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MLP 101: How and Why to Make a Referral to the Medical-Legal Partnership Clinic

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MLP 101: How and Why to Make a Referral to the Medical-Legal Partnership Clinic Lee Anna Botkin MD and Dan Szrom JD Monday, September 23, 2013 Noon conference NICU 3 rd floor conference room. Today’s Information Session. Why should I refer my patient to the MLP Clinic? Examples!

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MLP 101: How and Why to Make a Referral to the Medical-Legal Partnership Clinic

Lee Anna Botkin MD and Dan Szrom JD

Monday, September 23, 2013

Noon conference

NICU 3rd floor conference room

today s information session
Today’s Information Session
  • Why should I refer my patient to the MLP Clinic? Examples!
  • How do I refer a patient to the clinic?
  • When can a patient stop by the clinic to speak with a FREE and CONFIDENTIAL attorney?
  • Who do I contact if I have more questions?
why refer
Why refer
  • Questions about:
    • Special education
    • Housing
    • Guardianships
    • Family Law (teen parents)
    • DREAM Act
    • Public Benefits
    • Child Support
    • Emancipation
why refer1
Why refer
  • LACY’s legal services are focused on the child or youth. The issue should be one that is affecting the child/youth patient primarily
cases the clinic cannot cover
Cases the Clinic Cannot Cover
  • The clinic cannot assist with or even discuss questions about the medical provider’s own standard of care or legal responsibilities.
  • Examples
    • Medical malpractice
    • Advice regarding mandated reporter duties
    • Advice regarding patient confidentiality
can the clinic help my patient
Can the clinic help my patient?
  • Nurse Kathy’s 3-year-old patient Justin has come in for a check-up with his mom. While Kathy is taking Justin’s blood pressure, she notices that Justin keeps scratching his leg. Justin’s mom tells Kathy that Justin’s allergies have been getting worse and make him itch constantly.
  • Kathy looks in Justin’s chart and sees that Justin has come in several times in the last few months for asthma and allergies. Kathy asks Justin’s mom how Justin is responding to his inhaler.
  • Justin’s mom is worried that Justin uses his inhaler a lot. He needs the inhaler the most when he’s playing legos on the carpet. She thinks the carpet in their apartment needs to be replaced but her landlord never returns any of her phone calls. She is frustrated but doesn’t know what else she can do.
can the clinic help my patient1
Can the clinic help my patient?
  • Medical social worker Rita is checking in with her 16-year-old patient Marcy. Marcy suffers from a chronic illness that causes many symptoms, including interruptions to her sleeping, heart problems, and hyperactivity.
  • Marcy tells Rita that she’s really stressed out because she is in trouble for missing school. Her mom has to pay the school a bunch of fines and maybe go to court for something but she is not sure why. Marcy feels terrible because she knows her family has no extra money. Marcy tells Rita she goes to all her classes except P.E. because she can’t keep up with the running and warm-up exercises.
can the clinic help my patient2
Can the clinic help my patient?
  • Dr. Sanchez’s 17-year-old client Patty has brought her son Angel in for his 3-month well baby check-up. During the check-up, Dr. Sanchez notices that Patty is distracted and is getting agitated by repeated incoming texts on her cell phone.
  • Patty tells Dr. Sanchez that Angel’s father won’t stop texting her and keeps saying he wants to take the baby. She tells Dr. Sanchez that Angel’s father has never been involved in the baby’s care and has only seen the baby once. She thinks he smokes marijuana and might be in a gang. She is getting worried that he will try to take the baby from her school’s daycare when she’s in class.
can the clinic help my patient3
Can the clinic help my patient?
  • Medical assistant Sue is helping Maria check-in her grandson Felix for his doctor’s appointment. Maria tells Sue that Felix and his teenage sister Jennifer have been living with her for a few months because their parents are out of town.
  • Maria asks Sue how to get Felix a new pair of glasses. Sue asks Maria if she has Felix’s Medi-Cal card. Maria hesitates and then tells Sue that she doesn’t have it. She then tells Sue that her grandchildren’s parents are not actually out of town. She picked up her grandchildren from their home because she thinks their father is using meth. The children’s mother has been absent for a year.
the 9 best questions to ask
The 9 best questions to ask

“Every parent faces different stresses that can affect their child’s health. I ask every family about these issues because we may be able to help”

