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Introduction: Medical-legal partnerships (MLPs) provide civil legal services in concert with healthcare services to mitigate complex social conditions with health-harming effects. Currently, there are 333 MLPs in 46 states. Thomas Jefferson Health System (TJHS) does not have a systemwide MLP. (Magee Rehabilitation Hospital does have an MLP used by qualifying Magee patients). This project sought to identify the core components of an MLP and to demonstrate the value an MLP would provide TJHS.

Methods: Assessed existing literature. Interviewed an existing MLP director. Patients from the Jefferson Hospital Ambulatory Practice (JHAP) clinic completed a written survey regarding health-harming social-legal issues. Entered survey data into Excel and analyzed using descriptive statistics.

Results: Six common core components of all MLPs were identified. Existing MLPs have demonstrated a reduction in readmission rates, decreased inpatient and emergency department visits, and recovery of payments for unreimbursed clinical services. Patients report improved health when unmet civil legal needs are addressed. Results of the JHAP clinic survey are pending, but preliminarily many patients appear to have social-legal issues.

Conclusions: This project demonstrates that a TJHS MLP program could improve patient health and reduce overutilization of the health system. Over time the cost of the program would potentially be offset by the recovery of healthcare dollars. TJHS patients appear to have social-legal issues that negatively impact their health and could be addressed through legal remedies. Based on the analysis, an Opportunity Assessment was generated. Critical next steps are to draft a business plan and identify potential funding.