Site Visit

Pulling Together to Improve Health: Integrating Health, Social, and Legal Services in DC
July 20, 2012


Jessamy Taylor, MPP & Michele J. Orza, ScD


This one-day site visit in Washington, DC, was designed to expose congressional and federal health policy staff to programs that integrate medical, social, and legal services to improve the health of low-income individuals, families, and communities. Site visit participants toured the children’s health center at the Children’s National Medical Center and Mary’s Center, a federally qualified health center (FQHC). The Medical Legal Partnership program situates legal staff in clinical settings and seeks to provide patients with legal services they might need to deal with their health conditions. An analogous program, called Health Leads, also locates largely volunteer staff in clinics and in the community to connect patients and their families to needed social services. These programs focus on addressing the circumstances that may have led to a child’s medical condition and that may continue to exacerbate it even after proper medical treatment. The Home Visiting program for mothers and their children uses early and continuous intervention to improve children’s overall well being and to reduce child abuse and neglect. Together these programs seek to improve the efficacy of primary care by connecting people with supports and services to deal with aspects of their lives that may be contributing to poor health, but that are generally either seen as outside the traditional bailiwick or beyond the resources of the health care system. Most of these efforts are funded through philanthropic donations and therefore sustainability is a concern. It was suggested that covering these services under Medicaid could be a solution. Others noted national budgetary concerns and the need for more program specific data collection and evaluation.

Site visit agenda and list of participants are available for download. See below for select slide decks from speakers.

Related Materials

"Home, but Not Alone: Evidence-Based Maternal, Infant, and Early Childhood Home Visitation" (Issue Brief No. 843, May 26, 2011)

"Medical-Legal Partnerships: Transforming Primary Care By Addressing The Legal Needs Of Vulnerable Populations," Health Affairs 29, no. 9 (2010): pp. 1697–1705.

See also other related Forum materials, including "High Hopes: Public Health Approaches to Reducing the Need for Health Care" (Background Paper No. 78, September 27, 2010), "The Primary Care Safety Net: Strained, Transitioning, Critical" (Background Paper No. 79, September 28, 2010), and "Unusual Suspects: Focusing on Nonmedical Determinants to Improve the Nation’s Health" (Forum Session, November 5, 2010).

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