In 1995 Asheville, NC physician Dr. Susan Landis and others recognized a growing need to better
serve the community’s uninsured residents.
With the help of a handful of other physicians in the community and months of negotiating
with local hospitals, the Medical Society, and Buncombe County government officials, Dr. Landis
and her associates succeeded in gaining support for the effort. 
Eventually, nearly 75% of the county’s medical community agreed to commit to the project.
After the Buncombe County Medical Society received an implementation grant through the
Robert Wood Johnson Foundation’s (RWJF) Reach Out initiative, an advocacy planning group was
assembled to review the health status of the county’s low-income, uninsured residents, and how
those individuals accessed healthcare.
The group consisted of private physicians, agencies involved in healthcare delivery to the
underserved, agencies providing the underserved with other social services, representatives of
underserved population, county commissioners, and local business groups.
It was determined more than 15,000 were categorized as low-income and without any
form of health insurance.
In February of 1996, 50 members of the advocacy planning group met to review the health
assessment data and prioritize healthcare objectives.
The group identified specific priorities according to the level of importance and ability to initiate, and concluded that financial constraints in accessing healthcare was the most important issue.
As a result, The Access Task Force was formed to address this problem
and Project Access was born. Dr. Landis was named the program’s
volunteer Medical Director.
Since 1997, Project Access in Buncombe County has provided $65.6 million
in donated care to 2,700 patients per year. In 2003, seeing the same need
in Hamilton County, and knowing the success Project Access enjoyed in
Asheville, USA’s Dr. Joe Cofer set his sights on initiating the program here
locally.
On a personal level, Dr. Cofer will simply state there was an opportunity to
make a difference in the healthcare landscape of the community and that
opportunity was just too important to ignore .
He will also speak of the strategic aspect of Project Access - the side which
provides healthcare to those in need and the program’s ability to change
lives - which it does, and has done for the past two years.
Although Dr. Cofer will attest to the fact he organized the initial meetings
between Memorial, Erlanger, Parkridge, and other potential partners to
discuss the program’s implementation locally, that’s about all you’ll get out
of him regarding his role in this very important community partnership.
He credits the hard work of others involved in the program’s success, and is
quick to point out the enormous collaborative effort that has taken place
between many Chattanooga businesses since the project’s inception - especially the participation of Chattanooga’s three major hospital systems.
“Memorial has always been committed to providing care for all in the community,” said Ruth Brinkley, CEO of Memorial Health System, “and we also believe strongly in the value of partnerships – people and organizations working together. That made Project Access a perfect fit for us, and we support it wholeheartedly.”
Dr. Cofer, who is currently chair of the Operations Council overseeing the development of Project Access, is very proud of the more than 500 local participating physicians and surgeons who provide free care in the program.
He also speaks very highly of the support staff at the Medical Society and Foundation in charge of making sure all the parts are moving in the right direction - specifically Rae Bond, executive director of the Medical Society, Lisa Roche, operations director for Project Access, and Patient Care Coordinators Tommye Bryson, Cheryl Claiborne and Tonya Williams.
But the fact remains that Dr. Cofer saw a need in our community and decided to do something about it.
To his credit, and all those involved, Project Access has become an important option for the residents of Hamilton County.
“Project Access is a good thing for this community and I feel extremely blessed to have been put in a position of leadership where I was given an opportunity to make a difference,” said Dr. Cofer. “We all to strive to make a difference in life and I believe this program is changing lives for the better.”
Project Access is based on donated services. It is NOT an insurance plan and there is no “catch.” The program is designed to assist those Hamilton County residents whose family income is below 150 percent of the poverty level ($24,900 for a family of three), and those who do not have other insurance or are eligible for other coverage such as TennCare.
A residual effort of Project Access is to lower emergency room visits by uninsured patients by providing a clinical option.
Because emergency rooms are not allowed to turn patients away, oftentimes resources are used unnecessarily on uninsured patients who, if they were enrolled in Project Access, could see a participating physician in a clinical setting rather than being seen in the emergency room.
Project Access also provides a means to better coordinate the charity care Chattanooga physicians and surgeons already provide, while assisting additional medical professionals in the treatment of the uninsured patient.
“One of the things Project Access is designed to do is not only coordinate charity care - so one physician is not doing all the work, which is one of the reasons why the program works because you can play a smaller role, yet make a big impact - but the program also documents the care we provide,” said Dr. Cofer.
“That’s important in increasing the awareness as to just how much free care is provided by physicians in this community - something most people are unaware of, or unwilling to believe.”
Despite the program’s success in Chattanooga, it continues to battle awareness and perception issues.
“I don’t think most people really know what this program is all about and how beneficial it can be,” said Dr. Cofer. “I think there are several misconceptions regarding Project Access. First, I think people believe it to be an insurance program and because of that, assume they cannot afford to participate.
“Secondly, I think they assume there is a “catch” to the program. They assume there is no way physicians are going to give this care for free, so they simply refuse to investigate the program further.
“The reality of the program is simple. If you’re a Hamilton County Resident and you meet the requirements of the program, Project Access can help you - period.”
Since seeing its first patient in April, 2004, Project Access physicians, hospitals, health centers, and other partners of the collaboration have donated $12.9 million in healthcare to more than 1,300 patients.
The program has also directed more than 1,800 people to other services within the community.
The fact is, Project Access changes lives. And it’s not unusual for the program to actually catapult individuals into a better lifestyle.
Dr. Cofer explains:
“There have been several cases in which patients who are enrolled in Project Access utilize the program’s resources to receive care for a major problem, and then become well enough to secure a better job and a good insurance plan. Those who are eligible for our program mostly consist of individuals who want to work and do not want something for nothing.
“If the reason for one’s inability to secure a better job is due to a health-related issue, Project Access can be the bridge to better their situation. To me, that alone makes the program worthwhile.”
Project Access is a true community gem, but one which still needs recognition and support. The value of the program goes far beyond that of just providing quality healthcare to those who cannot afford it. Project Access creates a healthier community which, in turn, reduces the costs of healthcare for everyone. It also promotes collaboration and volunteerism, and brings the medical community closer together.
The program is gaining in popularity. In fact, more than 60 communities around the country are implementing similar programs based on the Project Access model. It’s amazing what can come from identifying a problem, committing to its cause, and implementing a solution. Project Access is a winning solution.
