august september 2014

The Official Journal of the South Carolina Pharmacy Association • Vol. 53, Num. 5

Palmetto Pharmacist • Volume 54, Number 4 1

PharmacistPalmetto

For Low-Income Patients, Eating Healthily is No SNAP

2 Palmetto Pharmacist • Volume 54 Number 4

R

Since we are committed to helping independent

pharmacies grow and prosper, we know that sometimes it

isn’t about volume, it’s about having the one product your

customer needs. That’s why we stock more than 30,000

items. And, just as important, is delivering it when you

need it.

To learn how we can help you serve your customers better,

visit www.smithdrug.com or call 800.554.1216 today.

We focuson the products you need.

Who do you trust to supply your pharmacy?

©2013 J M SMITH CORPORATION. The Smith mark is a registered trademark of the J M Smith Corporation.

800.554.1216

SDC_collage_Final.indd 3 4/11/13 12:00 PM

Palmetto PharmacistVolume 54, Issue 4 August/September 2014The Palmetto Pharmacist, the official publication of the South Carolina Pharmacy Association, is distributed to association members as a membership service. Statements of fact and opinion are made by the authors alone and do no imply an opinion on the part of the officers or members of SCPhA. For advertising rates and other information, contact SCPhA.

What’s Inside...

5 Recipe for Leadership SCPhA President Patti Fabel discusses what it takes to be a great leader

8 For Low Income Patients, Eating Healthily is no SNAP A look at how low income patients can still eat right, despite budget limitations

21 Academia APPE at PCSP A student’s perspective 22 Creating a Competitive Strategy for Independent Pharmacy Success The seventh in a series of articles aimed at giving independent pharmacy an edge

28 Pharmacists as a Critical part of Integrated Care

Regular Columns 40 PCSP 41 Financial Forum 43 Journal CE 51 Classifieds

Advertisers 2 Smith 4 Pharmacists Mutual 37 Display Options 37 Mutual Drug 42 PACE 51 JonWallace, AttorneyatLaw 52 QS/1


2014-2015 Board of Directors

President/Board Chair PattiFabel

Immediate Past PresidentSteveMcElmurray

President-Elect William Wynn

Treasurer

PamelaWhitmire

Director-At-Large MichaelGleaton

Midlands Region Director

Bryan Amick

Low Country Region Director Kristy Brittain

Pee Dee Region Director

JarrodTippins

Upstate Region Director EdVess

Speaker, House of Delegates Sarah Braga

Speaker-Elect, House of Delegates

KayceShealy

CEO CraigBurridge

General Counsel

JonWallace

Midlands DelegatesLynnConnellyBetsyBlakeBrian ClarkCraig HarmonMeganMontgomery

Low Country DelegatesDaveProujanWayneWeartDonNeuroth

Pee Dee DelegatesJimShulerKellyJonesDanBushardt

Upstate DelegatesWalterHughesDavidBanksSteveGreeneLindaReid

SCPhA StaffCraigBurridge ChiefExecutiveOfficer Cassandra-HicksBrown DirectorofOperations/CELauraReid DirectorofEventsLaurenPalkowski DirectorofCommunicationsKelleyFuller MembershipCoordinatorJonWallace GeneralCounsel CecilyDiPiro PPNNetworkCoordinatorJenniferSimmons Palmetto Pharmacist Layout


let our expertsdo the math

800.247.5930www.phmic.com

Now more than ever, pharmacists are learning just how important it is to have not only proper insurance coverage, but the right amount of insurance. We understand the risks involved in operating a pharmacy practice and have coverage designed to ensure that you and your business are protected. We even provide policies specifically designed for practices that offer specialty services such as compounding or home medical equipment.

Trust the experts - our representatives can help you determine the right coverage for you. We offer products to meet all your needs; everything from business and personal insurance to life and investments. We’re proud to be your single source for insurance protection.

• Pharmacists Mutual Insurance Company• Pharmacists Life Insurance Company

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Not licensed to sell all products in all states.Find us on Social Media:

Robby Peed800.247.5930 ext. 7162

843.319.1330

AttheconventionIgavetheattendeeswhatIcallmy“RecipeforLeadership”;a“how-to”guide,ifyouwill,onbeingaleaderinthepharmacyprofes-sion.Forthoseofyouunabletoattend,myRecipeisbelow:

(1) Just Show Up. Beatthetable.Youdon’tevenhavetosayanything.Thereisstrengthinnumbers,somostofthetimejustbeingthereisenough.Theneventually,someonesomewherewillaskyoutodosomething.Andwhenthathappens…

(2) Say Yes! Whichisthesecondstep.Volunteertoserve.Givingbacktotheprofessioncanbereward-ingandyoucangainvaluableexperiencethatcanhelpyouinotherareasofyourlife.

(3) Be Yourself.Don’ttrytobesomeoneyou’renot.Evenifit’ssomeoneyouadmire–youdon’thavetobecomethem.Tobehonest,theworldalreadyhasoneofthemanywayanditreallydoesn’tneedanother.Whatitreallyneedsisyou;itneedswhatyoubringtothetable.Sobeyourself.

