Overall, the Legal Aid Society helps more than 20,000 people a year. Thousands of referrals have come directly from Cincinnati Children’s since the launch of Child HeLP.
Many cases involve investigating housing conditions when a child winds up needing emergency care for asthma exacerbations. Other common situations include contesting eviction notices that can leave sick children homeless, representing families tangled in public benefits disputes (e.g., unlawful denials or delays of programs like SNAP or WIC), and resolving conflicts with schools when disagreements arise over disability accommodations. Overall, the cases can be as unique as the children involved.
Legal Aid serves seven counties in Southwest Ohio. Child HeLP receives referrals from three Cincinnati Children’s clinics; Avondale, Hopple Street and Fairfield.
Across the country, 450 health organizations have formed medical-legal partnerships, according to the National Center for Medical-Legal Partnership. However, virtually all of the agencies lack the funding to fully meet demand and many areas remain unserved.
“When we started, it was a critical response to an urgent need. We’ve certainly found that we are stronger together. In this kind of partnership, two plus two is absolutely more than four,” says Elaine Fink, JD, Managing Attorney at Legal Aid and a co-author of the study.
Hard-to-measure success
Pinning down the impact of a social program that involves such a wide variety of pediatric health situations was no simple task.
The project involved comparing outcomes for 2,203 children referred to Child HeLP over several years to 100 randomly selected control groups drawn from a pool of 34,235 children who were seen concurrently but not referred. The researchers matched referred with control patients as closely as they could, then applied statistic weighting when some factors could not be matched with precision.
Their methods were closely scrutinized by peer reviewers and editors at the journal. The work also impressed other professionals in the field.
“This is a terrific study,” says Laura Gottlieb, MD, MPH, a professor at the University of California, San Francisco and founding co-director of the Social Interventions Research and Evaluation Network (SIREN), a national research network that studies health care strategies to improve social conditions.
“This work could only be done in a place like a Cincinnati Children’s that has had such a long term dual commitment to addressing families’ social/legal and medical needs and to rigorously evaluating their programs. The study adds substantively to the literature in this area, in this case demonstrating that a strong medical-legal partnership can contribute to decreasing costly and avoidable health care utilization in children.”