COVID Events among Delawareans with Disabilities Data Generally Data on COVID-19 event incidence ... more COVID Events among Delawareans with Disabilities Data Generally Data on COVID-19 event incidence (infection, hospitalization, mortality) for people with disabilities is sparse. While Congress has required that the federal government include race and ethnicity among the demographic data in its COVID analyses, the Act containing that mandate (April's "Paycheck Protection Program and Health Care Enhancement Act") did not include an explicit requirement for disability. A subsequent request to specify "disability" as among the "other relevant data" required by the Act, tendered by letter from a congressional group to the Secretary of the United States Department of Health and Human Services (HHS), was to no avail. The Centers for Disease Control and Prevention (CDC) did amend its case reporting form (the "Human Infection with 2019 Novel Coronavirus Person Under Investigation and Case Report Form") to add "Disability" to its list of "underlying medical conditions," but neither the CDC nor any other federal agency has reported disability data. 1,2 Nonetheless, the limited direct impact evidence that is available strongly suggests that the pandemic is having an especially lethal impact on people with disabilities. A comprehensive study of death records in the United Kingdom released in June 2020, for example, determined that fully one-third of all COVID-related mortalities were people with disabilities. 3 Subsequent updates in September and in February 2021 confirmed the disparities: according to the last release, "in England, the risk of death involving the coronavirus (COVID-19) was 3.1 times greater for moredisabled men and 1.9 times greater for less-disabled men, compared with non-disabled men" and "the risk of death was 3.5 times greater for more-disabled women and 2.0 times greater for lessdisabled women, compared with non-disabled women." 4
What follows is a brief attempt to describe some of the ways the pandemic has challenged us: some... more What follows is a brief attempt to describe some of the ways the pandemic has challenged us: some of the ways it has visited its harms unequally, the ways in which–beyond COVID–the pandemic has been distinctively harmful to the health of disabled Delawareans. The hard data suggests that Delawareans with disabilities are especially vulnerable to such harms. Qualitative data–including the voices of Delawareans–suggests they have suffered those harms, are enduring them still, and that the challenges remain ours to meet.
economically comparable countries. 1 It is widely understood that social, economic, environmental... more economically comparable countries. 1 It is widely understood that social, economic, environmental, and political factors are strong influences on individual and population health. 2 Furthermore, evidence demonstrates that social and economic inequalities within societies can lead to poor population health outcomes. 3 Civil legal aid attorneys remediate social and economic injustices and harms at individual and community levels by providing low or no cost legal services to people in need who do not have the means to pay for those services. 4 These legal aid services can increase access to justice and contribute to improved health outcomes. 5 Despite this, a civil legal aid "justice gap" exists in the US resulting in over a million economically impoverished individuals who seek legal services from receiving aid each year. 6 1
An individual’s zip code is a key factor in determining his or her health, life expectancy and qu... more An individual’s zip code is a key factor in determining his or her health, life expectancy and quality of life. In the city of Chester, Pennsylvania over 30% of residents live in poverty and face numerous barriers to good health. An innovative collaboration between Widener University School of Law, Crozer-Keystone Nurse-Family Partnership and Crozer-Keystone Healthy Start aims to address key social, environmental and political factors through education, direct legal services and systemic policy advocacy in order to improve the health of the community. Since 2010 Health, Education & Legal assistance Project: A Medical-Legal Partnership (HELP: MLP) has utilized a multidisciplinary approach to remediate root causes of poor health. Attorneys, social workers and nurses work collaboratively to address issues including access to care, securing public benefits, obtaining healthy housing, protection from abuse, and enforcing rights for people with disabilities. To date HELP: MLP has resolved...
Collaborative care models are rapidly emerging within our healthcare system in order to achieve t... more Collaborative care models are rapidly emerging within our healthcare system in order to achieve the triple aim: better health, better healthcare and lower costs. The Medical-Legal Partnership (MLP) model goes beyond traditional healthcare provider partnerships by integrating a legal services component to address patients' complex social and legal needs. By addressing harmful social determinants of health, MLPs are able to reduce barriers to care and improve overall well-being. In addition to providing direct legal services, MLPs transform healthcare systems and engage in systemic policy change. Health Education and Legal Assistance Project: A Medical-Legal Partnership (HELP: MLP) is a collaboration between Crozer-Keystone Healthy Start and Nurse Family Partnership, and Widener University School of Law serving low-income residents in Delaware County, Pennsylvania. Legal and social work staff collaborate to remedy a variety of issues faced by clients including housing, public bene...
