Case Presentation:
A 10‐year‐old African American girl known to have asthma and followed by her pediatrician for The disease presenTed To our emergency department (ED) in January with an acute exacerbation of asthma. After appropriate treatment in the ED, she was discharged home. She returned to the ED 4 months later with another acute exacerbation and again after appropriate treatment was discharged home. After 3 months she was again seen in the ED, this lime in status asthmalicus, leading to a 4‐day pediatric intensive care slay. Because of the repeated visits to the hospital and concern for noncompliance, a social work consult was obtained. During the interview it was discovered that the family was having a mold problem in their Section 8 apartment. It was also discovered thai the mother had repeatedly attempted to get the landlord to remediale the problem. The increase in the exacerbations her child suffered were coincident with the beginning of the mold growth. A referral was made to our medical‐legal partnership called the Health Law Partnership (HeLP). A legal history was obtained, where it was noted that the mother made numerous unsuccessful requests to the landlord and housing authority to facilitate remediation. The law component of our partnership reviewed the sequence of events, collected available documentation, and was able to terminate the lease without penalty, obtaining a new housing voucher, expedite the inspection of the new apartment, remove the landlord from the Section 8 housing list, and identify a private volunteer lawyer to assist the client in obtaining damages for lost/damaged personal property.
Discussion:
Health care professionals often deal with poverty and illness in silos without a coordinated approach to problem solving. Legal problems That affect a family's ability To access and/or provide care to Their children can be addressed by creating a medical‐legal collaboration to improve health and the coordination of services among health care and other providers. Medical‐legal partnerships are relatively new but increasingly recognized enlities that can assist health care providers provide interdisciplinary and truly holistic care. The premise is that by combining the health care expertise of hospital professionals with the legal expertise of lawyers, resulting coordinated services provide a more holistic and integrated approach to addressing the multiple determinants of health.
Conclusions:
Legal problems driven by poverty can affect the health and well‐being of patients. A referral by medical staff to a medical‐legal partnership, and intervention by lawyers provide an interdisciplinary approach to patient care that can reduce family stress, improve health status, and potentially reduce ED utilization in certain patient populations.
Author Disclosure:
R. Pettignano, none; S. Caley, none.