Legal Services of North Dakota
Report date
October 2019
What has been most instrumental to your progress?
Legal Advocates for Health (“LAH”) is now a trusted legal source with multiple stakeholders. With increasing frequency 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. The LAH’s representative is present two days per week at Family Healthcare. This consistent and predictable presence is now well known in the community we serve. Clients wait until Tuesday or Thursday to walk in and ask for services or to follow up on services. FHC staff knows of, and counts on, our predictable presence. This is important to the community we serve for whom English is often not their first language, and there may be other cultural issues making access via a more formal route a barrier.
Our medical partners are increasingly committed to the importance of civil legal services to assist them in making people healthier. FHC, and now the Veterans Administration, are linking arms with us to serve the patients and improve their social determinants of health. This is important because much of the vulnerable population we serve is in significant need of comprehensive health care and a medical home.
Key lessons learned
LAH continues to advocate for a formal referral process similar to the process used to refer to medical specialties. To date, we have failed to create such a formal process, i.e., through FHC’s electronic medical records. At this time, we continue to increase referrals through our consistency and availability. We hope that a formal process may supplement this in the future. We have learned we need to be flexible and adaptable.
In a perfect world LAH would like to be present at all staff meetings of providers and interpreters. In this way we could educate the staff on civil legal health harming issues with a potential legal solution. At this time we simply do not have the resources to do so nor does the FHC staff have time at many of its meetings. As a work around we try to be present at as many meetings as possible if only to remind the staff of our presence. The lesson learned again is that we must be flexible and work with the resources provided.
Reflections on inclusive, collaborative or resourceful problem-solving
Collaborative -
LAH crosses a number of barriers: healthcare needs and privacy, cultural, and cross borders (Minnesota and North Dakota law). 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. We approached this project from a team perspective and its success has come only through a team/collaborative approach.
LAH crosses a number of barriers: healthcare needs and privacy, cultural, and cross borders (Minnesota and North Dakota law). 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. We approached this project from a team perspective and its success has come only through a team/collaborative approach.
Other key elements of Community Innovation
The LAH collaborators/partners developed a plan. Although we have had to continuously respond to improve upon the plan, our basic plan was based upon a pilot and agreed upon by all partners. This consistency and commitment to the concept have contributed to the success of the project.
Understanding the problem
Our work has confirmed that the vulnerable population served by FHC has unmet civil legal needs in the core areas we address. Our work has further confirmed that as legal aid providers that we benefit from the bridge of trust created by FHC. We have started to do some work with the Veterans Administration and likewise see that the trusted VA system can serve as a bridge to help our homeless veterans population.
If you could do it all over again...
It is best to be patient when trying to develop trust. Baby steps are what get you there.