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Mary Herbert, MS, MPH
Clinical Director, Program for Health Care to Underserved Populations
Sharon Connor, PharmD
Assistant Professor, University of Pittsburgh, School of Pharmacy
Director, Grace Lamsam Program
Lauren Jonkman, PharmD
Instructor, University of Pittsburgh, School of Pharmacy
Millions falling through the cracks Sept 2009: 46 million uninsured in US
July 2009: 8.5% of Pennsylvanians unemployed 50% increase over 1 year!
increase in unemployment rate
increase in the number of uninsured
increased need for safety net services
Community Campus Partnership =Safety-Net Provider
University of Pittsburgh School of
Pharmacy
Grace Lamsam Pharmacy Program
Salvation Army
Health Care for
the Homeless
University of Pittsburgh School of Medicine / Department
of General Internal Medicine
Program for Health Care to Underserved
Populations
The Birmingham Free Clinic
What do partners bring? Program for Health Care to Underserved
Admin oversight; network of volunteer physicians; service-learning opportunities for medical students; specialty services and AmeriCorps Members’ service
Salvation Army Genesis and evolution of Birmingham Clinic; in-kind donation of
physical space, maintenance and utilities; provides community access
Grace Lamsam Program Network of volunteer pharmacy faculty; on-site dispensing and
medication management; service-learning for pharmacy students
Health Care for the Homeless 340B purchasing power Annual grant support
Birmingham Free Clinic
Est. 1994
Who do we see? Homeless = 52% Uninsured = 98% Male = 69% Minorities = 45% African American & 19% Latino Low SES = 73% at or below federal poverty limit Patient Encounters = ~2,100 annually Unemployed = doubled over past year
How do we meet medication needs?1. Limited formulary
purchased through:○ 340b HCH funding○ programmatic budget
2. Samples3. Limited $$ through grant-
funded vouchers4. $4 prescription programs5. Pharmaceutical
Manufacturer Assistance Programs (PMAPs)
How much do we receive?1. PMAPs = ~ $20,000 estimated monthly value
○ 139 patients currently receiving meds○ ~ 60 individual medications received / month
2. Purchased meds = ~$100 monthly○ antibiotics, miscellaneous ○ chronic meds not available through PMAPs
How do we do it? Volunteer pharmacists
○ identify patients with chronic medication needs○ work side-by-side with clinicians to make best
therapeutic substitutions, and AmeriCorps members to facilitate PMAP application process
○ provide patient counseling & medication reconciliation services
Two AmeriCorps National Service Members○ dedicated to processing, coordinating and tracking
applications○ aide pharmacists in identifying patients & “paperwork”
Multi-disciplinary Student Interns○ Public Health, Medicine, Nursing, Social Work
Streamlined, Efficient, Collaborative Approach
What is the impact? More medication options for patients &
clinicians○ Increase opportunity for disease control
Expand access with limited impact on medication budget
Support addition of specialty clinics○ mental health services○ cardiology
Evolve pharmacist’s role○ medication therapy management○ refill clinic
What are the “keys to success” Dedicated, cost-effective staff
○ AmeriCorps Members are keyAnnual stipend = $8,400 vs. $200,000+ annually in free
medications for uninsured patients!
Pharmacist involvement ○ “wrap-around” care
Partnerships ○ Allows for success in making program work within the
processes/structure of clinic itselfcommunity agenciesuniversitiesothers
Thank you!
Mary Herbert, MS, MPHClinical Director, Program for Health Care to Underserved Populations
Sharon Connor, PharmDAssistant Professor, University of Pittsburgh, School of Pharmacy
Director, Grace Lamsam Program
Lauren Jonkman, PharmDInstructor, University of Pittsburgh, School of Pharmacy
