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PUBLICATIONS

The Access Project has produced a number of informational guides on topics of interest to community health organizations. These publications address issues of local health policy and organizational strategies. While not intended to be comprehensive "how-to" guides, they serve as an introduction to specific topics that may be valuable to your organization.

Staff of The Access Project have also co-authored reports in conjunction with other organizations advocating for increased access to health care.

Most publications are available to download free of charge, just follow the links below. Printed copies are also available for a fee. You may submit an order online, or send your request to info@accessproject.org.


NEW PUBLICATIONS

Not Making the Grade: Lessons Learned from the Massachusetts Student Health Insurance Mandate (33 p., ©2007)
This report describes the Qualifying Student Health Insurance Program (QSHIP) which was created under the 1988 Universal Health Care Law signed by Governor Dukakis. The program requires Massachusetts students enrolled at least three-quarters time in an institution of higher learning to have health insurance. This report examines the quality of the QSHIP health plans; assesses the effectiveness of the first Massachusetts “individual mandate” at providing quality, comprehensive health insurance protections for students; and draws lessons that may be relevant to the implementation of the Commonwealth’s new health reform law, Chapter 58.

The Illusion of Coverage (71 p., ©2007)
This report describes how private insurance products fail to protect people from financial hardship and guarantee access to care when they become ill or injured. The Illusion of Coverage discusses insurance characteristics and processes that cause medical debt, people's lack of meaningful choices when purchasing health plans, and the consequences of medical debt caused by inadequate coverage. It also provides recommendations on how to provide people access to comprehensive and affordable insurance products. The report is based on in-depth interviews with 45 people in seven states who accrued medical debt despite having health insurance.

Borrowing to Stay Healthy (20 p., ©2007)
In collaboration with Demos, The Access Project produced Borrowing to Stay Healthy, documenting how low and middle income households are turning to credit cards to pay for medical care. The report findings are based on a national telephone survey of over 1,100 low and middle income households.

Living In The Red (24 p., ©2007)
Living In The Red tells the personal stories that bring life to the statistics on medical debt. Seven Missouri residents from across the state share their personal experiences telling how medical debt affects their access to health care, as well as their families’ financial and emotional stability. As these stories attest, people with medical debt expect to and want to pay for the medical care they receive, but too often family budgets are overwhelmed by the rising costs of care.


Organizing, Policy & Data Guides

An Advocate's Guide to the Private Health Insurance Market (55 p., ©2001)
This guide, a primer on health insurance and public policy around health insurance, describes the complexities and interdependencies of the present system, with the intent of helping advocates realistically appreciate the challenges in changing it. The goal is to supply info rmation with which groups working to improve access might intelligently consider engaging the insurance market as a strategic option.
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Community Benefits: The Need for Action An Opportunity for Healthcare Change. A Workbook for Grassroots Leaders and Community Organizations (133 p., ©2000)
This manual is designed to assist healthcare advocates in developing a community benefits effort. It explains the concept of community benefits resources provided by health care institutions to meet community-identified health needs and concerns, and suggests many organizing techniques and strategies. This workbook contains group exercises and examples of community benefits successes from throughout the country.
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"Data + Organization = Change" Community-Based Participatory Research as a Strategy for Changing Health Care Policy (12 p., ©2003)
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
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Defending Community Benefits in a Changing Healthcare World-A Fact Sheet (7 p., ©2000)
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.
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Developing a Community-Based Response to Healthcare Issues: A Framework for Planning and Action (42 p., ©2000)
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 and involve them in healthcare action.
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Getting the Lay of the Land on Health: A Guide for Using Interviews to Gather Information (17 p.,©1999)
This guide is designed to help staff of community groups to assess the potential usefulness of using interviews of key members of the community to find out information about healthcare issues, the health care system, or about community organizations themselves. It is also a guide to conducting and using the results of these "key information" interviews. Case examples are included throughout the guide
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Handles for Organizing a Healthy Community-A Fact Sheet (5 p., ©1999)
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.
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Healthcare Policy: The Basics (In English) (63 p., ©1999)
La Politica del Cuidado de la Salud en los Estados Unidos: Informacion Basica (En Espanol)
This primer sets the context for access improvement work by drawing the "big picture" of the American health care system and health policy. The author,a health policy expert at Brandeis University, gives an overview of the national healthcare system in terms of access, cost and quality. He also describes past efforts
at health reform and current issues facing reformers, particularly those that concern coverage and care for the uninsured.
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Real Clout: A How-To Manual for Community Activists Trying to Expand Healthcare Access by Changing Public Policy (218 p., revised 2005)
Real Clout is a manual for community based activists who are trying to improve health care 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 support and 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.

