DHSS News Promoting the health and well-being of Alaskans.

Community Hereos

Every month we plan to highlight a community example of innovation and success. If you know of a program you think we should we highlight, please email me at anne.zink@alaska.gov.

This month we bring to you the Alaska Legal Services Medical-Legal Partnerships. We learned about this new program at State of Reform and thought it was a great example of the types of program we hope to highlight in this column.

The following is a question and answer session with Executive Director of Alaska Legal Services Nikole Nelson.

Q) Can you explain to the medical provider community how this program works?

Across the country, Medical-Legal Partnerships (MLPs) are revolutionizing how human services are provided to patients experiencing health-harming legal problems such as domestic violence, elder abuse, homelessness, and substandard living conditions. MLPs can help remove barriers to economic security and mobility and provide improved access to appropriate educational services. MLPs integrate legal aid into the health care system by embedding legal professionals into a health care facility to assist health professionals in identifying the correlation between legal issues and negative health outcomes, increasing understanding among health professionals about what information is needed by legal decision-makers, and jointly assisting patients facing a variety of health impacting legal needs. In the health care setting, these health-impacting legal issues are typically referred to as social determinants of health. When health care professionals effectively screen for legal needs, they can then link patients to an embedded legal professional for immediate help. The MLP model has proven successful for communities across the country, including Alaska, in improving access to civil justice in areas that are critical to patient health.

Q) When did it get started and how?

After seeing the clear success of the Navajo Nation’s MLP, in a community that dealt with similar distance and geographical challenges as Alaska, we began to explore the possibility of bringing the model to Alaska.  With support from the Rasmuson Foundation, ALSC held an Alaska MLP meeting in August of 2016 with local health care leaders.  With support from various leaders in Alaska’s tribally operated health care system, including the Alaska Native Tribal Health Consortium, we collectively decided to move forward. 

In Alaska, our locations have included: Alaska Native Medical Center in Anchorage, Chief Andrew Isaac Health Center in Fairbanks, Southeast Alaska Regional Health Consortium in Sitka, Dena’ina Wellness Center in Kenai, Norton Sound Health Corporation in Nome, and Kodiak Area Native Association in Kodiak. The goal of the project is to ensure every community in Alaska has access to the civil legal aid necessary to address social determinants of health.

Q) How is your program funded? How much money has it saved in other costs?

This program is supported through various funding streams including support from AmeriCorps and our partners in the Tribal health organizations where our legal staff are embedded. Since our first full year of implementation in 2017, 1,685 Alaskans living in 114 different communities were impacted by the six health centers and attorneys leading the MLP network. Every one dollar invested has generated six dollars in economic benefits—an estimated $3.49 million in economic support for patients, as well as $776,513 in savings related to reduced emergency shelter stays and avoided domestic violence injuries.  We also know there are cost savings related to shorter hospital stays for patients, for instance when we have been able to obtain or preserve their housing but we have not yet quantified those numbers.

Q) Will this program continue? What are your plans for the future?

Moving forward, ALSC is partnering with Alaska Native Tribal Health Consortium and Alaska Pacific University to grow its network of MLPs embedded in Tribal health organizations throughout Alaska. We aspire not only to connect all communities to our existing MLP network but also to provide legal education to remote communities about basic legal rights and remedies to increase community-based resources. In 2020, a distance learning curriculum for non-attorney advocates will be available that includes five initial legal topics. The distance learning curriculum will operate through APU and utilize the ANTHC’s Tribal health community health aid network to empower local communities to resolve health-impacting legal needs through a network of trained advocates who are supported by ALSC staff and pro bono attorneys.  We are also in the process of developing technology innovations that we hope will provide better access to self-help resources.

While this expansion is still in the early stages, it was recognized at the 2019 World Justice Challenge as one of the top five most promising access to justice solutions in the world.

 

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