HomeMy WebLinkAboutAgenda - 08-05-1996 - V-D 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No V-
ACTION AGENDA ITEM ABSTRACT
Meeting Date: August 5, 1996
SUBJECT: A Resolution endorsing a state-wide pharmaceutical assistance program for low
income senior adults.
DEPARTMENT Aging PUBLIC HEARING YES NO X
Adv. Board on Aging BUDGET AMENDMENT YES NO X
ATTACHMENT(S): INFORMATION CONTACT: George Snowden, Chair
1. Resolution of Endorsement TELEPHONE NUMBER: Jerry Passmore, Dir.
2. Report on the N.C. Symposium on Hillsborough 732-8181
Pharmaceutical Assistance Programs Chapel Hill 968-4501
Mebane 227-2031
Durham 688-7331
PURPOSE:
To consider a resolution endorsing the need for a statewide pharmaceutical assistance program for senior
adults, age 60+, who fall within a defined income/expense range and who do not qualify for Medicaid..
BACKGROUND:
The Orange Advisory Board on Aging established at their Nov. 16, 1995 meeting three 1996 goals,
one being improved medication purchase and proper use for older adults. The Orange County
Department on Aging participated in the first state Symposium on Pharmaceutical Assistance Programs
on June 12, 1996, sponsored by the N.C. Division of Aging and Triangle J Council of Governments. The
results of the symposium were reported and discussed at the Orange County Advisory Board on Aging
meeting on June 27, 1996..Orange County does not have any local pharmacy assistance program nor is
there a state program.
It was revealed that many seniors can not afford to pay for their needed prescription drugs, and the number
of available physicians' samples has drastically declined. Consequently, many people are faced with the
choice of purchasing food or their medication. Choosing the former over the latter may cause people to
develop severe conditions which often result in hospitalizations, or death. This costs the state a great deal
not only in the loss of quality of life, but also in money. The people who are especially victimized by this
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choice situation are those whose income disqualifies them from Medicaid and whose expenses drain their
financial resources(it isn't unusual for seniors to pay 47% or more of their monthly income for rent
alone).
Many existing pharmaceutical assistance programs not only provide prescriptions, but also educational
opportunities. In almost all of the current local North Carolina programs it has been found that a great
number of people, both literate and illiterate; do not understand why they are taking their prescriptions,
over the counter medications and vitamins. In addition, they can not say how, or when, they should be
properly administrated. It is not unusual for individuals to be on 32 -36 prescription medications
simultaneously- even after being hospitalized! This may be due to the lack of coordination by a single
physician.
Ten states which currently have a pharmaceutical assistance program generally receive funding from their
general funds. However, both foundation and corporate funds may be available for seed money in North
Carolina. In addition, to the public funding, recipients may pay a co-payment. If samples and
manufacturers donations are available, although limited, they can be utilized.
The Orange County Advisory Board on Aging reviewed the above information, and decided that there is a
definite need. 'At the meeting on June 27, 1996, the Board unanimously voted to recommend that the
County Commissioners endorse such a program and advise the Governor and the state legislators of the
need for a statewide pharmaceutical assistance program. It should be one that not only provides
medications, but also has a regular educational and counseling component. It would also save the state
money and resources to take care of people's needs before they escalate to crisis.
RECONEMENDATION:
The Orange County Advisory Board of Aging recommends that the County Commissioners adopt a resolution
endorsing the establishment of a statewide comprehensive pharmaceutical assistance program for senior adults,
age 60 t who fall within a defined incometexpense range and who do not qualify for Medicaid. This action
should be communicated to the county's state legislators and the Governor.
