Alice Rosenthal was born at Yale-New Haven Hospital. Now, as a trained professional, she's returning there to work.
But not as a doctor or nurse. Rosenthal is a lawyer and she'll be part of a growing effort statewide designed to improve the health and welfare of children from low-income families.
Under the initiative, attorneys from the non-profit Center for Children's Advocacy are stationed at hospitals around the state, where they work with families of young patients, and conduct training sessions with hospital physicians and social service staff on legal issues affecting children's health.
Rosenthal will help youngsters and their families with issues including health insurance challenges, disability benefits and access to mental health screenings. Further, she'll be available to assist families with non-medical problems, including housing, employment and educational problems.
"I've always done public interest work and worked with vulnerable children and families around issues of education and poverty law," said Rosenthal. "Now, it's just translating that experience into a medical setting,"
Dr. Ada Fenick, associate medical director of the Yale-New Haven Pediatric Primary Care Center, was among those pushing for such a program at Yale-New Haven Hospital.
"I just brought a kid over [to Rosenthal's office] who really needed help, and was able to get it," said Fenick, who focuses on health disparities that face low-income families that come to the clinic. The child is in a wheelchair and the mother is unemployed. The family has a medley of issues, including housing problems that have led to complications with the child transferring to a new school.
Fenick said the kids the project serves have mental health needs, physical health needs, and a living environment that can make it hard to address those needs.
Rosenthal "is terrific, personable, and I'm very excited to have her," Fenick said. "Before, I always had to give [families of patients] a number for New Haven Legal Aid. Now we have someone on-site to walk them over to the legal office to handle these issues. Instead of hoping someone is going to be on the other end of the phone, we now have immediate help."
These types of arrangements are known as a Medical-Legal Partnership Project, or MLPP. There are now 275 in the country and even a national center for them located in Washington, D.C., a project of the George Washington University School of Public Health. In Connecticut, Yale-New Haven is the fifth hospital to get an MLPP. The others are: Connecticut Children's Medical Center in Hartford; St. Francis Hospital and Medical Center, also in Hartford; the Hospital of Central Connecticut in New Britain; and Hartford's Charter Oak Health Center.
The Connecticut hospital-based lawyers, all of whom have a public service law background, are overseen by Jay Sicklick, who is the Center for Children's Advocacy deputy director. He has been involved with the project since it was launched in 2000 at the Connecticut Children's Medical Center. At the time, the medical center was the second hospital in the country to host an MLPP.
Sicklick said the original idea was hatched by Dr. Barry S. Zuckerman, a renowned pediatrician and pioneer in preventive pediatrics, who launched the first partnership at Boston City Hospital. The overall goal was to improve the overall health of the children treated at the hospital, which was "the default pediatric clinic for poorer kids in the Boston area," Sicklick said.
The name "Medical-Legal Partnership" came later, said Sicklick. "It makes sense," he said. "It represents the merger of lawyers and clinical folks who work towards a goal of improving health outcomes for those kids who are at most risk and most affected by socioeconomic determinants for health."
The deal with Yale-New Haven Hospital has been in the works for two or three years, with money being one of the obstacles. But thanks to a grant from the law firm of Wiggin and Dana and additional donations from the community, enough funds were raised to officially open the Yale-New Haven MLPP last week.
William J. Aseltyne, general counsel for the Yale-New Haven Health System, said he took Alice Rosenthal to meet members of the hospital's leadership team a few weeks ago. "I would say there were 30 people there in the room," said Aseltyne. "As soon as she entered the room, they applauded. I turned to her and said, 'They never applauded my arrival!'"
He said the hospital leaders were thrilled to have the additional resource. Up until now, hospital staff members tried to help out where the could.
"Our social workers are very good, they will work hard to find community resources for patients," said Aseltyne. "But if there's a child whose family is being evicted, and that eviction causes the family to have nowhere to bring the child home after being treated, that becomes an impediment to that child's health care." Dealing with such an issue is more the work of a lawyer than a hospital social worker, he said.
Aseltyne said Rosenthal's background will pay dividends for the new program. As a staff attorney for the Advocates for Children of New York, she conducted more than 200 training sessions over the past five years for families, health care providers, lawyers and social workers in New York.
Those who developed the MLPP program in Connecticut said there is a secondary benefit, beyond helping poor children and their families. As law schools look to give their students more real world experience, the hospital projects welcome the added help. Already, students at the University of Connecticut School of Law assist at the Hartford hospitals. It seems likely that sutdents at Yale and Quinnipiac law schools will be involved in New Haven.
"Even before we started this project, I was getting telephone calls and emails—'we heard you're starting a Medical-Legal Partnership, can we volunteer?'" said Aseltyne. "We're going to take this enthusiasm, the interest of the local state bar, and try and harness this energy to make this one of the best partnerships. You will see good things."•