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Community Driven MLPs: Exploring the New MLP with Christian Community Health Center & LCHJ

Author: Belle Duguid, Special Populations Community & Partner Liaison, AmeriCorps VISTA at the Legal Council for Health Justice.

In 2019, Legal Council for Health Justice partnered with Christian Community Health Center to initiate a new Medical Legal Partnership (MLP) serving Chicago’s far South Side and South Suburban neighborhoods. In May of 2022, the MLP had its official soft launch. This post will detail the origins of this MLP, the importance of community feedback and building relationships, Q&As with key players in the process, and recommendations for advocates in the early planning stages of a MLP.

A Brief History and Background

Legal Council for Health Justice, originally called AIDS Legal Council of Chicago (ALCC), was founded in 1987 as a response to the lack of legal services available to people with HIV. In 2014, ALCC became Legal Council for Health Justice (LCHJ) as their services were expanded to address health disparities more broadly. Currently, LCHJ has three programs: the AIDS Legal Council, the Children and Families Program, and the Homeless Outreach Program. These programs work together to support the mission of LCHJ, which is to use “the power of the law to secure dignity, opportunity, and well-being for people facing barriers due to illness or disability.”

Christian Community Health Center (CCHC), founded in 1991, is a 501 (C)3 non-profit organization and federally qualified health center dedicated to providing “high-quality primary healthcare and related services to the community regardless of the ability to pay.” CCHC strives to meet the holistic needs of both individual patients and their communities by providing services related to: health and prevention, housing and shelter, intervention and support, and education and life skills. CCHC has three locations throughout Chicago’s South Side and the South Suburbs, as well as a mobile health van that travels around the greater Roseland area and adjoining South Suburbs to provide health care and social services.

In expanding access to free legal services, the CCHC-LCHJ Medical Legal Partnership will complement CCHC’s holistic vision of health care. The two organizations will work in tandem to address patient’s health-harming legal needs, including: HIV/AIDS discrimination and confidentiality; public benefits assistance (e.g., SNAP, Medicaid/Medicare, Social Security, Ride Free Permits, ADAP, etc.); unemployment benefits; landlord-tenant issues; expungement and sealing of criminal records; name and gender marker changes; health insurance; and estate planning (e.g., Power of Attorney and simple wills).

Medical Legal Partnership in Action: Q&A with Kenya Garrett-Burnett, Ben Handy, and Nooreen Reza

Kenya Garrett-Burnett, born and raised in Chicago, joined LCHJ in 2017 and is the Legal Director of the AIDS Legal Council. Kenya has played an integral role in the creation of the CCHC-LCHJ MLP with her background in community health combined with over a decade of experience working in Chicago. You can read more about Kenya’s background here.

Ben Handy is the Community Organizer for the AIDS Legal Council and joined LCHJ in May of 2021. Ben has extensive experience in community outreach and non-profit/public sector management, and is currently focusing on community engagement and feedback through the creation of the Community Council (further details regarding the Community Council can be found in the “Community Feedback, Outlooks Regarding the Future, and Recommendations for Advocates” section). You can read more about Ben’s background here.

Nooreen Reza, is an attorney and Powell Fellow for the AIDS Legal Council and joined LCHJ in September 2021. Nooreen is passionate about integrating community and movement lawyering practices into direct services provision, and is currently on-site once a week at CCHC. You can read more about Nooreen’s background here.

The MLP between CCHC and LCHJ had its official soft launch in May of 2022. Right now, the focus is on providing free legal services to CCHC Housing patients, Ryan White patients, and PrEP eligible patients as LCHJ works towards eventually increasing capacity to all CCHC patients. Below is a Q&A with Kenya, Ben, and Nooreen about how and why this new partnership was established, their vision of community-driven medical legal partnerships, and their experiences thus far.

Question: What does a typical day in the life look like for you all?

Kenya: Meetings, meetings, and more meetings! *laughs* A typical day consists of meeting with team members to discuss their cases, troubleshooting issues, and assisting with professional development. Another focus of my role is policy advocacy. For example, recently I have been doing a lot of work with the Getting to Zero initiative, which is the statewide initiative to have no new HIV transmissions by 2030. Specifically, I’ve been focusing on HIV confidentiality training for care coordinators. I also spend time providing trainings to other organizations and advocating on behalf of our clients.

Ben: It’s still early days so my typical work schedule continues to evolve. When I joined LCHJ a year ago, the majority of my time was spent pouring through reports and statistics about health and legal issues affecting residents in our MLP service area. This work was critical in bringing me ‘up to speed’ with the why’s of our MLP. Later, I became the point person for our second phase of information gathering…surveys and focus groups gathered from the community. Most recently, I have been doing more traditional Community Organizing work. Pandemic restrictions are lifting so I’ve been pressing the flesh at CCHC Clinics, talking with Staff about our MLP to generate referrals, and recruiting new members for our Community Council.

Nooreen: Since I started at LCHJ in September 2021, the nature of a typical day has changed a lot. We went from being fully remote to having a hybrid in-office/at home model with me also being on site at our partner, Christian Community Health Center (CCHC), once a week. One thing that has remained a constant throughout is client relationships, though. A good portion of my days are spent calling clients about their cases to give them updates or discuss how things are going and gather information. When I’m not speaking with clients, I may be in meetings for our MLP project, doing research for cases, and occasionally doing presentations to different audiences, like CCHC staff and patients, about our MLP or other topics of relevance to them.

