Introduction
Waycross, a rural city located about 125 miles south of Savannah, Georgia, is recognized for its natural beauty and historical significance. However, it also faces significant health disparities common in many rural communities across the United States.[1] With nearly 14,000 residents, Waycross struggles with health issues comparable to urban areas, influenced by factors such as poverty, limited healthcare infrastructure, and transportation barriers, which disproportionately affect marginalized populations.
The situation is further complicated by conditions throughout Ware County, Georgia’s largest county by area, where over 35,000 residents contend with severe healthcare provider shortages and extremely limited access to legal services. In fact, since 2010, nine rural hospitals in Georgia have closed, exacerbating the health disparities seen in Waycross-Ware County. Resultingly, the 175 health centers and rural clinics in rural Georgia have played an increasingly crucial role in addressing the population’s physical, mental, and social health needs. These clinics serve as critical access points for comprehensive healthcare services, helping to alleviate the impact of provider shortages and infrastructure gaps.
In response to these complex issues, McKinney Medical Center [2] and Georgia Legal Services Program [3] formed a medical- legal partnership (MLP) to address the interconnected health, social, and legal needs of the Waycross-Ware County community. This partnership aims to provide integrated support, enhancing the well-being of residents by tackling the multifaceted challenges they face as a rural community.
McKinney Medical Center: A Vision and Mission to Serve Everyone in the Community
McKinney Medical Center, a Health Resources and Services Administration (HRSA)-funded Federally Qualified Health Center (FQHC) [5], has been serving the Waycross community since 1995. Led by CEO Ola Smith-Carter, the center has a rich history rooted in community service and the 1960s war on poverty. Named after Rev. Arnold McKinney, a visionary leader and community advocate, McKinney Medical Center is committed to providing high-quality, affordable care to all residents.
One example of McKinney Medical Center’s holistic approach is a senior community member initially diagnosed with dementia, whose condition was ultimately attributed to food insecurity. By assisting the patient in accessing SNAP benefits and other support services, the center addressed the root cause of the health issue, highlighting the importance of comprehensive care.
“Some people come into the [health] center on their last leg trying to make it, and we want to make them stand up tall and be a part of society.”
– Ola Smith-Carter, CEO of McKinney Medical Center
Georgia Legal Services Program: A Shared Mission and Vision, but Serving a Unique Purpose
Founded in 1971, Georgia Legal Services Program (GLSP) provides free civil legal services to low-income individuals outside the Atlanta metro area, including rural parts of Georgia. The organization was established by young lawyers who recognized the dire need for legal services in rural areas. They collaborated with the Younger Lawyers Section and the State Bar of Georgia to secure funding, leading to the creation of GLSP. The organization addresses a wide range of legal issues, including housing, employment, and healthcare access, reflecting its commitment to community empowerment.
Similar to McKinney Medical Center, GLSP’s origins are deeply connected to the war on poverty. The organization’s mission is to create equal access to justice and opportunities out of poverty, focusing on rural Georgians who often face insurmountable barriers to legal assistance. GLSP receives federal funding from the Legal Services Corporation, the single largest source of funding for civil legal assistance to the nation’s poor, enabling it to serve 154 of Georgia’s 159 counties.
“Our mutual goal is to enhance the livelihood of the people, especially in rural Georgia.”
– Racheal Henderson, Specialist Attorney at Georgia Legal Services Program and Co-Creator of the MLP
Implementation and Impact
The partnership between McKinney Medical Center and GLSP evolved from a longstanding referral network to a formalized MLP. Recognizing their shared mission to improve community well-being, the organizations collaborated to establish an MLP within a rural health center. Leveraging pandemic-era funding, they officially launched the MLP in May 2022, serving the rural population of South Georgia, including Waycross and surrounding counties.
The McKinney-GLSP MLP operates according to the eight core components outlined by the National Center for Medical-Legal Partnership (NCMLP):
- Lawyer in Residence: Legal staff from GLSP are stationed onsite at McKinney Medical Center’s health center sites, ensuring accessibility to legal aid for patients.
- Formal Agreement: A memorandum of understanding (MOU) formalized the partnership in May 2022.
- Target Population: The MLP targets adults, veterans, families, and children living in rural areas, including women and older adults.
- Patients Screened for Legal Needs: Healthcare staff screen patients for legal needs using various methods, including SDOH screening tools.
- Legal Staffing: Attorneys and paralegals from GLSP work on-site at McKinney Medical Center health center sites.
- Training on SDOH: Clinical and legal staff conduct and receive interdisciplinary training on specific SDOH issues facing their communities.
- Information Sharing: GLSP and McKinney Medical Center systematically share patient outcomes and data with each other.
- Designated Resources: The MLP was launched using pandemic-era funding and is exploring additional funding options for sustainability.
