Family Advocacy Program Celebrates Ten Years of Service

Stanford Medicine Children’s Health and Lucile Packard Children’s Hospital Stanford have partnered with an innovative medical-legal partnership to impact the lives of over 3000 families
by Dana Weintraub, MD

Since June 2004, lawyers from the Legal Aid Society of San Mateo County have partnered with health care providers to serve nearly 3,000 needy families in the region, and this makes everyone at Stanford Medicine Children’s Health proud.

It’s all thanks to the Peninsula Family Advocacy Program, a medical-legal partnership between the Legal Aid Society of San Mateo County, Stanford Medicine Children’s Health, Gardner-Packard Children’s Health Center, Ravenswood Family Health Center and San Mateo Medical Center. FAP was one of the first medical-legal partnerships on the West Coast and now is one of over 200 medical-legal partnerships across the United States.

Recently highlighted in the New York Times article, “When Poverty Makes You Sick, A Lawyer Can Be The Cure,” medical-legal partnerships are an innovative model of collaboration to address the social determinants of health. As the National Center for Medical-Legal Partnership states, “1 in 6 people need legal care to be healthy.”

Lee Sanders, MD, co-medical director of FAP and chief of the Division of General Pediatrics, highlights the importance of this movement. “The major determinants of health are not medical, but social: environmental exposures, social support, toxic stress, early-childhood education and other community resources. In fact, research suggests that the most effective way to improve adult health may be to address these social determinants during early childhood.”

Medical-legal partnerships help doctors identify social and legal problems that exacerbate or cause poor health. FAP attorneys have trained hundreds of health care providers to have a basic understanding of legal issues impacting child health, allowing them to identify and refer families who otherwise may never have accessed legal support.

The power of the program is huge. When a 10-month-old infant was referred to FAP for poorly controlled asthma, her condition was impacted by substandard housing conditions. As a result, the child had been seen twice within the last month in the emergency department and recently hospitalized. The family was living in a cockroach-infested apartment with dirty carpeting and mold.

Working together, a Peninsula Family Advocacy Program attorney and the family’s pediatrician wrote a letter to the landlord explaining the habitability violations, their impact on the child’s health, the exact housing regulations the landlord was violating, and requesting that the landlord make the appropriate repairs. After receiving the letter, the landlord hired an exterminator, put in new wallboard, and replaced the old carpet with linoleum. Six months following FAP’s intervention, the child was breathing comfortably and had no further emergency department visits.

In addition to direct service to patient families, FAP has spearheaded the establishment of the Medical-Legal Bay Area Regional Coalition, partnering health care providers from Gilroy to Napa Valley. FAP also teaches a multi-disciplinary course at both the Stanford University Law and Medical Schools that brings together future health care providers and lawyers to collaborate early in their careers. Three partnerships have been founded by former students. Most recently, Dr. Jennifer Newberry, co-medical director of FAP and Stanford Emergency Department physician, established a medical-legal partnership in the ED. Sabrina Adler and Jessa Barnard, Stanford Law School ‘08, helped create partnerships with the Santa Clara Valley Medical Center.

Looking back on a very successful first decade, it’s obvious that working together, health care providers and lawyers can better advocate for children and keep families healthy. We know 3000 families who will attest to that.

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For more information about the Peninsula Family Advocacy Program and National Center for Medical-Legal Partnership see http://www.medical-legalpartnership.org.