By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impac... more By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impact on the lives of people who are living in poverty. 1 Through improving housing conditions, preservi...
ABSTRACT The Medical-Legal Partnership (MLP) model is an effective method to address complex soci... more ABSTRACT The Medical-Legal Partnership (MLP) model is an effective method to address complex social determinants improving the health and well-being of individuals in need. Nationally, MLPs have been established in a variety of settings, including over 235 healthcare institutions. While MLP attorneys often provide imminent critical legal interventions to remedy a crisis after it happens, MLPs also deliver preventive legal services to avert detrimental events. In addition to providing direct legal services, MLPs focus on providing collaborative care, increasing the advocacy capacity of healthcare staff, and advocating for systemic policy change. Health, Education and Legal Assistance Project: A Medical-Legal Partnership (HELP: MLP) is a collaboration between Crozer-Keystone Healthy Start, ChesPenn Health Services, and Widener University School of Law. HELP: MLP serves clients in Chester, Pennsylvania, one of the nation's poorest cities. Legal and social work staff collaborate to remedy a variety of issues faced by clients including housing, public benefits, and domestic violence. Additionally, HELP: MLP staff utilize a legal needs screening tool to identify issues and provide preventive legal services including thwarting utility shut-offs, termination of benefits, and evictions. Since its inception in 2009, HELP: MLP has resolved over 200 legal issues, conducted more than 15 trainings for health care and social work providers and has educated more than 20 students from multiple disciplines. Moreover, results from program evaluation conducted by public health faculty at Thomas Jefferson University show that HELP: MLP services have been successful in reducing client stress and increasing provider knowledge and advocacy capacity.
Behavioral Health Workforce Research Center, University of Michigan, 2018
The Affordable Care Act’s expansion of Medicaid eligibility among participating states has increa... more The Affordable Care Act’s expansion of Medicaid eligibility among participating states has increased the number of per-capita behavioral health providers more significantly than increases seen in states that did not expand Medicaid eligibility. Further examination of the relationship between Medicaid and behavioral health workforce is necessary given the important role that Medicaid plays in financing behavioral health services across our nation.
Study findings support the National Health Service Corps Loan Repayment Program as an effective incentive to increase rates of behavioral health providers in underserved and high-need areas. However, this program could be made more effective with increased funding, improved behavioral health recruitment and retention strategies, and expanded participant eligibility for substance use disorder treatment facilities and providers
Behavioral Health Workforce Research Center, University of Michigan, 2019
Evidence-based services and treatment exist to address opioid use disorder and other substance us... more Evidence-based services and treatment exist to address opioid use disorder and other substance use disorders (SUDs), yet only approximately 20% of individuals with opioid use disorder receive treatment each year. Accessing evidence-based treatment is critical to help people with SUDs improve health outcomes and achieve long-term recovery.
Quantitative and qualitative data were collected from State Opioid Treatment Authorities, Single State Agencies, and behavioral health providers across the country to better understand systemic, social, and economic factors that impact access to medication-assisted treatment and other SUD treatment. Data related to organizational culture, provider perceptions and attitudes, access to Medicaid and other insurance coverage, and state-specific initiatives to address the opioid epidemic were collected, analyzed, and discussed.
States are engaging in prevention and treatment, as well as recovery support and harm reduction efforts. The important benefit of peer professionals in SUD treatment was emphasized, as was the importance of addressing stigma and insurance coverage as barriers to SUD treatment.
