Healthfirst and Mount Sinai Hospital Partner to Identify and Resolve Health-Harming Legal Needs for Patients

The Challenge

When facing health-harming legal needs, such as housing instability, lack of public benefits and threats to personal safety, an individual’s health is at a heightened level of risk. Frontline healthcare organizations increasingly understand that addressing patients’ social determinants of health and health-harming legal needs are as important as addressing medical needs. Yet, clinicians often do not have the tools or training to do so.

The Goal

1. Develop novel processes to identify legal determinant risks among patients and develop reliable workflows to address and mitigate such risks.
2. Advance innovative models of care management that incorporate legal personnel and services to address specified health-harming legal needs.
3. Provide patients with legal resources to directly address their health-harming legal needs.
4. Track patient outcomes to assess if there is a correlation between addressing patients’ health-harming legal needs and improving health outcomes.

The program needed to be scalable and replicable for the participating healthcare systems to implement and to meet the needs of its community and patient population.

The Healthfirst Solution

A partnership between Mount Sinai Healthcare System, Mount Sinai Health Partners (MSHP), Mount Sinai Medical-Legal Partnership (MSMLP) and New York Legal Assistance Group’s LegalHealth Division (LegalHealth) and Healthfirst created a working team to pilot a program to identify legal needs that could lead to negative health implications. The team curated a list of search terms to run through the medical record system and identify cases of potential medical-legal need. Upon consent from patients, their cases were referred to a third-party pro-bono legal services organization provided by LegalHealth.

Population Health Improvements

• Over an initial 12-month period, between September 8, 2020 to August 20, 2021, 165 patients were referred to the legal service organization for legal assistance.
• 157 of these referred patients consented to receiving legal assistance. Since most patients had multiple unmet legal needs, the attorneys handled 264 distinct legal matters.
• 211 legal matters were resolved for 137 patients and 104 of the cases were resolved through brief service by the attorney.

Takeaway

Housing and public benefits/income maintenance were the highest areas of need (41% and 35% of case matters respectively). Collaborative efforts among health plans, clinicians, healthcare IT, and legal services teams can identify and resolve critical health-harming legal needs for patients and improve their overall health and well-being.