So what does this playbook hope to empower building? A community charity pharmacy is a pharmacy which serves with the expressed purpose of improving health outcomes among the vulnerable by reducing health disparities and increasing medication access. Typically, a community charity pharmacy includes standard business features, such as:
- Structured as a nonprofit 501(c)3 or equivalent (university nonprofit, government nonprofit, etc.).Community charity pharmacies can be owned by a nonprofit (like a hospital) or can be a stand-alone nonprofit corporation. This playbook, while useful in any charity pharmacy design, will be focused on the most complex design – that being a stand-alone 501(c)3 – including legal, fund development, and board development activities unique to the design of such a model.
- In receipt of a valid, current pharmacy and/or pharmacist license, or similar dispensing authority.Each state manages charity pharmacy licensing in different ways. The principle is that every charity pharmacy is properly licensed, existing under the authority of all applicable oversight organizations pertinent to their locality.
- Adherence to all local and federal regulation pertaining to the management of a licensed community charity pharmacy and/or clinic.Again, each state has different regulation governing a charity pharmacy. This regulatory imperative impacts licensing, staffing, operational design, and other features of a community charity pharmacy.
- Dispensing a therapeutically broad formulary of medications for free or at a significantly reduced cost to the patient.That means that a charity pharmacy is primarily focused on increasing access to medications and reducing disparities.
- Bridging patients to external programs (such as Patient Assistance Programs, mail-order discount programs, vouchers, etc.) that are free or which assure a significantly reduced cost to the patient.At times, the role of the community charity pharmacy is to dispense medication, and in other instances, it is to ensure that the most financially and operationally effective medication access solution is used. While not always the case, community charity pharmacies generally seek to do this with and through access-expanding programs such as Patient Assistance Programs, donated medication programs, and other such services. Ideally however, community charity pharmacy programs are organized around programs that have a broad primary care formulary, with medications already stationed in a local inventory (so as not to delay access to the patient) and are dispensed immediately and with as little process and delay as may be possible.
- Eligibility processes which determines qualification for income status (not precluding other eligibility status features specific to the goals of each site, such as: health insurance status, assets, etc.). Typically, community charity pharmacies are focused on serving those with limited access to healthcare coverage, and limited financial means. This means that enrollment into a qualifying set of patient status guidelines is a part of the community charity pharmacy’s effort.
- Processes, culture, and systems which assure the dignity and respect for each patient served.
- Business hours and dispensing practices which allow for patients’ continual access to their medications, should the patient seek such access.
- Integration into the community healthcare safety net to support inbound referrals from prescribers for qualifying patients as a standard business practice (private practices, hospitals, free clinics).
- Integration into the community healthcare safety net to support outbound integration with community services necessary for improving health outcomes (medical home enrollment, care management, public health coverage model enrollment, ancillary medical services, etc.)
The above features of Community Charity Pharmacies form a three-part strategy, which has been studied and proven (research described below) to result in a positive impact on health outcomes:
- Carry essential medication via a smart, therapeutically-effective formulary targeted to manage primary care health conditions,
- Dispense the volume of medication needed to serve all patients, and
- Provide that medication in a consistent supply, day after day, year after year, for the patients who maintain health through medication therapies.