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Medical-legal partnerships

Evidence Rating
Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Disparity Rating
Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Community Conditions
Clinical care
Societal Rules
Institutional practices
Authors
Lead: Naiya Patel
Contributor(s): Bomi Kim Hirsch
Acknowledgements: Francis Amedoadzi, Alison Bergum, Lael Grigg, Jessica Rubenstein, Jessica Solcz
Date Last Updated
July 24, 2025

Medical-legal partnerships (MLPs) integrate legal services into health care settings, such as hospitals, public health departments, and behavioral health facilities (Regenstein 2018, NCMLP-Regenstein 2017). Health care providers refer patients to on-site legal assistance, which can include legal aid attorneys, private practice lawyers operating on a pro bono basis, and law professors and students (Tobin Tyler 2016). Patients are typically screened for legal needs in waiting rooms (Speldewinde 2015, Colvin 2012, Cohen 2010); electronic health records (EHRs) may also prompt providers to screen for legal needs (Sandel 2010). When needs are identified, legal providers work with health care providers and patients to address concerns related to housing, food and utilities assistance, and social services. Social workers, often located on-site, can also provide guidance (Speldewinde 2015, Colvin 2012, Cohen 2010). Some MLPs focus on specific patient populations or conditions such as pregnant women, patients with asthma, or patients with low incomes (Regenstein 2018). MLPs can be funded by hospitals or health care systems, health foundations, federal legal aid, law schools or firms, or state governments (Tobin Tyler 2016).

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Improved access to legal services
  • Improved health outcomes
  • Improved well-being
  • Reduced stress

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Improved access to social services
  • Increased enrollment in social services
  • Improved economic security
  • Increased housing stability
  • Improved housing quality

What does the research say about effectiveness? -+

Medical-legal partnerships (MLPs) can increase access to social services and supports (Teufel 2012, Weintraub 2010, NCMLP-Regenstein 2017, Pettignano 2013, Pettignano 2011), including social security benefits, family law services, end of life guidance (Teufel 2012, Rodabaugh 2010), and Medicaid (Teufel 2012, Pettignano 2012). MLPs can also increase access to education, employment (NCMLP-Regenstein 2017, Pettignano 2013, Pettignano 2011), and Supplemental Nutrition Assistance Program (SNAP) benefits (Pettignano 2011, Rodabaugh 2010). MLPs have been shown to increase access to legal services for disadvantaged populations (Speldewinde 2015), including patients experiencing homelessness (Tsai 2017a), families with low incomes (Sege 2015), cancer patients (Rodabaugh 2010), and families of children with chronic health conditions such as sickle cell disease (Pettignano 2011) and asthma (Pettignano 2013).

MLPs have been shown to increase patients’ comfort engaging with legal services (Hernandez 2016) and can reduce the need for litigation by addressing legal issues through administrative or informal processes (Tsai 2017).

Experts suggest that MLPs include social workers on-site to connect patients to social services and supports and to better address disparities in the social determinants of health (Colvin 2012). Programs may be more effective if providers use screening prompts in electronic health records (EHRs) to discuss legal issues and access form letters to connect to additional services (Sandel 2010a). Small budgets, reliance on volunteers with constrained time, and difficulty getting appropriate reimbursements for health care appointments can be challenges to sustainable MLP programs (Theiss 2017). Including MLP training in medical residency programs may increase providers’ understanding and use of MLPs (Paul 2017, Tobin Tyler 2016); training health care providers and staff to identify health-harming legal needs is a routine component of MLPs (NCMLP-Regenstein 2017, Tobin Tyler 2017).

Studies of MLPs in New York City, Atlanta, and rural Illinois have shown positive returns on investment (Atkins 2014, Teufel 2012, Tobin Tyler 2016, Pettignano 2013). MLPs may improve reimbursement for hospital services and contribute to health care system improvements (Pettignano 2012).

MLPs are increasingly essential for transgender people today with anti-trans laws threatening transgender and gender diverse (TGD) persons’ access to quality healthcare, their families, and their environment (Johnson 2024, LGBTQIA Health Education Center Fact Sheet).

How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by expert opinion. -+

Medical-legal partnerships (MLPs) are a suggested strategy to potentially decrease disparities among health outcomes and increase access to legal services (Johnson 2024, Beck 2022a, Keene 2020, Regenstein 2018).

