April 2007

Grant Results

SUMMARY

Between 1997 and 2006, staff from the national program office of the Robert Wood Johnson Foundation (RWJF) program Reach Out: Physicians' Initiative to Expand Care to Underserved Americans established and operated a technical resource center. The center, called Volunteers in Health Care, helped physicians, dentists and other providers meet local health care needs through their volunteer efforts.

Key Results

  • To support local efforts to use volunteer clinicians to provide free care and to create pharmaceutical access programs, Volunteers in Health Care staff made 9,600 contacts — by telephone, by e-mail or in person — at more than 7,700 different organizations.
  • Awarded close to $1.7 million in grants to 220 organizations providing or planning to provide free medical or dental care.
  • Launched two Web sites.
    • By the end of the grant period, the Volunteers in Health Care Web site had an average of 145,000 hits and 18,100 user visits per month.
    • The RxAssist Web site, designed to help clinicians access free medications for uninsured patients, was expanded to help patients access free medications in January 2006. It had an average of 4.8 million hits and 153,300 user visits per month by the end of the grant period.
  • Established collaborative relationships with national and state organizations to promote its work.
  • Developed 12 manuals, 51 field reports, a newsletter and other materials.
  • Offered 21 telephone-based workshops, leadership training sessions and a two-day summit to explore ways to improve access to pharmaceuticals.

After the Grants
Because it could not generate adequate funding, the resource center no longer exists, although the RxAssist Web site remains active.

Funding
RWJF supported Volunteers in Health Care with one solicited grant (ID# 030114) and three unsolicited grants (ID#s 035301, 040746 and 053639), totaling $8,353,238, to Memorial Hospital of Rhode Island, the site of the Reach Out national program office.

 See Grant Detail & Contact Information
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THE PROBLEM

The number of Americans without health insurance grew steadily during the 1990s, reaching 41.7 million (15.6 percent of the population) in 1996 — the year before the start of this project — according to the U.S. Census Bureau. One journal article, written by the project director, noted these consequences:

Studies have demonstrated that the uninsured have difficulty getting medical care, that when they are hospitalized their illnesses and injuries are far more acute and advanced than those of people with insurance and that the mortality rate is higher for uninsured than for insured persons. ("Physicians Helping the Underserved: The Reach Out Program," Journal of the American Medical Association, January 5, 2000).

RWJF Responds with Reach Out

In 1992, RWJF launched a national program, Reach Out: Physicians' Initiative to Expand Care to Underserved Americans, to promote the creation of physician-led systems of indigent care and expand the private sector's capacity to care for the medically underserved.

Based at the Center for Primary Care and Prevention of the Brown University School of Medicine/Memorial Hospital of Rhode Island, Reach Out was intended to complement publicly funded safety-net providers. Some 11,252 physicians participated in volunteer initiatives, and almost 200,000 patients were enrolled at the conclusion of the four-year program, according to the JAMA article cited above.

Many Reach Out projects used the patient assistance programs of pharmaceutical companies, which provide medications at reduced or no cost to some low-income people who lack prescription drug coverage. This is not always easy for patients, however, since each company's program operates individually and changes frequently, with differing application processes and eligibility criteria. Patients must apply separately to each company and may be required to reapply after only a short term of medication.

Reach Out's Accomplishments
In the view of the national program staff, Reach Out's single most important accomplishment was its documentation of physicians' capacity and willingness to lead communitywide efforts to provide care to the medically underserved. The program also showed that communities can develop and run programs for the medically underserved that suit their local needs and resources.

The Reach Out experience further demonstrated that volunteer physicians need help both in local organizational development and marketing, and in securing assistance from managed care organizations, organized delivery systems and the pharmaceutical industry. According to RWJF program officer Susan Hassmiller, "there was still more work to be done, and RWJF decided to continue the technical assistance."

