“First of its Kind” Medical-Legal Partnership Completes First Year

Appalachian School of Law (ASL), Ballad Health, and Virginia Tech have formed and launched a Medical-Legal Partnership (MLP) unlike any other in the nation.  The MLP spans two state jurisdictions, provides specialized legal aid to low-income rural and urban populations, and addresses the health-harming unmet legal needs of patients in about a dozen hospitals within the Ballad Health footprint.  While the legal services model and the breadth of the MLP are unique, one of the most distinctive components of this MLP’s design is a data collection program headed by Virginia Tech’s Pamplin College of Business in collaboration with the law school.  The data collection and analysis provide investigations and reports regarding the efficacy of the medical-legal interventions conducted.  The team evaluates its methodologies and processes to measure and continually improve the effectiveness of the MLP program in both holistic and precise ways.  The data collected from the program’s first year have recently been compiled and reviewed and are now available in a report.

The underlying premise of MLPs is an understanding that social factors, such as one’s physical environment and access to resources, have a profound impact on individual health outcomes.  These social determinants of health include access to legal assistance.  MLPs have long recognized the connection between chronic medical conditions and unmet legal needs.  During the last three decades, hundreds of MLPs were established to identify and treat such needs by having attorneys and medical practitioners in the hospital working together to resolve the negative social conditions of low-income patients and positively impact their health outcomes.  The ASL MLP addresses legal issues through Ballad’s hospital-to-MLP referrals.  In 2021, the ASL MLP received over 1500 referrals from medical professionals in the Ballad Health system. 

These referrals are handled by law students from Appalachian School of Law supervised by ASL professors and attorneys from Southwest Virginia Legal Aid and Legal Aid of East Tennessee.  In its first year, the primary legal services provided by the ASL MLP involved insurance matters, housing assistance, and family law matters, but also included legal help with consumer law, Social Security, food insecurity assistance, disability claims, advance medical directives, and estate planning matters.  Typically, one attorney was assigned per case, with one or more ASL student attorneys assisting.


“Ballad Health is thrilled to be a part of this program,” said Dr. Matthew Loos, Chief Academic Officer at Ballad Health.  “Ballad understands that the health of our region requires more than just access to our high-quality clinical care facilities and providers. Communities, neighborhoods, and individual homes within the Appalachian Highlands must also foster health and well-being. Ballad is committed to this ideal, and the MLP is a key component of the regional wellness we are building.”

Dr. Quinton Nottingham, a professor at Virginia Tech who headed up the data collection component of this program, said “six students from the Pamplin College of Business have been working with the MLP since it started seeing patients in 2021. These students have had an outstanding experiential learning opportunity by applying their data analytics skills in a manner that is truly impacting lives. With the data collected from the patients seen by the MLP,” Dr. Nottingham continued, “we are learning the type of patients that need help, the financials of the patients and their families, as well as the primary needs of the families. As we continue to see patients, we will learn to better allocate resources so that we can help even more patients.”

The Executive Director of the MLP Suzan Moore said “this first-of its-kind partnership among Ballad Health and ASL, with Virginia Tech providing data analytics, has demonstrated in its initial year of serving low-income patients that working together, unmet needs for legal services can be effectively addressed, and the social determinants of health can be positively impacted for such patients.  We look forward to continuing our work together to build upon these early favorable results.”

“Our MLP Clinic students experience working in a small law firm,” said ASL’s Dean of Experiential Learning, Lucy McGee, “which provides a unique opportunity to students to develop their professional identities as legal practitioners.  Those eligible for student practice in Tennessee and Virginia can practice law under the supervision of licensed attorneys in two jurisdictions before graduating law school.”

ASL President and Dean, B. Keith Faulkner, said “the MLP is an important piece of clinical training of law students as ASL works to prepare practice-ready lawyers. The program aligns perfectly with the spirit of ASL’s mission of increasing access to justice for the people of the Appalachian region.  We are proud to partner with Ballad and Virginia Tech on this project and encouraged by the data produced and results thus far.  It is our hope that this MLP will become a model for others across the nation.”

The MLP participants are passionate about their important work and see growth in the near future. While data are still incoming, the first year’s research indicates that overlapping and interacting needs, bound together in distinct combinations of legal and medical issues, are abundant and can be remedied through collaborative efforts between legal and medical professionals.

If you would like to learn more about this first round of research into the novel MLP, please contact Dr. Quinton Nottingham at notti@vt.edu or access the report here.


Posted July 6th 2022 Posted by