Keeping the Heat on for Children’s Health: A Successful Medical–Legal Partnership Initiative to Prevent Utility Shutoffs in Vulnerable Children

Objective. Energy insecurity may result in adverse consequences for children’s health, particularly for children with special health needs or chronic health conditions. We aimed to determine whether a multimodal intervention addressing energy insecurity within the framework of a medical–legal partnership (MLP) resulted in an increase in the provision of certifications of medical need for utility coverage in an inner city academic primary care practice. Methods. Working within a medical–legal partnership, we standardized criteria for providers approving medical need utility certification requests. We compared prior-year utility certification requests and approvals (pre-intervention) with the intervention year for families who reported energy insecurity on a waiting-room screening questionnaire. Results. Between the first and second years of the study, certification of medical need approvals increased by 65%, preventing utility shut-offs for 396 more families with vulnerable children. Conclusions. Energy insecurity can be screened for and addressed in a busy urban practice, potentially improving the wellbeing of vulnerable children.