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Medical-Legal Partnerships in Cancer Care

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Abstract

This chapter provides an overview of the medical-legal partnership (MLP) service delivery model, which integrates legal services into healthcare settings as a means of addressing the legal aspects of patients’ social determinants of health. It introduces the underlying concepts that drive MLPs, including the five “I-HELP” legal needs categories, and contextualizes them in the world of cancer care. The chapter then provides a basic introduction to the cancer-specific legal needs of low-income cancer patients for each of the five categories: income, housing, education and employment, legal status, and personal and familial stability. Each legal “snapshot” discusses the legal principles of each need, how those principles apply to cancer patients, and how an interdisciplinary MLP model can use those principles to address the needs of its patients. The discussion is intended to educate cancer providers on the MLP model as well as provide practical advocacy tips. It concludes with two case vignettes that demonstrate how MLP intervention can improve patient’s overall well-being and quality of life.

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Abbreviations

ACA:

Patient Protection and Affordable Care Act

ACP:

Advance care planning

ADA:

Americans with Disabilities Act

ALJ:

Administrative law judge

BCCPTA:

Breast and Cervical Cancer Prevention and Treatment Act

CAL:

Compassionate allowance

CHIP:

Child health insurance program

FDCPA:

Fair Debt Collection Practices Act

FHA:

Fair Housing Act

FMLA:

Family Medical Leave Act

FPL:

Federal poverty level

HCPOA:

Healthcare power of attorney

IEP:

Initial enrollment period

I-HELP:

Income, housing and utilities, education and employment, legal status, personal and familial stability

LPR:

Legal permanent resident

MA:

Medicare advantage

MAGI:

Modified adjusted gross income

MLP:

Medical-legal partnership

National Center:

National Center for Medical-Legal Partnerships

OOP:

Out-of-pocket expenses

POA:

Financial power of attorney

PRUCOL:

Permanent residence under color of law

PRWORA:

Personal responsibility and work opportunity reconciliation action

SDH:

Social determinants of health

SGA:

Substantial gainful activity

SSA:

Social security administration

SSDI:

Social security disability

SSI:

Supplemental security income

TANF:

Temporary assistance for needy families

TERI:

Terminal illness cases

TWP:

Trial work period

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Authors and Affiliations

  1. Philadelphia, PA, USA

    Tomas Bednar

  2. New York Legal Assistance Group, New York, NY, USA

    Domna Antoniadis

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  1. Tomas Bednar
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Editors and Affiliations

  1. Cape Cod Healthcare, Falmouth, Massachusetts, USA

    Peter Hopewood

  2. University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA

    Mary J. Milroy

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Bednar, T., Antoniadis, D. (2018). Medical-Legal Partnerships in Cancer Care. In: Hopewood, P., Milroy, M. (eds) Quality Cancer Care . Springer, Cham. https://doi.org/10.1007/978-3-319-78649-0_11

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