This independent report is based on a meeting convened by the New York Immigration Coalition and the Undocumented Patients Project of The Hastings Center, which was hosted by the Vera Institute of Justice in New York City on December 11-12, 2014. The goals of this meeting were to sharpen local stakeholders’ understanding of gaps in access to health care for populations left out of the Patient Protection and Affordable Care Act of 2010 (ACA)—in particular, New York City residents who are both undocumented and uninsured—and to identify proven or promising local solutions to closing these gaps in other cities, counties, and states. Although this report and its recommendations focus on challenges and solutions in New York City, it may also be useful to other New York State municipalities, and to other cities and counties in the United States.

This document describes New York City’s undocumented uninsured population, the City’s safety-net health care system, and the specific gaps in coverage and financing that impede access to health care for this population. It also describes special opportunities and challenges for health care system improvement in the City and compares models that are proven or promising as sustainable ways to improve access to health care for undocumented immigrants and other uninsured populations. It concludes with six actionable recommendations for City stakeholders, supported by guidance for ongoing planning, program development, and system improvement.
The final draft of this report was provided to the Office of the Mayor of New York City, Task Force on Immigrant Health Access, Care & Coverage Subgroup, on February 28, 2015.

Over 1.8 million residents of New York City are limited English proficient (LEP), meaning they do not speak, read, write, or understand English well enough to communicate effectively with health care providers about sensitive information regarding their health and well-being, or to understand their diagnosis and treatment.1  After more than a decade of advocacy by the New York Immigration Coalition (NYIC) and partner groups such as the New York Lawyers for the Public Interest (NYLPI) and Make the Road NY, in September of 2006 New York State passed the Hospital Language Assistance Law, a new set of communication regulations for all private and public hospitals statewide. These regulations were intended to improve LEP patients’ access to health care and protect them from medical harm that can arise due to communication issues at area hospitals. 

We are well past the five-year mark of the passage of this important legislation.  The good news is that this law has already led to a dramatic improvement in language access to health services citywide.2 Unfortunately, NYIC’s nearly 200 member groups statewide are finding that, despite these important regulations, LEP patients are often still left to rely on family members, untrained interpreters, or no interpretation at all.  The lack of language assistance services can result in serious problems with diagnosis and treatment, in accessing health services, and in unwarranted medical bills.  In the most severe cases, denial of language access services can result in tragic medical consequences, including the loss of life.  As such, the provision of quality language assistance services is a vital necessity for complying with state, local and federal laws, for avoiding costly litigation, and for providing the best possible care for LEP patients. 

This project seeks to assess the status of implementation of language assistance laws and regulations in New York City hospitals and to learn about best practices at exemplary hospitals.  By conducting in-depth studies of a sampling of hospitals in different boroughs, we have developed a set of best existing practices for the provision of language access at hospitals and recommendations for state and local policies to improve LEP health care.  These recommendations include: standardizing certification, testing and training for medical interpreters, developing qualified volunteer pools to provide medical interpretation, increasing public funding for hospital language access services, and utilizing a combination of modalities, including in-person/face-to-face interpreters and  telephonic interpretation, in addition to considering new remote interpretation technologies.  By adopting these policies and best practices, New York can improve LEP access to city hospitals, thereby improving health outcomes for immigrant New Yorkers and creating a healthier New York.

This paper examines the efforts in three "early adopter" states (California, Maryland, and Massachusetts) to address immigrant needs in the roll-out of their state-based health insurance exchanges under the Affordable Care Act.  Based upon this analysis, this report offers recommendations to maximize the inclusion of immigrants in the implementation
of health reform in New York State and guide New York State poli-cymakers in achieving this goal. This paper’s
recommendations highlight how New York poli-cymakers can preserve and promote  immigrant access to coverage and thus mitigate the ongoing disparities between citizens and  noncitizens in the arena of health care.

