Page 24 - Layout 1

PEDIATRICS

MEDICAL-LEGAL

AID PROGRAM

Helps Indigent Youth

Seeking Medical Care

By Darren Donahue, JD

has been well established that a child’s health depends poverty and that can be a factor in poor health. Currently, MLAF ac-
It on more than can be addressed by their pediatrician cepts referrals from the Baylor College of Medicine Department of
alone. According to the American Academy of Pedi-
Pediatrics at The Children’s Hospital of San Antonio and the Depart-
atrics, poverty is a strong risk factor for poor health and ment of Pediatrics at UT Health San Antonio.
has been linked to higher rates of asthma, obesity, poor language de- One of MLAF’s most active areas of advocacy is in helping pe-
velopment, increased infant mortality, and increased risk of injuries. diatric patients obtain coverage and assistance from their public ben-
And while pediatricians frequently identify the social and environ- efits as guaranteed by law. For children, under the Federal Medicaid
mental problems that harm their patients, they often lack the time, statute, Medicaid is required to provide “necessary healthcare, di-
training, or professional license to adequately address these issues. agnostic services, and other measures…to correct or ameliorate de-
In an alcove off the waiting room for the Children’s Hospital of fects and physical and mental illnesses and conditions.” 42. U.S.C. §
San Antonio’s primary care pediatric clinic lies a small team of legal 1396d(r)(5). However, in many cases, families find themselves being
professionals working diligently to ameliorate some of these social denied Medicaid coverage for exactly the test or procedure ordered
determinants. Titled Medical-Legal Assistance for Families by their pediatrician. Following such a denial, the patient has a right
(“MLAF”), this team makes up Texas RioGrande Legal Aid’s com- to a fair hearing to determine whether the denial was proper. And
ponent of San Antonio’s Medical-Legal Partnership. Formed in 2008, in these hearings, patients and their families can greatly benefit from
Texas’ first medical-legal partnership has created a referral pipeline the assistance of a lawyer.
for indigent families in San Antonio to obtain legal services for their In one recent example, MLAF was instrumental in obtaining
children. In so doing, MLAF addresses the challenges – education, Medicaid coverage for diagnostic services for a girl born with intel-
housing, guardianship, and accessing public benefits – that accompany lectual disability, short stature, dysmorphic facial features, and a

24 San Antonio Medicine • June 2018