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Abstract
The objective of this project was to implement preventative medical-legal consultations using an enhanced neonatal team consisting of a pediatrician, social worker and lawyer for improved access to public benefits, and to evaluate its success using metrics of parent and child functioning over time. Methods: NICU graduates, as patients at the Center for Healthy Families at the University of Chicago (CHF), were enrolled in the Silver Linings Project after screening when a disconnect between public benefits and developmental and financial needs was identified. At their regularly scheduled pediatrician visits, a legal advocate from the Chicago Medical-Legal Partnership for Children (CMLPC) worked with the medical team during consultation to build an action plan to improve access and utilization of public benefits. Within a year of enrollment, action plans were reviewed, measuring progress on action items in three domains: family items, medical items, and legal items. Results: Twenty-five families participated in this program over 18 months. The physicians, lawyers, and parents completed 80% of total action items across the sample. Completion of these action items resulted in improved access compared to the time of enrollment in Early Intervention (EI), food benefits (SNAP and WIC) and Individualized Educational Plans (IEP) for children involved. Conclusions: A preventative strategy to reduce social barriers for NICU graduates using a medical-legal consultation and action plan is feasible and effective at improving access to public benefits and decreasing reported parental stress.
Keywords: Medical-legal partnership, NICU, high-risk infants, early intervention, legal advocacy, NICU follow-up clinic, special education, public benefits
Introduction
Over the last three decades, considerable progress has been made in understanding the harmful effects of poverty and its correlates on family functioning and early childhood development (1-8). Research also indicates that risk is cumulative; children who experience multiple risk factors (e.g., abuse or trauma), in addition to poverty, are at increased risk for poor outcomes (9, 10). Significant progress has been made in developing interventions to ameliorate the effects of poverty and other risk factors. Notably, comprehensive and integrated systems of health, educational and social services are viewed as promising strategies to support healthy family functioning, child health and development, and, in turn, adult health and well-being (1, 2, 7, 8, 11-13).
Among the most vulnerable are graduates of the neonatal...