It is a simple question, and one that all civil legal aid offices who handle intake and requests for services - whether statewide, regional, local or subject matter specific – would do well to think about asking and tracking for all their clients and potential clients. Why? This one simple question offers important perspective on your clients, and creates opportunities for important community partnerships. And it is not difficult to collect.
Asking where clients receive their healthcare allows your staff to understand an essential - some would say dominant - aspect of your clients’ lives. The health picture of low-income, civil legal aid clients is pretty clear and fairly grim: one in four has been diagnosed with at least one chronic illness, requiring regular interfacing with healthcare and pharmacy services. Families have even greater frequency of contact with healthcare systems given the need for regular, preventive care for children. And the increasing focus in healthcare on superutilizers – the five percent of the population that account for 50 percent of healthcare services used – dovetails with potential civil legal aid clients who have multiple civil legal needs.
Bottom line: clients spend a lot of time and energy getting their healthcare needs met, so we should better understand the institutions that take care of them. We can’t do that until we know where they get their healthcare. Is it at a community health center? The emergency room of the local hospital? The outpatient clinic in a major academic hospital? A veterans medical center? Knowing this information tells us a lot about our clients’ lives.
It is also an excellent starting point for a conversation with local and regional healthcare institutions about civil legal aid, about the value of your services to their patients, and about forming a medical-legal partnership. As a community organization, being able to tell local hospitals and health centers how many of their patients seek your assistance is a powerful story. Knowing and sharing the number of their patients who use your services – and why – can help them grasp the value of a tighter, more structured relationship with you.
This is not a difficult data point to collect. It is data you can get directly from the person seeking your assistance, and it has the potential to yield a big return if it’s tracked universally across the civil legal aid agency. Here’s how to do it:
- Get your intake staff together and develop a dropdown box that captures all of the local and regional healthcare providers. Be sure that you have a good understanding of the different names (and nicknames) of healthcare entities, and make sure you specify emergency room versus outpatient services.
- Set a goal of tracking healthcare sites for both clients that are accepted for civil legal aid services, and those that are turned away.
- After three months, check the distribution of healthcare sites for clients that you had to turn away - and think about how to communicate that to the healthcare sites.
*Ellen Lawton, JD, is the co-Principal Investigator of the National Center for Medical-Legal Partnership.