In response to continuing concerns over access to health care by the uninsured, the W. K. Kellogg Foundation in 1998 launched an initiative called “Community Voices.” The goal ofthe initiative is to assist local organizations in strengthening community support services, giving the underserved a voice in the debate over health-care access, and identifying ways to meet the needs of those who now receive inadequate health care. One of the Community Voices grants went to Miami, Florida, where it is administered by Camillus House, a Catholic social service agency and health-care provider for the homeless.! Camillus House asked RAND to participate in the Community VoicesMiami project, to evaluate the five-year effort and to provide technical assistance. One aspect of the latter role was a request to investigate the flow of funds through Miami-Dade County hospitals, especially with regard to unpaid charges for care. In the course of conducting this analysis, it became clear that it was also necessary to analyze whether the funds-flow pattern was associated with where county residents receive care. This report presents the results of these two analyses.
lUnited Way of Miami-Dade was asked to join the effort to provide assistance with community outreach.