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ABSTRACT
Trends
In the United States, the unemployment rate has almost doubled in only five years; it has
gone from 4.7% in July of 2006 to 9.1% in July 2011. The increasing unemployment rate is
evident in Michigan as well; at a rate of 10.9% Michigan is tied with South Carolina as having
the fourth highest state unemployment rate in America (Local Area Unemployment Statistics,
2011).
1.) Puerto Rico
15.5% in Jul 2011
2.) Nevada
12.9% in Jul 2011
3.) California
12.0% in Jul 2011
4.) Michigan
10.9% in Jul 2011
South Carolina
10.9% in Jul 2011
Muskegon County is no exception; the unemployment rate in Muskegon County is 2 percent
higher than the national average at 11.2% (Economy at a Glance, 2011).
It is nowhere better evident than in the data, to grasp the trickledown effect of an
economic hardship and its influence on our communities. The poverty level in Muskegon County
has also increased as a result of the increased unemployment rate. In 2009, a person living below
the poverty level in Muskegon County was joined by 18.6% of the community in Muskegon
County (State and County Quick Facts, 2011).
It is unfortunate, but everyone knows that with unemployment and poverty, comes the
reality of unaffordable health insurance. An increase in Muskegon Countys unemployment and
poverty rate was a definite precursor to an increasing number of people left uninsured in
Muskegon County, approximately 17.7% in 2009 (Health Insurance, 2011).
Forces
The poor and underserved person is frequently unable to pay for housing, food, childcare,
health care, and education. Difficult choices must be made when limited resources cover only
some of these necessities.
People are being forced to choose between whether to eat and live or not eat and die or
not get their medications filled and die or get their medications filled and live. It is not
uncommon for people to become noncompliant in taking their meds simply because they have no
choice. For example, a person may take medications other than the way they were prescribed in
order to have bottles last longer, or share medications with a spouse (Angell,2004).
Prescription drug costs are high and continue to climb. In 2004, "Americans were
spending $200 billion a year on prescription drugs, and that figure was growing at a rate of 12
percent a year" (Angell,p.1,2004). As the cost of prescriptions climb and as the economy
declines there is a definite need for prescription coverage assistance. The cost of healthcare,
particularly medications, is being shifted to the individuals instead of being covered by insurance
companies. Some employers are dropping healthcare benefits altogether (Angell,p.1,2004).
We would like to think that the increasing cost of prescriptions was related to the
production or continued research for better medication, however, there is much doubt that this is
the case. Consumer Health Organization Families USA reports that drug companies are spending
more than twice as much on marketing, advertising, and administrations then they do on research
and development (Act up, 2011). Drug companies profits exceed their research and
development expenditures (Act Up, 2011).
Unaffordable medication is a challenge that a prescription assistance center would have
to face. Drug companies have methods for poor and underserved people to obtain their
medications, but they must first figure it out through unadvertised loop holes. If more people
were to have access to these programs drug companies may eventually feel it in their profits. One
would think if drug companies are not willing to sell their medications cheaper, they will
definitely not be too excited to see agencies willing to jump their loop holes and get people
medications for free or at cost.
Another challenge a prescription assistance center might face is funding. In order to get
through the red tape you would need knowledgeable educated staff, however, clients are looking
to cut costs not add new ones. One program that was created by Muskegon Community Health in
2007, was a pharmaceutical access program, which used a AmeriCorps VISTA volunteer grant
from the Michigan Council on Crime (Muskegon Community Health,2011).
Insurance companies, hospitals, and doctors should all be very supportive of such an
agency. One hundred billion dollars a year is spent on hospital admissions related to nonadherence to medications resulting in an estimated 89,000 deaths per year. Think of the money
and lives that can be saved if patients were able to afford to stay on their medications
(Vanderson, 2010).
