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A mother in her 40s is diagnosed with metastatic cancer. The patient is overwhelmed by trying to balance treatments, her job, and children at home. It is too much for one person to deal with alone, but she can't afford the kind of help she needs.
While at St. Peter's Hospital for treatment, she mentions her struggles beyond—but due to—her illness. The staff refers the patient to the Medical-Legal Partnership for help setting up a standby guardianship. In the process, the attorneys uncover much more and help her navigate custody issues through a separation, handle housing challenges, and secure disability benefits.
This Medical-Legal Partnership, or MLP, is a joint venture of St. Peter's Health Partners, the Legal Aid Society of Northeast New York and Albany Law School's Health Law Clinic. It offers free civil legal services to seriously ill, low-income patients in the Capital Region with health-related legal problems.
"They are able to relieve some of those external stresses that can actually make symptoms worse," says Dr. Catherine Adams, chief of palliative medicine at St. Peter's. "They help prioritize legal issues faced by patients, such as advanced directives and make it easier for providers to manage care in the best way possible."
"When dealing with patients with serious illnesses, our ability to help them feel better is limited by their major concerns—housing, custody, legal issues," says Adams. "Having a resource to address those is so valuable."
The MLP has helped nearly 90 patients to date.
"We have indeed seen a steady increase in people utilizing the program in its second year," confirms Alexis Kutski, Albany Law School Class of 2015, the Legal Aid Society attorney on-site at St. Peter's who spearheads the MLP. The increase is also thanks to training that Kutski has done at St. Peter's on how to identify and make a referral. Early on, they got mostly wills and powers of attorney and estate cases. Now, because of greater awareness of how the MLP can help patients, they see more Medicare appeals, disability benefits, housing cases, custody matters, and employment issues.
"The benefit of the MLP is that one referral may turn into multiple cases, ultimately helping the patient in so many ways," says Kutski.
LASNNY provides direct legal services to the majority of patients who come through the MLP, but some cases are well suited for the clinic environment. Certain social security disability appeals, standby guardianship cases, wills and powers of attorney cases are referred to the Health Law Clinic at Albany Law School. Kutski knows firsthand what cases may have pedagogical value having been a Health Law Clinic intern herself while attending Albany Law. Clinic Director Joseph Connors and Barry A. Gold Health Law Staff Attorney Chaula Shukla oversee the cases and supervise the clinic interns who work with the clients and gain valuable experience on real-world cases.
Professor Connors and the Health Law Clinic—part of the Law Clinic and Justice Center at Albany Law School—were early champions of the now-accepted understanding that addressing patients' legal problems can help improve their health outcomes.
St. Peter's Health Partners was eager to join forces for better outcomes for their patients. "This truly mission-driven initiative addresses a frustration our staff have when they hear about their patients' problems," says Robert Swidler, St. Peter's vice president of legal services. "Now we can provide them with assistance and not just listen."
While the program started at St. Peter's Hospital, cases can now be referred to the MLP from other St. Peter's sites including Samaritan Hospital in Troy and Albany Memorial Hospital. They plan to expand the program to home care as well. "We see the potential benefits of this program across our continuum of care," Swidler says.
The MLP is funded by an IOLA grant to the Legal Aid Society. IOLA stands for the New York State Interest on Lawyer Account (IOLA) Fund, which uses interest from lawyer trust accounts to provide civil legal assistance to low income people.