Legal help can be the prescription for health at Minneapolis clinic

Jewelean Jackson was in a legal fight over a disputed $6,000 bill from a real estate agent and she had already lost the first round in court.

It capped a six-year fight that the north Minneapolis resident had waged mostly by herself to prevent her house from being lost to foreclosure, and it was taking a toll on her health and well-being.

Eventually, Jackson found help, and it came from an unlikely source — her medical clinic.

The Community-University Health Care Center in south Minneapolis was one of the first health care clinics in the country to offer free legal services to its patients. It is an idea that has been adopted by more than 400 clinics and hospitals nationwide and continues to gain interest.

Serving primarily a low-income population, the clinic, known as CUHCC, has long lived the philosophy that circumstances outside the clinic walls, such as a lack of food or housing, have profound effects on the health of its patients.

Sometimes those circumstances can trigger health emergencies. Asthma patients, for example, are at risk for severe asthma attacks and emergency room visits if they live in substandard rental housing where landlords refuse to replace moldy carpets.

In 1993, Dr. Amos Deinard, then CUHCC's director, forged a partnership with a downtown law firm founded partly by his father and uncle — Leonard, Street and Deinard, now known as Stinson Leonard Street — to provide free legal services to patients.

Over the past 25 years, the partnership has strengthened and today the Stinson attorneys provide about 4,000 free hours of legal services to 100 to 200 patients a year.

"This work changes lives," said Colleen McDonald Diouf, CUHCC chief executive. "The legal implications in people's lives are huge. These are folks who didn't think they ever would have access to a lawyer."

Most of the cases the clinic handles involve immigration matters, family law, public benefits and housing issues. As a rule, the clinic, known as the Deinard Legal Clinic, does not take on criminal cases.

"The goal of the clinic is to provide access and provide legal services to people who aren't able to get them," said Theresa Hughes, Stinson's director of pro bono work. "We are mindful of the fact that we aren't taking business from smaller legal practitioners who are in the neighborhood."

With the help from the legal clinic, Jackson successfully overturned a court ruling that she owed $6,000 to a real estate agent. Jackson had turned to the agent to help her with the pending foreclosure, but she says he never informed her that he would charge that amount.

"Even when you know that you are right and you don't have the resources to make it right, it just adds to making you more unhealthy," said Jackson. Getting the backing of a large law firm changed that.

"When I went back to court, it gave me a sense of well-being," she said. "It was like, OK, so now I have help and even though I did not know what the outcome would be, I walked back into that room feeling a whole lot better."

Jackson was not able to prevent the foreclosure, but she was no longer saddled with a large debt.

"More than anything else I think there is a direct correlation between health care and well-being, which is why I continue to be pleased with CUHCC because they have the foresight to know that they go hand in hand," said Jackson, who is now one of the patients who sits on the clinic's board.

Studies of several medical-legal clinics have shown that access to legal services improves health. Patients helped by them have less stress and better asthma control, while newborns and infants get better access to preventive care. Additionally, readmission rates, hospital stays and emergency department visits decreased, according to a review of the scientific literature that appeared in the March issue of the journal Health Affairs.

There are now 17 medical-legal partnerships in the region and a local consortium has formed to help others get started.

"CUHCC is really the model," said Eileen Weber, a nurse and an attorney who teaches at the University of Minnesota School of Nursing. She helped launch the Upper Midwest Healthcare Legal Partnership Learning Collaborative.

"One of our goals going forward is to capture that model and try to take it to other law firms that might be interested in maybe adopting a clinic that way," said Weber.

Hughes said Stinson attorneys are eager to work on CUHCC cases and learn aspects of the law that help patients overcome legal barriers.

"I say that is in the firm's DNA," said Hughes. "It became the significant pro bono project of the firm."

Jane Godfrey, who was an attorney at the firm for 20 years in estate and trust law, said she remembered helping women who needed to escape from arranged marriages.

"I was not a family law lawyer but I think early on that I couldn't say no to cases of immigrant women who couldn't get out of situations that were prearranged or they had no say in it," said Godfrey. "Those were ones that felt particularly compelling. You learn a tremendous amount about what people are dealing with on a day-to-day basis."

CUHCC social workers, advocates and interpreters work closely with the Stinson lawyers, which also helps to build the bond between patients and the attorneys.

"A lot of the families trust us, so we can help them," said Mercedes Moreno, a victim advocate. "They feel like somebody is listening to them and is taking charge. It is important for them to know that somebody is listening."

Deinard, who is now an adjunct associate professor in the pediatrics department at the University of Minnesota Medical School, said it is important that health care providers understand that legal struggles affect health.

"Not much has changed," said Deinard. "A lot of these people who come to the clinic have got great needs."

"This was the first medical-legal partnership in the country and now there are about 400," he said. "I am delighted that it has gone so well."

Glenn Howatt • 612-673-7192