Evaluations of MLPs have shown that health care providers and lawyers working together can advance health equity for vulnerable community residents (Regenstein 2018), like immigrant community members (League 2021). By addressing upstream systematic legal and social issues (e.g., systemic housing code violations, utility disconnection laws) that affect population health, MLPs may also result in policy changes through partnerships between healthcare professionals, lawyers, and patients (Tobin Tyler 2017, NCMLP-Theiss 2016). Experts suggest that screening patients for legal issues become a standard practice in patient care (Theiss 2017). Experts also suggest that MLPs include social workers on-site to connect patients to social services and other supports to better address disparities in the social determinants of health (Colvin 2012).

MLPs are increasingly essential for transgender people. Recent increases in anti-trans laws have threatened transgender and gender diverse (TGD) persons’ access to quality healthcare, their families, and their environment. MLPs can provide legal pathways to addressing health-harming legal threats (Johnson 2024) for TGD community members (LGBTQIA Health Education Center Fact Sheet).

What is the relevant historical background? -+

Medical-legal partnerships (MLPs) began in 1967 to address patients’ food and housing problems in Mississippi (Lawton 2014). In the 1980s, these partnerships were utilized during the AIDS epidemic to meet the end-of-life needs of patients suffering from AIDS. MLPs have helped address recurring illnesses among patients, often linked to unhealthy living conditions caused by landlords who refused to comply with sanitary codes (Lawton 2014).

In 2006, the National Center for Medical-Legal Partnership launched and has continued to build partnerships to inform public health, medical, and legal professionals about these relationships (Lawton 2014).

Equity Considerations -+

  • Do the health systems in your community (i.e. hospitals, clinics, etc.) have medical-legal partnerships established? If not, how can you support health care professionals, patients, and lawyers to build and facilitatethispartnership?
  • Does your community have medical-legal partnerships accessible to patients who need legal support?
  • Are healthcare professionals in your community aware of medical-legal partnerships? Can education materials be shared with them,or can you facilitate a medical-legal partnership?
  • Is there a residency program in your community? Are medical-legal partnerships covered during residency training?

Implementation Examples -+

As of July 2025, there are medical-legal partnerships (MLPs) in 450 health organizations across 49 states and Washington, D.C. (NCMLP). The National Center for Medical-Legal Partnership (NCMLP) provides research and technical assistance to organizations interested in creating MLPs and offers a handbook with MLP evaluation guidelines (NCMLP, NCMLP Handbook). NCMLP and the American Bar Association each maintain lists of partners participating in MLPs across the nation (NCMLP-Partnerships, ABA-MLP).

The Washington Medical-Legal Partnership is an example of a long-standing MLP; it has provided direct legal assistance to 2,200 individuals and trained 2,000 health care providers and social workers in legal advocacy since its establishment in 2008 (WA MLP). Medical-Legal Partnership Boston is another MLP that provides training, coaching, and technical assistance to interested organizations (MLPB). UF Health Senior Medical-Legal Partnership, a partnership between University of Florida Health and Three Rivers Legal Services, Inc., offers confidential free legal assistance to senior patients with low incomes who reside in 17 counties in North Central Florida (UF Health-MLP).

Implementation Resources -+

Child HeLP - Cincinnati Child Health-Law Partnership (Child HeLP). Cincinnati Children’s Hospital Medical Center and the Legal Aid Society of Greater Cincinnati.

Girard 2022 - Girard, V. W., Perry, D. F., Kessler, L. P., Cannon, Y., Bhatnagar, P., & Roth, J. (n.d.). The academic medical-legal partnership: Training the next generation of health & legal professionals to work together to advance health justice.

LGBTQIA Health Education Center Fact Sheet - National LGBTQIA+ Health Education Center. (2018, August 23). Fact sheet: Transgender health and medical-legal partnerships.

NCMLP Handbook - National Center for Medical-Legal Partnership (NCMLP). National Center for Medical-Legal Partnership performance measures handbook. Social Interventions Research & Evaluation Network (SIREN). University of California San Francisco (UCSF); 2016.

NCMLP-Marple 2015 - Marple K. Framing legal care as health care: A guide to help civil legal aid practitioners message their work to health care audiences. Washington, D.C.: National Center for Medical-Legal Partnership. Milken Institute School of Public Health, George Washington University; 2015.

