SENIOR PHARMASSIST INC
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Mission Statement
Senior PharmAssist promotes healthier living for Durham seniors by helping them obtain and better manage needed medications, and by providing health education, Medicare insurance counseling, community referral and advocacy. After participants work with us for two years, they report significant reductions in hospital use and emergency department visits, among many positive outcomes. Our goal is to help seniors 60 and older to be as healthy and engaged as possible - for as long as possible.
About This Cause
Why we’re here, what we do and what we believe Older adults often struggle to access the healthcare they need. Many seniors find the process daunting due to living on fixed incomes, having multiple health problems, juggling several prescribers and taking numerous medications. Even those in good health with adequate means can struggle with navigating our healthcare system. In addition, older adults are frequently disconnected from community resources that could support their well-being. These difficulties often lead to needless suffering, unnecessary institutional care and wasteful healthcare spending. For 22 years, Senior PharmAssist (SPA) has worked hand-in-hand with seniors, caregivers, and healthcare and social service providers to help Durham County senior adults be as healthy and engaged as possible—for as long as possible. We believe that seniors enrich our community and that income shouldn’t determine how long you live or the quality of those years. We help Durham residents 60 and older to age well in place by providing four primary services: 1. Assistance paying for medications for seniors with incomes up to 200% of the federal poverty level (monthly income of $1,980/single; $2,670/couple in 2016). Medicare D plans pay first and we pay second, reducing participants’ co-payments at their community pharmacy to $2/generic and $5-10/brand for medicines on our geriatric formulary. We help seniors obtain good Part D coverage, and, if needed, apply for the federal “low-income subsidy” to greatly reduce co-payments and/or to drug manufacturers’ assistance programs. 2. Regular comprehensive medication reviews with pharmacists trained in geriatrics to achieve maximum benefits from medicines while minimizing risks; this includes coordination with healthcare and social service providers to ensure that everyone is on the same medication page. Participants are seen every six months to review each medication (prescription, over-the-counter and herbal) they’re taking and to assess medication knowledge, administration techniques (inhalers, insulin, etc.) and adherence. We discuss health promotion strategies like smoking cessation and sleep hygiene, and integrate motivational interviewing to help seniors “be in charge” of their health. 3. Care management and tailored community referral to help seniors access other valuable programs such as Meals on Wheels, medical transportation and MQB, which saves an individual over $1,200 per year on Part B premiums. 4. Medicare insurance counseling to help maximize drug and/or health coverage and overcome obstacles to using benefits. We ensure that those with private Medicare Advantage plans understand “networks,” which can dramatically lower their expenses. SPA is the Durham coordinating site for the Seniors’ Health Insurance Information Program (SHIIP), a division of the N.C. Dept. of Insurance. We offer reliable, timely information to help individuals make informed decisions about Medicare coverage. Results and more about insurance counseling Our work with seniors has shown a dramatic impact. After participants work with SPA for two years they report a 51% reduction in their rate of any hospital stays and a 27% decline in their rate of any emergency department use. Participants also report improved perceived health, demonstrate increased knowledge about their medications and maintain the ability to perform activities of daily living, such as bathing, dressing and taking medicines on their own (American Journal of Health-System Pharmacy, Vol. 63 Feb. 15, 2006). We believe it is the combination of our services that yields such positive outcomes. A more recent program review has produced initial findings consistent with these results. As the SHIIP coordinating site for Durham County, we provide any Medicare beneficiary in Durham, regardless of age or income, with dependable, objective advice about Medicare A (hospital care and what follows), B (physician and outpatient services), C (Medicare Advantage or health replacement plans), D (drug benefits and related governmental subsidies), supplements and other retiree medical coverage. It is especially critical that those living on limited, fixed incomes are able to understand their choices and weigh the potential financial risks associated with inadequate coverage or redundant, costly benefit plans. SPA is unique as a SHIIP site because we have clinical pharmacists trained in geriatrics who review the medications of each person who receives face-to-face insurance counseling. Our pharmacists screen for potential medication problems and additional cost savings. During Medicare’s seven-week open enrollment period (OEP), Oct. 15—Dec. 7, 2015, we helped 1,240 individuals review their options for Part D drug and/or Part C medical coverage, a 15.8% increase from the previous OEP and a 147% increase since 2010. For the seventh year in a row, at least 60% of beneficiaries seen with Part D coverage chose to change plans for the new year; Part D “switchers” obtained an average savings of $777 on projected medication expenses for 2016. Those with the most limited income saved TWICE that amount. SPA’s previous findings regarding insurance savings have been published in the Journal of the American Geriatrics Society and the Journal of the American Pharmacists Association. In 2013, our program was named outstanding SHIIP site for North Carolina. Increasing demand and the imperative to collaborate Over the next 10 years, the population of Durham residents 60 and older is projected to grow by 42%, primarily due to aging baby boomers. Many seniors will have not saved enough for retirement and few will have long-term care insurance, leaving them unable to pay for services they need, whether that care is delivered in their home, an assisted living facility or a nursing home. At present, our “system” forces such individuals to spend down their assets to qualify for Medicaid, which funds 70% of institutional care in the U.S. Bankrupting seniors and over-relying on costly institutional care, which will financially cripple future generations, are unsustainable policies. Moreover, the vast majority of older adults want to remain in their homes for as long as possible. To chart a better way forward, SPA is collaborating with the Duke Geriatric Education Center and other partners to implement and widely disseminate a new model of geriatric workforce development that improves outcomes for older adults in a sustainable manner. This project, funded by a three-year federal grant, is reimbursing our program for helping at-risk seniors transitioning from the hospital back home. We’re excited to be part of this effort and believe it will increase referrals for our comprehensive care. SPA collaborates with other community coalitions to ensure that we are all improving lives while decreasing barriers to care and services. Much of this work is focused on addressing racial inequities and social determinants of health. Our allies include the Partnership for a Healthy Durham, Durham Partnership for Seniors and End Poverty Durham. We also host meetings of the Durham Medicare Rx Network. Representatives from more than a dozen agencies in Durham (Dept. of Social Services, Social Security, Lincoln Community Health Center, hospital discharge planners, etc.) meet regularly to discuss Medicare, how to distribute good information and get people the help they need. In FY16, we provided one-on-one care to 2,232 individuals, a 13% increase from FY15; this year, if we raise sufficient funds, we have a chance to help 2,440 individuals. To address the increasing need for our specialized care we have expanded our “unpaid staff” in recent years by engaging additional highly qualified and specially trained volunteers. In FY16, volunteers—including SHIIP counselors, pharmacists, students and interns—contributed more than 3,300 hours. Paying for it all SPA’s diverse funding comes from Durham County, smaller family foundations, individuals, businesses and corporations, and community groups, i.e., faith and civic organizations. In FY16, individuals and community groups furnished nearly half of our annual revenue. In addition, our board and staff remain attentive to earned income opportunities that will help sustain or expand our program. Thanks to a generous bequest and a foundation grant, we have established the Senior PharmAssist Stewardship Funds. We are thoughtfully building these non-endowed funds so that we can weather future funding challenges and respond to the growing demand for our cost-effective care—as long as that care is needed.