In central Kentucky a new type of partnership is taking place, centered around the notion that some impediments to the health and well-being of children might be resolved by legal, in addition to medical, means. Child Advocacy Today (CAT) is a charitable medical-legal partnership that brings this cross-discipline approach to tackle pervasive issues of child health in and out of the clinic.
It started in 2008 with a part-time attorney from Access to Justice Foundation and a part-time social worker at the University of Kentucky.
“Our medical champion, Kim Northrip, came from a hospital that had a medical-legal partnership, and when she came to UK, she immediately wanted to be involved in what was starting to be developed. She had seen in practice how it works, how it helped resolve problems with her patients and how it made her a better pediatrician as a result,” said Andrea Welker, program coordinator and attorney for CAT, as an employee of UK’s department of pediatrics.
Since that time, through grants and other donations, the program has grown to have both a full-time and a part-time attorney, and it’s now a partnership between two Kentucky nonprofits – Kentucky Children’s Hospital and Access to Justice Foundation.
“We work out of Kentucky Clinic and two other clinics associated with UK,” said Welker, “and we are on-site for consultations, or [for] pediatric patients and their families who have some sort of legal problems that affect their health.”
While there are several medical-legal partnerships across the country, “ours is a little unique, because we focus on children,” said Chelsey Brammell, development director and part-time attorney for CAT as an employee of Access to Justice Foundation. “We have office space right there [in the clinic], so if the patient is in the room with the medical professional, they can pull us — we can pop by and do an initial interview there.”
The process begins with the doctors. For example, a child patient may have repeated visits for asthma-related respiratory issues. In the course of talking with child or the child’s family, the doctor might discover that there are mold problems with the family’s apartment and that the landlord has refused to fix them.
“For the child that has asthma and has a severe mold allergy, nothing that the physician is going to do is going to make that better. When they refer that patient to us, we are in a position that we can help. We can ask that repairs be made. If the repairs aren’t made, we can seek legal remedies for the family,” said Welker. “[The issues] that we see the most of are going to be housing issues related to mold, bedbugs or other safety issues on rental properties. We see a lot of education cases related to kids with special needs who need accommodations in schools. We also see a lot of issues related to Medicaid and health insurance in obtaining benefits and also fighting benefits denials.”
In addition to the direct health of the child, the health of the parents can pose an issue, such as when the child has health insurance through Medicaid or K-CHIP, but the parents have been unable to get health coverage for themselves.
“The parent who can’t get, for instance, treatment for their depression or treatment for their chronic illness is not going to be able to provide the safest and best home environment for their child. That plays into a lot of what we do and keeping the child in the best health and best environment,” said Welker. “As a preventative law program, we are trying not to sue anybody; we are trying to resolve the problems before they become crises, before they result in a hospitalization for a child with asthma, before they result in an eviction because the family has moved out of the home, frustrated with the repairs not being made. That’s really our focus — preventative law as a part of preventative medicine.”
Currently CAT is dependent mainly on grant money, but the need for individual donations from the community will increase over time as it expands to other area clinics and will need other personnel long after the grants have expired.
“Now we’re trying to get a lot of individual donations and build up our community donor base,” said Brammell. “In order to do that, we’ve kicked off the effort through the Good Giving Campaign and a nonprofit social-media blitz.”
CAT has also planned a fundraiser/community event for next October that promotes literacy in addition to health.
“One of the biggest social determinants of health is literacy,” said Brammell, “so getting children active in reading and getting them exposed to different types of literature is important for advocating for children’s health.”