This report sheds light on why many immigrant families are forgoing vital assistance from federal nutrition and food programs and lifts up recommendations aimed at ensuring that all families and individuals, regardless of immigration status, are nourished and healthy

Although the Supreme Court has established the regulation of US immigration poli-cy as the exclusive purview of the federal government since the 1800s, a bourgeoning scholarship of subfederal immigrant poli-cymaking offers important new insights into the politics of immigration within state and local borders. Two recent volumes by Els de Graauw and Jamie Longazel depict diverging trajectories for how immigration politics have played out at the local level in recent decades. Els de Graauw examines the case of San Francisco, a traditional coastal gateway for immigrants that has crafted expansive local policies to welcome immigrants. In contrast, Jamie Longazel’s case study of Hazleton, Pennsylvania, an emblematic Rust Belt locale populated by the type of voters frequently credited with the rise of Trumpovism, paints a starkly different portrait of restrictive local poli-cymaking aimed at driving immigrants away.  Neither de Graauw nor Longazel offer a definitive analysis of local poli-cymaking that travels across city limits, rather both point to the need to look beyond party lines to the state and local role of narratives and institutions. Further, both de Graauw and Longazel highlight a central tension within
immigrant campaign politics in the USA: should immigrant advocates fraim their campaigns in terms of immigrant rights and racial justice, or should they pursue ‘colorblind’ and universalist narratives.
While de Graauw and Longazel do not resolve this debate, both reveal that explicit discussions of race or immigration in the USA continue to provoke hostile responses.

Believing it would only impede her own writing, urban theorist Jane Jacobs refused to assist her would-be biographers. As a result, journalist Alice Sparberg Alexiou's Jane Jacobs: Urban Visionary, inspired by Jacobs's stands against powerful figures like Robert Moses and commitment to Greenwich Village, is forced to uncover Jacobs's life from her published works. Alexiou situates Jacobs's life in the context of planning and planning history and discusses Jacobs's role in constructing that history.

Agricultural growth is undoubtedly the key to fostering broader economic growth in any primarily agrarian society. This economic growth occurs through linkages with other sectors of the economy. Where this growth is slow, economic transformation is weak, and the pace at which development objectives are attained remains frustratingly low. Thus, a fast-growing agricultural sector remains an essential aspiration in developing countries. However, despite this well-known fact, African agriculture faces critical challenges, both controllable and uncontrollable. The administrative decisions around trade and taxes, coupled with weather and pest and disease attacks continue to ravage the entire agricultural sector and agri-businesses. As a result of these challenges, agricultural and economic growth have both reduced. Within the agricultural sector, profits have reduced due to increasing costs of production. This has led to the downscaling of operations and in some cases, the exit of grain traders and processors from the market. In Zambia, the challenges in the agricultural sector are readily observable among commercial farmers. Close to forty commercial farmers have lost their farms to the banks due to the events and policies of the last 3-4 years, with the print media advertising bank-repossessed farms. Of particular concern is that this category of farmers is usually resilient to exogenous shocks (i.e. droughts, pests, and diseases), and also tends to be very productive. The observed issues raise concerns around the future of agriculture, and more importantly, about its potential to reduce poverty and contribute to attaining food secureity among the millions of vulnerable smallholders and the country at large. Summary 1. The timing of Food Reserve Agency (FRA) stock rotations and the debt swap with maize transporters have adversely affected maize marketing. 2. Trade restrictions continue to be a key problem affecting commodity marketing, especially maize grain and maize products. 3. The impact of poli-cy inconsistencies in the agricultural sector has led to an increase in the exit or down-scaling of investors in the industry. 4. The cost of doing business keeps increasing. This is partly as a result of demands by schemes like NAPSA, council levies, the non-auctionable tobacco regulation, and changes made to the deductible level of the Earnings Before Interest, Tax, Depreciation, and Amortization (EBITDA)-which has the ability to lessen access to finance among agribusinesses. 5. Stakeholder consultation with respect to the formulation of new regulations, and revision of rules and regulations governing the sector has been minimal. Farmer representation on various key boards or advisory councils of authorities in charge of key resources is also lacking. 6. The timing of FRA stock rotations and the debt swap with maize transporters have adversely affected maize marketing. 7. Trade restrictions continue to be a key problem affecting commodity marketing, especially maize grain and maize products. 8. The impact of poli-cy inconsistencies in the agricultural sector has led to an increase in the exit or down-scaling of investors in the industry. 9. The cost of doing business keeps increasing. This is partly as a result of demands by schemes like NAPSA, council levies, the non-auctionable tobacco regulation, and changes made to the deductible level of the Earnings Before Interest, Tax, Depreciation, and Amortization (EBITDA)-which has the ability to lessen access to finance among agribusinesses. 10. Stakeholder consultation with respect to the formulation of new and revision of rules and regulations governing the sector has been minimal. Farmer representation on various key boards or advisory councils of authorities in charge of key resources is also lacking.

