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Published on December 01, 2010

Women's Wellness December 2010

Grant Creates Unique Medical-Legal Partnership to Help CKHS Women and Children’s Health Services Clients

Based at Community Hospital in Chester, Crozer-Keystone Healthy Start provides a range of case management, health education and outreach to women who are pregnant or who have children under two years old. The grant will be used to train Women and Children’s Health Services staff to conduct legal needs assessments when they first connect with a client, to identify legal needs and to make appropriate referrals to the legal component. The grant will fund the legal team, which will consist of a full-time attorney as well as Widener students from the School of Law as well as the Social Work, Public Health, Psychology and Spanish departments. The project will also collect data to measure the impact of their efforts.

Women and Children’s Health Services’ flagship program is Crozer-Keystone Healthy Start, which provides hands-on medical and social service assistance for women and families in need. The goals of the program are to reduce infant mortality and increase prenatal care and childhood immunizations in the community. Healthy Start is free for pregnant women and children younger than 24 months old who meet certain income limitations and live in Chester, Chichester, Eddystone, Woodlyn, Parkside, Upland, Toby Farms, Chester Township, Trainer, Marcus Hook or Linwood.

Fulfilling a Need

“The idea behind this program is that we have found that many of our participants have legal problems that literally affect their health and well-being. Our program participants often do not have the resources to manage these issues, or they are unaware of resources that are available to them. When they have to deal with these legal issues themselves, they do not have as much time to take care of themselves or their children,” says Joanne Craig, director of Women and Children’s health Services.

In the primary service area of Crozer-Keystone Healthy Start, almost one-third of the service area residents live in poverty and over half live under 200 percent of the Federal Poverty Line, according to data from the Public Health Management Corporation. PHMC data also suggests that residents in the service area are more likely to report fair or poor health status than adults in other areas of Delaware County, and service area residents are more likely to have diabetes and asthma.

A 2009 Widener School of Law legal needs assessment of Crozer-Chester Medical Center’s outpatient pediatric patients also revealed that patients in the same service areas have a range of legal needs. The survey revealed that low-income pediatric patients and their families experienced serious problems with public benefits, housing, health insurance and other issues that affect their health.

A History of HELPing

The HRSA grant will expand on an existing partnership between Crozer-Keystone and Widener. HELP currently operates a medical-legal partnership serving patients in the outpatient Crozer-Keystone Health Network pediatric practice based at Crozer as well as two ChesPenn Health Services sites (ChesPenn has a management agreement with Crozer-Keystone). HELP has conducted thorough needs assessments of medical providers and potential clients, retained a public health professional to develop evaluation methods and protocol, completed 15 trainings of medical providers and produced five brochures on legal topics for medical providers.

In just six months, HELP opened 48 cases, benefiting over 100 people. Among its many successes include preserving electric service for a woman who owed more than $1,000 to the utility company; helping homeless families find housing; and overturning the denial of Medicaid funding for the day care of a medically fragile child so that the mother could continue school.

Perhaps more importantly, 84 percent of clients participating in post-service evaluation reported a decrease in stress and an increase in the quality of their sleep following HELP services.

How It Will Work

All Healthy Start program participants will be eligible for the services provided by this new legal component. There will be no charge for the services.

Legal services will be tailored for the Healthy Start participant, delivered in a culturally appropriate manner. Legal staff will receive assistance with outreach and cultural sensitivity with Hispanic and African American clients by Widener advanced Spanish students as well as CKHS staff members, many of whom are from the service area. 

“The addition of an attorney to the Healthy Start offering of services is wonderful. This expertise will help our team do an even better job of serving our program participants and helping them access each of the resources that they are entitled to,” Craig says.

Supervision of the legal component staff will be conducted by Dan Atkins, a lawyer with more than 20 years of experience in poverty and disability law. Atkins will be supported at Widener by John Culhane, director of the School of Law’s Health Institute and a professor of law with experience in health law.

Pre- and post-training evaluations will measure the impact of training on staff members to identify and refer legal needs. The program will retain Thomas Jefferson’s School of Population Health so that evaluation tools and methods will be scientifically sound.

In addition to Healthy Start, Women and Children’s Health Services oversees the Nurse-Family Partnership, a nurse home-visiting program that improves the health, well-being and self-sufficiency of low-income, first-time parents and their children. Other Women and Children’s Health Services programs include the Children’s Health Connection Reminder Program, which helps parents keep up with health, safety and nutrition for their children; Cribs for Kids, which provides underserved families with education, awareness and free cribs; and the Hispanic Resource Center, which provides a range of services to the Spanish-speaking population in Chester and beyond.

For more information about Crozer-Keystone Healthy Start or any other Women and Children’s Health Services program, call (610) 497-7460 or e-mail

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