NCMLP-Regenstein 2017 - Regenstein M, Trott J, Williamson A. The state of the medical-legal partnership field: Findings from the 2016 National Center for Medical-Legal Partnership surveys. Washington, D.C.: National Center for Medical-Legal Partnership. Milken Institute School of Public Health, George Washington University; 2017.

NCMLP-Utilities - National Center for Medical-Legal Partnership (NCMLP). MLP in action: a utilities case study: What happened when the heat went off? An MLP patients-to-policy story. Washington, D.C.: Milken Institute School of Public Health, George Washington University; 2018.

Citations -+

* Journal subscription may be required for access.

ABA-MLP - American Bar Association (ABA). Medical-legal partnerships pro-bono project.

Atkins 2014* - Atkins D, Heller SM, DeBartolo E, Sandel M. Medical-legal partnership and healthy start: Integrating civil legal aid services into public health advocacy. Journal of Legal Medicine. 2014;35(1):195-209.

Beck 2022a - Beck, A. F., Henize, A. W., Qiu, T., Huang, B., Zhang, Y., Klein, M. D., Parrish, D., Fink, E. E., & Kahn, R. S. (2022). Reductions in hospitalizations among children referred to a primary care–based medical-legal partnership: Study examines hospitalizations among children who are referred to a primary care-based medical-legal partnership. Health Affairs, 41(3), 341–349.

Cohen 2010 - Cohen E, Fullerton DF, Retkin R, et al. Medical-legal partnership: Collaborating with lawyers to identify and address health disparities. Journal of General Internal Medicine. 2010;25(Suppl 2):136-139.

Colvin 2012* - Colvin JD, Nelson B, Cronin K. Integrating social workers into medical-legal partnerships: Comprehensive problem solving for patients. Social Work. 2012;57(4):333-341.

Hernandez 2016 - Hernández D. “Extra oomph:” addressing housing disparities through Medical Legal Partnership interventions. Housing Studies. 2016;31(7):871-890.

Johnson 2024 - Johnson, D. Y., Asay, S., Keegan, G., Wu, L., Zietowski, M. L., Zakrison, T. L., Muntz, N., Pillai, R., & Tung, E. L. (2024). U.S. medical-legal partnerships to address health-harming legal needs: Closing the health injustice gap. Journal of General Internal Medicine, 39(7), 1204–1213.

Keene 2020* - Keene, D. E., Murillo, S., Benfer, E. A., Rosenthal, A., & Fenick, A. M. (2020). Reducing the justice gap and improving health through medical–legal partnerships. Journal of Legal Medicine, 40(2), 229–245.

Lawton 2014 - Lawton, E. (2014). The history of the medical legal partnership movement. National Association of Community Health Centers.

League 2021 - League, A., Donato, K. M., Sheth, N., Selden, E., Patel, S., Cooper, L. B., & Mendenhall, E. (2021). A systematic review of medical-legal partnerships serving immigrant communities in the United States. Journal of Immigrant and Minority Health, 23(1), 163–174.

LGBTQIA Health Education Center Fact Sheet - National LGBTQIA+ Health Education Center. (2018, August 23). Fact sheet: Transgender health and medical-legal partnerships.

MLPB - Medical-Legal Partnership Boston (MLPB).

NCMLP - National Center for Medical-Legal Partnership (NCMLP). Washington, D.C.: Milken Institute School of Public Health, George Washington University.

NCMLP Handbook - National Center for Medical-Legal Partnership (NCMLP). National Center for Medical-Legal Partnership performance measures handbook. Social Interventions Research & Evaluation Network (SIREN). University of California San Francisco (UCSF); 2016.

NCMLP-Partnerships - National Center for Medical-Legal Partnership (NCMLP). Partnerships across the U.S. Washington, D.C.: Milken Institute School of Public Health, George Washington University; 2018.

NCMLP-Regenstein 2017 - Regenstein M, Trott J, Williamson A. The state of the medical-legal partnership field: Findings from the 2016 National Center for Medical-Legal Partnership surveys. Washington, D.C.: National Center for Medical-Legal Partnership. Milken Institute School of Public Health, George Washington University; 2017.