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ORANGE COUNTY BOARD OF COMMISSIONERS
A RESOLUTION ENDORSING
A STATEWIDE PHARMACEUTICAL ASSISTANCE PROGRAM
FOR LOW INCOME ELDERLY
WHEREAS, low income older adults comprise approximately one-fourth of the North Carolina elderly
population; and
WHEREAS, there is nearly 300,000 North Carolinians, many elderly, designated as"poor",and receive no
assistance with the purchase of prescription medications; and
WHEREAS, nationally, North Carolina has the ninth highest poverty rate for people age 65 and older; and
WHEREAS, Medicare, available to all citizens over 65, provides no assistance for purchase of retail
medications; and
WHEREAS, older adults represent 12% of U.S. population, but consume 34%of all prescription drugs
and by the year 2000 older adults are estimated to consume close to 50%of all prescribed drugs; and
WHEREAS, a high percentage of elderly hospital admissions are due to medication misuse; and
WHEREAS, in rccent years, prescription drug prices have risen at a rate three to five times that of inflation
making it difficult for low-income elderly to follow the doctor's orders; and
WHEREAS, low income older adults who do not qualify for Medicaid can not get assistance with the
purchase of prescription drugs in North Carolina like ten other states;
NOW, THEREFORE, BE IT RESOLVED THAT the Orange County Board of Commissioners does
hereby endorse the need for a statewide pharmaceutical assistance program for senior adults, age 60+, who
fall within a defined income/expense range and who do not qualify for Medicaid; and
FURTHER, BE IT RESOLVED that the Orange County Board of Commissioners advise the Governor
and state legislators of the need to establish a statewide pharmaceutical assistance program.
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North Carolina's First Symposium on Pharmaceutical Assistance Programs
June 12, 1996
Presentations were given on different pharmacy assistance programs for the working/retired poor
(most of whom are seniors) in the following counties: Durham, Forsyth, Guilford, Rockingham,
Wake, and Yadkin. Each one has tailored its program to meet their county's needs, and varied in
the length of their existence and experience from a few months to 23 years (Winston-Salem). All
had received startup grants, and many are looking for continuing funding. Each program has a
formulary, which is generally comprised of generic medications, and some have a system for
contacting churches or civic groups to pay for non-generic prescriptions. The individual programs
vary a great deal in how they're administered from those which operate out of hospitals during
designated hours, to those which enable individuals to get their medications from local pharmacies
(at a reduced cost to the program). Generally, a co-payment is requested but for those who can't
pay, it's waived. Winston-Salem, in particular, has an extensive program utilizing the support of its
medical community for the donation of samples, and for fund raising. Due to this support and
manufacturers' donations for individuals, they are able to distribute over$1,000,000 worth of
medications, utilizing 80-100 volunteers, with a$340,000 budget, All of the programs utilize
retired pharmacists, who have maintained their Iicenses, physicians and nurses. The pharmacists are
covered by their own insurance, or that purchased by the program.
There were also presentations and discussions on the fact that a large number of people are illiterate
and are unable to explain the correct administration of their medication. To address this issue, many
programs require people to"re-qualify"on a regular basis which varies from a month to six months.
This affords the pharmacist the opportunity to review all of a person's medications (including
vitamins), and their applications. It has been found that many people are on as many as 36 different
prescriptions at a time. Since many physicians are often involved (without the benefit of
coordination), the number of medications and their interactions should be questioned. Thus,
physician education is a strong component of many programs.
What are the consequences of not having a pharmaceutical assistance program? A higher morbidity
rate, more people needing hospitalization due to the seriousness of their illnesses - which also costs
the taxpayers more money. As one speaker said, "While we are planning,people are dying!"
What can we in Orange County do? We can write Gov. Hunt(put"Aging" in the lower left hand
corner of the envelepe so that he will read it) and our state legislators to urge them to have North
Carolina become the eleventh state with a state-wide program. The Advisory Board on Aging can
advise the county commissioners that they support such a program so that they, in turn, can convey
that to our legislators. With North Carolina the fifth state into which seniors migrate, and the
fiftieth from which they leave, it is imperative that something is done at this level. Within Orange
County, we can utilize the many retired pharmacists and medical professionals to organize a
program under the Wellness Program, which could receive funding. A central volunteer would be
an absolute necessity. If a needs assessment is required, Durham did one about three years ago
which is still valid. A committee of community representatives, including pharmacists,physicians
and the CEO of UNC Memorial Hospitals should be included in the planning and implementation.