Neighborhood Family Practice Drug Assistance Program

Summary: The Drug Assistance Program (DAP) is a service offered by Neighborhood Family Practice, through its Patient Benefits Department, to aid uninsured patients who are in need of prescription medications that they cannot afford. Many pharmaceutical companies have Prescription Assistance Programs that provide medications at no cost to patients who meet eligibility requirements. The purpose of the DAP program is to educate and assist patients in applying for these programs, as well as serving as the link between the pharmaceutical companies, the providers, and the patients.

How it works: —Roles and responsibilities of the providers, patients, and patient advocates

Referrals  DAP appointment - All patients must initially be referred to the DAP program by a provider. When a provider identifies a patient he/she believes will benefit from the DAP program, a referral needs to be sent through EPIC. * While in the patient’s chart go to orders  enter code 9156 or ‘Referral for Prescription Assistance’  enter medications, dosages, sigs and associated diagnoses  internal referral send to DAP pool. - After the referral is sent to the DAP pool, it will show up in our inbox as an ‘order’. Next, a member of PBS will check to see if the medication is offered through DAP by going to needymeds.org and checking to see if it is one of the medications provided through the Pharmaceutical companies’ prescription assistance programs. - If the medications are on DAP, PBS can now call the patient to set up an appointment so he/she can fill out the applications. o After a patient is called, in EPIC mark the order as ‘done’ In ‘Referrals’, enter result of call – in process, no answer/no response. In the MAP phone log, enter the date, time, pt name, result of call, provider, and medications referred for. - The patient needs to bring in proof of income-- - Previous year tax return  accepted by all companies - Current award letter (Social Security, unemployment, etc.)  accepted by most companies - W2’s, pay stubs, hardship letters  check the requirements of the prescription assistance program, not all accept - The patient needs to fill out all areas of the application and sign (not date). The PBS member then fills out the rest of the application with the provider’s information and handwrites the prescription. *At this point, only the provider’s signatures and dates are needed.

Sending applications  receiving medications - Once the provider has signed the application and prescription, the PBS member then dates everything and faxes or mails the application to the pharmaceutical company’s Prescription Assistance Program. *If mailing, make copies of all the information being sent and mail the originals. - Make the patient a folder, including: PAP Application and Medication Shipment Log sheet (with copy of application attached), DAP medications sheet, extra copies of proof of income. Put provider’s initials on outside of folder. Mark date faxed/mailed on both sheets. - On EPIC  o Open a refill encounter  enter patient’s name  provider’s name o Enter DAP medication in new order  enter sig, quantity for 90 days/3 month supply (or 120/4 month supply for Lilly)  DAP ORDERED o In comment section, leave message as new DAP application, DAP refill, etc. and ask provider to sign and close encounter. o Route to provider  close chart ***Providers must now sign the refill encounter and close it*** - Depending on the medication and the program, medication will either be shipped to the office or to the patient’s home. If shipped to the patient, he/she is responsible for refills. - For medication shipped to the office  Supervisor must open all medications first. - Retrieve the patient’s file. Contact the patient to come pick up the medication. Mark the date the medication came in and the date the patient was contacted. Put the medication in a bag with the patient’s name and whether they were spoken to, a message was left, or a letter was sent. Staple the packing slip with the name of the patient and the medication enclosed to the bag. Put the medication in the Med cabinet or in the refrigerator. - Log the medication into both the white and brown binders. The white binder is sorted alphabetically by last name; the brown binder is sorted by provider. - A patient has three months to pick up the medication, after that, a three-month letter is sent reminding the patient that the medication is here, and if it is not picked up in one week, it will be used for other purposes.

DAP received  reorders

- When a patient comes in to pick up the medication take the sheet where you logged the patient’s name and medication out of the white binder retrieve the medication from the cabinet or refrigerator  remove the packing slip and have the patient sign and date both sheet and slip. - Retrieve the patients chart and tape the slip to the log sheet, along with the date the patient picked up the medication. Open the DAP Calendar for three months (four months if Lilly) from when the patient picked up the medication and add their name to the refill calendar. - EPIC o Open a refill encounter  enter patient’s name  provider’s name o Enter DAP medication in new order  enter sig, quantity for 90 days/3 month supply (or 120/4 month supply for Lilly) make sure date matches date pt picked up meds  DAP RECEIVED o In comment section, leave message as ‘pt picked up DAP medication, please sign and close encounter’ o Route to provider  close chart - When medication comes to the office, we are responsible for refills. At the beginning of each month, print the refill calendar and call/fax/mail in all refills. Follow the same steps in EPIC, except when there are already medication orders for DAP ORDERED and DAP RECEIVED, hit “reorder” and reenter the information and dates. You do not need to start a new order. - Patients are eligible for up to one year/3 refills for each Prescription Assistance Program. At the end of that year, the patient will need to reapply for the program.