Q: Kenya, how did the new Medical Legal Partnership with Christian Community Health Center come about? Why now?

Kenya: We were looking at how we can make more of an impact in the African American community. This is not to take anything away from other communities, but we knew before the pandemic and before the protests in 2020, that health and social disparities existed in the South and West sides of Chicago in African American communities. There have been studies showing how, even when you control for education, socioeconomic status, and income, Black people receive poorer health services in their communities across the board; and the root cause of this problem is structural and societal racism. Therefore, we wanted our partner to be rooted in the Black community and to have a different population from the MLPs we were already serving. Approximately 90 percent of CCHC’s patients identify as Black; thus, partnering with CCHC happened naturally because their patient population would allow us to better serve clients in the far South Side and South Suburban communities, and we (LCHJ) already had an existing relationship with them.

Also, when you look at who is being impacted by HIV, the face of HIV has changed. It has changed from exclusively white gay males to that of people of color. While we have done a great job of reaching those traditionally impacted with HIV, we had to figure out a way to reach a more diverse population. So that was my push. It's great that we’re serving our current clients, but what about everybody else? We wanted to extend our reach to everyone impacted by HIV.

I have to give a lot of credit to Adoley Jordan, LCHJ’s former Development Director, because this project was really important to her. We also had support from our senior management team, and I want to say thank you to the McCormick Foundation who gave us funds to help really get this project off the ground.

Q: Ben, how has your role as a Community Organizer translated into creating this new MLP?

Ben: I’ve never been involved in an MLP before. As I understand it, although it’s typical to embed attorneys with healthcare professionals in most MLPs, it’s not so common to have a Community Organizer as part of the team. I see my role as important in communicating the power of law to address the social, physical, and economic conditions that affect individual and community health. We listened to the community and learned about historic mistrust of medical professionals and attorneys. I’m neither. I’m just a regular guy...albeit a charming one…and in many circumstances community members feel more comfortable and open to engaging with peers rather than with legal or medical professionals. I facilitate relationships based on trust. These relationships form the foundation of our Medical-Legal Partnership.

Q: Nooreen, what has your role been in the creation of this new MLP?

Nooreen: As the staff attorney on the project, my main role is to provide direct legal services to the clients referred to us by CCHC. That covers areas like public benefits, social security, Medicaid/Medicare, criminal record expungements, and some other issues as they arise on a case-by-case basis. So, that is more or less what I have been up to. I would like to think I’ve played some helpful role in the building/organizing side of things as well but my other team members are probably a better judge of that one, ha! (The other team members agree!)

Community Feedback, Outlooks Regarding the Future, and Recommendations for Advocates: Continued Q&A with Kenya Garrett-Burnett, Ben Handy, and Nooreen Reza

Another essential component of the creation of the CCHC-LCHJ Medical Legal Partnership was the collaboration between Legal Council for Health Justice and Candeo Consulting, a woman-owned consulting company, to gather information from South Side and South Suburban residents about the medical and legal needs in their communities. Feedback was obtained via focus groups and surveys, with a central focus on the following three questions: 1) What are the legal, health, and community needs and assets within the communities that CCHC serves?; 2) What are barriers to meeting legal, health, and community needs?; and 3) What assets and strategies can be leveraged to meet these needs?

The importance of community feedback and how it will be used to guide the MLP is discussed below, followed by the team member’s outlooks on the future of the MLP, and any suggestions or recommendations they may have for advocates looking to start a new MLP.

Q: A key element of the Legal Council for Health Justice and Christian Community Health Center Medical Legal Partnership is the feedback received from the community via Zoom and in-person focus groups, and also via the Community Needs Assessment Survey. Could you talk about your experience with, and the importance of community feedback when starting a Medical Legal Partnership?

Kenya: We want the community to guide this work. If we are off base, if we’re over there and the community says, “no we want you over here”, then we have to be able to make changes to get where the community needs us to be. Getting that voice and valuing people’s time is really important. It is also important to acknowledge that community members are not under any obligation to give us anything. Just because I have some degrees behind my name, doesn’t mean that I’m any more valuable than the person whose community I'm looking to impact. We have to continue to push this narrative and get the community to see that their opinions and what they have to say matters and is important.

Also, I have to credit Carrie Chapman. All along she has been pushing this idea of getting community input and valuing the community as a partner and not just as a group to which we’re providing services. We’re all equal, and she has never let us forget that. As a society we’re so used to jumping in and saying, “we’re lawyers, this is what we do, let us solve your problems and then we’re going to leave.” Carrie has always pushed our agency towards the model of everyone being equal partners, a model where legal aid lawyers value the community voice.

Ben: Certainly. Community input is critical to the success of our MLP with Christian Community Health Center. We put a lot of collective thought into crafting the questions used in both the survey and focus groups to coax out insights into both overlooked assets that make the community great as well as unmet needs that chronically challenge neighborhood wellness.

I’ll give you an example. One of the major findings that came out of our focus group discussions identified lack of social cohesion coupled with unreachable power brokers, like politicians, as caustic to individual capacity for self-advocacy or community-advocacy. Using this information, one of our new Community Council members, a young man from C