Dr. Annette Clark, dean of Seattle University’s School of Law, speaks about her own experience dealing with a family member and insurance claims in the hospital. A medal-legal partnership could help lower-income people have representation in the at times overwhelming field of medical payments. Ryan Murray/staff photo

Eastside Legal Assistance Program looks toward medical-legal partnership

When Washington’s poor get sick, sometimes the bills stack up and emergencies get more severe.

The Eastside Legal Assistance Program, a Bellevue-based nonprofit providing pro bono legal advice to low-income residents on the Eastside, announced at its 7th annual Breakfast for Justice that it was looking to start a medical-legal partnership.

A medical-legal partnership is one in which legal representatives are embedded at hospitals to help provide advice and legal assistance for myriad reasons.

Jerry Kröon, executive director of Eastside Legal Assistance Program, said he is in talks with two local hospitals to help the Eastside’s working poor.

“The classic example I give is a girl comes to the emergency room for asthma attacks, four times in one month,” he said. “A lawyer looks into the case, starts asking questions because she’s never come in for asthma before. The family had the power shut off on them because they couldn’t pay, so they couldn’t use the nebulizer for her breathing. So every time she has an attack they bring her in. The emergency room was the only option.”

The lawyer in this story filed a charity rule claim with the utilities provider, which cannot withhold services if they are medically required. By switching the power back on, the hospital saved more than $2,000 for every unpaid visit to the emergency room. Hospitals operate on and file taxes on charity care and bad debt every year.

The program’s proposed Medical-Legal Partnership would allow attorneys to work directly with physicians, nurses, social workers and other members of healthcare teams to address the needs of patients.

A survey of Washington’s working poor in 2003 found that homelessness was the biggest issue they were concerned about. One in 2015 found that medical issues were the number one concern by a wide margin.

Annette Clark, dean of Seattle University’s School of Law, spoke at the Breakfast for Justice about her own unique past and how it relates to medicine and the law.

Clark, who earned doctorate of medicine from the University of Washington before changing her career to law, said she was faced with a predicament when her own mother was sent to the hospital and had to battle insurance claims to get proper treatment.

Being a doctor and a lawyer, Clark has insight into how the medical field and the law work. She sent an eight-page brief and 35 pages of medical records to the insurance company. Unsurprisingly, it relented and paid what Clark’s mother was due.

“What do people in my situation do without people like you to advocate?” She asked the crowd of mostly lawyers. “More often than not, the answer is they go without.”

Kröon, who is in talks with Overlake Medical Center in Bellevue and EvergreenHealth Medical Center in Kirkland to try to get a pilot medical-legal partnership off the ground, said the lawyers under Eastside Legal Assistance Program’s purview were excited at the possibility.

“Attorneys embedded in a facility can meet these challenges head on,” he said. “Emotional health-harming legal issues are a thing too. You can be stressed out worrying about medical bills and it can have a negative effect on your health.”

The Eastside Legal Assistance Program has more than 260 attorneys providing assistance (more than 20,000 hours impacting more than 50,000 clients since it launched), along with six legal fellows and four staff attorneys.

A medical-legal partnership would hopefully save money in the long run too, Kröon said. Yes, poor families will avoid falling into medical debt they can never repay, but attorneys can also help people sign up for Medicaid, represent them in insurance disputes and work with the hospital to actually get paid.

“The return on investment for medical-legal partnerships is something like 7 to 1,” Kröon said. “This is just the next step in us trying to be as nimble and reach out to people as quickly as I can.”

Advance health care planning, housing, income support, public benefits and domestic violence are all issues which the partnership could assist with.

Until the country has universal health care, a medical-legal partnership might help families get the edge they need not to sink into a quagmire of debt and stress.


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Dan Satterberg, the King County Prosecuting Attorney, speaks at the Eastside Legal Assistance Program annual fundraising breakfast last week. Ryan Murray/staff photo

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