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PolicyGuides
Interpreter Services in Health Care Settings for People with Limited English Proficiency: An Action Kit
By The Access Project and the National Health Law Program
The materials in this Action Kit are designed to support advocates and others working to ensure that people with limited English proficiency in their state get appropriate language assistance services in medical settings. These materials include information and techniques you can use to demonstrate the need for language services in advocacy campaigns; models that some states have adopted to reimburse health care providers for language services, resources where you may find additional information about language services, and suggestions for some next steps for getting your advocacy efforts started. ***Available only on our Website:www.accessproject.org * 60 pages * May 2003
Servicios de idiomas Paquete de acción: Servicios de interpretación para personas con conocimientos limitados de inglés en instituciones de atención médica (Spanish translation of the Language Services Action Kit) $25.00 * 65 pages * September 2003
An Advocate's Guide to the Private Health Insurance Market
By Robert Seifert and Nancy Turnbull
Many issues of health care access are intertwined with issues of health insurance. It is commonly accepted, for example, that extending insurance coverage will improve access to care. But just what is "health insurance" and why has it become central to the financing of health care in the U.S.? What are the features of health insurance markets, and what are these markets good and not good at achieving? The goal of this guide is to supply information with which groups working to improve access might intelligently consider engaging the insurance market as a strategic option. $7.00 * 55 pages * 2001
Community Benefits: An Opportunity for Action and Healthcare Change
By Natalie Seto and Bess Karger Weiskopf, Community Catalyst
This manual is designed to assist healthcare advocates in developing a community benefits effort. It explains the concept of community benefits resources from a health provider to meet community-identified health needs and concerns and suggests many organizing techniques and strategies. The manual is extremely interactive with many group exercises and examples from throughout the country. $15.00 * 133 pages * 2000
A Community Leader's Guide to Hospital Finance: Evaluating How a Hospital Gets and Spends Its Money
By Sarah Gunther Lane, Elizabeth Longstreth, and Victoria Nixon
Community members need to have a basic understanding of hospital finance to evaluate a hospital's charitable commitment to the health of their community. This guide provides basic tools that can be used to make this evaluation as well as some tips on how to engage hospital leadership in meaningful discussion of hospital financial performance $7.00 * 45 pages * 2001
Healthcare Policy: The Basics
By John E. McDonough
This primer sets the context for access improvement work by drawing the "big picture" of the American healthcare system and health policy. McDonough gives an overview of the national healthcare system in terms of access, cost and quality who gets care, how good is it, what we spend on it as a country. He also describes past efforts at health reform and current issues facing reformers, particularly those that concern to coverage and care for the uninsured. $7.00 * 63 pages * 1999
La Politica del Cuidado de la Salud en los Estados Unidos
(Spanish translation of Health Care Policy: The Basics) $7.00 * 70 pages * 1999
Immigrant Access to Health Benefits: A Resource Manual
By Claudia Schlosberg, National Health Law Program
In order to organize to improve immigrants' access to health care, advocates need to be knowledgeable about two very complex and often highly technical fields: immigration and health. This manual was written for use as a resource in conjunction with an intensive training program developed by The Access Project and the National Health Law Program. It is essentially a primer on health access for immigrants. It details and explains basic eligibility requirements for key federal and state programs and identifies issues that can be significant barriers to access to health care for immigrants and their families. $25.00 * 189 pages * revised Jan. 2002
Untangling DSH: A Guide for Community Groups to Using the Medicaid
DSH Program to Promote Access to Care
By Jocelyn Guyer, Center on Budget and Policy Priorities, Andy Schneider & Michael O. Spivey,
Health Policy Group
If you are looking for resources to increase access to healthcare services in your state, you may want to learn more about Disproportionate Share Hospital (DSH) funds. DSH was created as part of the Medicaid program to compensate hospitals for the added costs of serving a disproportionate share of low-income individuals who either are part of the Medicaid program or have no insurance at all. DSH is a very large funding source-$9 billion in 2000-yet the distribution and use of these funds are not widely understood. This manual helps to "untangle" DSH. $7.00 * 77 pages * 2000
Fact Sheet: The Free Care Safety Net
Information about what free care is and why providers should be expected to provide it. Includes a discussion of how free care is different from bad debt, what a model hospital free care policy should include, and how to help hospitals to be accountable for their community responsibilities. An appendix lists how several states have addressed free care obligations in legislation and regulation.