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THE PROJECT

With four RWJF grants running from July 1997 through March 2006, staff of the Reach Out national program office established a technical resource center, called Volunteers in Health Care, to help physicians, dentists and other providers meet the health care needs of underserved populations through their volunteer efforts.

Under grant ID#s 030114, 035301 and 040746, Reach Out staff and additional, newly hired personnel implemented and operated the new resource center. Under grant ID# 053639, staff redesigned the RxAssist Web site, which assists clinicians in accessing free medications for uninsured patients (see Results). H. Denman Scott, M.D., M.P.H., Reach Out's national program director, served as project director of Volunteers in Health Care.

Project staff conducted the following activities.

Data Collection

Project staff gathered data to guide its work with volunteer providers throughout the country by:

  • Locating volunteer-based health care programs around the country and assessing their needs through surveys, focus groups and interviews. Staff published the results of one survey. (See Appendix 1 for further details.)
  • Gathering information about patient assistance programs offered by national pharmaceutical manufacturers by:
    • Surveying pharmaceutical manufacturers' patient assistance programs.
    • Conducting a pilot study of patient assistance programs at free clinics to learn how they are used and to identify barriers to their use.

Grantmaking

Project staff distributed requests for proposals to more than 1,600 organizations, seeking new strategies to address health care access issues.

A separate request for proposals offered grants specifically for projects to expand access to oral health services. Volunteers in Health Care partnered with the American Dental Association on this effort.

See Results for information on grants awarded.

Communications

  • Project staff gave briefings about project activities to federal, state and local officials at organizations that included:
    • U.S. Health Resources and Services Administration (HRSA): Office of Pharmacy Affairs, Office of Area Health Education Centers and other offices.
    • National Governors Association.
    • National Conference of State Legislatures.
    • National Association of County and City Health Officials.
  • Project staff presented information on Volunteers in Health Care to 33 organizations, including the American Pharmaceutical Association, the National Association of Community Health Centers and free clinic associations in Louisiana, Ohio and Vermont, among many others.

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RESULTS

During the grant period, project staff:

  • Made 9,600 contacts — by telephone, by email or in person — at more than 7,700 different organizations to support efforts to use volunteer clinicians and to create pharmaceutical access programs. These contacts involved free clinics, government agencies, universities, medical and dental societies, physician's offices, not-for-profit organizations, health care coalitions, hospitals and professional associations. Topics covered included:
    • Using volunteer clinicians.
    • Program operations and funding.
    • Creating and maintaining oral health programs.
    • Technical questions about the project's data management software.
  • Awarded a total of almost $1.7 million in 220 grants (ranging from less than $1,000 to $50,000). These included larger grants to clinics and community groups to promote access to medical and dental care; grants to support free clinics; and mini-grants to purchase computers and other items needed for basic operations.

    Eight grants were jointly sponsored with the American Dental Association to expand oral health access. Other grants:
    • Created free clinic associations.
    • Assisted with technology development.
    • Enhanced program operations or expanded capacity.
    • Helped to find medical homes for patients without them.
    • Created and improved interpreter services.
    • Created and expanded pharmaceutical access.
    • Supported evaluation efforts.
  • Launched two Web sites:
    • The Volunteers in Health Care Web site supplied information to organizations and individuals who were providing free health care to people without health insurance. The site averaged 145,000 hits and 18,100 user visits per month by the end of the grant period. It is no longer accessible. See the Bibliography for details.
    • The RxAssist Web site assists clinicians in accessing free medications for uninsured patients. Initially launched in 1999, the Web site was the first to include online application forms to most pharmaceutical company patient assistance programs. It was expanded to include assistance directly to patients. The RxAssist Web site had an average of 4.8 million hits and 153,300 user visits per month by the end of the grant period. See the Bibliography for details.

