Kokua Kalihi Valley Comprehensive Family Services
Honolulu, HI | kkv.net/index.php/medical-legal-partnership-for-children & www.law.hawaii.edu/mlpc
Contact: Dina Shek, Co-Founder and Legal Director
For many low-income and immigrant communities in Hawai’i, getting cut off from food stamps, struggling to pay rent, or trying to access health care services–often without the availability of interpreters–can significantly impact their health and well-being. As a response, the Medical-Legal Partnership for Children in Hawai’i (MLPC), a collaboration between Kalihi Kokua Valley Comprehensive Family Services (KKV) and the University of Hawai’i William S. Richardson School of Law, provides legal services to and advocates for the children and their families in the Kalihi Valley of Honolulu on the island of O’ahu in Hawai’i. MLPC operates a legal advocacy clinic at KKV’s main clinic and also serves families living at Kuhio Park Terrace, the state’s largest public housing complex. MLPC’s legal services are fully integrated into the activities of the health center and considered as one of the many specialized services offered by KKV. This innovative partnership strives to be medical and legal champions for health by addressing the legal and social needs of patients, their families, and communities.
Photo: The first MLPC Hawaii team at Kokua Kalihi Valley health center: Chris Derauf (MD, MLPC co-founder and medical champion), Alicia Turlington (MD, MLPC medical champion), Dina Shek (JD, MLPC co-founder and legal champion), Joy Quensell (MD, MLPC Peds Resident), Kathy Anderson (MD, MLPC Peds Resident)
The Medical-Legal Partnership for Children in Hawai’i currently engages in the following three core activities:
- Legal Advocacy Clinics: Provides direct legal assistance through legal advocacy clinics on-site at a community health clinic setting.
- Trainings and Educational Workshops: Trains health professionals about the underlying legal needs of the low-income families they serve.
- Systemic Advocacy: Works together as doctors and lawyers to address systemic advocacy issues, including policy change, community empowerment, and professional training.
Since its inception in April 2009, MLPC conducts its legal advocacy clinic every Tuesday and Thursday from 2:00 pm – 5:00 pm at the health center. The legal clinic days were chosen to align MLPC outreach with the Well-Child checkups conducted by KKV’s pediatric team on those days. MLPC works closely with the pediatricians and the pediatric residents to identify legal issues that their patients are facing. During a routine screening, the clinicians, who are well-versed in the social issues that come up for their patients, help to screen for any legal needs of their patients and informs them about the availability of legal services at KKV. Patient families can meet with MLPC’s lawyers in the exam room (often while waiting for their vaccinations) or be referred to the on-site legal clinic office. The range of legal services provided by MLPC is quite broad and free of charge. Services may involve a one-time appointment to review a letter that the client may not understand, calling a landlord to fix a leaky roof, or more long term issues such as guardianships and housing problems. MLPC often works closely with other legal services, such as Legal Aid, Hawai’i Immigrant Justice Center, Domestic Violence Action Center, and Volunteer Legal Services of Hawai’i, to ensure that their clients receive the appropriate legal assistance they need, as well as to not duplicate services.
KKV serves a diverse group of people in Kalihi Valley, which is a common entry-point for new immigrants. MLPC’s client population reflects KKV’s patient base, including significant numbers of immigrant Micronesians, Filipinos, Samoans, Vietnamese, Laotians, Native Hawaiians, and many families living below the Federal Poverty Level[1]. Recognizing that collectively the larger community faces enormous cultural, social, and economic barriers to health, MLPC also engages in activities that go beyond the health center walls. MLPC conducts community outreach to build relationships and to understand the needs and concerns of the community. Community outreach activities include trainings on newcomer rights, such as civil rights, housing rights, and language access rights, and dissemination of information on relevant resources and services that are available to the community. By working directly with the communities they serve, MLPC have come to be viewed by low-income families in Kalihi Valley as “their lawyerâ€.
Due to the innovativeness of the partnership, MLPC has been asked to introduce the Medical-Legal Partnership (MLP) model for other clinicians and hospitals throughout the island, as well as at national legal and health conferences. MLPC stresses that the effectiveness of the MLP model is due to the co-location of services within the health care setting, which offers families a one-stop site for help with medical, social, and legal needs. Further, the MLP partnership fosters a close doctor-lawyer relationship, which facilitates better collaborations and faster interventions. In addition to addressing the legal needs of the community, MLPC’s community outreach helps to inform their own policy work. For several years, MLPC has partnered with Micronesian community members and leaders to advocate for the restoration of Medicaid benefits, engaging in both state and national advocacy. MLPC’s policy work is always done from the “ground†up, listening to and following the lead of the community itself.
The MLPC legal advocacy clinic is currently staffed by the Legal Director and a Law Fellow, working alongside law students and pro bono attorneys. In the upcoming years, MLPC hopes to create more Law Fellow positions, providing new attorneys the opportunity to gain legal experience doing social justice work. MLPC currently provides legal services to over 150 families each year and reaches hundreds more through community outreach and education. MLPC has an annual budget of about $175,000 and is funded through strong institutional support from the University of Hawai’i William S. Richardson School of Law and KKV health center, and small grants from various foundations, corporations, and individual donations. The next step for MLPC is to develop a long-term plan, which ensures the quality and sustainability of the partnership and expansion of its services to other community health centers across the state of Hawai’i.
The medical-legal partnership at KKV started as an idea during MLPC’s Legal Director’s third year at law school where she took a health law class and learned about the MLP model. After receiving a small start-up grant, she utilized the MLP network to conduct visits to other MLP models at four different sites in California (Marin, Oakland, East Palo Alto, and Stanford/Packard Hospital), and learned about all the philosophical and technical aspects of developing a MLP model. Early planning discussions with KKV’s chief pediatrician centered on defining shared values and philosophies about their views on patient and client care. They recognized that the partnership had to start from their shared values, and required committed engagement of both a “medical champion†and a “legal champion.†This was the ultimate lesson for them and the MLP model.
MLPC understands that their efforts cannot be effective by doing it alone. Collaboration has been the key to their success, through partnerships at the clinic, with other agencies and attorneys, through interdisciplinary clinical teaching, with the larger MLP network, and with the community. Having champions on all sides has helped to maintain the partnership and keep things moving forward. Most importantly, through their legal services, advocacy and collaborations, MLPC is working together with their communities to demystify and navigate the health and legal system, so that they are all empowered to live healthier lives.