1. Are you doing okay making ends meet?

2. In the past month, did anyone in your family go hungry because there was not enough money?

3. Are you having problems receiving WIC, food stamps, daycare vouchers, health insurance?

4. Problems with housing conditions (overcrowding, evictions, lead, utilities, mold, rodents)?

the 9 best questions to ask1
The 9 best questions to ask

5. Is your child getting the help that he/she needs in school?

6. Do you have any questions about your immigration status?

7. Do you feel that you and/or your children are safe in your relationships?

8. Do you have questions about child support or custody or guardianships?

9. Over the past 2 weeks, have you felt down, depressed, or hopeless, or felt little interest or pleasure in doing things?

how do i do this
How do I do this?
  • HealthLink
    • Progress Note: .mlpscreen
    • Referral: .mlpreferral
    • Patient Information: .mlpinfo


  • Paper
    • referral form
    • patient information flyers in 3 languages
how do i refer a patient to the clinic
How do I refer a patient to the clinic?
  • Any of three ways
    • Fax
    • Call
    • Drop In
  • Be sure to mention the clinic is FREE and CONFIDENTIAL
number one fax
Number One: FAX
  • Fax Referral form and a completed Release of Information Form to (408) 288-8850
  • Write on Release of Information Form: “provide medical records and discuss” to cover both verbal and written communication
  • You MUST send in a Release of Information Form with the Referral Form!
  • Place completed Referral Form and Release of Information Form in the chart
number two call
Number Two: CALL
  • Patients or families can also call the LACY intake line directly (408) 280-2416
number three drop in
Number Three: DROP IN
  • Patients or families can drop in at the clinic to speak directly with a LACY attorney
    • Every Wednesday afternoon 1:30 pm to 3:30 pm at VHC Bascom (in Social worker’s office in Suite 240)
    • 2nd and 4th Thursdays from 2 pm to 4 pm at VHC Gilroy (in Pediatrics waiting area)
how do i create a referral form in healthlink
How do I create a Referral Form in HealthLink?

-From a patient’s chart, select COMMUNICATION on the left hand vertical menu.


-Under Recipient select OTHER. Enter in LACY and FAX # 408-288-8850 (currently not working—until Optimization fixes this, print out forms on paper and fax like usual)

-Under Letter, select OTHER (very right hand side). In the box, type MLP which brings up HHS AMB MLPREFERRAL.

-Form will auto-populate with demographic info—fill out the section below the demographic info with the reason for referral, other info.

-Print form (eventually this will also print out the Release of Information form too).

-Fax form and Release of Information form with patient/guardian signature to 408-288-8850.

-Discuss the referral in your note as usual.

what happens after the referral is sent
What Happens After the Referral is Sent?
  • You get an email when the referral is received
  • All referrals undergo a legal intake process
after the intake 3 outcomes
After the Intake: 3 outcomes
  • Case accepted OR
  • Case referred OR
  • Case not accepted
    • LACY can only give the medical provider information if the client agrees
after the intake case accepted
After the Intake: Case Accepted
  • Patient eligible for MLPC and legal need is within scope of MLPC services.
  • Legal assistance could be anything from providing information to full representation
    • Discussion
    • Advocacy
    • Attending meetings together
    • Letter writing
    • Court appearances
after the intake case referred
After the Intake: Case Referred
  • Actually needs social work or other service instead
    • LACY would refer to the other service
  • Legal issue outside scope of practice of LACY
    • LACY would refer to another legal aid provider
  • Conflict with prior client of LACY
    • LACY would refer to another legal aid provider
after the intake case not accepted
After the Intake: Case Not Accepted
  • Patient declines services
    • Some patients may tell the medical provider they are interested but later tell the lawyer they are not
  • Lawyer unable to reach patient
who do i contact if i have more questions
Who do I contact if I have more questions?
  • Call LACY intake line at (408) 280-2416
  • MLPC at VHC Bascom
    • Dan Szrom JD
  • MLPC at VHC Gilroy
    • Neha Marathe JD
more information
More information
  • Local
    • VMC’s webpage has MLP info
    • Valley Pages (VMC intranet) has links to patient handouts in English, Spanish and Vietnamese
    • MLPC materials on the Pedi Shared Drive (VMC staff have access)
  • National