      Under grant ID# 053639, project staff redesigned and relaunched the RxAssist Web site in January 2006. For further details about the redesigned Web site, see Appendix 2.
  • Distributed RxAssist Plus, software used on the RxAssist Web site that makes it easier to apply for free pharmaceuticals through manufacturer patient-assistance programs. Systemetrics, a software development firm, created RxAssist Plus as a data management tool for clinicians, nonprofit organizations and government agencies.

    Under a contract that generates about $18,000 per year for Volunteers in Health Care, staff provides Systemetrics with updated information on pharmaceutical companies' patient assistance programs. This enables the company to maintain an up-to-date software package that is available to medical practices.
  • Established collaborative relationships with national and state organizations. Examples of national organizations included the American College of Physicians and the American Dental Association; state organizations included the North Carolina Rural Health Association and the Virginia Health Care Foundation.

    Under a subcontract, Howard Shapiro, Ph.D., a Washington-based policy consultant, helped Volunteers in Health Care staff gain access to key personnel in these organizations. The collaborations created opportunities to:
    • Promote Volunteers in Health Care services.
    • Work together on issues such as access to pharmaceuticals and dental care.
    • Advance the development of the RxAssist Web site and the Volunteers in Health Care grant program.
  • Developed learning materials for the field:
    • 12 Volunteers in Health Care Guides (technical assistance manuals).
    • 51 Field Reports from grantee sites.
    • An in-house library of articles, books and other items; promotional materials.
    • A bimonthly newsletter. See Appendix 3 for details.
  • Conducted 21 teleworkshops to educate providers about specific issues via telephone conference call. Volunteers in Health Care staff and representatives of government agencies and organizations that provide care to the uninsured made presentations to an average of 80 listeners, representing 40 organizations, at each teleworkshop. Among the topics:
    • Developing innovative dental access programs.
    • Charitable immunity legislation: Implications for volunteer clinicians.
    • Grantwriting tips from grantwriters and grantmakers.
  • Provided leadership training to 11 individuals with leadership potential selected from Reach Out sites. Paul Hattis, M.D., J.D., M.P.H., from the department of family medicine and community health at Tufts University Medical School, developed a leadership training curriculum under a subcontract. Three training sessions were held over 18 months in Boston, Charleston, S.C., and San Francisco.
  • Sponsored the Collaborative Leadership Summit: Designing a Framework for the Sustainability of Patient Assistance, held March 5–6, 2001, in Princeton, N.J. The summit brought together 22 pharmaceutical industry, health care and government leaders, including representatives from the Association of Clinicians for the Underserved, the American Academy of Family Physicians and the federal Bureau of Primary Care's Office of Pharmacy Affairs. Participants explored ways to improve access to pharmaceuticals, particularly through patient-assistance programs.

Challenges to Long-Term Sustainability

Project staff did a limited amount of work to develop a business plan with benchmarks and action steps for moving Volunteers in Health Care toward sustainability; it was unable to reach that goal.

Staff considered a variety of options for generating ongoing revenue, including seeking grants from foundations and corporations, charging fees for selected products and services and seeking subcontractor arrangements with other organizations and government agencies. Eventually, Volunteers in Health Care imposed charges for some of its products and established small contractual relationships with the American Dental Association (see Results), Systemetrics (see Results) and Express Scripts (see After the Grant), but these generated only limited revenue.

Project staff noted that the major external challenges to the long-term sustainability of Volunteers in Health Care was generating adequate interest from government agencies or from the professional medical and dental associations it considered to be the project's "natural allies." According to a report to RWJF:

It was impossible to get either physician/dentist organizations or the U.S. Department of Health and Human Services to give it any focused attention. They did not identify clinician volunteerism as a priority issue… Nor did the Volunteers in Health Care mission fall within the guidelines of national health care funders and local foundations could only fund projects in their geographic areas.

Project staff also observed that its efforts to achieve sustainability should have begun earlier.

