Attorneys Join the Health Care Team

Toward a Healthier Virginia for All

This article is part of an ongoing series of stories highlighting VCU Health programs and initiatives aimed at addressing issues of access and equity in health care.

In early 2020, child psychiatrist Parna Prajapati, M.D., recognized that if his patient — a 17-year-old who battles intellectual disabilities, autism, seizures and cerebral palsy — did not get additional help, their challenges were going to become far more detrimental very quickly.

It was help the Children’s Hospital of Richmond at VCU Health psychiatrist could not provide. His young patient and their family needed an attorney.

As children who lack capacity to make health care and financial decisions for themselves transition into adulthood, it is often essential for their parents or caregivers to establish guardianship to ensure seamless transitions and access to care and financial resources.

This is where a program not seen anywhere in Central Virginia except for VCU Health was able to step in to help.

The program, MLP-Richmond at VCU Health, is a medical-legal partnership (MLP) that works to ensure legal and social issues no longer challenge patients and their families, enabling those patients to focus instead on treatment and healing.

The program at VCU Health, like similar MLPs across the nation, intervenes to address social determinants of health such as unlawful evictions, poor housing conditions, insurance and public benefit denials, employment discrimination and domestic violence by providing free civil legal aid to low-income patients.

“The medical-legal partnership at CHoR has been a blessing to those families who cannot afford costly legal services,” Dr. Prajapati said. “It takes a huge burden off the shoulders of patients and families when they learn that I can refer them to this kind of help through the health system. Many people don’t know how impactful social issues, once mitigated, can be on overall health, and particularly mental health. I am immensely thankful for this partnership and the service it enables us to provide for the families in need.”

Part of VCU Health’s Division of Community Health, MLP-Richmond launched in 2018 with the help of start-up funding from the MCV Foundation. It began by serving VCU Massey Cancer Center and Children’s Hospital of Richmond at VCU, and today it serves patients and families in six clinical locations and offers free legal services at two community sites.

Through partnerships with Central Virginia Legal Aid Society, CancerLINC, McGuire Woods, Dominion Energy and the University of Richmond School of Law, MLP-Richmond has nearly doubled the number of patients it serves in just the past year. A recent $25,000 grant from the MCV Foundation has helped the program purchase a robust case management system necessary to support its growing caseload and expansion.

This expansion has been particularly important during the past year, said Allison Held, MLP-Richmond director.

“The COVID-19 pandemic, which disproportionately impacts low-income families and people of color, has highlighted issues of health disparity in Richmond and created an even greater need for the services provided by MLP-Richmond,” she said.

In the case of the 17-year-old in early 2020, Lindsay Pickral at the law firm ThompsonMcMullan provided pro bono services that succeeded in establishing ongoing guardianship for the family.

“Like so many parents, the mother in this case had put her child’s interests first since the day she gave birth,” Pickral said. “She had been involved in every decision for her child for 18 years, but on her child’s 18th birthday — literally overnight — the legal authority to manage health care and other needs was going to evaporate. MLP-Richmond meets an essential need in connecting VCU Health families with critical legal services, and in this case allowed a parent to continue what she’d always done – protect her child.”

The mother told MLP-Richmond she had an excellent experience. She was initially tense and worried about the process, having already gone through so much managing her child’s care as a single parent, but her attorneys explained every step thoroughly.

“If I could take them with me every day, I would,” she said. “The whole experience, the whole group came together as one … There was caring there, there was a heart there.”

Mother, patient and family recently celebrated a big 18th birthday with the assurance that the best possible care will continue seamlessly for their loved one.

It you're interested in learning how to help families navigate legal issues that threaten their health, please explore our past story on Keith Chantree, or contact us directly.