(4) Don’t be Afraid to Make Mistakes. Leaderstakerisksinordertomovetheorganizationfor-ward.Acceptingriskmeanssometimesyou’llmakethewrongdecision.Atsomepointyouwillmakeamistakeandyouwillfail.AndIdon’tmeanthattosoundasdiscouragingasitdoes,becausemistakesareactuallyagoodthing.Youcanlearnmorefromyourfailuresthanyouwilleverlearnfromabookorevenfromyourcurrentpresi-

PRESIDENT’S PLATFORM

dent.

(5) Expect the Unexpected. Expectthatthenextphonecall,email,textmessage,orconversationwillbringaproposal,problemorsituationthatyoudidn’tseecoming.Maybesomeoneyourespectisleaving,maybeyouhavetoletsomeonego,orit’sentirelypossiblethatsomeonewantstohaveaflashmobatconventionanddoesn’twanttheCEOtoknow!Ifyouarepreparedfortheunexpected,youarelesslikelytoreactnegativelyoroverreact.

(6) Be Humble. Noonelikesworkingwithsomeonewhoisfullofthemselvesandifnoonelikesworkingwithyou,youwon’tac-complishverymuchnomatterhowgoodyouactuallyare.

(7) Say Thank You.Nooneeverac-complishesanythingontheirown.Nooneevergetstowheretheyarealone.AndIamnoexception.Atruelead-ergivescreditwherecreditisdue,andduringmyaddressIthankedthosewhohavehelpedmegethere.Ithankedyou,themem-bersforbeingsowelcom-ing.Foranon-southerner,Ihaveneveroncefelt


PRESIDENT’S PLATFORM

Recipe for Leadership

unwelcomed.Rightfromthebeginning,youhaveacceptedandmentoredme,andforthatIsaythankyou.Iwouldnotbeyourpresidenttodayifitwasn’tforallofyourhelp,guidance,andencouragement.Ialsothankedmyfamilywhoattendedthebanquet.Ithankedmyparentsforgivingmethefreedomtomakemyowndecisions;Ithankedmyin-lawsforac-ceptingandlovingmeasifIwastheirownfleshandblood;lastlyIthankedmyhusband,Josh,forbeingthereandsupportingme,despiteallofmyfaults.

Duringmyaddress,Ididn’tmentionreimbursement,theroleofthepharmacist,thestatehealthplan,pro-viderstatus,PEBA,orscopeexpansiononce.That’snotbecausethesethingsaren’timportant.Believeme,Iknowjusthowimportantthesethingsare.ButtheonethingIhavelearnedovertheyearsisthatthesethingschange.Whatwearefightingfor,whowearefighting,thedetails…allthatchanges.Whatwecallwhatitisthatweaspharmacistsevendochanges.Whatdoesn’tchangeisthefactthattherewillalwaysbesomethingtofightfor,andwewillalwaysneedpeopletoleadthatfight.

Twoyearsago,theincomingpresidentissuedachallengetothemembership.Hechallengedustobecomesomeone’spersonalpharmacist.I’mgo-ingtofollowhisleadandissuemyownchallenge.Ichallengeyoutobecomeoneofthesepeoplethatleadsthefight.

Now,nowhereinmyrecipeforleadershipdoIsayyouhavetobeuponastagegivingaspeechtobeoneofourleaders.NordoIsaythatyouhavetobeontheBoardtobeoneofourleaders.Thefirststepistojustshowup.Soplease,acceptmychallengeandhelpusfightwhateverissuewearefacingtoday,tomorrowandintheyearstocome.

IhopemyRecipeforLeadershipwillinspireanden-courageyoutoacceptthischallenge,andifyousayno–yourhomeworkistogobackandreviewstep#2!Butinallseriousness,withyourhelp,thiscouldbeanamazingyearforpharmacy.Icannotwaittoseewhatwecanaccomplishtogether.

IfthereisanythingIcandotohelpyouthisyear,pleasedonothesitatetoask.

Sincerely,PattiFabel


QS/1 Leads Industry in EPCS Security Contact: Judy Armandroff864-253-8600

Spartanburg, SC (July 31, 2014) –QS/1islead-ingthewayinthehealthcareindustrybyimple-mentingadditionalsecuritymeasurestobettervalidateelectronicprescriptionsforcontrolledsubstances(EPCS).

ThroughitspartnershipwithSurescripts,QS/1pharmaciesalreadyhaveaccesstothenewSig-natureIndicator(SI). “TheSignatureIndicatorflaghasbeenthemostcommonsigningapproachbyearlyadopterstoEPCS,”saidJohnFrady,QS/1’sMarketAnalystforpharmacyproducts.

“Asmoredoctorsandpharmaciesuseelectronicmeanstoprescribecontrolledsubstances,therewillbeanincreaseintheuseoftheevenmoresecureFBCAPKIstandard.” ThenewsecuritystandardistheFederalBridgeCertificateAuthorityPublicKeyInfrastruc-ture(FBCAPKI)DigitalSignaturesforEPCStransmissions.Surescriptsusesthisstandardtotransmitsignaturestoverifytheyarevalid.TheSurescriptsnetworkenablesbi-directionalexchangeofinformationbetweenhospitals,physicians,payers,pharmacies,labsandmore.