Similar Services
For the idea of a prescription drug assistance program, similar services was searched for
using google.com. The first website we found was www.pparxmi.org. This website helps
individuals find affordable drugs. The problem with this website is that it is not local and it is
difficult to navigate. We also found that this website is difficult to verify its authenticity; this can
lead to identity theft and the dissemination of personal medical information. The second website
we found was http://www.sav-mor.com/assistance_programs. This website is linked off of a
pharmacy website. These links linked to pharmaceutical company assistance programs. The
problem with this one is that would be hard for an individual to get their prescription drugs
because you need to jump through so many hoops to prove that youre in need, you also need to
find a pharmacy to accept your medications for you. The third website we found was
http://www.aaa1c.org. This website is a state sanction agency that assists the elderly. The
problem with this group is that it is centered in south east Michigan, which is far away from
Muskegon and the prescription assistance, comes from out of state and it also focuses on helping
individuals navigate Medicare prescription drug coverage.
After searching for a prescription assistance programs in Muskegon, Michigan it appears
to us that there is a need for a prescription drug assistance program. The first reason is there does
not seem to be an assistance program in this area and if there is, it is poorly advertised. Secondly
the prescription drug assistance websites we did find appeared to be difficult to use because they
are difficult to navigate, possibly predatory, and have some many hoops to jump through that a
normal person would have difficulty getting prescription drugs on their own. For these reasons
there is a need in the community to assist this vulnerable population.
We will support one another in serving our patients and in serving our community.
Collaborate with other medical professionals and services to provide smooth continuation
of pharmaceutical care.
goals. MPAC has come up with some solid objectives that we believe will allow the center to
develop and maintain a thriving foundation onto which it will grow. MPACs current objectives
include, but may not be limited to, the following:
To reduce the number of hospital admissions in the Muskegon area related to nonadherence to medication regimens by 20 percent within the agency's 1st year.
To establish a community prescription service so that all people in the target population
have equal access to prescription medication.
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professional and dedicated individuals. Below is a listing of MPACs current positions that will
need to be filled in order to support our mission, philosophy, goals, and objectives.
1.) Doctor/Medical Director/CEO
General Responsibilities
The Medical Director will be responsible for the supervision of administrative, clinical,
and educational activities. The medical director will perform all of the tasks that are necessary
for the MPAC to provide efficient, high-quality, patient care.
Duties and Responsibilities
Supervise all professional and non-professional activities of MPAC, to assure that the
center is in compliance with the appropriate standards required by all governmental
agencies and conforms to the rules, regulations.
Monitoring physician and patient satisfaction with MPAC including services, policies,
and personnel.
Assisting with orientation and educational programs for the medical and non-medical
community at large.
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Using other appropriate means to inform the staff and the public of activities and services
available through the Muskegon prescription assistance center.
Establish organizational relationships and assign duties and responsibilities to the MPAC
personnel, assist the personnel to effectively carry out those duties and responsibilities.
Qualifications
Has experience or a strong desire to perform managerial functions for the management
and operation of MPAC.
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nurse director is responsible for developing and maintaining a program of excellence in clinical
practice, and quality service to the patients of the MPAC. The nurse director is responsible for
establishing and meeting quality care and service standards. Establishes program goals and
monitors performance. Manages the daily operations of this program, provides clinical
supervision covering the Muskegon prescription assistance center, and administrative
supervision to other staff. Requires clinical and management expertise and the ability to
coordinate efforts with area hospitals, pharmacies, doctor offices, and other allied health
professionals.
Duties and Responsibilities
Develops and promotes appropriate collaborative and consultative relationships with area
hospitals, pharmacies, doctor offices, and other allied health professionals.
Manages the operations of MPAC and oversee adequate staffing, equipment, and
supplies.
Monitors patients and workflow, while making changes to improve patient access, patient
satisfaction and provider/staff efficiency and effectiveness.
Supervises and manages staff (interview, hire, train, assign work to, evaluate
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Responsible to ensure that clinical care at MPAC are of high quality, in accordance with
applicable laws, regulations, pharmacy standards, and principles of professional ethics.
