The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61597

Jocelyn A. Hirschman, MPH¹, Janell F. Fuller, MD², Laura Barnickol, JD, MSW³, Gopal Srinivasan, MD⁴, Stephen N. Wall, MD, MSH⁵, and Julie Justicz, JD³. (1) Sinai Health System, Sinai Urban Health Institute, California Ave at 15th St., K430, Chicago, IL 60608, 773-257-5329, hirj@sinai.org, (2) Pediatrics/Neonatalogy, University of Chicago Hospitals, 5841 S. Maryland Ave., MC 6060, Chicago, IL 60637, (3) Health & Disability Advocates, 205 W. Monroe St., 3rd Floor, Chicago, IL 60606, (4) Pediatrics, Sinai Health System, California Ave at 15th St., Chicago, IL 60608, (5) Pediatrics - Section of Neonatology, University of Chicago, MC 6060 - 5841 S. Maryland Ave, Chicago, IL 60637

Infants with special medical needs and their families frequently encounter barriers to important medical and welfare services, and may often need legal intervention to access these services. Hospital-based legal aid programs may be effective in improving access to critical services for these infants. Yet, few hospital-based legal aid programs exist, and none have been rigorously evaluated. This presentation describes results of a randomized controlled trial of post-NICU legal and case management services (CM/LS) at two, large inner city Chicago hospitals.

To date, 97 infants have been enrolled and randomly assigned to receive either CM/LS or routine care. We expect 200 by August 2003. Infants/families in the CM/LS group are screened by a case manager for their eligibility to receive health and welfare services. Referral to a lawyer (on-site in the clinic) is made if the family is unable to obtain a health or welfare service for which they were eligible. All infants are followed for 1-year corrected-age. A battery of standardized and research team designed instruments are administered to measure: compliance with scheduled care, re-hospitalization and frequency of ED visits, growth and developmental outcomes, utilization of services, maternal quality of life and parental stress.

Data analyses address the questions: 1) does providing CM/LS improve the high-risk infant’s receipt of services after NICU discharge, and 2) does it improve outcomes for the high-risk infant and mother after NICU discharge? Finally, this presentation provides recommendations/strategies for bringing legal advocacy to the clinical setting.

Learning Objectives:

Participants will be able to:
• define a medical-legal collaboration,
• describe the benefits received by families through post-NICU legal and case management services,
• discuss the public policy implications of these results, and
• begin to develop a plan to bringing legal advocacy to their clinical settings.

Keywords: Infant Health, Advocacy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.