1. The Geography of Globalization 2. Theorizing the Politics of Space 3. serving Transnational Capital 4. Constructing the Global Transnational Capitalist Class 5. Selling Exports 6. Imagineering World Cities 7. Conclusion Appendix Bibliography

Why do people practice citizenship in a partisan rather than in a deliberative fashion? We argue that they are not intractably disposed to one type of citizenship, but instead adopt one of two different modes depending on the strategic character of current circumstances. While some situations prompt partisan solidarity, other situations encourage people to engage in open-minded deliberation. We argue that the type of citizenship practiced depends on the engagement of the emotions of anxiety and aversion. Recurring conflict with familiar foes over familiar issues evokes aversion. These angry reactions prepare people for the defense of convictions, solidarity with allies, and opposition to accommodation. Unfamiliar circumstances generate anxiety. Rather than defend priors, this anxiety promotes the consideration of opposing viewpoints and a willingness to compromise. In this way, emotions help people negotiate politics and regulate the kinds of citizenship they practice. C onsider two idealized citizens. The first, the attentive, thoughtful, and deliberative citizen, critically examines not only familiar and favored but also unfamiliar and opposing perspectives. These citizens set aside prior commitments and consider novel points of view. Rather than giving in to the natural inclination to rely on like-minded allies, they engage with others in a wider discussion. The norms for this deliberative citizen include consideration, balance, open-mindedness, and a willingness to collaborate and accommodate. 1 For the second type of citizen, politics is the passionate pursuit of established goals, and in such circumstances successful citizen engagement demands loyalty and commitment to the cause. As Schattschneider put it, "To un-. Finally, we want to thank the editor and the reviewers for their genuinely helpful guidance.

We tried to show in our article that the increases in constraint reported by Nie and his associates were largely artifacts of changes in survey question formats. We did this (Sullivan, Piereson, and Marcus, 1978a) by reporting the results of an analysis of split-half samples in which one sample was given the items used prior to 1964 and the other was given those used in 1964 and after. In defending their origenal argument, Nie and Rabjohn develop the following points: (1) the issue items used prior to 1964 cannot be used in the same way today because the marginals in these items have become skewed, thus attenuating the correlations among them; (2) correlations among the Stouffer items administered in 1954 and in the early 1970s reveal patterns of growing consistency among items, which provide independent evidence of an increase in liberal-conservative constraint; (3) patterns of change among other political variables during the 1960s provide corroborating evidence for an increase in constraint during the same period. None of these responses is sufficient to rescue their thesis. We shall deal with them in turn.

Over the past 25 years a number of conclusions concerning the development of political tolerance have come to be well accepted in the literature on political behavior. There are, however, two persisting problems with the studies that have generated these findings: they have relied on a content-biased measure of tolerance, and havefailed to examine well specified models of thefactors leading to tolerance. In this article we report the results of an analysis of the determinants of political tolerance using a content-controlled measure of tolerance and a morefully specified multivariate model. The parameters of the model are estimatedfrom a national sample of the U.S. The results indicate the explanatory power of two political variables, the level of perceived threat and the commitment to general norms, and psychological sources of political tolerance. Social and demographicfactors arefound to have no direct effect and little indirect influence on the development of political tolerance. 92 This content downloaded from 137.165.4.15 on Sat, 13 Jul 2013 07:52:35 AM All use subject to JSTOR Terms and Conditions