Health Advice



At this county health center, a lawyer is just what the doctor ordered

Emily Alpert Reyes, Los Angeles Times on

Published in Health & Fitness

Then there was the 68-year-old man battling prostate cancer, who was concerned about mounting medical bills. Patlán walked him through some options, including a program that provides free treatment for eligible men with the illness. She explained upcoming changes in California law that could help him get better coverage under Medi-Cal.

When Patlán heard that he was using a Mexican government ID, the paralegal printed out a list of the documents he would need to get a California card, recommending it as a good step to avoid questions about his immigration status if he were ever detained.

Medical officials at the MLK Jr. Outpatient Center said the initiative is tied to their growing focus on "the social determinants of health" — the broader conditions beyond hospitals and clinics that shape how people live and whether they thrive.

"The hard truth about medicine is that when you go into an underserved area, the things that make the most immediate impact on health is actually your housing, access to water and sanitation," said Dr. Ellen Rothman, medical director at the center. For instance, if a diabetic patient "is living in a single room without access to a refrigerator and needs to eat only at McDonald's once a day, I can give that patient a lot of insulin and it's not going to address the main problem."

Dr. Khanhphong Trinh, the center's director of continuity care, recounted the case of an elderly couple getting care at MLK who lived in their car and kept getting tickets that they struggled to pay. The legal team stepped in to help with the tickets and eventually helped get them into housing, which allowed the elderly patients to start focusing on their health needs.

"When you start to address some of these bigger needs," Trinh said, "it complements the health care."


The budget this year for the program was $1.5 million, which includes legal services from several nonprofits — including the Legal Aid Foundation of Los Angeles — that subcontract with Neighborhood Legal Services of Los Angeles County.

Until now, the L.A. County program has been funded through a California program called Whole Person Care, which covers services that would not typically be funded by Medi-Cal to address both medical and social needs.

Whole Person Care is ending at the end of December, with some funding rolling into the next year. As the state shifts to a new system for managing care, the county health department is figuring out how it will fund the medical-legal partnership. So are other California programs that rely on the same program.

"Right now I don't think anyone has really cracked the code," said Daniel Nesbit of California Rural Legal Assistance, who is managing attorney for a medical-legal partnership with Monterey County clinics.


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