San Francisco VA Health Care System
Medical Legal Partnership Helps Senior Veterans
When older Veterans get free legal advice along with their VA health care, good things happen.
“It was very enlightening and took all types of pressure off me, especially for a Veteran of my age and my position,” said Veteran Fred Wolf. “The way Sara conducts herself—she’s so efficient and knowledgeable. She’s a special lady.”
“Sara” is attorney Sara Huffman, JD, who was competitively selected as an Equal Justice Works Legal Fellow, sponsored by PG&E and Latham & Watkins LLP, to bring the Medical Legal Partnership for Seniors (MLPS) to the San Francisco VA Medical Center (SFVAMC). The MLPS was created and developed by the University of California, San Francisco (UCSF)/ UC Hastings Consortium on Law, Science & Health Policy, a partnership between UCSF Medical Center and UC Hastings College of the Law.
By doctor referral and appointment, Sara sees senior Veterans every Monday between 1-5 p.m. in the Geriatric Clinic in Medical Practice at SFVAMC. There she performs an initial, in-depth “legal checkup” to learn the legal needs of her Veteran patients, and how she can best assist. Follow-up appointments are then scheduled in the clinic, or at her off-campus office, or even at a Veteran’s home if they’re homebound.
“Most low-income geriatric patients don’t realize that many of the issues they’re facing are actually legal needs,” says MLPS Legal Director Yvonne Troya. “It’s through the legal checkup that we identify what kind of comprehensive advanced care and financial planning the patients need, and make that happen, and also look into their eligibility for additional public benefits, and how they can maintain those benefits.”
“The point of a medical-legal partnership is that it’s about health,” says UCSF/UC Hastings Consortium Executive Director Sarah Hooper, JD. “It’s not a legal intervention for its own sake. Our ultimate goal in this model is to improve health, and we know that health is about much more than health care. Legal issues are important because they have implications for a Veteran’s health. We’re partnering with VA physicians, who can help their patients identify these needs before they become really expensive, stressful, emergency legal needs with health consequences.”
The legal assistance provided is civil in nature, such as help with family issues, money, and housing. “I see a lot of clients who need help with simple estate planning, such as a health care directive, durable power of attorney for finances, or a simple will,” says Sara, who has been providing free legal services to geriatric patients in the MLPS program since September 2015.
“For these senior Veterans, taking care of advance planning really reduces their stress,” says Sara. “Finding agents to make decisions for them—if sometime in the future they are no longer to make those decisions—prevents big emergencies down the road. If they have someone to take care of those things, they don’t have to go to court to have a conservatorship put in place. It’s preventive and cost-saving; and it can protect against the risk of being taken advantage of in the future.”
The MLPS not only benefits Veterans, it educates providers. “The reason that this MLPS is important for all health care providers caring for older Veterans is, it helps us realize that things that improve people’s health are often not medications, not more procedures, but the social aspects of care—especially in our older adults who are at risk for future impairments to their ability to make decisions, whether those are financial or health care decisions,” says Eric Widera, MD, Director of Hospice and Palliative Care, and Geriatrics Fellowship Director at San Francisco VA Health Care System (SFVAHCS). “Thinking about these things beforehand is incredibly important. A lot of the success of MLPS is having people with great vision who can see the importance of this, and who are willing to dedicate themselves to this great project.”
This collaboration, like the other free legal clinics for Veterans offered by SFVAHCS, reflects a growing recognition by VA of the value to Veterans of having access to legal help. “VA has made increasing commitment in recent years to programs that improve legal access for its Veterans, spurred in large part by VA studies showing that many of our Veterans’ most pressing needs often involve legal issues that need to be resolved,” says VA attorney Janice Bressler.
SFVAHCS Free Legal Clinics for Veterans:
SFVAMC Geriatric Legal Clinic (by referral and appointment) – Mondays, 1 – 5 p.m., Medical Practice, Bldg. 200, 1st Floor (Attorney Sara Huffman)
SFVAMC Walk-in Legal Clinic – Wednesdays, 9 a.m. – 3 p.m., Bldg. 200 Main Lobby (Swords to Plowshares, Attorney Devin Bissman)
SFVAMC Walk-in Legal Clinic – Friday, 1 – 3 p.m., Bldg. 200 main lobby (UC Berkeley Law School)
Santa Rosa VA Legal Clinic – Wednesdays, 1 – 4 p.m. (walk-in or sign-up), Attorney Ron Dinan)
Ukiah VA Legal Clinic – 1st Thursday of each month, 12 – 3 p.m. (walk-in or sign-up, Attorney Geraldine Lewis)
San Francisco VA Downtown Walk-in Legal Clinic – 2nd and 4th Thursdays, 9 – 11:30 a.m. (Swords to Plowshares)