“WhileotherpharmacymanagementsystemsoftwareprovidersmayhavetakenaneasierrouteforEPCSsecurity,”Fradyadded.“QS/1tooktheextrastepstousetheFBCAPKIstan-dard.Whenthisbecomesthepreferredmethodofvalidation,QS/1willnothavetogothroughtheprocessofrecertification.”

QS/1customerswhohavesignedupforEPCSandareonServicePack19.1.12orhigherhavetheabilitytousethisnewformat.

About QS/1: QS/1, a complete healthcare automation solutions provider, serves pharmacies, HME busi-nesses and LTC facilities. QS/1 is a division of the J M Smith Corporation, the third largest privately held company in South Carolina. For additional information about QS/1, visit www.qs1.com, or call 800.231.7776.


For Low-Income Patients, Eating Healthily is No SNAP

Planning a Week’s Meals: Our ExperienceWestartedoutwithataskyoumightthinkwouldbesimple—createanutritious,lowsodium,sevendaymealplanforafamilyoffourusingSNAP(Supple-mentalNutritionAssistanceProgram)benefits.Thismealplanwillbeusedasatoolwithinaprogramwherepharmacistscoachhypertensionpatients.Beforewecouldstartgroceryshoppingormealplan-ning,wefirstneededanestimatedbudgetforSNAPbenefits.Tofindthisinformation,weusedafoodassistancecalculatoronthewebsitefortheSouthCarolinaDepartmentofSocialServices.Wereceivedanestimateof$620permonthforafamilyoffour(twoadultsandtwochildren)1.

WefollowedguidelinesfromtheDASHdietandre-searchedrecipesontheinternet.Oncewecompiledanumberofoptions,wesetoutforthelocalWal-Martwherethepricesaregenerallycheapest,couponsareaccepted,andpricematchingisoffered.Weexam-inedallofthefooditemsweneededandanalyzedthenutritionfactsandprices.Usingthisinformation,wenarroweddowntheoptionstotheitemsthatstruckthebestbalancebetweentheleastamountofsodium,fat,andsugar,andthelowestprice.Afterfivehoursinthegrocerystore,wecamebacktoputourmenustogether.Atfirst,weweremainlyconcernedaboutourbudget,butoncewefinishedourmenu,wewereactuallyunderbudget.Thenwerealizedourbiggestproblem—calories.Wedidsowelloncontrollingsodiumandpricingthatweonlyhadabouthalfofthedailyrecommendedcalorieintake,whichis2,000caloriesfortheaverageperson.Themenuwasalso

Lindsey Helms, PharmD Candidate 2015, PCSPSarah Robbins, PharmD Candidate 2015, SCCP-USC

lackingintherecommendedservingsoffruit,dairy,andvegetablesperday.Wecalculatedtotalcalories,fat,carbohydrates,sugar,protein,andsodium,aswellastherecommendedservingsneededofmeat,dairy,fruit,vegetables,grains,fatsandoils.Aswesetbackoutonanothergrocerytrip,wekeptinmindourbudget,recommendedcalorieintake,andrecom-mendedfoodgroupservings.

Weneverthoughtaddingcalorieswouldbeachal-lenge,butwewereabletoincreasethecaloriesto2,000caloriesperdaywhilemeetingtherecommend-edfoodgroupservings.However,oncewetotaledthecosts,thenewmenuwasnowoverbudget.Backtothedrawingboardwewent.Howcouldwecutcostswhilemaintainingallrecommendationsforsodiumanddailyfoodgroupservings?Wewantedtobere-alisticinthesensethatnoonewantstoeatthesamemealmultipletimesduringaweek.Everyonewantsahealthful,nutritiousmealthatalsotastesgood.Thebestoptionwastoswapoutfooditemsforsimilaroneswhichcostless,buthadsimilarvalueinnutri-tion.Forexample,wehadtosubstitutecheeseforyogurtasasnack.Eatinghealthilyonastrictbudgetmeansmakingsomesacrifices,butwewerestillabletocreateanourishingmenufullofdiverseoptions.

Numerouswebsitesandresourcesareavailableforeatingonabudgetandincorporatingnutritiousfoodsintoone’slifestyle.However,therearefewreliableresourcestakingbothhealthandcostintoconsid-eration,especiallyconsideringthetightbudgetonSNAPbenefits.Wedidnotuseortakeintoaccount

STUDENTS


anyadditionalresources,suchasWIC(Women,Infants,andChildrenNutritionProgram),freeschoollunchprograms,oranyotherfoodassistanceprograms.Althoughchildrenwouldmostlikelybereceivingfreeschoolbreakfastand/orlunch,westillcountedtheirmealsintothebudget,forthosewhomaynotreceivethisbenefit.Wedidnotuseanycouponsorpricematchingfromothergrocerystoreadswhencreatingthisplantokeepitsimpleandconservative.However,wecouldhavereceivedmuchcheaperpriceshadweusedcouponsandpricematching.