Develops and maintains relationships with city, state, and national health resources.
Qualifications
Bachelors or Masters prepared registered nurse with three to five years clinical
experience with concentration in a related field as determined appropriate by the CEO of
MPAC.
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Research foundations and corporations to approach for private funding and proceed as
needed;
Work with the CEO and Program Director to understand unmet needs and develop and
write proposals to secure private funding;
Work closely with program staff to develop program budgets for submission to funders;
Secure and submit follow up and final reports to foundations and corporations for both
unrestricted and restricted grant funding;
Work closely with program staff to report on spending in accordance with budgets
submitted at the end of each grant period;
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Assist in drafting, editing and submitting proposals in response to federal, state, and other
sources of public funding Requests for Proposals;
Orchestrate and lead program site visits for potential corporate and foundation donors;
Maintain up-to-date records demonstrating the status of each proposal on the grant
slate, i.e. what proposals are pending, for how much, what has been awarded, what is to
be submitted, deadlines, etc.;
Present progress and status toward achieving fundraising goals monthly basis to the CEO,
and quarterly basis to the Board of Directors.
Maintain regular communication and interact directly with client personnel on accounting
information, due dates, deadlines, and other compliance matters keeping them informed
Recognize potential
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Interact pleasantly with funders, board members, potential donors and other community
representatives;
Maintain strict confidentiality regarding all donor records and giving histories, prospect
research and identification, board member information, client/consumer information and
other confidential agency information problem areas in projects and discuss with
appropriate company personnel
Qualifications
Ability to manage multiple projects and priorities; Proficiency in MS Word, Excel and
PowerPoint.
Highly organized
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Qualifications
5.) Pharmacist
General Responsibilities
The pharmacist is responsible for collaborating with case managers and physicians to
maintain a safe and attainable medication regimen for clients along with educating the
community on safe pharmaceutical practices.
Duties and Responsibilities
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Qualifications
State licensure with PharmD degree required. Five years of experience preferred.
6.) Nursing
General Responsibilities
Nursing will work in partnership with the medical director, program director, pharmacist,
and all other relationships within MPAC to see patients efficiently and to provide nursing care.
Vital signs, history, basic laboratory procedures, administration of medication, and assistance
with simple procedures will all be part of her/his responsibility.
Duties and Responsibilities
Assist the medical director, program director, pharmacist, and all other relationships
within MPAC as needed.
Weigh patients and take their blood pressure and other vital signs; take patient medical
history.
Perform simple lab tests such as urine dipsticks, finger stick glucose, PT/INR levels, etc.
Ensure complete and proper documentation of all patient care and instruction in patient
medical records.
Qualifications
7.) Volunteer
General Volunteer Qualifications
Competency in languages other than English strongly preferred but not required
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volunteers will ensure that patients move through their visit with ease and be sure that the
patients understand each part of the process.
Qualifications
Be able to communicate great warmth while at the same time maintain professional
boundaries with regard to confidentiality, personal space, and levels of comfort.
Administrative Volunteer
General Responsibilities
MPAC administrative volunteers serve a behind-the-scenes role by accomplishing special
projects. An administrative volunteer could help with various tasks that aid in daily clinic
activities such as making reminder phone calls to patients, making patient charts, entering data in
our system, organizing/tidying up the waiting room, and stocking and organizing items donated
to the clinic and other clerical tasks.
Qualifications
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Patient intake volunteers assist patients while they are in our clinical areas.
Responsibilities includes: escorting patients in the clinical area, checking patients in, obtaining
patient data such as weight, height, blood pressure, and vitals. Patient intake volunteers work
alongside the nursing staff to get patients checked into their consultation/assessment room. Other
services include: straightening up consultation rooms and preparing the room for the next patient.
Qualifications
Familiarity with the intake process including taking information about prescriptions,
temperature, allergies, vitals, and chief complaints.
