Utilizing baccalaureate nursing students to sustain access to a Prescription Assistance Program in a rural public health clinic: A public health nursing solution

This presentation will describe the role of nursing students in a rural public health clinic to maintain access to a valuable community health service program. The Brown County Health Support Clinic (BCHSC) operates a Prescription Assistance Program (PAP) that provides approximately $25,000.00 to $35,000.00 in market value prescriptions to its clients on a monthly basis; $300,000.00 to $420,000.00 on an annual basis. The PAP provides services to persons uninsured and under-insured persons that cannot afford to purchase necessary medications to treat their illnesses. In addition, the BCHSC serves as an educational site for nursing students. The PAP serves approximately 100-115 clients on a monthly basis and allows clients to remain healthy and continue to hold jobs in the community. The services provided through the PAP are critical to effective chronic disease management for such conditions as diabetes, hypertension, and hyperlipidemia. The health outcomes include: 1) improved readings for HgbA1C, cholesterol, and blood pressure, 2) less employment absenteeism with increased worker productivity, 3) self reported enhanced well-being, and 4) decreased utilization of tertiary care facilities. While the PAP provides a valuable service there are several issues facing its continuance. Pharmaceutical companies no longer provide assistance to persons eligible for Medicare D. In addition, there are limited grant opportunities to provide funding assistance to operate PAPs. PAPs generate no cash flow to assist in paying for staff and overhead. Separate forms are often required for each drug that result in increased staff time. While the PAP is successful in its mission to provide medications that would otherwise be unaffordable to its participants, it is not cost-effective for the clinic to operate. In order to continue the PAP, the Indiana University School of Nursing and BCHSC partnered with nursing students to provide valuable health education/learning opportunities and continued services for its participants. Student nurses were provided with employment and learning opportunities for community health and nursing management courses. Student nurses developed management solutions to streamline the PAP to make it more cost effective. Results of the students' involvement with the PAP will be described, including documented health outcomes and estimated savings.