Intheend,ourhealthymealplancameouttobe~$20/dayforatotalof$603/month.Bythoroughlyexaminingthenutritionalinformationandcostofeveryingredientineachmeal,ourfinalmealplancamein$17underthemonthlybudget.Assemblingthismenuprovedtobechallengingandtimecon-suming,yetenlightening.Thisplanprovidesagreatexampleofalow-sodium,balanceddietforanyoneonatightbudget.Manypeoplearefortunateenoughtoneverneedthisinformation.Butforthe840,000peopleinSouthCarolinathatareusingSNAPben-efits,hopefullythiswillbehelpfulformaintainingahealthylifestyle2.Sincewetooksomuchtimeandeffortcompilingallthisinformation,wethoughtweshouldalsoshareitwithourpharmacycommunitysothatyoucanhaveausefulguidelineatyourdisposalshouldtheneedarisewhencounselingapatient.

ReferencesPrice and nutrition information was obtained from visiting a local supermarket and examining food item labels.

References for Introduction1. SNAP benefits calculator. South Carolina Depart-ment of Social Services. Accessed 30 July 2014. URL: https://dss.sc.gov/content/customers/food/foodstamp/food-stampcalc.aspx2. Fraser R. Facts about hunger in South Carolina. Feeding America. Updated: 18 Sept 2012. Accessed 30 July 2014. URL: http://feedingamerica.org/press-room/press-releases/south-carolina-facts.aspx

References for Patient Handout1. National Heart, Lung, and Blood Institute. Heart healthy home hooking: African American style. Accessed 30 July 2014. National Institutes of Health. US Depart-ment of Health and Human Services. URL: http://www.nhlbi.nih.gov/files/docs/public/heart/cooking.pdf2. National Heart, Lung, and Blood Institute. Keep the beat recipes: deliciously healthy dinners. National Institutes of Health. US Department of Health and Human Services. Accessed 30 July 2014. URL: http://healthyeat-ing.nhlbi.nih.gov/pdfs/Dinners_Cookbook_508-compliant.pdf3. National Heart, Lung, and Blood Institute. Keep the beat recipes: deliciously healthy family meals. National Institutes of Health. US Department of Health and Human Services. Accessed 30 July 2014. URL: http://healthyeat-ing.nhlbi.nih.gov/pdfs/KTB_Family_Cookbook_2010.pdf4. National Heart, Lung, and Blood Institute. Low-ering your blood pressure with DASH. National Institutes of Health. US Department of Health and Human Services. Accessed 30 July 2014. URL: http://www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf5. National Heart, Lung, and Blood Institute. What is blood pressure? National Institutes of Health. US De-partment of Health and Human Services. Accessed 30 July 2014. URL: http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/6. National Heart, Lung, and Blood Institute. Your guide to lowering blood pressure. National Institutes of Health. US Department of Health and Human Services. Accessed 30 July 2014. URL: http://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf7. Newens J, Dickhaut S. Basic cooking. Santa Rosa, CA: . Silverback Books Inc.; 2000.8. United States Department of Agriculture. Healthy eating on a budget. URL: Choosemyplate.gov

How to use the handouts for your patients:

The next eight pages contain helpful handouts for your patients. The first handout is a two-sided tri-fold bro-chure. The second handout includes a sample 7-day menu, fresh produce calendars, and resources for patients.

Feel free to make copies of this and use it as a bag insert or keep on hand in a brochure display.

STUDENTS

Prov

ided

by

your

pha

rmac

ist a

nd th

e

Sout

h Ca

rolin

a Ph

arm

acy

Asso

ciati

on

Wha

t is S

odiu

m?

Acco

rdin

g to

the

Nati

onal

Insti

tute

s of H

ealth

, sod

ium

in

an e

lem

ent t

hat t

he b

ody

uses

to c

ontr

ol b

lood

pre

ssur

e an

d bl

ood

volu

me.

Tab

le sa

lt co

ntai

ns so

dium

, and

salt

is th

e m

ost c

omm

on fo

rm o

f sod

ium

. Low

am

ount

s of s

odi-

um o

ccur

nat

ural

ly in

mos

t foo

ds, b

ut p

acka

ged

and

pro-

cess

ed fo

ods o

ften

have

hig

h am

ount

s of s

odiu

m a

dded

to

mai

ntai

n fla

vor a

nd sh

elf l

ife. E

ating

a d

iet w

ith to

o m

uch

sodi

um c

an le

ad to

hig

h bl

ood

pres

sure

and

flui

d re

tenti

on.

How

doe

s Sod

ium

Affe

ct B

lood

Pre

ssur

e?

Eatin

g a

diet

with

too

muc

h so

dium

can

lead

to h

igh

bloo

d pr

essu

re a

nd fl

uid

rete

ntion

, whi

ch p

lace

s add

ed

stre

ss o

n th

e he

art a

nd k

idne

ys. E

ven

thou

gh y

ou m

ay n

ot

feel

thes

e eff

ects

, ove

r tim

e, th

is ca

n in

crea

se y

our r

isk o

f he

art d

iseas

e, in

clud

ing

hear

t att

ack

and

stro

ke.

To re

duce

the

risk

of th

ese

com

plic

ation

s, it

is re

com

-m

ende

d to

kee

p yo

ur b

lood

pre

ssur

e be

low

this

goal

.

