Abstract

This article describes the study to assess the benefits provided by the Health Law Partnership (HeLP), a medical-legal partnership (MLP), to pediatric patients with neuro-developmental disabilities and their families. The study is a descriptive analysis that examines legal, social, and health issues addressed and outcomes attained through inter-professional collaboration among healthcare providers and lawyers to address health-harming legal issues that exasperate families with children with neurodevelopmental disabilities who have complex medical needs. During the time period of January 1, 2006, to June 30, 2018, a retrospective cohort of families of 651 patients with 1.071 parent-reported neurodevelopmental disabilities were able to have their legal concerns addressed. Forty-seven percent of children served experienced developmental delays, 29 percent had ADHD, 23 percent had autism, and 14 percent were premature at birth. Of these children, 63 percent were male and 34 percent were ages 5-10 years. Families referred to HeLP received a legal check-up that is the legal equivalent to a medical history to assess legal problems/needs and financial eligibility (<200%). Legal cases were assigned to an inter-professional team of lawyers and law students through Atlanta Legal Aid and Georgia State University College of Law, and physicians and medical students associated with Children’s Healthcare of Atlanta and Emory University and Morehouse Schools of Medicine. The most common legal problems addressed by HeLP among 457 cases receiving extended legal services were education (225; 25.1%), Supplemental Security Income (SSI) (189; 21%), and family law (166; 18.5 %). Benefits obtained/retained through legal services exceeded $4.9 million in total value over the life of the study. Medicaid, State Children’s Health Insurance Program (SCHIP) and other health-related assistance resolved cases resulted in an average benefit value of $18,925 per case, followed by SSI and education cases with an average benefit value of $9,585 and $5,336, respectively. HeLP services resulted in improved access to education resources and also resulted in financial cost savings to families. Additionally, HeLP services provided cost savings to the healthcare system by securing entitlement benefits (Medicaid, SCHIP, SSI) for children with neurodevelopmental disabilities who may otherwise be subjected to indigent or charity care. In conclusion, inter-professional practice among healthcare and legal providers can result in more timely access to resources to address legal and other social determinants of health that exacerbate the complex needs of children with neuro-developmental disabilities and their families. Additionally, access to entitled benefits and resources result in short- and long-term cost savings to both families and systems.