***Available only on our Website:www.accessproject.org 9 pages * 1999 ***
Fact Sheet: Defending Community Benefits in a Changing Healthcare World
Community benefits are the unreimbursed goods and services, provided by local health care institutions, that address community identified health needs and concerns. This fact sheet explains the rationale for community benefits, what constitutes a good community benefits process, and how some states and communities have taken action to ensure the continuation of community benefits
***Available only on our Website www.accessproject.org 7 pages * 2000 ***
The Uncompensated Care pool: Saving the Safety Net
By Robert Seifert
This Issue Brief examines the Uncompensated Care Pool through the lens of access to care. It presents the basics of the history of the Pool, how it works and how it is funded; considers how well the Pool promotes access to care; and examines whether Pool financing is adequated to fulfill its central purpose. Finally, the brief identifies areas of reform for policy makers to consider concerning financing, how and where care is provided, and the monitoring of Pool operations.
***Available only on our Website www.accessproject.org * 32 pages * 2002 ***
Organizing Guides
Developing a Community-Based Response to Healthcare Issues: A Framework for Planning and Action
By Community Catalyst
This framework provides specific steps your group can take to effectively address healthcare issues. The ideas offered are flexible enough to be used by any group, from an established organization to a start-up group. The framework will help you build community participation by offering ways to reach out to new community groups and individuals an involve them in healthcare action. $7.00 * 42 pages * 2000
“Data + Organization = Change” Community-Base Participatory Reasearch as a Strategy for Changing Health Care Policy
by Susan Parker
This guide shows how research that actively engages community groups in all phases of the research process can lead to real-world policy changes that improve access to health care. It describes a survey of over 10,000 uninsured people that The Access Project conducted in collaboration with 24 community groups across the country, and presents case studies illustrating how these groups used the research process to both enhance their organizational capacity and achieve actual policy change. No fee *12 pages * 2003
Getting the Lay of the Land on Health: A Guide for Using Interviews to Gather Information
By Susan T. Sherry and Aimee Marlow
This guide is designed to help staff of community groups to assess the potential usefulnes of using interviews of key members of the community to find out information about healthcare issues, the healthcare system, or about community organizations themselves. It is also a guide to conducting and using the results of these "key informant" interviews. Case examples are included throughout the guide. $3.00 * 17 pages * 1999
Real Clout
By Judith C. Meredith and Catherine M. Dunham
Real Clout is a manual for community-based activists who are trying to improve healthcare access by influencing public policy. Responsibility for many aspects of health policy has lately shifted from the federal government to states. This presents an opportunity for community activists to encourage state policy-makers to promote policies that expand access. Real Clout is a how to” guide for activists who want to seize that opportunity but lack the relevant experience. $15.00 * 218 pages * 1999
Fact Sheet: Handles for Organizing a Healthy Community
A "handle" is an opportunity that an organization grabs onto to move its work forward. This fact sheet describes a number of "process handles" and "substance handles" and explains how an organization can use them to turn problems into issues with potential solutions.
***Available only on our Website www.accessproject.org 5 pages * 1999 ***
Data Guides
A Selection of Essential Data Sources
A compilation of some of the best sources of healthcare data available on the World Wide Web and through various public and private groups and where to find them.
***Not Available on our Website at this time. Hard copy only $7.00 * 60 pages * Updated 2000 ***
How Many Uninsured? A Resource Guide for Community-Level Estimates
By Elinor Socholitzky and Nancy Turnbull
Information on the number of uninsured in a community is spotty at best, and often non-existent. This guide describes methods for using available data to construct estimates, and low, medium, and high cost options for collecting your own data. $7.00 * 67 pages * 1999
Using Data: A Guide for Community Health Activists
An introduction to getting and using data for the data-shy, this guide discusses the value of using quantitative and qualitative data to score points with healthcare providers, funders and the media. It suggests where to go to get data, and describes some simple ways to present it. $3.00 * 20 pages * 1999
Fact Sheet: Using Risk Factors to Assess Health Care Access in a Community
Risk factors are a useful tool in local policymaking efforts. Although there is no single access measure broadly available that evaluates access to health care in any state, county, or town, research literature has documented "risk factors"--certain population and economic characteristics-- that are associated with primary measures of access. This paper examines those risk factors and suggests how this information might be used to improve access. It also gives examples of how local activists have used risk factor information to advance their work, bringing objective information to a policy discussion.