Bloo

d Pr

essu

re G

oals

Age

is 60

yea

rs o

r old

er

Syst

olic

Blo

od P

ress

ure

< 15

0 m

mHg

Di

asto

lic B

lood

Pre

ssur

e <9

0 m

mHg

Age

is yo

unge

r tha

n 60

ye

ars o

ld

Syst

olic

Blo

od P

ress

ure

< 14

0 m

mHg

Di

asto

lic B

lood

Pre

ssur

e <9

0 m

mHg

Eatin

g a

diet

low

in so

dium

can

hel

p lo

wer

you

r blo

od

pres

sure

. Rec

omm

enda

tions

stat

e to

kee

p so

dium

con

-su

mpti

on b

elow

2.3

gra

ms (

or 2

300

mg)

of s

odiu

m p

er

day.

For

eve

n be

tter

resu

lts, a

lim

it of

1.5

gra

ms (

or 1

500

mg)

of s

odiu

m p

er d

ay is

reco

mm

ende

d. T

he g

ood

new

s is

that

low

er so

dium

food

s ten

d to

be

heal

thie

r in

othe

r as-

pect

s, su

ch a

s hav

ing

low

er c

hole

ster

ol a

nd lo

wer

fat.

Ea

ting

heal

thie

r foo

ds w

ith lo

wer

sodi

um, a

long

with

en-

gagi

ng in

dai

ly p

hysic

al a

ctivi

ty, c

an g

o a

long

way

tow

ard

low

erin

g yo

ur b

lood

pre

ssur

e an

d ke

epin

g yo

ur h

eart

he

alth

y.

Begi

n by

look

ing

at th

e Se

rvin

g Si

ze

The

serv

ing

size

tells

you

the

exac

t am

ount

of f

ood

incl

ud-

ed in

one

serv

ing,

as w

ell a

s the

tota

l ser

ving

s tha

t are

in

the

pack

age.

Pac

kage

s can

ofte

n be

misl

eadi

ng in

rega

rds

to th

e nu

mbe

r of s

ervi

ngs.

Be

sure

to c

heck

the

num

ber

of se

rvin

gs p

er c

onta

iner

.

Perc

ent D

aily

Val

ues

The

perc

ent d

aily

val

ues a

re c

alcu

late

d ba

sed

on a

200

0 ca

lorie

die

t for

one

day

. Thi

s can

be

easie

r tha

n lo

okin

g at

m

illig

ram

s and

gra

ms t

o ad

d up

the

tota

l fat

or s

odiu

m

you

are

getti

ng. I

f one

serv

ing

has

470

mg

of so

dium

and

is

20%

of y

our d

aily

val

ue, t

hen

that

shou

ld b

e 20

% o

f yo

ur so

dium

inta

ke fo

r the

enti

re d

ay.

Thin

gs to

lim

it Tr

y to

lim

it th

e am

ount

of f

at, c

hole

ster

ol, a

nd so

dium

th

at y

ou e

at e

ach

day.

Rea

ding

the

nutr

ition

fact

s la

bel

will

hel

p yo

u de

term

ine

the

amou

nt th

at is

in e

ach

serv

-in

g an

d th

e am

ount

you

are

getti

ng a

s par

t of a

tota

l dai

ly

diet

. Don

’t fo

rget

to lo

ok fo

r key

wor

ds o

n th

e fr

ont o

f the

fo

od p

acka

ge la

bel.

If it

says

cur

ed, p

ickl

ed, s

mok

ed, o

r br

oth,

it w

ill h

ave

a hi

gh so

dium

con

tent

. If i

t is l

ow fa

t or

low

suga

r, it

may

hav

e in

crea

sed

sodi

um to

mak

e up

for

the

tast

e.

On

left:

One

4 o

z. (1

13 g

) pie

ce o

f cod

is 6

0 ca

lorie

s, 0

g

fat,

45 m

g ch

oles

tero

l, an

d 51

0 m

g so

dium

. O

n rig

ht:

One

4 o

z. (1

13 g

) pie

ce o

f tila

pia

is 10

0 ca

lorie

s,

1.5

g fa

t, 50

mg

chol

este

rol,

and

25 m

g so

dium

.


Yes! W

ith thoughtful planning, shopping, and cooking, feeding a fam

ily of four a healthy, low sodium

diet can be done. Included here are tips to help you low

er the sodium

in your diet, as well as tips to help you save

money.

To get you started, an entire week of m

eals has been planned w

ith sodium levels and food costs in m

ind. This m

enu uses an estimated budget of SN

AP benefits for a fam

ily of four, while m

aintaining daily sodium consum

p-tion below

the goal of 2.3 g (or 2300 mg) for each per-

son. All the price and nutrition information included in

these meals w

as gathered from a trip to a local low

-price superstore. O

nly products actually available in the store w

ere used when planning the w

eeklong menu.

