Prescription Drug Assistance Program Support For Primary Care Clinics
I. Purpose of the Prescription Drug Assistance Program (PDAP)
The 2005 Kansas Legislature added $750,000 to the State Fiscal Year 2006 budget of the Kansas Department of Health and Environment (KDHE) and established an account for prescription support for community based primary care clinics. The purpose of these funds is to improve access to prescription drugs for Kansans served by certain federally qualified health centers [1](FQHCs) and community-based public or not-for-profit primary care clinics.
The funding was originally proposed in Senate Bill 84 which provided for three forms of financial assistance to community-based primary care clinics. The first category of support was for purchase of drug inventory under section 340B. Section 340B limits the cost of drugs to federal purchasers and to certain grantees of federal agencies including the FQHCs (also known as Community Health Centers – CHC) and FQHC Look-Alikes established by the Health Resources and Services Administration, Bureau of Primary Health Care. The 340B Drug Pricing Program is authorized through Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act.
The second method of support is to provide a subsidy for each prescription to a qualifying individual. The legislation authorizes a subsidy for a portion of the cost of prescription drugs purchased through the 340B program for patients on a sliding fee scale. The estimated average subsidy is $4.00 per prescription.
The third category of support is to cover operating costs of Medication Assistance Programs (MAP), also known as manufacturers’ indigent drug or Prescription Medication Assistance (PMA) programs. Funds could be used for the operational costs of hiring persons to administer the various pharmaceutical industry assistance programs. Staff would coordinate the application procedures and eligibility requirements for physicians and patients in order to obtain supplies of free, or low-cost pharmaceuticals through manufacturers’ indigent drug programs. In these programs, filled prescriptions are mailed directly to the physician and, under physician supervision, certain licensed personnel may disburse the medication to patients of the clinic.
KDHE Page 3 of 4 February 21, 2006
II. Funding Strategy:
Based upon the availability of funding for state fiscal year 2007, these grants are intended to support operating costs for expanding access to prescription drugs. These funds will be made available to qualified applicants submitting project proposals meeting one or more of the following objectives:
1. Participate in the federal discount drug pricing program [2](Section 340B pharmaceutical discount purchasing program), eligibility restricted to qualifying Community Health Centers, also referred to as Federally Qualified Health Centers (FQHC) and FQHC Look-Alikes.
• inventory acquisition or formulary expansion, and/or
• prescription subsidy for sliding fee discounts to qualified clients
- Employ professional staff. CHCs participating in the 340B program are eligible, for example, to hire qualified health care providers to disburse drugs.
- Hire dedicated staff to manage medication resources acquired through participation in pharmaceutical manufacturers’ prescription drug assistance programs, also known as indigent drug programs or patient assistance programs. Non-FQHC facilities could employ staff to coordinate and conduct pharmaceutical manufactures’ assistance program activities.
III. Eligibility
Eligibility is limited to not-for-profit or publicly-funded primary care clinics, including community health centers defined as Section 330 Health Centers in the Public Health Service Act (42USC254b) and federally qualified community health center look-alikes defined in Social Security Act (§ 1905(l)(2)(B)). Clinics must provide comprehensive primary health care services, offer sliding fee discounts based upon household income and serve any person regardless of ability to pay. Policies determining individual patient/client eligibility due to income or insurance status may be determined by each community but must be clearly documented and posted.
IV. Funding Guidelines
Requests are considered based upon project objectives, demonstrated need and the availability of funding. Applicants with small, start-up projects are encouraged to apply.
Application Process and Term Of Grants – Funding will be for the state fiscal year beginning July 1, 2006 and ending June 30, 2007. Application deadline has been extended to March 30, 2006.
Factors to Consider in Funding Requests - Applicants are required to provide local support which meets the local match requirement of one dollar for each one dollar of funding awarded through this program. Funding for continuation requires Legislative authorization and is not assured.
Fiscal control and fund accounting procedures must exist to assure the proper disbursement and accounting of grant funds. Account methods must be maintained for grant-supported activities reflecting all receipts, obligations, and revenue, including non-cash contributions and disbursement of grant and local funds. The applicant will be fully responsible for providing workers compensation, unemployment insurance and social security coverage. The local health agency is also responsible for income tax deductions, and for providing any benefits required by law for those employees who are employed on behalf of the grant program.
Factors Considered In Funding Decisions – The key criteria for funding consideration will be proposals that focus on new or expanded service to vulnerable populations, strengthen an organization’s capacity to fulfill its mission and/ or enhance its ability to operate efficiently and effectively.
KDHE will notify all applicant organizations in writing of the decision to deny a funding request.
V. PROGRAM NARRATIVE INSTRUCTIONS FOR NEW APPLICANTS
Each program varies greatly in terms of mission, service area, range of services, client eligibility, and local project goals and objectives. Submit a brief written narrative including the following:
Organizational Background – Briefly describe the history and current activities of your organization, including your mission, founding date, major programs and working relationships with local community partners.
Proposal Details – Please answer the following questions:
- Define your target population. How is your target population currently obtaining needed prescription medication? Is this working well for your clients?
- Will this grant enable you to implement a new project or expand a current one?
- What are the desired outcomes of your project?
- How will you achieve your desired outcomes?
- How will you track, measure, evaluate and report your activities (outputs) and your outcomes?
f. Written agreements
If this project relies upon a partner or partners to contribute services, financial or non-financial resources, please submit a written memorandum of agreement with the other agency(ies).
g. Letters of Support
Letters of support are not required but may be submitted to explain working relationships or partnerships.
h. Supporting Documents
Applicants who are not currently receiving grants through the Community-Based Primary Care Clinic Program are required to include additional supporting documents:
List and brief biographical sketches of key project staff;
As appropriate to your type of organization (please include only one copy of each)
- IRS Letter of Determination
- Most recent Audited Financial Statement
- IRS Form 990
Limited additional attachments that will be helpful in demonstrating the merit of your proposal (please include only one set of such items).
KDHE Page 3 of 4 February 21, 2006
[1] http://bphc.hrsa.gov/programs/CHCPrograminfo.asp
[2]
Federal Office of Pharmacy Affairs website: http://bphc.hrsa.gov/opa/howto.htm
The 340B Drug Pricing Program resulted from enactment of Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act. Section 340B limits the cost of drugs to federal purchasers and to certain grantees of federal agencies. Significant savings on pharmaceuticals may be seen by those entities that participate in this program.