University of Houston’s Humana Institute to Address Health Harming Legal Needs

doctor and lawyer

The University of Houston (UH) College of Medicine and the Humana Integrated Health System Sciences Institute at the University of Houston (Humana Institute) have teamed up with Lone Star Circle of Care, a federally qualified health center, and Lone Star Legal Aid, a free legal aid provider, to launch a medical legal partnership (MLP) at Lone Star Circle of Care’s clinic at UH.

While food insecurity, loneliness and transportation are some more well-known social risk factors and determinants of health, patients also struggle with workplace discrimination, disability issues, inadequate housing or potential incarceration. These factors are known as health harming legal needs (HHLNs) and, through stress, can lead to serious illness. The Humana Institute, a strategic partnership between Humana and UH, will assess the outcomes and the extent to which the partnership can help patients experiencing HHLNs. A disproportionate 33% of low-income families are experiencing legal problems and recent crises, including Hurricane Harvey, the February 2021 freezing weather and the coronavirus pandemic have exacerbated these problems.

If unaddressed, HHLNs can cause increased stress, anxiety, depression and high-risk behaviors such as alcohol, tobacco and substance abuse. Prolonged stress can contribute to coronary artery disease, obesity, diabetes and low birth weight babies, all of which can worsen health disparities. Patients struggling with HHLNs cannot adequately attend to health conditions, limiting the effectiveness of clinical care.

“Research increasingly shows that a comprehensive approach to patient health and well-being leads to more effective, higher-quality care. At UH, we want to train future health care leaders to provide holistic, collaborative care within clinics and health systems,” said Winston Liaw, MD, MPH, chair of Health Systems and Population Health Sciences at the UH College of Medicine. “Working across disciplines allows health care teams to get on the same page, see the whole picture, and provide more personalized care. We can provide this model of care by integrating our health ecosystem.”

The Centers for Disease Control and Prevention (CDC) defines social determinants of health (SDOH) as “conditions in the places where people live, learn, work and play that affect a wide range of health and quality-of life-risks and outcomes.” Addressing HHLNS and SDOHs can be an effective part of health care business strategy because these contribute to adverse health outcomes. Attending to them is complex, requiring a coordinated and collaborative effort across the health ecosystem. When clinicians and primary care and community health providers work together, patients receive integrated and holistic care to serve their individual needs.

Patients at Lone Star Circle of Care’s University of Houston clinic will complete a screening questionnaire aimed at identifying legal needs. If legal needs are identified, the clinic connects these patients with a Lone Star Legal Aid lawyer or paralegal. Lone Star Legal Aid will meet with patients eligible for its free legal aid services to identify legal issues and determine what legal recourse may be needed. The lawyer and paralegal may interact with patients virtually or in-person. Patients ineligible for Lone Star Legal Aid’s free legal services may be referred to other legal or social service providers.

“Humana is committed to providing seamless delivery of care to our members, and addressing social determinants of health is an integral part of our business strategy,” said Jay Morris, MD, JD, MBA, Humana Medical Director. “Meeting patients where they are and examining their holistic needs helps clinicians and social care workers provide them with a care plan that addresses the whole person. Thinking innovatively and creating partnerships across disciplines creates a system which can meet the needs of today’s patients and provide a more equitable treatment plan. We are excited to work with our partners on this innovative and timely partnership.”

Researchers from the UH College of Medicine and the Humana Institute will study the MLP and determine how best to connect patients with services to address HHLNs and SDOHs. Through support from Humana, the researchers at the medical school will also examine the relationship between HHLNs and chronic disease control, and will study the adoption, implementation and effectiveness of the MLP.

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