Sample Recipe: Healthy Ham

and Beans IN

GREDIEN

TS ½

medium

onion 2 cloves garlic 2 pounds sm

oked ham hocks

8 cups water

1 pound frozen lima beans

½ teaspoon ground black pepper

DIRECTION

S 1. Peel, rinse, and chop onion. Peel and m

ince garlic. 2. In a large pot over high heat, add ham

hocks and wa-

ter. Bring to a boil. Reduce heat to a simm

er. Add onion and garlic. Cover and cook until m

eat is tender and internal tem

perature registers 145°F on a food ther-m

ometer, about 30-40 m

inutes. 3. Transfer ham hocks

to a clean cutting board. Let cool.

4. Add lima beans to pot. Cook according to package

directions. 5. W

hen ham hocks are cool, shred m

eat from the bone,

removing any fat. Return to pot. Stir in pepper. If using

salt, stir in now.

Substitute for low

er-sodium item

s

Sodium

is high in many snack foods. Instead of chips

or crackers, eat a piece of fruit or raw vegetable, like

carrot sticks.

Fresh or frozen produce contains less sodium

than canned versions.

Look for “low

sodium,” “reduced sodium

,” or “no salt added” versions of food item

s.

Before cooking fresh m

eats and canned foods, such as tuna and beans, rinse them

with w

ater to wash aw

ay excess sodium

.

W

hen preparing pasta, rice, potatoes, or oatmeal,

cook them w

ithout adding salt. Avoid packages of in-stant or flavored pasta, potatoes, and rice, as they usually have added salt.

M

ake your own salad dressings and sauces, because

store-bought versions are usually high in sodium.

Drink w

ater at most m

eals, add a lemon or lim

e w

edge for flavor.

Instead of using salt to add flavor to your food, add spices, herbs, lem

on or lime, vinegar, or salt-free sea-

sonings. If you’re used to adding a lot of salt to your food at the table, start by cutti

ng the amount of salt

added in half and then gradually decrease the amount

of salt added.

W

hen you eat out, ask about how foods are m

ade. Ask your order to be m

ade without adding sodium

or salt-containing ingredients. Choose vegetables instead of salty sides, and lim

it condiments and sauces, w

hich contain high am

ounts of sodium.

$ W

hen shopping for groceries, look for generic store brand products if available because they tend to be cheaper than brand-nam

e items. How

-ever, som

e store brands may not sell a low

-sodium

version of a product, so you may need to

look at multiple brands to find the best low

sodi-um

option.

$ Buying larger package sizes is often cheaper per ounce or per cup of the item

you’re buying. For m

eats, freeze any unused portions to use at a later date.

$ Fresh fruits and vegetables have low

er sodium

than canned versions. Therefore, it is important

to know w

hen various fruits and vegetables are in season because they w

ill be cheapest during this tim

e. At other times of the year, frozen versions

with no salt added m

ay be a cheaper option. A chart w

ith the best time to buy produce is includ-

ed at the end of this handout.

$ Plan a w

eek or two w

eeks of meals at a tim

e and buy everything you need in one trip. This w

ay, you can use less gas driving to the store.

$ For fam

ilies who are especially busy during the

week, try m

aking all your meals in advance.

Choose one day to prepare all your meals.

$ U

se coupons and ad-match program

s to find the best prices w

hen shopping.


Example Menu: Day 1

Calo

ries

Sodi

um

(mg)

Cost

per

Se

rvin

g

Cost

per

4

Serv

ings

Breakfast Oatmeal with raisins, medium banana, wheat toast with peanut butter, and glass of milk 700 396 $0.94 $3.76

Lunch Salad with baked tilapia, saltines, unsweetened applesauce, and cheddar cheese 495 488 $2.29 $9.16

Dinner Hawaiian chicken with brown rice, broccoli, corn, whole grain dinner roll, and glass of milk 631 562 $1.89 $7.56

Snacks Homemade snack mix 134 63 $0.21 $0.84

Total 1960 1509 $5.33 $21.32 Day 2 Breakfast

Crisp rice cereal with cup of milk, mixed fruit, and wheat toast with peanut butter 585 620 $1.06 $4.24

Lunch Chicken sandwich, cabbage slaw, potato wedges, banana 575 448 $1.45 $5.80

Dinner Brunswick stew with frozen yogurt and strawberries 666 411 $1.56 $6.24

Snacks Large apple, orange juice 165 7 $0.54 $1.72


Oatmeal with cinnamon, medium banana, and yogurt 422 152 $0.74 $2.96 Lunch

Tuna salad on wheat toast with animal crackers, peanut butter and celery sticks, and mixed fruit 557 831 $1.91 $7.64

Dinner Garden turkey meatloaf with baked potato, cabbage slaw, and whole grain dinner roll 667 406 $1.64 $6.56

Snacks Large apple, glass of milk, and cheddar cheese 330 312 $0.96 $3.84

Total 1976 1701 $5.25 $3.84


Day 4

Calo

ries

Sodi

um

(mg)

Cost

per

Se

rvin

g

Cost

per

4

Serv

ings

Breakfast Oatmeal with raisins, yogurt with strawberries, and glass of milk 503 280 $1.12 $4.48

Lunch Crunchy chicken salad with unsalted saltines, animal crackers, and medium banana 448 387 $1.01 $4.04