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CONCLUSIONS

In interviews conducted for this report, staff of Volunteers in Health Care offered the following conclusions:

  • Volunteers in Health Care created a community and legitimized the concept of clinician volunteer programs. "People no longer had a concept of these as being fly-by-night programs. Now if you read about safety nets, they always mention free clinics as part of the safety-net community." (Project Director)
  • "We learned early on that people thought they were alone. They had no idea it [volunteerism] was going on in many places in the country. We began to overcome this sense of social isolation." (Project Director)
  • "We brought the issue of oral health access to the forefront. We learned how the dental community is different from the medical community and medical practice and the constraints that dentists are working under. We showed it is possible to create volunteer free access programs among dentists. Volunteers in Health Care was one of few national organizations with this as a primary goal." (Deputy Project Director)

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LESSONS LEARNED

  1. Create multiple types of resource materials when providing technical assistance on a broad, national basis. A combination of Web sites, software, manuals, teleworkshops, phone and e-mail consultations and grantmaking made project staff confident that everyone could gain access to the technical assistance they needed. (Project Director)
  2. Identify a project's trademark characteristics and keep true to them. Project staff decided early that materials would be practical, comprehensive and easy to use, while satisfying professional standards. This made them useful to diverse audiences, from the American Hospital Association to free clinic associations and academicians. (Project Director)
  3. Understand the operational and funding environments in which a project's constituents operate in order to custom-tailor technical assistance. The target audience for Volunteers in Health Care's efforts included small to medium-sized organizations with modest budgets and large percentages of unpaid staff. It was important to keep those characteristics in mind while developing and implementing technical assistance. (Project Director)
  4. Review and evaluate project mission, goals and objectives throughout the life of the project to ensure they are commensurate with the current environment. (Project Director)
  5. Create an ongoing research capacity, either through staff expertise or through relationships with academic institutions or researchers. Much of the work done by Volunteers in Health Care was service-based. Solid research, especially where existing research was minimal, might have led to partnerships that could have contributed to the project's sustainability. (Project Director)
  6. Create a work plan that is detailed enough to guide specific project activities, yet broad enough in vision to provide unified direction to the project and its staff. Review and adjust the plan regularly to accommodate changing conditions and client needs. (Project Director)
  7. Use project activities not only to meet immediate needs, but also to serve longer-term objectives. For example, the project's grantmaking activities helped to raise grant recipients' awareness of specific issues, to introduce new project models and to create field reports that became part of the Volunteers in Health Care library. (Project Director)
  8. Use external advisors to guide thinking about specific programmatic and strategic issues. Paid consultants, an advisory board or organizations keyed to the project's issues bring a useful perspective because they work outside day-to-day operations. (Project Director)
  9. Pay attention to sustainability and marketability from the beginning of a project. Developing a business plan early can increase the project's potential to continue after grant funding ends. (Project Director and Deputy Project Director)
  10. Consider charging fees for some products and services as part of a sustainability plan as early as possible in the project. Volunteers in Health Care staff initially planned to offer all products and services without charge. Ultimately, staff introduced charges for its teleworkshops and discovered that clients were quite willing to pay them. Such fees might have created a revenue stream earlier in the project's life. (Project Director and Deputy Project Director)
  11. Develop relationships with local or regional funders. Contacting funders with overlapping interests might have opened doors to future funding. One option would have been to explore local funding for local and regional projects with the potential for national significance. This, too, could have contributed to the project's continuation. (Project Director)

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AFTER THE GRANT

In the absence of ongoing funding, the Volunteers in Health Care resource center has closed, although staff continues to answer questions from the field when contacted.

The Volunteers in Health Care Web site is no longer in operation. Project staff have preserved its content and hope eventually to move it to the RxAssist Web site or elsewhere. The pharmaceutical company Astra Zeneca has provided funding to maintain the RxAssist Web site for two years (into 2008). As of mid-December 2006, there were 60,000 registered users of the RxAssist Web site, according to the deputy project director.