By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impac... more By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impact on the lives of people who are living in poverty. Through improving housing conditions, preserving public benefits, and restoring utilities, civil legal aid attorneys provide assistance critical to the health and well-being of vulnerable and at-risk populations. Nevertheless, because of an inadequate level of funding, needs overwhelm resources. While civil legal aid attorneys represented more than 2 million poor people in 2011, 80% of the civil legal needs of people who are living poverty were unmet. The value of civil legal aid services historically has been confined to theories of social justice; however, public health evidence strongly suggests that civil legal aid services positively can impact individual and population health. The medical-legal partnership (MLP) model provides civil legal aid attorneys a new framework to measure and communicate the true value of their work.
This article: (1) presents the public health evidence demonstrating how resolving unmet legal needs improves health; (2) describes the MLP model; and (3) reframes the value of civil legal aid services by focusing on the work of one MLP partnering with a social services agency serving very low-income, pregnant women, and parents with young children.
COVID Events among Delawareans with Disabilities Data Generally Data on COVID-19 event incidence ... more COVID Events among Delawareans with Disabilities Data Generally Data on COVID-19 event incidence (infection, hospitalization, mortality) for people with disabilities is sparse. While Congress has required that the federal government include race and ethnicity among the demographic data in its COVID analyses, the Act containing that mandate (April's "Paycheck Protection Program and Health Care Enhancement Act") did not include an explicit requirement for disability. A subsequent request to specify "disability" as among the "other relevant data" required by the Act, tendered by letter from a congressional group to the Secretary of the United States Department of Health and Human Services (HHS), was to no avail. The Centers for Disease Control and Prevention (CDC) did amend its case reporting form (the "Human Infection with 2019 Novel Coronavirus Person Under Investigation and Case Report Form") to add "Disability" to its list of "underlying medical conditions," but neither the CDC nor any other federal agency has reported disability data. 1,2 Nonetheless, the limited direct impact evidence that is available strongly suggests that the pandemic is having an especially lethal impact on people with disabilities. A comprehensive study of death records in the United Kingdom released in June 2020, for example, determined that fully one-third of all COVID-related mortalities were people with disabilities. 3 Subsequent updates in September and in February 2021 confirmed the disparities: according to the last release, "in England, the risk of death involving the coronavirus (COVID-19) was 3.1 times greater for moredisabled men and 1.9 times greater for less-disabled men, compared with non-disabled men" and "the risk of death was 3.5 times greater for more-disabled women and 2.0 times greater for lessdisabled women, compared with non-disabled women." 4
What follows is a brief attempt to describe some of the ways the pandemic has challenged us: some... more What follows is a brief attempt to describe some of the ways the pandemic has challenged us: some of the ways it has visited its harms unequally, the ways in which–beyond COVID–the pandemic has been distinctively harmful to the health of disabled Delawareans. The hard data suggests that Delawareans with disabilities are especially vulnerable to such harms. Qualitative data–including the voices of Delawareans–suggests they have suffered those harms, are enduring them still, and that the challenges remain ours to meet.
economically comparable countries. 1 It is widely understood that social, economic, environmental... more economically comparable countries. 1 It is widely understood that social, economic, environmental, and political factors are strong influences on individual and population health. 2 Furthermore, evidence demonstrates that social and economic inequalities within societies can lead to poor population health outcomes. 3 Civil legal aid attorneys remediate social and economic injustices and harms at individual and community levels by providing low or no cost legal services to people in need who do not have the means to pay for those services. 4 These legal aid services can increase access to justice and contribute to improved health outcomes. 5 Despite this, a civil legal aid "justice gap" exists in the US resulting in over a million economically impoverished individuals who seek legal services from receiving aid each year. 6 1
An individual’s zip code is a key factor in determining his or her health, life expectancy and qu... more An individual’s zip code is a key factor in determining his or her health, life expectancy and quality of life. In the city of Chester, Pennsylvania over 30% of residents live in poverty and face numerous barriers to good health. An innovative collaboration between Widener University School of Law, Crozer-Keystone Nurse-Family Partnership and Crozer-Keystone Healthy Start aims to address key social, environmental and political factors through education, direct legal services and systemic policy advocacy in order to improve the health of the community. Since 2010 Health, Education & Legal assistance Project: A Medical-Legal Partnership (HELP: MLP) has utilized a multidisciplinary approach to remediate root causes of poor health. Attorneys, social workers and nurses work collaboratively to address issues including access to care, securing public benefits, obtaining healthy housing, protection from abuse, and enforcing rights for people with disabilities. To date HELP: MLP has resolved...