Dinner Spaghetti and meatballs, cabbage slaw, and broccoli 594 225 $2.41 $9.64

Snacks Large apple with peanut butter, glass of milk 410 222 $0.81 $3.24


Scrambled egg substitute, wheat toast with peanut butter, medium banana, and glass of milk 480 576 $1.01 $4.04

Lunch Tuna cucumber wrap with brown rice, large apple, and homemade snack mix 589 508 $1.60 $6.40

Dinner Oven-fried chicken with baked potato, mixed vegetables, whole grain roll, and frozen yogurt with strawberries 773 633 $1.67 $6.68

Snacks Animal crackers 120 105 $0.15 $0.60


Apple cinnamon oatmeal with yogurt and mixed fruit 439 160 $1.19 $4.76 Lunch

Pasta salad with wheat crackers and cheddar cheese 638 435 $1.66 $6.64 Dinner

Baked tilapia with brown rice, green beans, peas and carrots, and a whole grain dinner roll 423 332 $1.60 $6.40

Snacks Banana with peanut butter, animal crackers, glass of milk 525 326 $0.72 $2.88

Total 2025 1253 $5.17 $20.68



Find free cookbooks on choosemyplate.gov:

Day 7

Calo

ries

Sodi

um

(mg)

Cost

per

Se

rvin

g

Cost

per

4

Serv

ings

Breakfast Breakfast burrito with medium banana, wheat toast, and glass of milk 566 663 $1.24 $4.96

Lunch Oven-fried chicken fingers with potato wedges and large apple with peanut butter 710 483 $1.68 $6.72

Dinner Healthy shepherd’s pie 379 703 $1.04 $4.16

Snacks Baby carrots, yogurt with strawberries, and wheat crackers 290 180 $1.16 $4.64

Total 1945 2029 $5.12 $20.48 For additional recipes, check out these sites:

healthyeating.nhlbi.nih.gov/default.aspx www.choosemyplate.gov

For additional information on blood pressure and low sodium diets, visit: www.nhlbi.nih.gov/health/health-topics/topics/hbp/

When Is Produce in Season?

Fresh Vegetable Calendar Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Bell Peppers Broccoli Carrots Celery Green Beans Lettuce Onions Peas Potatoes Spinach leaf Tomatoes


Fresh Vegetable Calendar Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Bell Peppers Broccoli Carrots Celery Green Beans Lettuce Onions Peas Potatoes Spinach leaf Tomatoes

Fresh Fruit Calendar Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Apples Bananas Blueberries Grapes Lemons Oranges Peaches Pears Pineapple Strawberries Watermelon

Key Supply is good, and prices are low. Supply is low, and prices are higher. Hardly any in the market. If available, prices are much higher.


Pharmacistsareoftenconsideredtobeoneofthemostaccessibleandconvenienthealthcareproviders.Thisaccessibilityisdueinlargeparttothefactthat93%ofUSresidentslivewithin5milesofacommu-nityretailpharmacy1.Featuressuchasdrivethroughwindowsand24houravailabilityhelpincreaseop-tionsforpatients.Thisaccessibilityandconvenience,combinedwithknowledgeofpatients’medicationhistories,allowspharmaciststheopportunitytoiden-tifyeligibleorhigh-riskpatientswhomaybenefitfromvaccinations.

In1996,theAmericanPharmacistAssociationcreateditsfirstimmunizationtrainingprograminMississippi.Thisprogramhassincebecomethegoldstandardforimmunizationtraining,beingrecognizedforitscontentandquality.In1999,APhAbeganli-censingschoolsofpharmacy,statepharmacyassocia-tions,andotherpharmacycorporationstoadministerthisprogram.Whilepharmacistsincertainstateshavebeenabletoimmunizesincethelate1970’s,itwasnotuntilthelate1990’sthatpharmacistimmuni-zationsbecameacceptedinmorestates.In1996,14states/territoriesallowedpharmacistimmunization.In2002,thenumberofstates/territoriesallowingpharmaciststoimmunizedoubledto30.Overthelast10years,thisnumberhasincreasedto52statesandterritories2.Itisinterestingtonotethattheincreaseinthenumberofstatesallowingpharmacistimmuniza-tionincreasedshortlyafterthelicensinganddissemi-nationofthestandardizedAPhAPharmacy-BasedImmunizationDeliverytrainingprogram.Thecurrentversionofthistrainingprogramrequires12hours

ofself-studyaswellas8hoursofliveseminar,whichincludesassessmentofinjectiontechnique.Thispro-gramisverycomprehensiveandprovidesbackgroundonimmunologyandthevaccinepreventablediseases,discussestherolethatpharmacistshaveasimmunizersandadvocatesforvaccination,howtoidentifythosewhomaybenefitfromimmunizations,andhowtooperateapharmacybasedimmunizationprogram3.

Whilemanypeopleassociatepharmacybasedimmuni-zationexclusivelywiththeinfluenzavaccine,phar-macyadministeredimmunizationprogramscanconsistofmanymorevaccines.Examplesincludethepneu-mococcal,zoster,tetanus,diphtheria,pertussis,HPV,andtravelvaccines.Infact,44states/territoriesallowpharmaciststoadministeranyvaccineanddonotrestrictpharmaciststocertainimmunizations4.Floridaisasanexampleofastatethatrestrictspharmacistvaccinationauthority,bylimitingimmunizationstotheinfluenza,pneumococcal,andzostervaccines,whileSouthDakotalimitsitspharmaciststotheinfluenzaandzostervaccines4.

