The Medical-Legal Partnership for Families in Durham
The Medical-Legal Partnership provides an opportunity for medical providers to refer patients for legal assessment in situations where a non-medical obstacle is impairing the overall health of a family.
The Medical-Legal Partnership is an alliance between health care providers and lawyers to benefit low-income and at-risk families. It provides an opportunity for pediatric providers to refer patients for legal assessment in situations where a non-medical obstacle is impairing the overall health of their patient. The legal team provides training for the pediatricians, nurses, social workers, and other staff about legal issues that may be facing their patients. A referral mechanism allows the providers to refer the patients to the legal team. A member of the legal team will interview the family about the situation and provide free legal help where appropriate.
A family’s overall health and wellbeing can be improved not just by good medical care, but by good legal care as well. A number of negative conditions, such as poor housing, denials of public benefits, inadequate education, and violent or unstable homes, can put families at risk of worsening health conditions. Many of these negative conditions can be solved by legal action. Medical providers can learn more about the basic rights of families and when to refer their patients to the legal team by reviewing slide presentations on the following topics:
Growing up in a home filled with domestic violence can be a terrifying experience for the children that live there. In fact, studies suggest that a child’s response to the ongoing violence can be deeply disturbing and result in a variety of difficulties for the child, ranging form persistent physical ailments to emotional and psychological trauma.
To best minimize a child’s exposure to domestic violence, the battered parent should apply for and obtain a domestic violence restraining order as quickly as possible to stop the violence. Under North Carolina law, a battered parent who needs protection can apply for a 50B domestic violence restraining order in which the judge can order immediate relief from the violence as well as other options for the battered parent.
This power point presents more information about domestic violence protection available to victims and contains information on how medical personnel can assist parents to get help.
Except in unusual situations, minor children cannot receive health care without consent from a parent or someone standing in for the parent. A child's medical condition can deteriorate if the physician does not have contact with an appropriate adult to make important medical decisions. The law allows persons other than the parent to make decisions for the child, but legal intervention is often needed to establish authorization for a non-parent to make decisions regarding a child's medical care.
This PowerPoint presentation addresses the following questions:
- Who is a minor?
- Who is permitted to make medical decisions for a minor child?
- Who is not permitted to make medical decisions for a minor child?
- When can a minor consent to his or her own health care?
- How can a non-parent be empowered to make health care decisions for a minor?
Children who don’t get enough to eat, have insufficient heat in their homes, or have no health insurance may be entitled to public benefits to assist them. Food Stamps, Temporary Assistance for Needy Children, Medicaid, and Energy Assistance can provide more stability and health for a sick child and her family.
If a family is turned down for benefits, the family has a right to appeal the denial decision. An attorney can represent the family in an appeal. If a low-income family is not getting benefits, the family should be referred to the Department of Social Services to apply. If the application is denied, the family should be referred to the legal team of the Medical-Legal Partnership for legal analysis and potential representation.
This power point provides more information about the public benefit programs available to low-income families.
A child’s housing conditions can seriously affect the child’s health. Molds, insects, and poor ventilation are just some of the housing conditions that can make a sick child sicker.If a child has a chronic health problem, questions about the child's living conditions may reveal relevant information.
Families in rental housing have the right to safe and habitable housing conditions. An attorney can help enforce a family’s right to habitable housing. If a child’s health is affected by poor housing conditions, the family should be referred to the Medical-Legal Partnership legal team.
This powerpoint provides more information about the rights of tenants and provides information about housing resources in the Durham community.
All children who qualify for Medicaid are entitled to early and periodic screening, diagnosis, and treatment (EPSDT). EPSDT benefits include all treatment and services in the federal Medicaid Act that are medically necessary to improve or maintain a child’s overall health, whether or not the services are covered for adults under the North Carolina Medicaid Plan. If a family is denied approval for a service, or Medicaid reduces or changes the level of recommended service, a family has a right to appeal this decision. If the appeal is regarding a change in the level of service, the child continues to receive his or her previous level of services until all appeals have been concluded. If a child has been denied a Medicaid service that the child’s medical providers believe is medically necessary, then the provider should refer the family for legal analysis and potential representation.
The Division of Medical Assistance (DMA) has information for providers on the EPSDT program, including a training powerpoint presentation. Visit the DMA website for EPSDT and Medicaid for Children. Health Check and EPSDT for Providers about Medicaid Services for Children (and click on training slides on right).
Children with disabilities are entitled to special education in the public schools. A child who is not receiving appropriate services has a legal issue.
Watch for the following characteristics:
- lagging academic performance
- behavior problems
- lack of interest in school
At regular check-ups, ask parents about the child’s school performance. The child might have a learning disability or other disability that has not been diagnosed that is interfering with school progress. If the parent feels the child is not getting what the child needs at school, a legal advocate with knowledge about special education can provide advice.
This power point will acquaint you with the special education system and help you know when to refer your patient to the legal team of the Medical-Legal Partnership.
A child with a significant impairment in a low-income family is entitled to SSI benefits. SSI is a monthly check that can be used to help meet the child’s needs. A child who gets SSI benefits is automatically entitled to Medicaid.
Children are eligible if an impairment causes a severe functional limitation. If a child’s ability to think, speak, hear, walk, eat, breathe, or engage in normal activities is well below average, the child might be eligible for SSI. Refer the family to make an application at the Social Security Administration.
If SSI benefits are denied, the parent can appeal the decision. The legal team at the Medical-Legal Partnership may be able to represent the child in the appeal. The doctor should refer the case and work with the lawyer to establish eligibility for the child.
This power point will acquaint you more fully with the Supplemental Security Income program and will help you know when to refer your patient to the legal team of the Medical-Legal Partnership.
is a community law office providing free legal advice, advocacy, and legal representation to low-income children.
has board certified Pediatricians, a Nurse Practitioner, and Pediatric Residents to provide well-child and urgent care.
is a statewide, nonprofit 501(c)3 law firm that provides free legal services in civil matters to low-income people.
provides accessible, affordable, highquality outpatient health care services to the medically underserved.
coordinates and manages care for children with medical complexity at Duke Health.
provides trauma-informed, culturally-responsive mental health services to Spanish speaking families in North Carolina.
provides health care services to veterans in Durham.
Referrals sent through the Medical-Legal Partnership are private and confidential. A referral does not create an attorney-client relationship between the legal team and the person referred. Information on this website is for education purposes only and should not be construed as legal advice.