Bluestem Health partnership provides hope, legal services to low-income Nebraskans, refugees and immigrants

Andrew Schill, Health, Education & Law Project (HELP) attorney at Legal Aid, meets with clients who’ve emigrated from places like Iraq, Myanmar (formerly Burma), and Sudan on Thursday mornings in Lincoln at Bluestem Health.

Bluestem Health, a Federally Qualified Health Center (FQHC) provides medical, dental and behavioral health services.

If a client has a medical issue tied into a legal issue, Legal Aid can assist the client while they receive their medical treatment. “We are on-site, providing community-based direct legal services,” Schill said.

Bluestem Health and Legal Aid join services through a medical-legal partnership that originally received financial support from the Community Health Endowment of Lincoln in 2016.

Since then, Bluestem Health has grown significantly and Legal Aid has supported that growth with quality legal services.

“We are on-site, providing community-based direct legal services.” 

“Legal Aid helps our patients who need legal assistance. We make referrals to Legal Aid. Then, Andrew will refer them to the rest of the Legal Aid team, depending on what their needs are,” said Brad Meyer, CMPE, Chief Executive Officer of Bluestem Health.

“I think the partnership is great for our patients — those who are underserved, low-income, and maybe don’t have the resources that other patients have in our organization.”

“We also have patients who … had run-ins with the law previously, and just never took care of it for one reason or the other. Legal Aid is good at helping them figure out what all of their cases are, and help them adjudicate those cases appropriately, or try to get them dismissed so that the patient can move on with their lives,” Meyer said. 

“Those types of things probably wouldn’t have been possible if it wasn’t for this partnership.”

Bluestem Health sees growth to five locations

When Meyer began at Bluestem Health more than 10 years ago, the organization served roughly 9,300 patients in one clinic. At the end of 2020, Bluestem Health saw more than 17,000 patients in five clinic locations and one administration building.

The medical-legal partnership has been able to continue in part due to the organization’s success and the determination of those behind it.  

“We’ve been very fortunate over the last few years to be able to extend that project through building it into new grants we’ve written,” said Meyer.

“Health Resources & Services Administration (HRSA) has been gracious enough to see the value in what Legal Aid does for our patients so they approved the funding that we included into our grant applications.”

Forming a bridge to clients in need of services

On Thursday afternoons, Schill holds office at Health 360 Integrated Care clinic, a partnership of Lutheran Family Services of Nebraska and Bluestem Health.

With the wealth of interpreters at Bluestem, clients who have emigrated to the U.S. feel more at ease to open up with the attorneys about difficult topics.

 “They’re sitting near you [Arabic, Spanish, and Karen interpreters] and we just have a conversation. The clients are more comfortable opening up,” Schill said.

 “They often don’t know where to reach out or they won’t reach out to me, but they’ll reach out to that interpreter. And then that forms the bridge to have them come in because they’re already a Bluestem patient,” Schill says.

Meyer is pleased with the services that Legal Aid and attorneys like Andrew Schill provides Bluestem Health patients.

“Andrew is very compassionate about what he does. He’s empathetic to the situation and he does try to help patients out as much as possible,” Meyer said.

“I think the partnership is great for our patients — those who are underserved, low-income, and maybe don’t have the resources that other patients have in our organization.”

The Bluestem Health and Legal Aid of Nebraska partnership is one of many of the Health, Education & Law Project partnerships in Nebraska that address legal problems that impact health. HELP provides legal education and services in partnership with hospitals, health centers, and medical providers.

 

Nearly half of Bluestem Health patients speak a language other than English

“We get a lot of refugees from other countries that come to Lincoln,” Meyer said. “45% of Bluestem Health patients speak a language other than English.”

Nebraska is one of the largest refugee resettlement states in the nation. Lutheran Family Services and Catholic Social Services are two organizations that assist with resettlement.

For some cases, a Karen refugee and client from Myanmar (formerly Burma) seeks assistance with filing for legal guardianship for their sister who has developmental disabilities.

Another Karen refugee needs help getting a divorce. Her husband lives in the Mae La refugee camp in Thailand and they haven’t spoken in years. 

“The clients enjoy having legal services at Bluestem Health. Many of our clients know, ‘Hey, If I go to this spot on a Thursday, I could talk to an attorney,” Schill said.

Many clients are mothers experiencing stress over family law issues

“Our clients are trying to do all of the familial duties and take care of their own health issues. It’s impossible,” Schill said.

He describes a client who needs help with a custodial arrangement. As a diagnosed diabetic, they will need regular healthcare for the rest of their life but are failing at daily tasks like attending appointments or taking medication.

“The problem is, life has its challenges, right? Maybe they have one car and their spouse is abusive and won’t allow them to use the car. Or there are three or four little kids to take care of and they need childcare,” Schill said.

“They can’t maintain their healthcare, because of what’s going on in their external life. And because of that, it just circles around and around and around.”

Another common scenario involves adult children serving as the caretaker of a parent with dementia while also raising their own children.

“Legal Aid gets to step in and help them know they have the legal authority to make decisions and help out the family member and get them the treatment they need and maybe that alleviates some of their burdens,” Schill said.

“Now they can focus on everything else that’s going on in their life.”

“They can’t maintain their healthcare, because of what’s going on in their external life. And because of that, it just circles around and around and around.”

These legal issues linger in clients’ lives. “It affects your life in so many tangential ways. You can’t hold a regular job because you’re taking care of a family member or you have this ongoing disability that isn’t an everyday thing. But it’s enough that it just harasses your life,” Schill said.

“If you can just get Social Security Disability Insurance (SSDI) or Social Security Insurance (SSI), it would make things so much easier right?”

Making daily life livable

The legal services provided allow immigrant clients to have reliable transportation, or apply for benefits and keep their medical appointments.

“You came over and now you’re working 12-hour shifts with very sharp knives and you’re standing on your feet. And you have kids in the community going to school. And you’re just trying to take care of your mom to help her out with her medical decisions,” Schill said.

“Let me do as much as I can for this tiny little area of your life to make your life easier.”  

Schill works at Legal Aid of Nebraska because he believes everyone gets a shot.

“Your life outcomes shouldn’t be pre-determined. If you need good quality legal services, you should be able to get it regardless of your income. I believe in the work we do and I believe in the clients we serve.”

Schill sees a strong future for this partnership. “Brad Meyer has done a phenomenal job of making sure that a Bluestem patient can reach our services in an easy, accessible way and I think it’s going to continue to grow.”

Jen Litton, Development Coordinator at Legal Aid of Nebraska, is the author of this article

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