Embedding Legal Support in Preventive Health Care

Health care systems are increasingly recognizing the value of legal expertise as a tool for addressing some of the social and material needs that can impact healthy child development and family well-being. Medical–legal partnerships, a model for integrating legal services and expertise into healthcare settings, have expanded rapidly in the past decade. These partnerships can amplify the ability of healthcare systems to address families’ social needs and mitigate contributors to toxic stressThis study examines the multisite implementation of the preventive legal partnership component of Developmental Understanding and Legal Collaboration for Everyone (DULCE). This approach embeds holistic problem solving with legal support into preventive health care for young children. 

This brief is part of Chapin Hall’s evaluation of innovations designed to promote screening for contributors to toxic stress during pediatric well-child visits and connect families to early childhood and community service providers.  

What We Did 

We interviewed legal partners, health care, and early childhood staff implementing DULCE in seven pediatric clinics across five communities in California, Florida, and Vermont. Through 60 interviews over two time points encompassing initial implementation and adaption over time, we explored adaptations to clinic and community context, barriers to family participation, and lessons learned about integrating legal expertise into preventive pediatric health care.

What We Found 

DULCE’s integration of legal expertise into the preventive pediatric health care setting strengthened clinic capacity for holistic care and increased the range of resources offered to families. Legal partners trained and supported family specialists in offering legal information and education to families as part of the well-child visit, in addition to serving as a referral resource for legal advice and direct representation for more complex issues. By applying a prevention lens, legal partners helped clinic staff learn where legal advice could help address family social and material needs before issues became legal crises. DULCE’s emphasis on educating clinic staff also broadened opportunities to address families’ legal needs beyond resource-intensive legal consultation with individual families. 

What It Means 

DULCE’s preventive legal partnering approach creates new opportunities to positively impact children’s health at scaleCommunities exploring the potential of preventive legal partnering as part of preventive health care should identify what common legal issues are faced by families and articulate the partnership’s priorities in addressing these issues. Clinics should also explore legal partners’ capacity to contribute to holistic problem solving, particularly for specialized legal referrals and direct legal representation. 

Recommended Citation
Brown, A., Spain, A. K., Sander, A., Rathore, K., & McCrae, J. S. (2020). Before crisis hits: Embedding legal support in preventive health care for families with young children. Chicago, IL: Chapin Hall at the University of Chicago.


JPB Research Brief 6 Legal Support