Advertisements
In order to help facilitate acquiring positions for MPAC we developed an example flyer
which will help to promote applicants into applying for the job of the MPAC Nurse/Program
Director (see Appendix A). In order to get an idea of how much it would cost to run our flyer in a
credible journal we looked up quotes from three nursing journals for a comparison (see
Appendix B).
Another way we thought we could advertise would be to place our flyer in brochures at
local medical centers, doctors offices, health clubs, and emergency departments. Fed Ex printing
has tri-fold brochures that start at $1.06 per brochure. A billboard promoting MPAC and our
open position could be another avenue to take for advertising.
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ROUGH REFERENCES
Partnership for Prescription Assistance (2011).
Find a Free or Discounted Drug Program. Retrieved September 14, 2011, from http://www.pparxmi.org/
Sav-Mor Drug Stores (2011). Patient Drug Assistance Programs. Retrieved September 14, 2011, from
http://www.sav-mor.com/assistance_programs
The Senior Alliance. (2011). Prescription Drug Assistance Programs. Retrieved September 14, 2011, from
http://www.aaa1c.org/consumers/resource13.htm
Muskegon community heath project. (n.d.). Pharmaceutical access program. Retrieved September 11,
2011, from http://mchp.org/aboutus/pap.html
ACT UP. (2010, April 20). LINKS HIGH DRUG PRICES TO ADVERTISING, PROFITS, AND ENORMOUS
EXECUTIVE SALARIES. In Off the Charts: Pay Profits and Spending by Drug Companies. Retrieved
September 11, 2011, from http://www.actupny.org/reports/drugcosts.html
Angell, M. (n.d.). The truth about drug companies. In The New York Review of Books. Retrieved
September 11, 2011, from http://www.nybooks.com/articles/archives/2004/jul/15/the-truth-about-thedrug-companies/
Vanderson, . (2010, April 20). The High Cost of Medical Noncompliance. In One med Place. Retrieved
September 11, 2011
Economy at a Glance. (2011, September 9). Retrieved September 11, 2011, from United States
Bureau of Labor Statistics:
http://www.bls.gov/eag/eag.mi_muskegon_msa.htm#eag_mi_muskegon_msa.f.P
Guiding Behaviors. (2011). Retrieved September 18, 2011, from Trinity Health:
http://www.trinity-health.org/body.cfm?id=25
Health Insurance. (2011, June 6). Retrieved September 14, 2011, from U.S. Census Bureau:
http://www.census.gov/hhes/www/hlthins/data/acs/up-to-138-pov.html
Local Area Unemployment Statistics. (2011). Retrieved September 11, 2011, from Unites States
Bureau of Labor Statistics: http://www.bls.gov/lau/
State and County Quick Facts. (2011, June 3). Retrieved September 14, 2011, from U.S. Census
Bureau: http://quickfacts.census.gov/qfd/states/26/26121.html
Yoder-Wise, P. S. (2011). Leading and Managing in Nursing. St. Louis: Elsevier.
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Appendix A
Appendix B
Journal
American Nurse
Association
Size
Full page
2/3 page
1/2 page
1/4 page
1/8 page
Journal of Professional Full page
Nursing
1/2 page
1/4 page
Journal of Holistic
Full page
Nursing
1/2 page
1/4 page
Add/Flyer Pricing
1x
2x
$5485
$5065
$3510
$3335
$3250
$3180
$1910
$1795
$985
$900
$960
$940
$730
$710
$605
$600
$575
$550
$400
$380
$275
$260
6x
$4795
$3250
$3120
$1690
$845
$950
$700
$595
$525
$360
$245
12x
n/a
n/a
n/a
n/a
n/a
$920
$670
$585
$495
$340
n/a
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Appendix C
Organizational Chart Muskegon Prescription Assistance Center
Center Medical
Director
Program Director
Jane Doe RN, BSN, MSN
Case Manager
The Director of
Corporate Finance &
Foundation Relations
Susie Que
Volunteers
Pharmacist
Sara Smith, PharmD
Nursing