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A Lawful Dosage: A Medical-Legal Partnership Fills in Some Gaps in Child Health-Care Issues

Wednesday, January 28, 2009

By KIM ARCHER World Staff WriterAdrienne Watt (left), a lawyer with Legal Aid Services of Oklahoma

Adrienne Watt (left), a lawyer with Legal Aid Services of Oklahoma, consults with Deni Fholer (center), a social worker, and Dr. William Geffen, a clinical professor in the Department of Pediatrics at the OU Schusterman Clinic. Watt works with clinic patients on matters of law.

When a Tulsa infant's foster parents took their child for a checkup at the OU Schusterman Clinic recently, they happened to mention to the pediatrician that their heat wasn't working.

It was below freezing outside.

And although they had complained to their landlord, their house was still cold.

That's when Adrienne Watt stepped in. She is the attorney for the Medical-Legal Partnership for Children, a new project aimed at improving child health by breaking through legal barriers.

"It was super cold outside at that time," she said. "I was really worried."

Watt wrote to the family's landlord to inform him that the family is entitled to heat under the law. Within 48 hours, the landlord installed a new furnace in the home.

"Sometimes it (a situation) can be taken care of by a letter," she said. "Other times, I need to do more."

Amid emerging research that shows a link between adverse childhood experiences and health and behavioral outcomes in adulthood, health clinics across the country are launching programs such as the Medical-Legal Partnership for Children at OU-Tulsa.

The University of Oklahoma and Legal Aid Services of Oklahoma implemented the first such program in the state and one of only a handful in the Southwest. It is one of 72 similar programs nationwide, most of which are on the East or West coasts.

As the brainchild of Dr. Barry Zuckerman at Boston Medical Center in 1993, the programs provide attorneys to help fill the gaps that
can't be filled by doctors or social workers.

"Let's say there's a child with malnutrition because the family can't afford food," Watt said. "Maybe the family can benefit from food stamps."

She might help the family fill out the paperwork. Or if there is domestic violence in the family, Watt might file a protective order to keep the abuser away from the child.

"Even children being a witness to violence damages them," she said. "Some referrals can be resolved by advice or by helping people fill out forms."

Others might require Watt to go to court.

"It's a broader conception of what health is," she said. "It looks at the social, environmental and economic determinants of health."

Watt works in a small office in OU's Schusterman Clinic, just feet from where children are getting medical care from pediatricians such as Dr. William Geffen.

He worked for years as a private-practice pediatrician before going to OU-Tulsa, where he also is a clinical professor in the Pediatrics Department.

"I would see issues in my practice that we couldn't do much about," Geffen said.

He is one of the catalysts for bringing the program to Tulsa.

"It gets down to the question of providing the most healthful environment for children to grow up in," Geffen said. "If you can change the environment, you can protect the child."


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