLP

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  • Referrals
  • Write letters
  • Testify
  • Answer questions

Healthcare Providers’ Role in MLP

  • V. What if your organization is

not part of an MLP?

?

Look for resources:

  • Local legal services providers
  • Local social services organizations

What if your organization is not part of an MLP?

Contact the National Center for Medical Legal Partnerships

What if your organization is not part of an MLP?

Contact your alma mater

(Tyler, ET et al. J Leg Med. 2014;34:149-177)

Active Learning Question #3

You are a pharmacist who works with elder, low- income patients. A patient comes to the window and says that Medicare is refusing to pay for his dental surgery, even though it was medically necessary. Your

  • rganization is not part of an MLP. To best assist him

you could: a) Say I’m sorry and wish him a good day. b) Give him the website for local food pantries. c) Give him the contact information for a local legal services organization that works on Medicare issues. d) Offer to start a collection jar at the pharmacy.

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11/29/2018 8 Questions?

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