The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61699

Laura Barnickol, JD, MSW¹, Jocelyn A. Hirschman, MPH², Janell F. Fuller, MD³, Gopal Srinivasan, MD⁴, Swarupa Nimmagadda, MD³, and Stephen N. Wall, MD, MSH⁵. (1) Health & Disability Advocates, 205 W. Monroe St., 3rd Floor, Chicago, IL 60606, 312-223-9600, lbarnickol@hdadvocates.org, (2) Sinai Health System, Sinai Urban Health Institute, California Ave at 15th St., K430, Chicago, IL 60608, (3) Pediatrics/Neonatalogy, University of Chicago Hospitals, 5841 S. Maryland Ave., MC 6060, Chicago, IL 60637, (4) Pediatrics, Sinai Health System, California Ave at 15th St., Chicago, IL 60608, (5) Pediatrics - Section of Neonatology, University of Chicago, MC 6060 - 5841 S. Maryland Ave, Chicago, IL 60637

Our study examines the need for legal advocacy to overcome systemic barriers to health and welfare services among indigent former NICU infants. We conducted a nested cohort study of high-risk infants who were assigned to receive post-NICU case management and legal services (CM/LS) as part of a randomized controlled trial. A case manager screened each infant/family for their eligibility to receive health and welfare services. Referral to a lawyer (on-site in the clinic) was made if the family was unable to obtain a health or welfare service for which they were eligible. Legal assistance was provided as needed to enable the infant and family to gain access to the service(s). Legal assistance was defined as legal counsel when direct services were provided to the client, and legal advocacy when intervention with service agencies on behalf of the client was required.

Between April and October 2002, 44 enrolled infants were randomly assigned to receive CM/LS. Annual household income was <$5000 in 45%. Most mothers were single (84%) and the sole caretaker (61%). Among the 44 families, 37 (84%) needed legal counseling and 28 (64%) needed legal advocacy to receive medical and/or welfare services. Legal advocacy was needed to access a wide range of services among eligible families: Supplemental Security Income (14/35), Medicaid or medical insurance (7/44), Temporary Assistance for Needy Families (9/24), and food stamps (7/35). Legal advocacy resulted in receipt of benefits in 33/39, actions are pending in 3/39, and 3/39 are still not receiving benefits.

Learning Objectives:

Participants will be able to:
• list some of the obstacles families of high-risk infants face accessing health and welfare benefits,
• describe the need for legal advocacy in order for these infants to receive health and welfare services for which they are eligible,
• recognize the need for public policy action in order to reduce the barriers to health and welfare services.

Keywords: Infant Health, Advocacy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.