Friday, April 13, 2012

UC Hastings & UCSF Collaborate on Medical-Legal Partnership for Seniors

University of California Hastings College of the Law is now partnering with UCSF in one of the few geriatrics-focused medical-legal partnership clinics in the country.

The new Medical-Legal Partnership for Seniors (MLPS) will begin providing legal aid to low-income seniors this fall at the UCSF Lakeside Senior Center. Physicians seeing patients who have legal issues or need advice about public benefits will be able to write a prescription for legal aid, filled by supervised law students working on-site at the clinic.

Medical-legal partnerships embody the ideals of both holistic medicine and holistic legal practice. “Historically, doctors and lawyers haven’t gotten along so well,” said Professor Yvonne Troya, a new faculty member at UC Hastings who will direct the legal clinic. Troya has run a similar pediatric MLP. “These partnerships are about building trust and teamwork among professionals for the greater good,” she said.

“We've taken an innovative model and pushed it in a new direction to benefit older adults,” said Adjunct Professor Sarah Hooper, who is the Assistant Director of Programs of the UCSF/UC Hastings Consortium on Law, Science and Health Policy.

By having law students on site, seniors can get legal help before their problems turn into crises. “Typically, lawyers are practicing emergency care” by the time most issues reach them, Hooper explained. Inexperience with the legal system and scarce resources only compounds the problems, both legally and medically.

And often, solving legal issues and eliminating the accompanying stress can greatly improve a senior’s overall health.

A major focus of the clinic will be helping seniors plan for the future. Advanced planning reduces stress for patients and their families and can help to avoid negative health consequences or elder abuse. Students will assist in estate planning and planning for long-term care. They will also help seniors draft wills, advance health care directives and durable powers of attorneys for finances.

The goal is not only to help patients, but to lay the groundwork for ongoing partnerships between doctors and lawyers. “We are training the medical staff to listen for legal issues,” said Hooper. In working with patients with dementia, for example, staff will learn the differences between medical capacity and legal competence.

“These are the frailest, oldest adults, the ones who we consider vulnerable, whether from a medical or social perspective,” said Dr. Helen Kao, assistant professor of medicine and active member in the partnership. “But as a geriatric specialist, I had never even contemplated what it meant to be legally vulnerable. The way that we are currently trained in medicine and geriatrics, we have no understanding of the legal processes and the ways in which legal advocates can help our patients” Kao said.

“This project speaks to the core tenets of MLP, which is service, education and ultimately advocacy,” she said.

Students will be exposed to the problems of seniors, learn practical skills in interviewing and relating to clients, and develop a more integrative approach to legal issues. “Students are learning how to partner across disciplines, outside the typical legal framework,” said Troya. “My hope is they will become more thoughtful and reflective as individuals, not only in their legal practice, but in every part of their lives.”