Under a contractual arrangement with Express Scripts, a pharmacy benefits manager, Volunteers in Health Care helps to market Express Scripts' patient assistance program and receives a small fee for each program application downloaded from the RxAssist Web site. This contract, scheduled to last until June 2007, brings in about $48,000 per year for the RxAssist Web site. The Systemetrics contract (see Results above) provides additional, short-term funding.

Project staff is working with the federal Centers for Medicare & Medicaid Services (CMS) to ensure that pharmaceutical patient assistance program information on the CMS Web site parallels that on the RxAssist Web site.

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GRANT DETAILS & CONTACT INFORMATION

Project

Volunteers in Health Care

Grantee

Memorial Hospital (Pawtucket,  RI)

  • The Volunteer Physicians Technical Resource Program
    Amount: $ 1,639,460
    Dates: July 1997 to May 2000
    ID#:  030114

  • Volunteers in Health Care
    Amount: $ 3,031,006
    Dates: July 1999 to June 2003
    ID#:  035301

  • Volunteers in Health Care Technical Assistance Center
    Amount: $ 3,533,255
    Dates: July 2001 to January 2006
    ID#:  040746

  • Rx Assist: An Internet-Based Program to Assist Low-Income and Uninsured Populations to Obtain Medications
    Amount: $ 149,517
    Dates: August 2005 to March 2006
    ID#:  053639

Contact

H. Denman Scott, M.D., M.P.H.
(401) 729-3284
h_scott@brown.edu

Web Site

http://www.rxassist.org

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APPENDICES


Appendix 1

Data Collection Activities

To guide the development and expansion of the Volunteers in Health Care technical resource center, project staff:

  • Surveyed more than 600 local, state and specialty medical societies about their knowledge of individual physicians and physician-led organizations that provide care to people without health insurance.
  • Surveyed more than 700 current or potential physician volunteers across the country about their needs and preferences for technical assistance.
  • Conducted seven regional focus groups with physician volunteers to determine their preferred technical assistance services and products.
  • Conducted 115 interviews with project directors from the Reach Out national program to collect lessons learned to share with Volunteers in Health Care technical assistance clients.
  • Surveyed some 2,250 organizations on the Volunteers in Health Care mailing list to obtain information on their models of care and services.
  • Surveyed users of the Volunteers in Health Care Web site about their preferences in format and topics.
  • Surveyed the Free Clinics of the Great Lakes Region about the quantity and types of free care provided at 106 clinics in this seven-state region. Staff reported survey findings in the Journal of Health Care for the Poor and Underserved (2004). See the Bibliography for details. Key findings included:
    • During the study year (1998), the surveyed clinics provided medical, dental and pharmaceutical services to more than 200,000 patients.
    • An average of 93 percent of clinic clients had no health insurance at all. Half of the responding clinics reported that all of their patients were uninsured.
    • An average of 22 volunteer physicians provided care at the clinic and 56 provided care off site (usually at their offices) or through referral. A total of 16,425 clinicians gave 356,000 hours of volunteer time in 1998.


Appendix 2

RxAssist Web Site

The RxAssist Web site, which was redesigned and relaunched in January 2006, includes:

  • A registration and log-in feature with a brief survey so that staff can tailor the site to fit its users.
  • RxConnects, a listserv for providers and advocates with 499 participants as of April 26, 2006.
  • RxAssist Updates, weekly information on changes to patient assistance programs, new program forms and summaries of listserv issues, sent to 518 participants as of April 26, 2006.

Links to the RxAssist Web site are included on the Web sites of the AFL-CIO, the Centers for Medicare & Medicaid and hundreds of other sites, including academic health centers, medical societies, disease-specific organizations, insurance associations, state governments and other health care entities.

In a report to RWJF, project staff called RxAssist "the best source of information for how Medicare Part D [Medicare's new prescription drug coverage launched January 1, 2006] affects eligibility in pharmaceutical company patient-assistance programs. We were the first organization to post information on this topic and have been the only organization to regularly contact programs for updates."


