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University Hospitals physician highlights importance of Legal Aid, Right to Counsel

Posted March 14, 2022
10:38 am

Dr. Amy Grube

From Crain's Cleveland Business:

Personal View: Medical-legal partnership creates healthier communities
By Dr. Amy Grube

Shelly had weathered so many challenges during COVID-19: losing her job, caring for four children on her own, supervising remote school, and managing her son Calvin's complex health conditions — which required frequent visits to my colleagues at our pediatric practice in MidTown, University Hospitals Rainbow Babies & Children's Ahuja Center for Women & Children.

Cal is deaf and has ADHD; he often speaks and yells at a high volume without meaning to, and the noise disturbs Shelly's neighbors. At the same time, Shelly fell behind on rent. Due to the multiple concerns, building management sent her an notice to vacate.

Shelly was scared. The situation looked pretty bleak.

But this story has a happy ending.

Two Cleveland-based, innovative programs were the difference between housing and homelessness for Shelly and her kids: a medical-legal partnership based at University Hospitals, combined with Right to Counsel in Cleveland Housing Court — led by Legal Aid and United Way.

Medical-legal partnerships further health equity by integrating the unique expertise of lawyers into health care settings. Research shows social and economic factors contribute to 80% of a person's health outcomes. The first medical-legal partnership was created in Boston in the late 1990s, and since then, the evidence-based model has expanded nationwide; there are now more than 450 health care organizations with an established medical-legal partnership in 49 states and Washington, D.C.

Thanks to philanthropy from the Benesch law firm, University Hospitals created a medical-legal partnership in 2018, integrating a Legal Aid attorney onto our team at the UH Rainbow Ahuja Center for Women & Children. Legal Aid helps the patients and families we serve achieve a healthier and less stressful life. Shelly's case is a great example.

But, often more than one intervention is needed to create good community health, and that is why Right to Counsel in Cleveland Housing Court is so important. It provides another tool in our toolkit to stabilize housing. Legislated by the city of Cleveland, led by United Way, supporting outreach and evaluation, with legal services provided by Legal Aid, there is now a "right" to an attorney in Cleveland Housing Court for certain low-income families. In 2021, Legal Aid prevented eviction in 93% of Cleveland's housing right to counsel cases (for a full report on 2021 success, go to One of those cases was Shelly's.

When Shelly mentioned the potential eviction at her son's well visit, my colleague referred her to the Legal Aid office located within the UH Rainbow Ahuja Center for Women & Children. Health care providers at UH are trained to recognize when legal issues create barriers to health for our patients. We connect with Legal Aid attorneys through a streamlined referral portal, and work with them to secure resolutions to the challenges our patients face. Housing issues are incredibly common, and they rose during the pandemic.

Immediately after the referral, Legal Aid recognized Shelly was eligible for Cleveland's right to counsel in housing, and another Legal Aid attorney got to work on her case. The attorney first helped Shelly submit the correct paperwork to be covered by the Centers for Disease Control and Prevention's federal eviction moratorium, and helped Shelly through the complicated application for rent assistance funds. The Legal Aid attorney obtained a letter from her son's UH medical provider to support the application for rent assistance. Even though the moratorium had ended by the time the money came through, Shelly's landlord accepted the money and did not pursue eviction despite the noise concerns. Thanks to Legal Aid and UH working together, Shelly was able to keep a roof over her family while she looked for a new job.

Unstable housing circumstances, such as lack of housing, multiple moves and rent strain, have been associated with adverse health outcomes for caregivers and young children. For example, evictions are associated with higher rates of depression, childhood hospitalizations and emergency department visits. Counties with higher eviction rates have higher rates of accidental deaths due to drugs and alcohol. Housing is health care. My employer's medical-legal partnership with Legal Aid has proven repeatedly that the combination of civil legal aid and medical care can stabilize families and make our communities healthier places for children and families to thrive.

Cleveland is fortunate to have a strong Legal Aid and United Way, with a Right to Counsel program that has already kept hundreds of families like Shelly's safely housed since its launch just a year and a half ago. We as a community should continue to support a right to counsel in housing cases, as housing is a human right. I am proud to live in a city that is leading the way when it comes to leveraging institutional partnerships to improve population health.

Grube is medical director of pediatrics at UH Rainbow Ahuja Center for Women & Children.


Read the original story at Crain's Cleveland Business: Personal View: Medical-legal partnership creates healthier communities | Crain's Cleveland Business (


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