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Rural Health Information Hub
Rural Health Information Hub

Medical-Legal Partnerships

Medical-legal partnerships (MLPs) provide legal services to patients in conjunction with healthcare services. MLPs offer civil legal support, including legal consultation and advice to address housing quality conditions, denial of public benefits, and other social needs to address social determinants of health (SDOH) that can impact quality of life. Often, MLP services are free for patients.

MLPs are increasingly being used in rural communities as a model to help address SDOH. Programs that use MLPs can connect people to legal services in the same vicinity where they receive healthcare, increasing opportunity for coordination of services.

Examples of Rural MLPs Addressing SDOH

  • Medical-Legal Partnership of Southern Illinois (MLPSI) was founded in 2002 to connect patients to legal assistance through referrals from their medical providers. MLPSI helps address SDOH by connecting patients with health and social services, such as healthcare, educational services, housing subsidies, and protection against eviction and foreclosure. MLPSI has connected thousands of patients to local attorneys and helped relieve millions of dollars of medical debt.
  • The Montana Health Justice Partnership (MHJP) is an example of an MLP that embedded legal staff into healthcare teams to address SDOH. Issues addressed included housing quality complaints, environmental exposures, and domestic issues such as family violence. MHJP operated in several health clinics in rural Montana. The program helped participants save money, address housing concerns, and improve overall health.
  • The Northern Dental Access Center Medical-Legal Partnership helps address SDOH by assisting low-income patients in rural Minnesota with legal and social challenges that affect their oral health. They provide counseling about insurance, care coordination services, and help with transportation needs. They also connect patients with community health worker (CHW) support. The dental center employs a full-time attorney and was one of the first MLPs to operate in a dental clinic.

Implementation Considerations

MLPs may require substantial resources to provide services at no or reduced cost to patients. Rural hospitals and community health centers implementing this model often utilize a combination of funding strategies and include financial support from both the healthcare organization and the legal partner. Healthcare organization funding can come from foundation funding, grants, and donations, while legal partner organizations often mobilize funding from legal foundations, government contracts, grants, donations, or other legal services funding.

MLPs in rural areas may face unique barriers to implementation due to limited funding and staffing. For example, in rural areas, MLPs may only have a single employee, and attorneys are often less specialized than those in urban areas. These factors may limit the capacity of services that MLPs provide in rural settings.

MLPs need to identify strategies to identify patients with legal and social needs that impact their health and well-being. Rural organizations implementing MLPs may need to train healthcare providers and staff about screening for needs and making referrals to MLP services.