Appendix 3

Materials Development

As part of its efforts to provide an array of technical assistance and promotional materials available, project staff:

  • Prepared 12 Volunteers in Health Care guides. These are technical assistance manuals on topics such as volunteer clinician recruitment and retention, starting a free clinic and charitable immunity legislation (providing malpractice coverage to physicians operating in a volunteer capacity). See the Bibliography for details.
  • Assisted staff of grantee site projects in preparing 51 field reports that offer information and advice on specific topics from those who are working daily in the field. Sites produced:
    • Thirty-two reports on developing programs to provide free medical care to people without insurance.
    • Eleven reports on starting dental programs.
    • Three reports on fund-raising.
    • Five reports on starting a pharmaceutical access program.
  • Created an in-house library of academic articles, books, news clippings and other resources on:
    • Dental access.
    • Pharmaceuticals.
    • Culturally competent health care.
    • Fund-raising strategies.
    • Charitable immunity legislation.
    • Malpractice insurance.
  • Created materials to promote Volunteers in Health Care, including brochures, mailers and fact sheets. Staff also advertised the RxAssist Web site in journals, including the New England Journal of Medicine and the Journal of the American Medical Association, and in online banner advertisements on Web sites, including Medscape and Physicians Online.
  • Developed and produced a bimonthly newsletter, Rx for Access, which covered pharmaceutical access topics for safety net providers. This was a collaboration with Medicine for People in Need (Medpin), a program of the California-based Public Health Institute, which is a nonprofit organization focused on public health improvement.

Volunteers in Health Care published seven issues of Rx for Access before ending the relationship in June 2005. Medpin published four additional issues through December 2005. Archived copies are available at RxforAccess. See the Bibliography for details.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

Geller S, Taylor BM and Scott HD. "Free Clinics Helping to Patch the Safety Net." Journal of Health Care for the Poor and Underserved, 15(1): 42–51, 2004. Abstract available to subscribing libraries online.

Scott HD, Bell J, Geller S and Thomas M. "Physicians Helping the Underserved: The Reach Out Program." Journal of the American Medical Association, 283(1): 99–104, 2000. Abstract available online.

Reports

Hattis PA, Staton S and Walton J. Understanding Charitable Immunity Legislation: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2000, 2001, 2001, 2003 and 2004.

How to Start a Free Clinic: Basic Starter Kit. Pawtucket, R.I.: Volunteers in Health Care, 2000.

Volunteer Retention and Recruitment Manual. Pawtucket, R.I.: Volunteers in Health Care, 2000.

Volunteers in Health Care. (Newsletter). Pawtucket, R.I.: Volunteers in Health Care, 2000 (one issue), 2001 (one issue), 2002 (two issues), 2003 (one issue).

A Comprehensive Resource on Pharmaceutical Patient Assistance Programs. (RxAssist information packet). Pawtucket, R.I.: Volunteers in Health Care, 1999.

Locate Free Medications Online at www.rxassist.org (RxAssist Web Site promotion brochure). Pawtucket, R.I.: Volunteers in Health Care, 1999.

What Makes Volunteers in Health Care One of a Kind? (Volunteers in Health Care Web site promotion brochure). Pawtucket, R.I.: Volunteers in Health Care, 1998.

VIH Leadership Institute brochure. Pawtucket, R.I.: Volunteers in Health Care, 1998.

Volunteers in Health Care: Community, Commitment. (Volunteers in Health Care promotion brochure). Pawtucket, R.I.: Volunteers in Health Care, 1999.

Goldin GL. Sample Policy and Procedure Manuals: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2001 and 2004.

Richardson K and Walton J. Managing Medication Samples: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2001 and 2004.

Goldin GL and Hanson SH. Recruiting and Retaining Medical Volunteers: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2002 and 2004.