***Available only on our Website: www.accessproject.org 12 pages * 2000 ***
National Reports
Action Where it Counts: Communities Responding to the Challenge
of Health Care for the Uninsured
By The Access Project
Describes the results of a national survey conducted by The Access Project. Attempts to identify, quantify, and categorize local efforts in providing healthcare to better understand who is doing what to promote healthcare access in various parts of the country. $3.00 * 21 pages * 1999
The Consequences of Medical Debt: Evidence from Three Communities
The Access Project collaborated with the Champaign County (IL) Health Care Consumers, the Human Services Coalition of Dade County (FL), and the Tenants’ and Workers’ Support Committee (Alexandria, VA) on this study. The report examines the effects of unaffordable medical bills, including restricted access to further health care, damaged credit status, altered lifestyles, and even financial ruin. Medical debt appears to be a large component of overall personal debt, but it is unique in that it is usually acquired involuntarily – that is, people often do not have the choice to defer needed care for which they are unable to pay. The problem is compounded by aggressive billing and collection practices employed by some health care providers.
$7.00 * 40 pages * 2003
Paying for Health Care When You're Uninsured: How Much Support Does the Safety Net Offer?
This report presents national findings from the Community Access Monitoring Survey (CAMS). Based on responses of 6,448 uninsured respondents who received care at one of 51 hospitals or clinics included in the study, the report describes the financial barriers these respondents faced when seeking care, even at safety-net facilities. The report presents information about patients' difficulties in paying for care, their likelihood of receiving information about financial assistance programs, and their likelihood of being in debt to the facility where they received care. $7.00 * 18 pages * 2003
What a Difference an Interpreter Can Make: Health Care
Experiences of Uninsured with Limited English Proficiency
This report presents national findings from the Community Access Monitoring Survey (CAMS). Based on responses of 4,161 uninsured respondents who received care at one of the 23 urban hospitals included in the study, it compares the perceptions and experiences of adults who needed and had ready access to an interpreter with both those of adults who needed and did not have an interpreter readily available, and those who did not need an interpreter. $7.00 * 14 pages * 2002
Community Reports
Don't Lien on Me: Why the State's Medical Indigency Program is Unhealthy for Idahoans
By Kevin Borden, Northwest Federation of Community Organizations, Matt Haney, Idaho Community Action Network, with Renee Markus Hodin and Kim Shellenberger, Community Catalyst
A report on Idaho's County Medical Indigency Care Program. One of the unique provisions of the program is that Idahoans who avail themselves of county assistance for health care have liens automatically placed on their propety. This report looks at the damaging effects of this provision, in terms of access to health care and broader financial repercussions, and makes recommendations for reforming the County Medical Indigency Care Program. $7.00 * 34 pages * 2001
Ecu-Health Care: An Ecumenically Sponsored Medical Program in North Adams, Massachusetts
By Anne Standley and Jeffrey Prottas
Private citizens helping members of their community: Educating public agencies and combating the stigma associated with public health insurance programs. $3.00 * 14 pages * 1999
Health Care Access for Immigrants and Refugees (specific to Illinois)
By the Illinois Coalition for Immigrant and Refugee Rights
This guide was created for Illinois health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to enrolling immigrant families in health programs. $7.00 * 53 pages * 2001
Health Care Access for Immigrants and Refugees (specific to Massachusetts)
By Tyler Moran, Massachusetts Immigrant and Refugee Advocacy Coalition
This guide was created for Massachusetts health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to enrolling immigrant families in health programs. $7.00 * 51 pages * 2000
Health Care Access for Immigrants and Refugees (specific to New Jersey)
By the New Jersey Immigration Policy Network
This guide was created for New Jersey health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to enrolling immigrant families in health programs. $7.00 * 53 pages * 2001
Health Care Access Issues in Palm Beach County
Prepared for Quantum Foundation by Carol Pryor of The Access Project
The information included in this report was gathered from a review of available secondary materials, including census data, state health data, and local reports and assessments, and from key informant interviews with 28 community leaders in Palm Beach County. This report summarizes the results of this information gathering effort, and presents recommensdations to the Foundation on a future course of action.