Collaborative care models are rapidly emerging within our healthcare system in order to achieve t... more Collaborative care models are rapidly emerging within our healthcare system in order to achieve the triple aim: better health, better healthcare and lower costs. The Medical-Legal Partnership (MLP) model goes beyond traditional healthcare provider partnerships by integrating a legal services component to address patients' complex social and legal needs. By addressing harmful social determinants of health, MLPs are able to reduce barriers to care and improve overall well-being. In addition to providing direct legal services, MLPs transform healthcare systems and engage in systemic policy change. Health Education and Legal Assistance Project: A Medical-Legal Partnership (HELP: MLP) is a collaboration between Crozer-Keystone Healthy Start and Nurse Family Partnership, and Widener University School of Law serving low-income residents in Delaware County, Pennsylvania. Legal and social work staff collaborate to remedy a variety of issues faced by clients including housing, public bene...
By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impac... more By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impact on the lives of people who are living in poverty. 1 Through improving housing conditions, preservi...
ABSTRACT The Medical-Legal Partnership (MLP) model is an effective method to address complex soci... more ABSTRACT The Medical-Legal Partnership (MLP) model is an effective method to address complex social determinants improving the health and well-being of individuals in need. Nationally, MLPs have been established in a variety of settings, including over 235 healthcare institutions. While MLP attorneys often provide imminent critical legal interventions to remedy a crisis after it happens, MLPs also deliver preventive legal services to avert detrimental events. In addition to providing direct legal services, MLPs focus on providing collaborative care, increasing the advocacy capacity of healthcare staff, and advocating for systemic policy change. Health, Education and Legal Assistance Project: A Medical-Legal Partnership (HELP: MLP) is a collaboration between Crozer-Keystone Healthy Start, ChesPenn Health Services, and Widener University School of Law. HELP: MLP serves clients in Chester, Pennsylvania, one of the nation's poorest cities. Legal and social work staff collaborate to remedy a variety of issues faced by clients including housing, public benefits, and domestic violence. Additionally, HELP: MLP staff utilize a legal needs screening tool to identify issues and provide preventive legal services including thwarting utility shut-offs, termination of benefits, and evictions. Since its inception in 2009, HELP: MLP has resolved over 200 legal issues, conducted more than 15 trainings for health care and social work providers and has educated more than 20 students from multiple disciplines. Moreover, results from program evaluation conducted by public health faculty at Thomas Jefferson University show that HELP: MLP services have been successful in reducing client stress and increasing provider knowledge and advocacy capacity.
Behavioral Health Workforce Research Center, University of Michigan, 2018
The Affordable Care Act’s expansion of Medicaid eligibility among participating states has increa... more The Affordable Care Act’s expansion of Medicaid eligibility among participating states has increased the number of per-capita behavioral health providers more significantly than increases seen in states that did not expand Medicaid eligibility. Further examination of the relationship between Medicaid and behavioral health workforce is necessary given the important role that Medicaid plays in financing behavioral health services across our nation.
Study findings support the National Health Service Corps Loan Repayment Program as an effective incentive to increase rates of behavioral health providers in underserved and high-need areas. However, this program could be made more effective with increased funding, improved behavioral health recruitment and retention strategies, and expanded participant eligibility for substance use disorder treatment facilities and providers
Behavioral Health Workforce Research Center, University of Michigan, 2019
Evidence-based services and treatment exist to address opioid use disorder and other substance us... more Evidence-based services and treatment exist to address opioid use disorder and other substance use disorders (SUDs), yet only approximately 20% of individuals with opioid use disorder receive treatment each year. Accessing evidence-based treatment is critical to help people with SUDs improve health outcomes and achieve long-term recovery.