Using I-HELP™ to Support Patients and Providers
The MLP model in Waycross is based on the National Center for Medical-Legal Partnership’s I-HELP™ framework, addressing common health-related social and legal needs, including income maintenance, housing, education, employment, and personal and family stability. As the only known MLP in rural South Georgia, GLSP and McKinney Medical Center assist patients with various legal issues, from Medicaid applications to veterans’ benefits. Their collaboration with Veterans Affairs agencies, social services organizations, and community partners ensures a seamless referral network for comprehensive support.
“The MLP model in Waycross is based on the national I-HELP model… We help people with income maintenance issues, health issues, education, landlord/tenant issues, and personal and family stability issues… disability issues, last will and testaments, retirement, power of attorney…”
– Ira Foster, General Counsel of Georgia Legal Services Program and Co-Creator of the MLP
The Courage to Start and Tenacity to Continue: Finding Resources to Scale and Sustain the MLP for Rural Georgians
In 2023, the NCMLP conducted an Environmental Scan [6] which estimated that there are currently between 150 and 200 health center-based MLPs across the country. The scan highlighted persistent challenges faced by both the legal and healthcare sectors due to funding and staffing limitations, emphasizing the need for innovative strategies to ensure long-term sustainability.
McKinney Medical Center and GLSP are actively collaborating to address these challenges, focusing on scalability and sustainability. They are working to secure dedicated resources specifically for the legal services aspect of the MLP, while also participating in national initiatives aimed at finding new funding pathways for MLP services.
Recognizing that sustainability requires a comprehensive approach, McKinney Medical Center and GLSP are planning to increase efforts to share information about the impact of their MLP model, their implementation experiences, as well as both successes and challenges with other health centers, Georgia’s primary care association, and the broader national community.
Conclusion: Success through Collaboration
The partnership between McKinney Medical Center and GLSP exemplifies the power of multisector collaboration in addressing the complex needs of rural communities. By combining healthcare and legal expertise, the MLP has made significant strides in improving access to care and legal aid for underserved populations. As the partnership continues to evolve, it sets a precedent for similar initiatives nationwide, demonstrating the transformative potential of collaborative approaches to community well-being.
“We didn’t anticipate this being a success story so quickly… I think this is the best, classic example of a holistic approach to community that you could come up with… [We are] identifying needs and meeting those needs.”
– Racheal Henderson, Specialist Attorney at Georgia Legal Services Program and Co-Creator of the MLP
Learn more about the McKinney Medical Center and Georgia Legal Services Program medical-legal partnership team and their work in this national audience webinar presentation.
Endnotes
[1] U.S. Government Accountability Office. (2023). “Why Health Care Is Harder to Access in Rural America.” www.gao.gov/blog/why-health-care-harder-access-rural-america
[2] McKinney Medical Center website: https://www.mckinneymedicalcenter.com/
[3] Georgia Legal Services Program website: https://www.glsp.org/
[4] 2022 American Community Survey 5-Year Estimates; Census Bureau, 2020 Census Redistricting Data (Public Law 94-171).
[5] The defining legislation for Federally-Qualified Health Centers, or FQHCs, (under the Consolidated Health Center Program) is Section 1905(l)(2)(B) of the Social Security Act. HRSA-funded FQHCs are community-based health care providers that receive funding under Section 330 of the Public Health Service Act for the purpose of providing primary and preventative care services in underserved areas. These providers must meet a stringent set of requirements, such as providing services on a sliding fee scale and operating under a governing board that includes patients. As an FQHC, they qualify for reimbursement under Medicare and Medicaid using specific methodologies.
[6] Regenstein M., Baños, J., & Trott, J. (2023). Environmental Scan of Medical-Legal Partnerships in Health Centers. National Center for Medical-Legal Partnership. https://medical-legalpartnership.org/mlp-resources/report-environmental-scan-of-medical-legal-partnerships-in-health-centers/
Acknowledgements
We would like to express our deepest gratitude to the staff and champions of the McKinney Medical Center and Georgia Legal Services Program Medical-Legal Partnership who graciously participated in interviews and provided valuable insights and quotes for this MLP Spotlight. Their firsthand experiences and perspectives have been instrumental in highlighting the impactful work being done through multisector collaboration to meet the complex needs of rural communities.
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an FY23 award to the National Center for Medical-Legal Partnership totaling $602,314.00 with 0 percent financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
About the National Center for Medical-Legal Partnership (NCMLP)
NCMLP’s mission is to help health organizations leverage legal services as a standard part of the way they respond to patients’ social needs. With funding from the Health Resources and Services Administration (HRSA), we provide free technical assistance to health centers, primary care associations, and Health Center-Controlled Networks interested in implementing medical-legal partnership strategies. Learn more about us here and subscribe to the MLP Update, our biweekly newsletter.