***Available only on our Website: www.accessproject.org * 24 pages * 2002 ***
A Healthcare Safety Net in Tatters: Hospital Free Care in the District of Columbia
By Community Catalyst and Health Care Now
This report is the result of Health Care Now's efforts to learn more about free care policies at District of Columbia acute care hospitals and how easy it would be for an uninsured person to obtain free care at one of these facilities. The report presents Health Care Now's findings and recommendations.
$3.00 * 16 pages * 2000
Lives At Risk: Nearly Half Million Without Health Insurance in Miami-Dade County
by Carol Pryor, The Access Project
Using comprehensive data provided by the Florida Health Insurance Study along with other sources, this report was designed to develop a picture of the uninsured in Miami-Dade County--who they are and how local policies affect the availability of care for the uninsured. $3.00 * 41 pages * 2000
The Marion and Polk Counties Health Access Monitoring Project: A Report on Health Access for the Underserved Populations of Marion and Polk Counties
This report was done in collaboration with the Oregon Health Action Campaign. The report represents OHAC's
recommendations to improve health access in Marion and Polk counties by broadening and deepening community involvement in healthcare advocacy. $3.00 * 14 pages * 2000
National Survey of Uninsured: Community Access Monitoring Survey (CAMS)
The Access Project collaborated with 24 community-based organizations to survey the uninsured on their experiences and perceptions of the care they received from local health care institutions. The Access Project assisted sites in training survey administrators, data entry, data analysis, writing the reports, and the design and implementation of a communication strategy. Reports for each participating organization describe the survey results. (The national report, "What a Difference and Interpreter Can Make: Health Care Expereinces of Uninsured with Limited English Proficiency" is available under National Reports.) These reports are intended for strategic use in moving forward a community-based access expansion agenda. The CAMS reports provide a practical application of data and are part of a research-supported, action-oriented national effort.
***Available only on our Website: www.accessproject.org ***
Profile of the Uninsured in Texas
By Robert Seifert, The Access Project
Texas has one of the highest uninsured rates in the country; more than one-tenth of the nation's uninsured live in Texas. This report describes the characteristics of the uninsured in Texas comparing some of the key characteristics with national data. The report then looks at where the important gaps in coverage are and recent Texas policies to address the problem. $3.00 * 23 pages * 2000
Providing Health Care to the Uninsured in Texas: A Guide for County Officials
By Caton Fenz
This comprehensive guide provides, in detail, a description of the health care system for the uninsured in Texas. It includes an outline of the types of health insurance people have in Texas, and a description of the Texas uninsured in comparison to the general population. It outlines the many pieces of the Texas health care system for the uninsured, with a special focus on the role of counties, and explains how all of the health care system for the uninsured gets paid for. $7.00 * 72 pages * 2000
Random Access: Holes in the Health Care Safety Net: Reports from the Communities
By The Texas Health Access Project with support from The Access Project
This report provides insight into the gaps in care that persist for uninsured and under-insured Texans in nine smaller Texas cities and towns as well as El Paso and the surrounding rural West Texas counties.
Please contact the Texas Health Access Project at http://txhap.protex.org to order this publication * 152 pages * 2001
Reducing the Number Of Uninsured People in Illinois: Models for Action
By Brian Rosman, Lisa Cacari Stone, and Robert W. Seifert
Also produced to support the work of United Power for Action and Justice, it discusses trends within the state that impact this group and some policy changes that may be options. $3.00 * 9 pages * 2000
The Uninsured in Illinois and Chicago: Close to 2 Million Face Barriers to Health Care
By Robert W. Seifert and Kara Sokol
Produced to support the work of United Power for Action and Justice, it describes the growing number of people without health insurance in Illinois and the consequences associated with this situation.
$3.00 * 19 pages * 1999