Law Practice,
Health Care & Hospital Law,
Government
Jun. 8, 2018
VA hospitals and legal aid must team up to serve veterans
How the JD-MD duo is the modern day Batman and Robin.
Antoinette Balta
Executive Director and Co-Founder Veterans Legal Institute
Email: abalta@vetslegal.com
The Veterans Legal Institute in Santa Ana is a nonprofit law firm that provides free legal services to low income and homeless veterans. Antoinette is also an officer in the California State Guard.
There is no more powerful synergy than an attorney and doctor assisting a low-income U.S. military veteran patient, save for when a social worker is involved. A new type of partnership is sweeping the nation -- one that allies medical agencies and legal aid lawyers with the common goal of providing better and more holistic services to the patient. At present, there are approximately 18 VA medical-legal partnerships nationwide. This progressive model observed by forward-thinking professionals is making high-impact change and better addressing social determinants for health.
A 2017 study led by researchers from Yale and the Veterans Affairs New England Mental Illness, Research, Education, and Clinical Center in West Haven states, "Veterans who receive legal help with housing, benefits, and consumer or personal matters have increased income, fewer problems finding housing, and even experience some mental health benefits." In essence, the end user -- U.S. military veteran patients -- receive greater services and are better equipped to become self-sufficient.
It is estimated that there are close to 20 million U.S. military veterans -- women and minority veterans are the fastest growing groups. In addition, veterans are significantly older than non-veterans, according to the VA's "Profile of Veterans: 2016" survey. Veteran median age is 64 compared with 44 for non-veterans. Given these demographics, patients at VA hospitals often have correlated legal needs, including assistance with VA benefits for service-connected illnesses, estate planning, landlord-tenant, Social Security, consumer law and more.
How does one correlate medical health with the right to access justice? It is often lamented that poor people are less likely to access health care and expensive medication for a variety of reasons, be it lack of insurance, knowledge, access to transportation or access to a medical center. This leads to poor heath choices and sometimes, at the extreme end, loss of life. The same exists when it comes to legal services. Rarely can a low-income person living off a Social Security check of $1,000 per month afford an attorney to draft a will or represent them in an action against a slum landlord, or appeal the denial of veterans benefits for a service-connected illness like traumatic brain injury or post-traumatic stress.
What happens is that the veteran becomes a victim of her own poverty -- because she is poor, she cannot access justice, even though legal services may remove barriers to health care, housing, employment or education, and pull her out of poverty. The cycle is vicious and unforgiving. Those who get it team up in what are no longer nontraditional partnerships. The resulting medical-legal partnerships are powerful and changing the quality and breadth of services received by those in need.
A longtime proponent of innovative and creative solutions to serve veterans, the VA hospital in Long Beach has had a medical-legal partnership since 2014 with nonprofit law firm Veterans Legal Institute. The model was born when a service-passionate homeless provider employed by the VA lobbied to bring in legal services. Understanding the power of accessing justice, albeit not directly linked to health care, a powerful case was presented to the VA who eventually signed a memorandum of understanding with the institute at no cost to either entity. Since then, on-site monthly legal clinics serve between 30-50 veterans per month, many of whom have incomes of less than $1,000 per month. The clinic has witnessed a myriad of cases ranging from estate planning for older adult and terminally ill veterans to habitability and eviction cases, and everything in between. The end result is that veterans at this particular VA hospital are receiving more holistic services, and are doing better overall.
Richard Beam, director of Public and Community Affairs at VA Long Beach Healthcare System states it eloquently: "Dispensing health care divorced from considering the entirety of the patient is like repairing the door of a house built upon a faulty foundation. It will work for a time, but will ultimately fail with the rest of the house. Similarly, when we treat depression, sleeplessness, high blood pressure and heart disease without treating high stress unmet social needs, we are only postponing a negative outcome. That is why coalitions and partnerships between clinical care professionals and non-clinical professionals are crucial."
Take the case of Jean, a female Marine Corps veteran who receives mental health treatment at the VA. Jean attended a free clinic at the VA hospital in Long Beach. Distressed, she shared that a previous employer fraudulently issued her 1099s that caused her to owe excessive taxes. As a direct result, Jean's paycheck was being garnished monthly, to the point where she was one month away from becoming homeless. This was negatively affecting her health and relationships at home. Through the VA medical-legal partnership, Jean was able to have an attorney represent her pro bono and work with the IRS to rectify her situation and return to her over $10,000 in wrongfully garnished wages. Having access to a pro bono attorney, one that she could not otherwise afford, made a life altering impact on Jean's life, health and housing.
Progressive thinking and movement across the national VA healthcare system is on the rise. Finding great need at the VA hospitals, attorney patriots are volunteering their time to make a difference. A law degree is proving to be just as helpful inside a courtroom as it is at a medical center.
Aditi Mukherji
aditi_mukherji@dailyjournal.comxx
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