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Investigating the Return on Investment for Medical-Legal Partnerships

This study was completed by Erin Davison, MPH and independent consultant of Davison Strategic Solutions


Between 2018 and 2023, the Medical-Legal Community Partnership (MLCP) at Philadelphia Legal Assistance (PLA) closed 3,671 cases that impacted approximately 2,169 clients. The direct impact of this legal assistance was life-changing for clients and their families, and had an economic impact on the regional economy. 

A return on investment study led by Erin Davison, found that investments in the MLCP between 2018 and 2023 yielded $41,226,771.05 in financial, social, and emotional returns for residents and communities in Philadelphia. Notably, for every $1 invested in the MLCP, there is an $11 return. 

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Financial Return

Three different types of benefits were examined: direct benefits, indirect benefits, and the multiplier effect.

Direct benefits are tangible, financial benefits that enter the economy because of PLA’s work. Direct benefits include federal and state benefit payments, such as Social Security benefits, that PLA obtains for clients. Between 2018 and 2023, direct benefits excluding grants and contracts totaled $16,095,207.51. 

Indirect benefits refer to costs that are avoided as a result of PLA’s advocacy. This study examined four types of costs related to income as a determinant of health: the costs associated with homelessness, domestic violence, lack of access to health care, and utility payments and/or shutoffs. Chronic conditions and emergency room recidivism, homelessness and domestic violence carry tremendous costs; by reducing the incidence of each of these problems, PLA provides huge savings for taxpayers. Additionally, utility restoration and support significantly impact the habitability of client homes and their ability to afford other basic health-promoting payments. Between 2018 and 2023, these indirect benefits totaled 13,648,247.51.

Finally, the multiplier effect signifies the injection of new funds into the local economy, generating a ripple effect of financial activity. This study's calculations demonstrate direct benefits stemming from federal benefit program payments, enabling clients to participate in the local economy. When the multiplier effect is applied to these dollars, an additional $11,483,316.03 was brought into the Philadelphia economy. The multiplier effect ensures that the impact these new dollars have on the economy is fairly assessed.

The MLCP at PLA’s financial impact on the economy was $41,226,771.05 between 2018 and 2023. This represents a return of $11 for every one dollar invested in PLA’s MLCP. 

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Social and Emotional Return

The financial aspects of receiving civil legal aid representation, while very significant, tell only part of the story. 

For many low-income Philadelphians, even more significant benefits come from non-monetary outcomes they achieve. Three major themes were identified during the analysis of staff and client interviews: MLCP advocacy results in stress reduction, promotes long-term economic stability, and encourages self-efficacy in clients and their families. 

Additionally, the co-location of legal aid providers with medical partners in local health centers and hospitals has significant impacts on client accessibility and self-advocacy. Notably, 60% of respondents referenced building a community knowledge base because of their interaction with legal aid providers. 

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