Addiction treatment providers, lawyers partner to help patients stay in recovery - and housed
By Shawna James and Kyndall Hubbard
Youthcast Media Group™
Veronica Benson had already experienced being unhoused at the start of the pandemic, years of chronic pain due to arthritis and an addiction to the painkillers prescribed to treat it, when miscommunication and missing paperwork put her at risk of losing her home again. Undergoing treatment for substance use, the anxiety of potentially returning to rooming homes and hotels triggered a relapse.
Benson, a former preschool teacher who has a bachelor’s degree in psychology, knew she needed help — but not just with her addiction.
That’s when a therapist at the Cooper Center for Healing, where she was receiving treatment for substance use, directed her to legal services just a couple of floors above. There, she met Landon Hacker, an attorney with the Camden Coalition, a nonprofit addressing health and social barriers to care. Hacker, who started working with the coalition in 2022, filled out her paperwork with her, helped her navigate an extensive and complicated appeals process, and got her federal housing voucher reinstated.
“I mean, he helped me a lot to the point where I was able to keep my housing, I got help with my electric [bill], I got help with my gas [bill] and everything, so it was amazing,” Benson said. “The program is beautiful.”
The Camden Coalition launched its medical-legal partnership (MLP) with Rutgers Law School in 2017 and the MLP has been working closely with the Center for Healing since 2022. One of hundreds between healthcare organizations and legal teams across the country, the partnership is an effort to remove legal obstacles that may prevent people with substance use disorders from getting or sticking with addiction treatment. The MLP has received funding from multiple local and national organizations.
The work done by the Center for Healing and the Camden Coalition is part of a larger, nationwide effort to destigmatize and decriminalize mental illness and substance use. Steering away from moralization, which many experts consider inaccurate and detrimental, allows accessible and humane care without judgment.
“Any of us can fall susceptible to a mental health disorder or an addiction at any point in our lives,” said Iris Jones, clinical operations manager at Cooper. “People in recovery are not morally failing and they're not bad people…they're human beings like everyone else, they deserve medical care just like everyone else and they deserve not to be punished for having a [substance] use disorder.”
In its first year of work with the Center for Healing, the partnership received 183 legal referrals and has maintained a similar rate of referrals entering its second year.
Removing obstacles to recovery
According to the team at Cooper and the Coalition, it’s common for patients to face multiple obstacles in addition to— and sometimes due— to substance use.
“Substance use is a chronic disease. It's a neurological disorder,” said Jones. “What we're talking about is people who have social issues that stem from their disorders, from their medical condition. We see impaired judgment in substance use, and so many times that can result in legal charges or other challenges.”
Benson, 48, had arthritis for several years before the constant pain forced her to leave her job in billing at Virtua Voorhees Hospital in Voorhees Township, New Jersey and receive temporary disability.
“It was to the point where it was so debilitating I couldn't even go to work anymore,” Benson said.
After losing her house to a fire in February 2020, Benson’s mental health declined, intensifying her opioid addiction.
Hacker, who is also in recovery from substance use disorder, said to be in active addiction or recovery is “like juggling 20 to 30 balloons.”
“What we seek to do is take on those burdens of juggling some of those balloons so the patient or the client can focus on their treatment and their recovery only, while we address their legal issues, their housing issues or social issues,” said the attorney.
The MLP’s work with the Cooper Center aims to help substance use patients avoid incarceration and reincarceration which the team says disrupts care. Instead the partnership works to provide an alternative, non-punitive approach to recovery.
“What we realized is no matter how much medical care and social support we're able to provide a patient, if they happen to encounter incarceration, we're starting over from square one,” Jones said. “So we wanted to find a way to prevent them from being incarcerated, which is ultimately a risk to their lives if they don't have access to appropriate treatment.”
Although she has never faced criminal legal trouble, Benson says she also benefited from the judgment-free “open door” policy of the treatment center. When her drug tests were positive, Cooper staff did not turn her away. Instead, they gave her medicine and encouraged her to come to the center more frequently.
“They kept me coming no matter what,” said Benson. “That's what made me keep coming back – because they didn't give up on me.”
Positive results, but obstacles to scaling model
Benson credits the Cooper Center for Healing and the Camden Coalition with helping her get her life back on track, and, according to the partnership, she’s not alone. Jeremy Spiegel, the supervising attorney for the MLP, says many patients have reported improved employment prospects and mental health.
“That's the biggest takeaway from that, that you get another chance because so many people don't have another chance, they didn't get another chance,” Benson said.
While the MLP does not yet have data to reflect its impact, the organization says patient outcomes have been overwhelmingly positive. The partnership is working on an evaluation of their results led by the Senator Walter Rand Institute for Public Affairs at Rutgers University.
To be sure, there are limitations to the MLP model, mostly in its ability to be scaled up and paid for. The MLP currently has two attorneys with plans to add a third in the fall.
“With an expansion and more doctors and lawyers, that cuts down one of the biggest barriers,” said Hacker. “I can't take on 500 cases but as an organization, if we had more lawyers, we absolutely could.”
The Camden MLP, like many others across the country, is supported by a patchwork of funding sources. The Camden Coalition declined to disclose the annual budget for its MLP. Spiegel says its legal services average less than $1,000 per referral. The median budget for an MLP is about $100,000 a year, according to a report by the National Center for Medical-Legal Partnership. That number is likely low, however, because most MLPs draw on in-kind support from healthcare organizations and donated time from attorneys, the report said.
In at least seven states (California, Colorado, Indiana, Massachusetts, New York, Ohio, and Oregon) and the District of Columbia, Medicaid managed care contracts or waivers include funding for legal services, according to the report. The arrangement allows for the impact of legal services on healthcare to be tracked, too.
The Camden MLP knows that stable funding is key to its long term success, and the coalition plans to advocate for government funding for this type of work, as well as money from the opioid litigation settlements, says Spiegel.
Inspired to give back
Benson, who plans on returning to school to receive a master’s degree and doctorate in psychology, hopes to eventually help introduce or support similar programs in the Gloucester County, New Jersey area where she lives.
“Even if I had to volunteer, I would love to work with those programs because that's always been a passion of mine to help other people,” Benson said. “Before I became sick and became addicted I was just like those programs helping other people, reaching out to other people, wanting to help anywhere I possibly can.”
For Benson, a former daycare owner who recalls moments when she was able to help young people in her community, it’s all connected.
“The help that I was able to give other people, I was able to receive myself.”
Shawna James is a senior at Julia R. Masterman Laboratory and Demonstration School in Philadelphia. Kyndall Hubbard, who graduated from University of Missouri with a documentary journalism degree in May ‘22, is a YMG editorial assistant. This reporting was supported by funding from The Sozosei Foundation, which also gives money to the Camden Coalition MLP. YMG maintains editorial independence from any funders or donors.