NCMLP-Theiss 2016 - Theiss J, Sandel M, Teitelbaum J, Marple K. Applying the medicallegal partnership approach to population health, pain points and payment reform. Washington, D.C.: National Center for Medical-Legal Partnership. Milken Institute School of Public Health, George Washington University; 2016.

Paul 2017 - Paul EG, Curran M, Tobin Tyler E. The medical-legal partnership approach to teaching social determinants of health and structural competency in residency programs. Academic Medicine. 2017;92(3):292-298.

Pettignano 2011* - Pettignano R, Caley SB, Bliss LR. Medical-legal partnership: Impact on patients with sickle cell disease. Pediatrics. 2011;128(6):e1482-e1488.

Pettignano 2012 - Pettignano R, Caley SB, McLaren S. The health law partnership: Adding a lawyer to the health care team reduces system costs and improves provider satisfaction. Journal of Public Health Management and Practice. 2012;18(4):E1-E3.

Pettignano 2013* - Pettignano R, Bliss LR, Caley SB, McLaren S. Can access to a medical-legal partnership benefit patients with asthma who live in an urban community? Journal of Health Care for the Poor and Underserved. 2013;24(2):706-717.

Regenstein 2018* - Regenstein M, Trott J, Williamson A, Theiss J. Addressing social determinants of health through medical-legal partnerships. Health Affairs. 2018;37(3):378-385.

Rodabaugh 2010* - Rodabaugh KJ, Hammond M, Myszka D, Sandel M. A medical-legal partnership as a component of a palliative care model. Journal of Palliative Medicine. 2010;13(1):15-18.

Sandel 2010* - Sandel M, Baeder A, Bradman A, et al. Housing interventions and control of health-related chemical agents: A review of the evidence. Journal of Public Health Management and Practice. 2010;16(5 Suppl):S24-33.

Sandel 2010a* - Sandel M, Hansen M, Kahn R, et al. Medical-legal partnerships: Transforming primary care by addressing the legal needs of vulnerable populations. Health Affairs. 2010;29(9):1697-1705.

Sege 2015* - Sege R, Preer G, Morton SJ, et al. Medical-legal strategies to improve infant health care: A randomized trial. Pediatrics. 2015;136(1):97-106.

Speldewinde 2015 - Speldewinde CA, Parsons I. Medical-legal partnerships: The role of mental health providers and legal authorities in the development of a coordinated approach to supporting mental health clients’ legal needs in regional and rural settings. Rural and Remote Health. 2015;15(4):1-11.

Teufel 2012* - Teufel JA, Werner D, Goffinet D, et al. Rural medical-legal partnership and advocacy: A three-year follow-up study. Journal of Health Care for the Poor and Underserved. 2012;23(2):705-714.

Theiss 2017* - Theiss J, Regenstein M. Facing the need: Screening practices for the social determinants of health. The Journal of Law, Medicine & Ethics. 2017;45(3):431-441.

Tobin Tyler 2016* - Tobin Tyler E, Teitelbaum J. Training the 21st-century health care team: Maximizing interprofessional education through medical-legal partnership. Academic Medicine. 2016;91(6):761-765.

Tobin Tyler 2017* - Tyler ET. Medical-legal partnership in primary care: Moving upstream in the clinic. American Journal of Lifestyle Medicine. 2017;XX(X):1-10.

Tsai 2017* - Tsai J, Middleton M, Villegas J, et al. Medical-legal partnerships at Veterans Affairs medical centers improved housing and psychosocial outcomes for vets. Health Affairs. 2017;36(12):2195-2203.

Tsai 2017a* - Tsai J, Jenkins D, Lawton E. Civil legal services and medical-legal partnerships needed by the homeless population: A national survey. American Journal of Public Health. 2017;107(3):398-401.

UF Health-MLP - UF Health Senior Medical-Legal Partnership. University of Florida Health and Three Rivers Legal Services, Inc.

WA MLP - Washington Medical-Legal Partnership (WA MLP). Working towards better health through legal advocacy.

Weintraub 2010* - Weintraub D, Rodgers MA, Botcheva L, et al. Pilot study of medical-legal partnership to address social and legal needs of patients. Journal of Health Care for the Poor and Underserved. 2010;21(2 Suppl):157-168.

WPP-MLP - Wisconsin Partnership Program. Medical Legal Partnership.