What is MLP?

Sometimes you can learn about the most amazing things just through casual conversation. While attending a conference a few years ago, I struck up a conversation. We exchanged the usual information, where we were from, what type of work we did, and so forth. When he learned that part of my practice involved defending medical professionals, he asked me if I knew about medical legal partnerships. I confessed that I was not sure and he went on to explain:

Say that a child comes into an emergency department at a local hospital with acute asthma. The doctor successfully treats the asthma and sends the child home with her parent. A couple days later, the child returns to the emergency department with another acute asthma attack. The doctor again successfully treats the asthma. In the process, however, she learns that the child is living in apartment housing with mold that severely aggravates the child’s asthma. The child’s parent had repeatedly requested the landlord clean up the mold, but the landlord failed to remedy the mold problem. Fortunately, the hospital had a medical legal partnership with the local legal aid society. The doctor was able to make a referral for the child’s family to get the legal assistance they needed to positively affect the child’s health issues. Now the child and her family are living in a mold-free apartment, and the child has not been back to the emergency department with acute asthma.

Wow, I thought. This is pretty amazing stuff. The idea of lawyers working with doctors and other health care providers to improve the health of the citizens of Tennessee really appealed to me. So I did a little research about medical legal partnerships. I learned that medical legal partnership was conceived at the Boston Medical Center in 1993. The program emerged in a primary care setting, like the example above. The Boston medical legal partnership now also serves chronic disease populations and related specialties. I learned that medical legal partnerships have since spread across the country. The partnerships take various forms that reflect the needs and resources of the communities in which they develop. I learned that what is often perceived as a cost of the legal services actually turns out to be a revenue stream for the health care partner in terms of actual dollars realized from legal advocacy for patients, as well as benefits to the community as a whole in terms of reduced demand on medical services. And I learned that we already have medical legal partnerships right here in Tennessee.

In Chattanooga, Erlanger Health Law Partnership is a collaboration between Erlanger Health System and Legal Aid of East Tennessee that provides free, direct legal services to patients whose household incomes are at or below 200 percent of the Federal Poverty Level. In Nashville, the Middle Tennessee Medical Legal Partnership includes the United Neighborhood Health Services clinic and Vanderbilt University’s student-run Shade Tree Clinic as partner service providers along with Legal Aid Society of Middle Tennessee and the Cumberlands (LAS). That partnership provides free, direct legal services to low-income patients and their families receiving treatment at UNHS and Shade Tree Clinic, as well as training and education to health care professionals to help them identify their patients’ need for legal assistance as it relates to their illness. The Shade Tree Clinic also involves both medical school and law school students. In addition, the Medical Legal Partnership for Children is a collaboration between the LAS and the Monroe Carell Jr. Children’s Hospital at Vanderbilt to provide free legal aid to low-income patients and their families. That partnership works to improve the health of children by addressing social, economic and physical needs through legal intervention.

We also have developing medical legal partnerships in Tennessee. In Memphis, Le Bonheur Children’s Hospital, Memphis Area Legal Services, the University of Memphis Law School, and the UT College of Medicine are developing a medical legal partnership to improve the health of children in Memphis and the surrounding communities. Le Bonheur hosted a symposium this past April that included a Grand Rounds, where the medical director of the Health Law Partnership (HeLP) in Atlanta and his colleagues presented an introduction to medical legal partnership at the hospital. HeLP is a collaboration among a pediatric health system, a legal services provider, and a law school to improve the health and well-being of low income children and their families, and is a model that is well suited for Memphis.

So why didn’t I already know about MLP? And why don’t many lawyers or doctors I talk with know about MLP? As a good friend of mine said when I was describing medical legal partnership to him: “maybe because the name is no good. It doesn’t really tell people what it is.” That could be the thought behind the name of the Atlanta Health Law Partnership - HeLP. But even that name still doesn’t tell the whole story of how doctors and lawyers are working together to solve the medical and legal issues that negatively impact the health of those in their community. The wonderful possibilities of medical legal partnership shouldn’t be obscured by the vagueness of a name.

In order to shine a light on the great work being done through MLP, this year, we have formed the Medical Legal Partnership Working Group to identify ways the Tennessee Bar Association can support medical legal partnership in Tennessee. I recognize that medical legal partnership is not a one-size-fits all concept, and that the particular model of partnership must be tailored to meet the particular needs of the community it serves. I also recognize that the development process takes a good deal of effort from all of the community partners. But the idea of doctors and lawyers working together to solve the medical and legal issues that negatively impact the health of the citizens of Tennessee — through medical legal partnership — is an idea worth pursuing.


Jonathan Steen Tennessee Bar Association President JONATHAN O. STEEN is a civil trial lawyer with Redding, Steen & Staton PC in Jackson. He is a past president of the TBA Young Lawyers Division.