Medical Legal Partnership of Southern Illinois
- Need: Legal barriers often prevent economically disadvantaged people in Southern Illinois from obtaining positive health outcomes despite receiving medical care.
- Intervention: The Medical Legal Partnership of Southern Illinois (MLPSI) was formed to create a system where medical providers can refer patients in need of legal assistance to local attorneys.
- Results: Over 4,300 patients have utilized MLPSI since its founding in 2002. The program has relieved over $8.1 million in medical debt for both hospitals and patients.
Evidence-levelEffective (About evidence-level criteria)
The Medical Legal Partnership of Southern Illinois (MLPSI) is a combination of legal aid and healthcare to improve low-income patients' situations by addressing their social determinants of health. Attorneys and paralegals work with healthcare professionals to offer services to economically disadvantaged people in 7 impoverished rural Southern Illinois counties that are designated Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs).
This collaborative effort was originally formed in 2002 between Southern Illinois Healthcare (SIH) (the largest healthcare provider in Southern Illinois) and Land of Lincoln Legal Aid (formerly Land of Lincoln Legal Assistance Foundation), a nonprofit organization.
Because MLPSI serves rural residents of Southern Illinois, their method differs than that of urban medical legal partnerships (MLPs). The variety of services provided by the number of legal professionals is the main difference. In a city, 1 MLP may specialize in a single population only (like pediatrics or geriatrics), but, like many other rural MLPs, MLPSI's services cover all ages, populations, and specialties.
Partnering healthcare professionals are trained to identify the potential need for legal intervention for their patients. Referrals made to MLPSI come mainly from the following partners:
- Herrin Hospital
- Memorial Hospital of Carbondale
- Shawnee Alliance for Seniors
- Shawnee Health Services
- Southern Illinois Healthcare (SIH)
- SIH Medical Group
- SIH Cancer Institute
In addition to Land of Lincoln, a variety of other legal professionals assist MLPSI in their advocacy for patients. Law students from Southern Illinois University School of Law, paralegals from AmeriCorps VISTA, and independent attorneys and paralegals donate their time and expertise. MLPSI consults with the National Center for Medical-Legal Partnership and MLP Illinois (a collaboration of Medical Legal Partnerships located in Illinois) for further education, resources, and support.
The projected annual cost to run MLPSI is $221,114, which pays for legal services, project coordinators' salaries, paralegal-intake specialist's salary, and travel. The partnership is a joint venture between SIH and Land of Lincoln.
Below are the primary ways MLPSI serves patients, outlined with the acronym I-HELP:
Income – Assists in appealing
denials and/or terminations of food stamps, cash
assistance, Medicaid, income support, public
benefits, and social security disability. Provides
advice and representation regarding consumer
Housing & Utilities – Secures
housing subsidies, improves substandard conditions,
prevents evictions, protects against utility
shut-offs, provides foreclosure defense.
|Education & Employment – Secures educational services. Assists in the expungement and sealing of criminal histories to remove barriers to employment.|
|Legal status – Clears criminal/credit histories, power of attorney, wills, and end-of-life documents.|
|Personal & Family Stability – Secures orders of protection for domestic violence cases, divorce, and guardianship for children; assists with other family legal situations.|
Over 4,300 patients have utilized MLPSI since its founding in 2002. This has resulted in more than 5,900 individual cases because patients often have more than one legal issue. Some of the partnership's largest accomplishments include the following:
- Secured 2 healthcare partners (SIH and Shawnee Health Services)
- Acquired a referral network of over 180 people from over 20 sites
- Provides ongoing training for medical staff of these 17 sites on health harming legal needs and their remedies
- Relieved over $8.1 million in medical debt for both hospitals and patients
- Developed systematic tracking method of socio-legal outcomes and projected health impacts
- The MLPSI return on investment (ROI) model has been used as a national model for sustaining MLPs
Read more about medical legal partnerships and their involvement in rural communities in the RHIhub Rural Monitor's Bringing Law and Medicine Together to Help Rural Patients. Other publications include:
- Health Care Recovery Dollars: A Sustainable Strategy for Medical-Legal Partnerships?, The Medical Legal Partnership for Children, 2008
- Teufel, J., Brown, S., Thorne, W., Goffinet, D., Clemons, L. (July, 2009). Process and Impact Evaluation of a Legal Assistance and Health Care Community Partnership; Health Promotion Practice, (10)3, 378-385. Article Abstract
- Teufel, J.A., Werner, D., Goffinet, D., Thorne, W., Brown, S.L., & Gettinger, L. (May 2012). Rural Medical-Legal Partnership and Advocacy: A Three-Year Follow-up, Journal of Health Care for the Poor and Underserved, 23(2), 705-714.
In 2012, MLPSI was honored by the National Center for Medical-Legal Partnership as Outstanding MLP of the Year.
Since medical and legal practices are very different from one another, joining the cultures for this partnership was a challenge. Below are some additional barriers MLPSI encountered when setting up and administering their services:
- Establishing a payer source in order to start the program. Financing their services through public means, like Medicaid, was complex and not a viable option for sustainability.
- The time it took to train the medical providers in the benefits of the legal program and obtaining their buy-in. Once the providers saw success in their referrals, interest in referring more patients increased.
- Communicating the value of MLPSI's services to their partners. One way they did so was encouraging medical providers to attend the Annual Medical-Legal Partnership Summit. Surprisingly, there was more willingness from the providers to commit to several days of training rather than a few hours in the middle of their busy weeks.
- Receiving referrals for services that the Land of Lincoln Legal Assistance Foundation does not actually offer to patients. Specific training regarding this topic has helped to increase appropriate referrals and decrease inappropriate ones.
MLPSI shared key principles they learned through the process of setting up a successful MLP operation:
Housing and homelessness
Income support and assistance
Networking and collaboration
Uninsured and underinsured
October 14, 2016
Date updated or reviewed
June 20, 2019
Suggested citation: Rural Health Information Hub, 2019. Medical Legal Partnership of Southern Illinois [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/929 [Accessed 25 October 2020]
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.