MLPB began as a pathbreaking innovation based in the Pediatrics Department at Boston Medical Center in 1993. In those early years, team attorneys primarily carried pagers and responded in real-time to patients’ acute legal crises. Often this response was in housing court, in immigration court, and in other “legal emergency room” settings.
In 2012, MLPB spun off from BMC and is now independent of any health or legal organization. MLPB is the national leader in preventive law as preventive medicine. In a range of partnerships across Massachusetts, Rhode Island, and the country, we are demonstrating the power of legal partnering as prevention – with a growing focus on lifecourse health through perinatal and early childhood partnerships.
Toward Greater Impact
After many years of experience at the household impact level, we reflected on whether we might allocate our law and policy expertise – and scarce team resources – differently, in ways that could promote prevention. Helping people through direct legal representation was – and remains – critically important in our democracy. We wondered, however, if we might help communities of care better identify people’s legal rights, risks and remedies before a crisis hits. This was especially true given the trust-building that can happen in care relationships. By shifting our work midstream and upstream, fewer people might land in high stakes and high stress legal proceedings.
From 2010-2012, MLPB participated in a pilot called DULCE (Developmental Understanding and Legal Collaboration for Everyone) geared to families with infants 0-6 months. Co-developed by Dr. Robert Sege (now at Tufts Medical Center) and MLPB CEO Samantha Morton, the DULCE pilot at Boston Medical Center generated promising results published in 2015. Findings showed reduced ED utilization, greater engagement with preventive care, and accelerated access to concrete supports like food resources and utility service.
Among many valuable lessons learned from this pilot, these results were achieved with a high dose of Family Specialist and a low dose of legal support. When MLPB deployed its legal resources preventively – offering continuous, proactive legal education and problem-solving insight to the DULCE Family Specialist and broader multidisciplinary team – only a
small percentage of DULCE families required resource- and time-intensive legal representation support. DULCE now operates in several communities in California, Florida, and Vermont and is expanding to six additional states in 2021 under the thoughtful stewardship of the Center for the Study of Social Policy.
The data-driven learning prompted MLPB to fully embrace and refine a new operating model that is geared to prevention and capacity-building: team-facing legal partnering.
MLPB has adopted a preventive law approach, reflected in our Unlocking Access capacity-building supports for our partners.
We are honored and energized to partner with communities of care who understand that human-centered care must systematically account for people’s legal rights, risks, and remedies.