This project, Medical Legal Partnership (MLP), led by Wisconsin Primary Health Care Association, Wisconsin Primary Health Care Association (WPHCA), Legal Action Wisconsin (LAW) and Judicare Legal Aid (Judicare) aims to improve financial stability and well-being for patients with lower incomes and unmet civil legal needs by connecting them with free health related legal services. Amy Washbush, PhD, UW–Madison School of Human Ecology, serves as the academic partner.
The Challenge
Medical Legal Partnerships (MLPs) integrate lawyers into health care settings to address the legal needs of patients. In this collaboration, health care professionals screen for legal needs and facilitate hand-offs to legal partners who provide direct support to patients as they navigate legal barriers to health, such as eviction, debt or benefit denial.
Recognizing the challenges that community health center (CHC) patients face, including limited legal staff capacity and lack of systems-based referral approaches connecting patients to legal experts, the Wisconsin Primary Health Care Association (WPHCA), Legal Action Wisconsin (LAW) and Judicare Legal Aid (Judicare) are piloting a MLP program. WPHCA is a non-profit membership organization representing Wisconsin’s 19 federally qualified CHCs. Participating CHCs serve over 50,000 patients and disproportionately reach populations with lower income levels and fewer insurance options. Of the patients receiving care at CHCs, 77 percent have incomes at or below 200 percent of the federal poverty level (compared to 25 percent of the state’s population), 55 percent have Medicaid insurance (compared to 18 percent of the state) and 15 percent are uninsured (compared to 5 percent of the state). The populations served by LAW and Judicare largely reflect CHC patient demographics. About one-third of clients report a disability of some kind, one-fifth are survivors of domestic violence and more than three-quarters are at or below 126 percent of the federal poverty level
Project Goals
This MLP pilot program has four goals to drive greater health and well-being for Wisconsinites, particularly those at or below 200 percent of the federal poverty level, Medicaid beneficiaries and uninsured individuals experiencing barriers to health:
Establish a robust MLP system that will pilot the sustainability and replicability of an MLP program design.
Enhance patient financial stability by addressing unmet legal needs with increased MLP capacity.
Elevate patient voices by establishing a patient advisory group to influence program design, inform insights, amplify patient experience and advance systems change.
Increase the scale of impact on communities and systems factors by documenting evidence to address sustainability and support for continuation of the MLP pilot, increase partnerships and support for future growth of the MLP program.
Progress Update
As of year two, the Wisconsin Primary Health Care Association Medical Legal Partnership (WPHCA MLP) advanced implementation and demonstrated progress in identifying and addressing patients’ health-related legal needs. Across three Community Health Center partners, 3,461 patients were screened for social drivers of health, resulting in 420 positive screenings for legal issues, primarily related to housing and public benefits. These screenings led to 108 referrals to legal aid partners, with 96 cases formally opened, including 57 housing-related and 39 benefits-related cases. Notably, 77 of these cases served individuals who were new to legal services, expanding access to critical legal support for underserved populations.
Legal interventions expanded and directly supported patients facing eviction, unsafe housing conditions and denials of essential health and nutrition benefits, contributing to improved housing stability, financial security and overall health outcomes. The project also expanded its reach through additional case types and strengthened referral pathways, ensuring that patients received timely and appropriate legal assistance.