A Workbook has been developed as a companion to Real Clout: A How-To Manual for Community Activists Trying to Expand Healthcare Access by Changing Public Policy. It is available for download at www.realclout.org.
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Using Data: A Guide for Community Health Activists (55 p., ©2001)
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 health care providers, funders and the media. It suggests where to go to get data, and describes some simple ways to present it. Also includes an appendix of specific sources for various types of data.
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Community/State Specific Reports:

Arizona
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Two Facilities in Somerton and Yuma Arizona
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California
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Six Health Care Facilities in Fresno California
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Three Community Clinics in Berkeley California
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District of Columbia
A Healthcare Safety Net in Tatters: Hospital Free Care in the District of Columbia
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Florida
2002 Palm Beach County Community Health Assessment
Access to Public Health Trust Services: Success and Challenges
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Four Facilities in Volusia County Florida
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Two Community Clinics in Miami-Dade County Florida
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients Receiving Care from Five Providers In Tallahassee Florida
Health Care Access Issues in Palm Beach County
Health Care Access in Palm Beach County :  A Review of Available Data
Lives At Risk: Nearly Half Million Uninsured in Miami-Dade County
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Georgia
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Four Facilities in Southwest Georgia
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Idaho
Don't Lien on Me: Why the State's Medical Indigency Care Program is Unhealthy for Idahoans
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Four Facilities in Nampa and Twin Falls Idaho
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Illinois
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Mile Square Health Clinic in Chicago Illinois
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Two Clinics in Chicago Illinois
Health Care Access for Immigrants and Refugees (specific to Illinois)
Reducing The Number of Uninsured People in Illinois: Models for Action
The Uninsured in Illinois and Chicago: Close to 2 Million Face Barriers to Health Care
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Iowa
How Iowa Farmers and Ranchers Get Health Insurance and What They Spend for Health Care
The Linn County, Iowa Small Employers Health Insurance Survey Results
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Kansas
Heartache in the Heartland: Kansans Speak About the Burden of Medical Debt
Losing Ground: Eroding Health Insurance Coverage Leaves Kansas Farmers with Medical Debt
Playing by the Rules: How Medical Debt Threatens Kansans' Healthcare Access and Financial Security
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Kentucky
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Three Hospitals in Lake Cumberland District Kentucky
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Louisiana
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Earl K. Long Medical Center in Baton Rouge
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at the Istrouma School-Based Health Center Baton Rouge
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Massachusetts
Ecu-Health Care: An Ecumenically Sponsored Medical Program in North Adams, Massachusetts
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at North Adams Regional Hospital
Health Care Access for Immigrants and Refugees (specific to Massachusetts)
The Impact of Eliminating Dental Benefits for Adults on Medicaid
Not Making the Grade: Lessons Learned from the Massachusetts Student Health Insurance Mandate
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Missouri
Living In The Red
Health Care In the Heartland
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New Hampshire
Assessing Language Interpretation Capacity among NH Health Care Providers
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New Jersey
Health Care Access for Immigrants and Refugees (specific to New Jersey)
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New York
Getting Health CareWhen You Are Uninsured:A Survey of Uninsured Patients at North Central Bronx Hospital in The Bronx, New York
Neglected and Invisible: Understanding the Unmet Healthcare Needs of People on Long Island
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Nevada
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Two Hospitals in Las Vegas Nevada
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North Carolina
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Wake Medical Center in Raleigh North Carolina
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Ohio
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Four Hospitals in Cleveland Ohio
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at University Hospital in Cincinnati Ohio
Into the Red to Stay in the Pink: The Hidden Cost of Being Uninsured
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Oregon
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Two Hospitals in Lincoln County Oregon
The Marion and Polk Counties Health Access Monitoring Project: A Report on Health Access for the Underserved Populations of Marion and Polk Counties
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Pennsylvania
The Pennsylvania Community Health Reinvestment Agreement: Establishing Non-Profit Insurers' Community Benefit Obligations
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Tennessee
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at The Regional Medical Center In Memphis, Tennessee
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Texas
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at CHRISTUS Jasper Memorial Hospital in Jasper, Texas
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Fannin Family Planning Clinic in Houston,Texas
Profile of the Uninsured in Texas
Providing Health Care to the Uninsured in Texas: A Guide for County Officials
Random Access: Holes in the Health Care Safety Net. Reports from the Communities
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Virginia
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Inova Alexandria Hospital in Alexandria, Virginia
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West Virginia
Getting Health Care When You Are Uninsured: A Survey of Uninsured Patients at Four Facilities in West Virginia
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Last Updated October 2008