Crozer-Keystone Healthy Start, part of Women and Children’s Health Services, recently received a one-year, $166,000 grant from the Health Resources and Services Administration to create a unique medical-legal partnership in conjunction with the Widener University School of Law. The grant will be used to help program participants obtain free legal assistance, allowing them to have more time to care for their children and maintain healthy lifestyles.
Based at Community Hospital in Chester, Crozer-Keystone Healthy Start provides a range of case management, health education and outreach to women who are pregnant or who have children under two years old. The grant will be used to train Women and Children’s Health Services staff to conduct legal needs assessments when they first connect with a client, to identify legal needs and to make appropriate referrals to the legal component. The grant will fund the legal team, which will consist of a full-time attorney as well as nine Widener students from the School of Law and graduate and undergraduate students with social work, public health, psychology and nursing concentrations. Two of the students have Spanish-language skills that will benefit client outreach efforts. The project will also collect data to measure the impact of their efforts.
Women and Children’s Health Services’ flagship program is Crozer-Keystone Healthy Start, which provides hands-on medical and social service assistance for women and families in need. Healthy Start is free for pregnant women and children younger than 24 months old who meet certain income limitations and live in Chester, Chichester, Eddystone, Woodlyn, Parkside, Upland, Toby Farms, Chester Township, Trainer, Marcus Hook or Linwood.
“The idea behind this program is that we have found that many of our participants have legal problems that literally affect their health and well-being. Our program participants often do not have the resources to manage these issues, or they are unaware of resources that are available to them. When they have to deal with these legal issues themselves, they do not have as much time to take care of themselves or their children,” says Joanne Craig, director of Women and Children’s health Services.
In the primary service area of Crozer-Keystone Healthy Start, almost one-third of the service area residents live in poverty and over half live under 200 percent of the Federal Poverty Line, according to data from the Public Health Management Corporation. A 2009 Widener School of Law legal needs assessment of Crozer-Chester Medical Center’s outpatient pediatric patients also revealed that patients in the same service areas have a range of legal needs. The survey found that low-income pediatric patients and their families experienced serious problems with public benefits, housing, health insurance and other issues that affect their health.
The grant will expand on an existing partnership between Crozer-Keystone and Widener. In 2010, Widener operated a medical-legal partnership serving patients in the outpatient Crozer-Keystone Health Network pediatric practice based at Crozer as well as two Ches Penn Health Services sites (ChesPenn has a management agreement with Crozer-Keystone).
In just six months, Widener opened 48 cases, benefiting over 100 people. Among its many successes include preserving electric service for a woman who owed more than $1,000 to the utility company; helping homeless families find housing; and overturning the denial of Medicaid funding for the daycare of a medically fragile child so that the mother could continue school. Perhaps more importantly, 84 percent of clients participating in post-service evaluation reported a decrease in stress and an increase in the quality of their sleep following these services.
All Healthy Start program participants will be eligible for the services provided by this new legal component. There will be no charge for the services. Legal services will be tailored for the Healthy Start participant, delivered in a culturally appropriate manner. Legal staff will receive assistance with outreach and cultural sensitivity with Hispanic and African American clients by Widener advanced Spanish students as well as CKHS staff members, many of whom are from the service area.
Supervision of the legal component staff will be conducted by Dan Atkins
, a lawyer with more than 20 years of experience in poverty and disability law who is a member of the Widener Law adjunct faculty. Atkins will be supported at Widener by Professor John G. Culhane
, director of the school’s Health Law Institute
, who has expertise in public health law.
“Healthy Start has had measurable – and remarkable – impacts on the health outcomes for at-risk babies and their mothers, in large part because Joann Craig and her able staff understand the complexity of the problems their target population presents,” Culhane says. “With this generous grant, Widener Law and the Health Law Institute will be able to supply an important, but often overlooked, piece of the full health care puzzle. Solving the legal problems of the indigent can and does contribute to better health outcomes.”
Pre- and post-training evaluations will measure the impact of training on staff members to identify and refer legal needs. The program will retain Thomas Jefferson’s School of Population Health so that evaluation tools and methods will be scientifically sound.