Goldin GL and Hanson SH. Starting a Dental Project for the Uninsured: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2002.

Goldin GL and Hanson SH. Starting a Free Clinic: A Volunteers in Health Care Guide. Pawtucket, Rhode Island: Volunteers in Health Care, 2002.

Hanson SH and Goldin GL. Recruiting and Retaining Dental Volunteers: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2002 and 2004.

Jacobs EA and Goldin GL. Overcoming Language Barriers: Part 1 for Clinicians: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2002.

Walton JM. Starting a Pharmaceutical Access Program: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2002 and 2004.

Bancroft MA and Goldin GL. Overcoming Language Barriers: Part 2 for Administrators: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2003.

Geller S. Understanding the Health Insurance Portability & Accountability Act: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2003.

Richardson K and Geller S. Using Pharmaceutical Company Patient Assistance Programs: A Volunteers in Health Care Guide. Pawtucket, R.I.: Volunteers in Health Care, 2004.

Audio-Visuals and Computer Software

RxAsssist Plus, Version 1.0, medication and patient tracking program on CD-ROM. Pawtucket, R.I.: Volunteers in Health Care, 2001.

RxAssist Plus, Version 2.3, medication and patient tracking software on CD-ROM. Pawtucket, R.I.: Volunteers in Health Care, 2001.

RxAssist Plus, Version 3.0, medication and patient tracking software on CD-ROM. Pawtucket, R.I.: Volunteers in Health Care, 2003.

RxAssist Plus, Version 3.2, a web-linked program providing a searchable database of pharmaceutical company patient assistance program information that allows for patient and medication tracking on CD-ROM. Pawtucket, R.I.: Volunteers in Health Care, 2004.

Survey Instruments

"Volunteers in Health Care Physician Volunteer Focus Group Study," Volunteers in Health Care and National Research Corporation, fielded September 1998–March 1999.

"Physician Survey," Volunteers in Health Care, fielded October 1998–March 1999.

"Indigent Drug Program Survey," Volunteers in Health Care, fielded October–November 1998.

"Pharmaceutical Access Monitoring Study." Volunteers in Health Care, fielded March–May 1999.

"Assessing the Impact of the Free Clinics of the Great Lakes Region," Volunteers in Health Care and Free Clinics of the Great Lakes Region, fielded June–November 1999.

"VIH Mailing List Telephone Survey," Volunteers in Health Care, fielded June 2000.

"Assessing the Impact of the Free Clinics of the Great Lakes Region," Volunteers in Health Care and Free Clinics of the Great Lakes Region, fielded June–September 2000.

"National Survey of Programs Using Dental Volunteers," Volunteers in Health Care, fielded September–October 2004.

World Wide Web Sites

www.volunteersinhealthcare.org (no longer operative as of January 2007). Provided information about Volunteers in Health Care; guides on many topics, such as starting a free clinic and overcoming language barriers; resource tips; field reports from free clinics throughout the nation; and other relevant materials. Pawtucket, R.I.: Volunteers in Health Care, Spring 1998.

www.rxassist.org. Provides an informational database on pharmaceutical manufacturers' patient assistance programs as well as pharmaceutical news and information on issues of interest to health care providers and consumers. Also includes a packet for patients on obtaining free/low cost medications. Pawtucket, R.I.: Volunteers in Health Care, Spring 1999. Redesigned site launched January 3, 2006.

www.rxforaccess.org. Provides access to the 11 published issues of Rx for Access (seven issues published with Volunteers in Health Care), which offered information to safety net providers delivering pharmaceutical services between July 2004 and December 2005. Created in conjunction with Medicine for People in Need. Pawtucket, R.I.: Volunteers in Health Care and Oakland, Calif.: Medicine for People in Need, 2004.

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Report prepared by: Mary B. Geisz
Reviewed by: Karyn Feiden
Reviewed by: Molly McKaughan
Program Officer: Susan B. Hassmiller

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