Legal Services of North Dakota
Report date
October 2020
What has been most instrumental to your progress?
Legal Advocates for Health (“LAH”) is now a trusted legal resource in the Cass-Clay Community. The healthcare providers at Family Healthcare are comfortable with referrals to LAH and understand its value to the patients we all serve. We see the LAH phone line being called by representatives of the New Americans Consortium, Lutheran Social Services, and Homeless Health. As a result, we are able to meet the health harming legal needs of a population that otherwise was not served or is underserved.
LAH has increased and improved upon its visibility for referral purposes. This is important to the community we serve who are often uncomfortable using a legal central intake line due to language and other cultural issues. Our LAH attorney is comfortable with the use of an interpreter for multiple languages. LAH is skilled at explaining the solutions and resources available to solve the patient’s civil health harming legal needs.
With the advent of the COVID-19 crisis we have developed new skills. We are doing more work through electronic means. We are spending significant time educating patients and providers on legal resources available during the COVID-19 crisis and on changes in laws.
Key lessons learned
We learned that we need to mold our service delivery model to the model desired by the healthcare providers. We knew this fact at the time we started LAH but the reality is even clearer. We cannot propose changes to service delivery without one hundred percent buy-in from the medical partner. For example, our presence at meetings or educational opportunities is at the discretion of the medical provider.
We learned that although the interpreters present at FHC were accessible to us in theory, using them sometimes conflicts with our confidentiality needs or the needs of the medical provider. As a result, we more frequently used our language line where the interpreter is not a member of our patient’s close knit community.
Reflections on the community innovation process
Collaborative -
LAH crosses a number of barriers, including healthcare needs and privacy, as well as cultural, and cross borders competency. We meet quarterly as a team and informally more often to resolve issues that come up. We are regularly tweaking our cross legal borders referral process, learning the importance of a warm handoff. Our cultural acumen is strong and our relationships with interpreters and the communities we serve are now well known.
LAH crosses a number of barriers, including healthcare needs and privacy, as well as cultural, and cross borders competency. We meet quarterly as a team and informally more often to resolve issues that come up. We are regularly tweaking our cross legal borders referral process, learning the importance of a warm handoff. Our cultural acumen is strong and our relationships with interpreters and the communities we serve are now well known.
Progress toward an innovation
LAH has succeeded in improving the social determinants of health for New Americans and other vulnerable populations. We can measure this through our outcomes and through the significantly increased contact we have with the New American community. We have created and sustained a collaborative relationship with the groups that serve our New Americans and we are a known resource to other stakeholders in the community. We still have work to do, but we are headed in the right direction.
What it will take to reach an innovation?
not applicable
What's next?
LAH is well established in the community and we are committed to its continuation. We are currently waiting to hear from another funder about a grant application. We plan on expanding to more healthcare sites, largely through the use of legal kiosks and hopefully a paralegal.
If you could do it all over again...
Before starting LAH we had an advocate on the FHC board. Since that time we have developed medical advocates. However, if we could go back, having a medical advocate behind the program from the beginning would have facilitated the speed of our progress.