North Bay health centers adding pharmacies

NORTH BAY -- Two of Sonoma County's biggest federally qualified health centers are in the process of opening in-house pharmacies at key locations, a move aimed at further integrating primary care services with the hopes of improving outcomes for patients who struggle with prescription medications.

Both Santa Rosa Community Health Centers and Petaluma Health Center are following the lead of another North Bay FQHC, Marin Community Clinics, which opened an on-site pharmacy about a year ago. Since then, Marin's safety-net provider has seen a dramatic improvement in reducing repetitive visits from patients, many of whom struggled with medications and ended up either back at clinics or in emergency rooms for treatable conditions, said Linda Tavazsi, CEO of Marin Community Clinics.

While having a pharmacy within a nonprofit health setting isn't unheard of, certain expertise are required and not every location is well suited for the service, depending on whether there is enough patients that come to a centralized location. Startup costs can be a hindrance as well, Ms. Tavazsi said of the program, known as the 340b Drug Pricing Program and Pharmacy Affairs overseen by the Health Resources and Services Administration.  Until the Marin pharmacy, none existed in the North Bay, where the networks of clinics provide a significant share of primary care services. 

"It was a little scary because I didn't know 340b so well, but the evolution has been unbelievable," Ms. Tavazsi said. "The most striking thing is when we started the pharmacy in-house, 30 percent of our patients would never pick up their drugs at outside pharmacies.

"From 30 percent noncompliant, we are now at 1 percent," she said. "We started doing 10 to 20 prescriptions per day. Last week we did 423 in one day."

At safety-net health centers across the North Bay, patients, many low income and of immigrant status, often face language barriers with medications and instructions, or a general unfamiliarity with the retail pharmacies, and as such face difficulty navigating the system as a whole, officials said. So having a pharmacy on-site, where physicians can confer directly with pharmacists and the patient all at once, has great potential to correct seemingly intractable communication or transportation issues that can lead to less favorable outcomes.

At Santa Rosa Community Health Centers, the estimated number of patients who face challenges with prescription compliance is similarly about 30 percent, according to Naomi Fuchs, CEO.  The expansion of Medi-Cal under the Affordable Care Act is adding further motivation, she said.

"Access to affordable medications has always been an issue for our patients," Ms. Fuchs said. "It's hard to improve their health if they can't get the medications. Why this has come up now is because we used to be able to offer these kinds of medications only to uninsured and Medicare patients. As a result of the (Affordable Care Act), we can now offer them to Medi-Cal patients, which are two-thirds of our patients."

Ms. Fuchs said the new pharmacies could serve between 30 percent and 40 percent of its 40,000 patients. The Santa Rosa safety-net provider is in the process of setting up a pharmacy first at its Southwest Community Health Center on Lombardi Court within the next month and another later this year at its Vista Health Center.

Petaluma Health Center likewise will open a pharmacy at its main location in the coming month or so, according to Ciera Rudin, community relations manager.


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