Health Share Looks “Upstream” at Legal, Housing Issues that Affect Health

The first Medical-Legal Partnership in Oregon is set to begin a pilot project this fall

Medical-legal partnerships and the connections between health and housing dominated the May 1 meeting of Health Share’s Community Advisory Council.

“We’re trying to think upstream, about the social determinants of health,” said Rachel Arnold, contracting and provider relations manager.

Laura Russell, a law student at Lewis & Clark College, has been interning with Health Share to examine legal needs related to health.

“One in six people need legal interventions to be healthy,” said Russell. “Civil legal services for Medicaid or low-income people can transform healthcare.”

Examples of legal services that can help include:

  • Assistance accessing health benefits after a denial, such as filing an appeal;
  • Housing and utilities, such as eviction prevention and challenging unhealthy conditions such as household mold;
  • Access to education and employment, which Russell said are “strongly tied to health;”
  • Legal status, which mostly concerns immigrants;, and,
  • Personal stability, such as living in a domestic violence situation.

A one-year pilot project and an advisory board, the Medical-Legal Partnership of Oregon, is expected to begin at Oregon Health & Science University’s Richmond Clinic this fall.

Its goal is to determine the importance of legal assistance to a patient’s health, with participation from OHSU, Health Share, pro bono attorneys and law students from Lewis & Clark. The team will do interviews to determine the legal needs of the clinic’s population, then determine whether legal interventions improve patient outcomes and reduce healthcare costs.

“We’re hoping to show ‘Here’s how we’re saving money and why this is worth funding,’ ” said Russell, with a goal of expanding the partnership across the Portland area.

“We’re one of just a few states in the country without an MLP,” said Arnold. “This is the first one in the state of Oregon.”

The housing hurdle

Next up, a three-member team dove into the thorny issue of housing’s importance to health:

Amanda Saul, senior program director of Enterprise Community Partners;

Martha McClennan, executive director of Northwest Housing Alternatives; and

Kenny LaPoint, housing integrator with Oregon Housing and Community Services.

“The shortage of affordable housing is currently 20,000 units in Multnomah County alone, with prices rising rapidly,” said Saul.

Enterprise Community Partners is forming a health and housing initiative to assess links between housing and healthcare and its effects on vulnerable populations. The initiative will form a learning collaborative; document costs with third-party research; and support housing providers with grant funds, establishing best practices and sharing successful pilot projects.

Learning Collaborative members include Cascadia Behavioral Health Care, Catholic Charities, Cedar Sinai Park, Central City Concern, Home Forward, Human Solutions, Innovative Housing and Northwest Housing Alternatives.

“There’s a new study we’re doing with CORE (Providence Center for Outcomes Research and Education),” added Saul. “It’s due out in August, and we hope to get good policy recommendations.”

The study will include 10,000 “affordable” units in Multnomah County that house at least 7,000 Medicaid enrollees covered by Health Share.

For now, the panel recommended that members of the Community Advisory Council:

  • Advocate for a Medicaid supportive housing services benefit to pay for housing retention services delivered in supportive housing;
  • Implement “Home for Everyone” recommendations, which would bring health and support services into community-based settings and make other improvements;
  • Support House Bill 2198, which would provide $100 million for affordable housing;
  • Support Senate Bill 5513, which would provide $20 million to the Emergency Housing Account and the State Homeless Assistance Program; and,
  • Support House Bill 2564, which would repeal statewide pre-emption on inclusionary zoning.

Kendra Hogue is a Portland-based freelance writer. She can be reached at

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