300 Participants Needed

Medical-Legal Partnership Intervention for Preventing Veteran Homelessness

MI
JT
AL
CM
Overseen ByChristina M Lazar, MPH
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: VA Office of Research and Development
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

Trial Summary

What is the purpose of this trial?

The legal team in medical-legal partnerships works with healthcare providers to improve their clients' lives. It is unknown whether this approach is better than providing usual legal services, with no special emphasis on non-legal matters and no particular collaboration with healthcare providers. The investigators propose to randomly assign 300 Veterans with housing-related legal problems to either legal help from a medical-legal partnership or help from lawyers in the community. The investigators will follow the randomized Veterans in this study for one year to determine if there is a difference between the two groups of Veterans in their housing situations and their mental health. The investigators will also interview Veterans in both groups about their experience of the legal services they have received.

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants must stop taking their current medications. It seems unlikely that you would need to stop, as the study focuses on legal services rather than medical treatment.

What data supports the effectiveness of the treatment Medical-legal partnership for preventing veteran homelessness?

Research shows that Medical-legal partnerships (MLPs) can improve health outcomes by addressing legal issues that affect health, such as housing and income. In Colorado, MLPs led to improvements in health care experiences and reduced stress, while in North Carolina, they successfully resolved legal cases that contributed to better health and financial outcomes.12345

How is the Medical-legal partnership treatment different from other treatments for preventing veteran homelessness?

Medical-legal partnerships (MLPs) are unique because they integrate lawyers into healthcare teams to address legal issues that affect health, such as housing and benefits, which are not typically addressed by traditional medical treatments. This approach focuses on the social factors that contribute to health problems, offering a comprehensive solution that combines legal and medical support.34567

Research Team

MI

Marc I. Rosen, MD

Principal Investigator

VA Connecticut Healthcare System West Haven Campus, West Haven, CT

Eligibility Criteria

This trial is for Veterans engaged in VA mental health or homeless programs, with an income at or below 200% of the federal poverty level, and facing housing-related legal issues. It's not for those under conservatorship, already getting help from Connecticut Veterans Legal Program, or unable to complete follow-up assessments.

Inclusion Criteria

Able to provide informed consent
Engaged in a VA mental health or homeless program
Has a legal problem related to housing (e.g., eviction, rent arrears, housing violation)
See 2 more

Exclusion Criteria

Already receiving civil legal aid from Connecticut Veterans Legal Program
I can attend all required follow-up assessments.
I have a legal guardian assigned to make decisions for me.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the MLP intervention or referral to pro-bono lawyers for housing-related legal issues

12 months
Initial in-person and subsequent in-person interviews, phone discussions, and formal hearings

Follow-up

Participants are monitored for housing status and mental health outcomes

12 months
Interviews at 3-month and 6-month follow-ups

Qualitative Interviews

Participants are interviewed about their experiences with the legal interventions

6 months
2 interviews per participant

Treatment Details

Interventions

  • Medical-legal partnership
  • Referral to pro-bono lawyer
Trial OverviewThe study compares two types of legal assistance: one through a medical-legal partnership that collaborates with healthcare providers and another through usual community lawyers. The goal is to see which better improves housing stability and mental health over a year.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Medical-legal partnershipExperimental Treatment1 Intervention
Treatment group will receive the MLP intervention through the Connecticut Veterans Legal Center in partnership with the VA Connecticut Healthcare System. The MLP intervention can be categorized into seven activity components: initial in-person and subsequent in-person interviews; discussions with clients by phone; research and review of relevant documents; consultations with clinicians or other attorneys; interactions with opposing parties; time appearing at formal hearings; and travel time.
Group II: Referral to pro-bono lawyerActive Control1 Intervention
Control group will receive outside legal aid, i.e., control participants will be referred to pro-bono lawyers in the state.

Medical-legal partnership is already approved in United States for the following indications:

🇺🇸
Approved in United States as Medical-legal partnerships for:
  • Preventing evictions and homelessness among veterans
  • Addressing housing-related legal issues
  • Improving mental health outcomes

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

Connecticut Veterans Legal Center

Collaborator

Trials
1
Recruited
300+

Findings from Research

The Medical-Legal Partnership (MLP) in Colorado significantly improved health care experiences for clients, with 61.4% reporting great or moderate improvements, particularly in physical and mental health.
Clients experienced a reduction in missed appointments after engaging with the MLP, highlighting its potential to enhance health outcomes and reduce healthcare utilization, such as emergency department visits.
Improving Health Outcomes in Vulnerable Populations: The Medical-Legal Partnership-Colorado's Experience.Sauaia, A., Santos, G., Scanlon, M., et al.[2022]
Over a 24-month period, a medical-legal partnership (MLP) in rural North Carolina successfully addressed 629 cases related to health-harming social needs, with a resolution rate of 98% for cases investigated by a lawyer.
The MLP not only provided legal support for issues like domestic violence and housing but also generated significant monetary benefits for patients, totaling over $484,000, demonstrating the effectiveness of integrating legal services into healthcare to improve patient outcomes.
Better Together: A Descriptive Analysis of a Medical-Legal Partnership in Western North Carolina.Cené, CW., Buys, E., Clark, JW., et al.[2023]
Medical-Legal Partnerships (MLPs) at Yale Law School effectively address the social determinants of health for diverse patient populations, including children, immigrants, and veterans, by integrating legal support with healthcare services.
The article emphasizes the need for a research agenda to evaluate the impact of lawyers in MLPs, aiming to establish quality metrics and best practices for these partnerships, which have been underexplored in previous studies.
Medical-Legal Partnership: Lessons from Five Diverse MLPs in New Haven, Connecticut.Benfer, EA., Gluck, AR., Kraschel, KL.[2020]

References

Improving Health Outcomes in Vulnerable Populations: The Medical-Legal Partnership-Colorado's Experience. [2022]
Better Together: A Descriptive Analysis of a Medical-Legal Partnership in Western North Carolina. [2023]
Medical-Legal Partnership: Lessons from Five Diverse MLPs in New Haven, Connecticut. [2020]
Partnerships Between Health Care and Legal Providers in the Veterans Health Administration. [2022]
Pilot study of impact of medical-legal partnership services on patients' perceived stress and wellbeing. [2013]
Interprofessional Education in Medical-Legal Partnerships (MLPs) to Address Social Determinants of Health. [2021]
Evaluating the Efficacy of Medical-Legal Partnerships that Address Social Determinants of Health. [2022]