Many patients at Vanderbilt University’s Shade Tree Clinic are there because of chronic health conditions that are aggravated by where and how they live. In addition to medical treatment, these people usually need some kind of entry into the legal or court system to resolve those issues.

And now, thanks to a new medical-legal partnership (MLP) with the Legal Aid Society, that gap is beginning to be bridged.

“We are seeing a lot of disability issues, as well as problems around housing,” says Chay Sengkhounmany, a Legal Aid attorney and legal director of the MLP.

“A lot of people are facing eviction for one reason or another, and those who are trying to get on disability are unaware that it can be a two- or three-year process, and that there can be a lot of denials, and appeals, before it is completed.”

The Shade Tree Clinic opened in 2004 and provides free medical care for acute and chronic illnesses. It is located at 1223 Dickerson Pike, and sees more than 400 patients annually, by appointment only on Tuesdays and Saturdays.

Its new MLP, which will offer patients a variety of free legal services, is an outgrowth of one that was set up and is still operating in a limited capacity at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Most MLPs are formed at children’s hospitals because they are teaching hospitals and thus can partner with other university resources, and because they have a higher concentration of families in need than a regular hospital might have, Sengkhounmany says.

“Dr. Barry Zuckerman, who founded that first MLP, tells the story of how he would treat asthmatic patients, but then send them home to substandard housing and then see them a few weeks later with the same symptoms,” she says. “They were living in substandard conditions, and the landlords were doing nothing. He called a lawyer to take care of the problem, and that’s how it all began.”

The Legal Aid-Shade Tree partnership is unique because the clinic is student-run, as opposed to a community health center or larger hospital. Student physicians and, increasingly, student lawyers, gain real-world experience while providing an immediate service to the patient base, says Shannon Jordan, LMSW, a medical social worker at Shade Tree.

“I think the medical students are realizing what the barriers are between people and care,” Jordan says. “Those barriers have to be removed, or at least diminished, before care can be effective. I’ve been with Shade Tree almost five years, and worked with the other MLP project at the children’s hospital before that, and so I know how effectively it can connect people to resources.

“When that happens, a lot of pressure will ease up on these people, and they’ll be more compliant with their doctors’ directives. Just giving them the number to Legal Aid isn’t enough; they need a true advocate. Now we can be there for them and touch the medical, social and legal aspects of their lives, and the ripple effect is huge.”

One of the chief benefits of partnership is what it can do on the prevention side of medical care, notes Stephen Dorner, student medical director for the MLP and a second-year med student.

“One hundred percent of our patients are here because of their underlying social issues, as well as their medical issues,” Dorner says. “The great thing about the MLP is that it’s really focused on trying to resolve those underlying social ills. It provides a focused and strengthened way to address those problems that we as physicians, or physicians in training, aren’t able to offer.

“It’s fantastic for students because when you’re going through medical school, you’re memorizing antibiotics and learning how to do procedures, but there’s not much time dedicated to analyzing the social aspect of what’s going on with patients,” he continues. “Working side by side with lawyers, and soon with law students, broadens everyone’s perspectives and benefits the patient immediately.”

Currently, patients can schedule an appointment with Sengkhounmany, who also helped establish an MLP with United Neighborhood Health Services, on the first and third Thursdays and last Saturday of the month.

As the university’s law students become more involved in the MLP, she expects those hours to broaden and more people to be served.

“We want to provide one-stop shopping for these people,” Sengkhounmany says. “We had a case at the children’s hospital where a family had been flooded out of their apartment in the 2010 floods, but three months later were still living there in horrible conditions.”

Attorneys helped that family and several others in the housing complex get out of their lease without paying the $4,000 termination fee the landlord was demanding. Metro Codes and Health department workers were brought in, and the complex was eventually condemned.

“We got those clients out of their lease, and when they found another place to stay their health improved,” Sengkhounmany says. “The family would never have sought Legal Aid’s help had they not been referred through the MLP.”