Quantitative and qualitative data were collected from State Opioid Treatment Authorities, Single State Agencies, and behavioral health providers across the country to better understand systemic, social, and economic factors that impact access to medication-assisted treatment and other SUD treatment. Data related to organizational culture, provider perceptions and attitudes, access to Medicaid and other insurance coverage, and state-specific initiatives to address the opioid epidemic were collected, analyzed, and discussed.
States are engaging in prevention and treatment, as well as recovery support and harm reduction efforts. The important benefit of peer professionals in SUD treatment was emphasized, as was the importance of addressing stigma and insurance coverage as barriers to SUD treatment.
By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impac... more By resolving a wide range of civil legal needs, civil legal aid attorneys have a tremendous impact on the lives of people who are living in poverty. Through improving housing conditions, preserving public benefits, and restoring utilities, civil legal aid attorneys provide assistance critical to the health and well-being of vulnerable and at-risk populations. Nevertheless, because of an inadequate level of funding, needs overwhelm resources. While civil legal aid attorneys represented more than 2 million poor people in 2011, 80% of the civil legal needs of people who are living poverty were unmet. The value of civil legal aid services historically has been confined to theories of social justice; however, public health evidence strongly suggests that civil legal aid services positively can impact individual and population health. The medical-legal partnership (MLP) model provides civil legal aid attorneys a new framework to measure and communicate the true value of their work.
This article: (1) presents the public health evidence demonstrating how resolving unmet legal needs improves health; (2) describes the MLP model; and (3) reframes the value of civil legal aid services by focusing on the work of one MLP partnering with a social services agency serving very low-income, pregnant women, and parents with young children.
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Study findings support the National Health Service Corps Loan Repayment Program as an effective incentive to increase rates of behavioral health providers in underserved and high-need areas. However, this program could be made more effective with increased funding, improved behavioral health recruitment and retention strategies, and expanded participant eligibility for substance use disorder treatment facilities and providers
Quantitative and qualitative data were collected from State Opioid Treatment Authorities, Single State Agencies, and behavioral health providers across the country to better understand systemic, social, and economic factors that impact access to medication-assisted treatment and other SUD treatment. Data related to organizational culture, provider perceptions and attitudes, access to Medicaid and other insurance coverage, and state-specific initiatives to address the opioid epidemic were collected, analyzed, and discussed.
States are engaging in prevention and treatment, as well as recovery support and harm reduction efforts. The important benefit of peer professionals in SUD treatment was emphasized, as was the importance of addressing stigma and insurance coverage as barriers to SUD treatment.
medical-legal partnership (MLP) model provides civil legal aid attorneys a new framework to measure and communicate the true value of their work.
This article: (1) presents the public health evidence demonstrating how
resolving unmet legal needs improves health; (2) describes the MLP model; and (3) reframes the value of civil legal aid services by focusing on the work of one MLP partnering with a social services agency serving very low-income, pregnant women, and parents with young children.
Study findings support the National Health Service Corps Loan Repayment Program as an effective incentive to increase rates of behavioral health providers in underserved and high-need areas. However, this program could be made more effective with increased funding, improved behavioral health recruitment and retention strategies, and expanded participant eligibility for substance use disorder treatment facilities and providers
Quantitative and qualitative data were collected from State Opioid Treatment Authorities, Single State Agencies, and behavioral health providers across the country to better understand systemic, social, and economic factors that impact access to medication-assisted treatment and other SUD treatment. Data related to organizational culture, provider perceptions and attitudes, access to Medicaid and other insurance coverage, and state-specific initiatives to address the opioid epidemic were collected, analyzed, and discussed.
States are engaging in prevention and treatment, as well as recovery support and harm reduction efforts. The important benefit of peer professionals in SUD treatment was emphasized, as was the importance of addressing stigma and insurance coverage as barriers to SUD treatment.
medical-legal partnership (MLP) model provides civil legal aid attorneys a new framework to measure and communicate the true value of their work.
This article: (1) presents the public health evidence demonstrating how
resolving unmet legal needs improves health; (2) describes the MLP model; and (3) reframes the value of civil legal aid services by focusing on the work of one MLP partnering with a social services agency serving very low-income, pregnant women, and parents with young children.