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From rats to heaters, doctor-lawyer team fights barriers to family health care

A medical-legal partnership between Children's National Medical Center and the Children's Law Center helps patients overcome legal challenges that threaten the care of patients.

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Washington Post Staff Writer
Wednesday, May 26, 2010

Thirteen-year-old Haji Conteh had all the irritating symptoms of seasonal allergies when her father took her to see a pediatrician at a D.C. clinic last summer.

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But when the doctor questioned Haji and her father, she began to suspect there might be a cause other than pollen for the girl's sneezing and itchy eyes: the rats and mold in the family's Northwest Washington apartment.

The pediatrician didn't have the time or expertise to probe more deeply. But she did refer the family to a specialist-- not another doctor, but a lawyer.

The family is among 1,400 referred by doctors and others at Children's National Medical Center to the Children's Law Center. As part of a medical-legal partnership that began in 2002, lawyers work alongside doctors at four District clinics run by the hospital. Their shared goal is to overcome legal and social challenges that threaten the care of their patients -- low-income children, predominantly African American, and virtually all covered by Medicaid.

The lawyer who took on Haji's case secured housing inspections that documented numerous violations in the family's Adams Morgan apartment. She forced the landlord to replace water-damaged ceilings in which mold had festered and to seal holes in the floor and walls where rats scampered.

Within several months, "everything was fixed," said Haji's father, Idrissa Munu. Her allergies are now manageable. Family members no longer jump on the couch, feet tucked beneath them, he said, to escape the scurrying rats.

The doctors who work in the clinics say they welcome the lawyers' help. More than ever, they say, the pediatric patients going through their doors complain of symptoms that stem from social and legal problems. Catching them early can prevent full-blown emergencies that are more difficult and costly to treat, say supporters of such partnerships.

"If a child comes in and they're failing kindergarten, or their asthma isn't getting better because of substandard housing conditions, it gives us a chance to do something about them," said Alsan Bellard Jr., medical director of two clinics in Southeast Washington.

The partnership that operates through the four clinics in the District -- part of a grass-roots program launched in Boston in 1993 that has 85 partnerships in 37 states -- is the only one in the Washington area. Some other D.C. primary-care physicians say they would like to team up with lawyers, but the law center can't afford to hire more full-time staff lawyers, Executive Director Judith Sandalow said.

Even existing funds could be in jeopardy. The law center relies in part on a D.C. government grant that could be cut next year because of tight budgets. The D.C. Council is scheduled to take its final budget vote Wednesday.

In Washington, lawyers from more than 70 firms assist the Children's Law Center. The American Bar Association supports the partnerships and recently opened an office to help firms interested in participating.

The success of the integrative approach is one reason advocates say there is bipartisan support, even in health care-weary Congress, for a federal demonstration project to measure the effects on patients, physicians and health centers, said Ellen Lawton, executive director of the National Center for Medical Legal Partnership.


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