Externship Opens Doors and inspires Charleston Law student

When asked to describe Lori Horst, Kirby Mitchell said, “She is not your average law school student. She has remarkable poise and maturity and ‘gets’ the real world in a practical way.”

Last year, during a Zoom lecture for the summer honors program, Mitchell, Senior Litigation Attorney at South Carolina Legal Services in Greenville, led a discussion on the importance of access to justice. Horst, then a 1L student at Charleston School of Law, was fascinated by the subject so she reached out to Mitchell and invited herself to the table, offering to work an externship on Mitchell’s team.

Another set of hands and feet? He jumped at the opportunity. “Lori has a real ability and initiative to connect,” said Mitchell. “Her administrative and research skills and attention to detail are remarkable. She was a great match for us. It was clear she was not your average law school student.”

The opportunity paid dividends for Horst too. Not only did she learn a lot, she was inspired to action.

“I quickly started learning all this stuff about medical legal partnerships,” she said. “Years ago, my brother was very sick and died of leukemia. We weren’t in a situation where we needed legal services, but I could see how easily how that could happen. That was sort of the trigger point for me. I realized this can help somebody.”

As part of her externship, Horst collaborated with Mitchell to co-publish a feature story in South Carolina Lawyer magazine titled, Sharpest Tool in a Doctor’s Toolkit. The idea was to create greater awareness for the medical legal partnership (MLP) model.

What is an MLP?

In the article published in South Carolina Lawyer magazine, Horst and Mitchell defined it this way:

Medical-Legal Partnerships (MLPs) go beyond treating symptoms to address root contextual causes that limit child and family health and well-being. Through a holistic approach, MLPs foster immediate and long-term health while removing barriers to supporting healthy child development and healthy families.

Using this approach, doctors and lawyers work together to address and prevent health-harming civil legal barriers to a person’s quality of life and health outcomes.

The timely and careful intervention of a civil legal aid attorney helps healthcare providers respond more effectively to the social needs which negatively impact health.

Horst described the classic example of a patient who goes to the doctor for breathing issues. “The patient would go home where they would get sick again and they would bring them back in,” said Horst. “There was something else happening here. Using an MLP approach, medical and legal professionals can ask questions in the intake process to identify the potential root cause(s) of the health condition.”

“The doctors say: ‘We don’t have the time, expertise, or resources to get in there and figure out what’s wrong in the home,” said Horst. “But we were trying to help. So, they reached out and asked legal services to investigate what was happening in these patients’ homes.’ That’s when they found that there was a lot of mold and landlord/tenant issues.”

But Mitchell said the data reveals “health equity improvements and patient satisfaction” for those who have employed an MLP. According to the latest data:

  • Over the last decade, 333 hospitals and health centers across the U.S. have adopted the medical legal partnership (MLP) approach.
  • 146 legal aid agencies and 53 law schools across 46 states collaborate on MLPs.
  • Numerous pro-bono partners, medical schools, and higher education institutions partner to serve as additional community partners in the MLP approach.

“The embeddedness of the MLP is kind of the ‘secret sauce,’” said Mitchell. “You have social workers, doctors and lawyers communicating with each other. It’s an effective design and an effective way to interact with low-income people who are struggling.”

Lana Kleiman, Executive Director for Charleston Legal Access, has first-hand experience of the impact that an MLP can have on community health when she served as senior staff attorney for the New York Legal Assistance Group (“NYLAG”), the largest community health MLP in New York.

“The idea is to be able to really provide wraparound services,” said Kleiman. “Social service and medical organizations that are really trying to help the patient should provide legal services as part of the process. It is a holistic approach to patient care.”

The goal is simple: Improve health. Achieving that goal would require a systematic change to community healthcare.

“A lot of people haven’t heard of an MLP,” said Kleiman. “Right now, it’s about education. The idea is that we train enough doctors, social workers, administrators, people who are in contact with the patients we treat. They can identify someone who may need assistance may need legal assistance, do a brief intake, send them to the appropriate legal service agency to do the follow-up to then do the follow-up screening.”

In 2016, a collaboration between South Carolina Legal Services, Prisma Health and Furman University’s Institute for the Advancement of Community Health formed South Carolina’s first MLP in Greenville. Since then, a second MLP has launched in Columbia.

While two MLPs are available in South Carolina (Greenville and Columbia) one does not yet exist in the Charleston market – but that is the working goal. The Medical University of South Carolina (MUSC) plans to launch a pilot medical legal partnership with the hope of making the service offered publicly to their pediatric patients and families.

“We have many families who have come to us with legal concerns, and I’ve been looking for places to send these people,” said Angela LaRosa, Medical Director, Developmental and Behavioral Pediatrics at MUSC. “It is going to improve the care we provide holistically for our children and their families.”

“Our model is going to be a little different,” said Kleiman. “Charleston Pro Bono is a free legal service and Charleston Legal Access picks up where free legal aid leaves off. We will provide ‘sliding scale’ legal services, a small fee will be required based on income and household size.”

The Charleston School of Law experiential learning opportunities sends students from the classroom to the front lines of the professional legal system. This experience provides the next generation of legal professionals with practical, hands-on experience.

CHARLESTON SCHOOL OF LAW QUICK FACTS

The Charleston School of Law is an ABA-accredited law school nationally recognized for its student-centric culture. Our faculty and staff are committed to preparing you for success both in the classroom and in the legal profession.

  • The Princeton Review ranks Charleston School of Law professors second in the country for faculty accessibility (2021)
  • Charleston School of Law faculty ranked among the top of The Princeton Review’s list of Best Professors in the nation (2016-2018)
  • Experiential Learning: Charleston School of Law students have access to about more than 150 externship sites, creating opportunities for experiential learning in the legal field.
  • Community Service: Charleston School of Law students have performed more than 241,000 community service hours (2004-current).
  • Students have won the National Tax Moot Court Championship for seven consecutive years (2012-2018)

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