Therearethreewayspharmacistsmayimmunize:viaapatientspecificprescription,throughprescriberis-suedprotocols,andstatelegislation.Apatientspecificprescriptionistypicallylessrestrictiveinregardstoageorvaccinelimitations.Prescriber-basedprotocolstendtohavemorerestrictionswrittenintoindividualstatelawinregardstopatientageandimmuniza-tionsthatmaybeadministered,aswellaswhetherornotapharmacyinternmayadministerthevaccine.Statelegislationdiffersforeachstate.SouthCarolina

Pharmacy-Based Immunization

STUDENTS

By Andrew Stoessel,South Carolina College of Pharmacy, USC PharmD Candidate, 2015


legislationallowsforaBoardofMedicalExaminersissuedprotocolthatoutlinestheauthorityofpharma-ciststoadministertheinfluenzavaccinewithoutanorderfrompractitioner.Thisprotocolsetsoutre-quirementsfortrainingandsuppliesthatimmunizingpharmacistsmusthave.RequirementsincludeCPRcertification,continuingimmunizationeducation,andspecifiedsupplies.

Theconvenienceofpharmacy-basedimmuniza-tionprogramshasbeenhighlytouted.A2004studyshowedthatasmorestatesallowedpharmaciststovaccinate,theimmunizationratesinthosestateswerehigherthantheratesforstatesthatdidnotallowpharmacistvaccinations,suggestingthatpharma-ciesaren’tjustshiftingpatientsawayfrommedicalclinics,butidentifyingnewpopulations5.Similarly,astudydocumentedintheCDCMorbidityandMortal-ityWeeklyReportreportedfindingthatadultswhoselastroutinedoctorvisitwasmorethan1yearpriorweremorelikelytobevaccinatedforinfluenzainanonmedicalsettingsuchasapharmacy.Thissug-gestedthattheavailabilityofinfluenzavaccineinnonmedicalsettingscancomplementhealthcareprovidereffortsbyreachingpopulationslesslikelytobeseenbyproviders6.Additionally,aretrospec-tivestudyofvaccinationsbyWalgreenspharmacistsduringAugust2011andJuly2012wasconductedtoanalyzetypesofvaccinesadministeredandpatientpopulationsvaccinatedduringoff-clinichours.Off-clinichourswereconsideredtobe6:00PM-9:00AM,weekends,andallfederalholidays.Ofthemorethan6millionvaccinesadministered,30%(around1.8million)wereduringoff-clinichours7.

Whilepharmacybasedimmunizationdeliveryisveryimportantforpublichealth,itisveryimportanttokeepinmindthatthepracticeofpharmacyisregulat-edbyeachindividualstate.Immunizationauthorityandregulationmayvaryconsiderablybetweenstates,soitisimperativethatoneknowthelawsofeachstateinwhichtheypractice.

SouthCarolina’sBoardofMedicalExaminer’swrit-tenprotocolauthorizespharmaciststoadministertheinfluenzavaccinetopersonsovertheageofeighteen.Itfurtherauthorizestheadministrationofcertainpre-specifiedmedicationsnecessaryinthetreatmentofadverseevents.Immunizingpharmacistsmustsuc-cessfullycompleteanauthorizedimmunizationtrain-ingprogram.Furtherrequirementsincludeobtainingsignedinformedconsent,maintainingarecordof

vaccineadministration,informingthepatient’spri-marycarephysician,andmaintainingacurrentcopyofthestateprotocolinthepharmacy,andmaintain-ingrecordsforasixyearperiod.Pharmacistsareexpresslyforbiddenfromdelegatingadministrationofinfluenzavaccinestoapharmacytechnicianorayotherpersonwhoisnotapharmacist,suchasphar-macyinterns.

IntheFall/Winterlegislationsession,theSouthCaro-linaPharmacyAssociationwillintroducelegisla-tionthat,ifpassed,wouldexpandtheimmunizationauthorityofSouthCarolinapharmacists.Underthisnewlegislation,pharmacistswouldhavetheauthor-itytoadministeranexpandedsetofvaccineswithoutapatientspecificorderfromapractitioner.Thisnewlegislationwouldalsoallowpharmacyinternstoadministervaccines.TheFall/WinterlegislationwillbeanexcitingtimeforpharmacyinthestateofSouthCarolina. References1. RxImpact Community pharmacy brings innova-tion to patient care. Drug Store News Web site. http://www.drugstorenews.com/rximpact-2012. Published March 2012. Accessed May 25, 2014.2. Rothholz, Mitchell C. The role of community pharmacies/pharmacists in vaccine delivery in the united states. Presented at: Advisory Committee on Immunization Practices (ACIP); June 19-20, 2013. Atlanta, Georgia. http://www.cdc.gov/vaccines/acip/meetings/downloads/slides-jun-2013/01-Pharmacies-Rothholz.pdf. Accessed May 25, 2014.3. American Pharmacists Association. Pharmacy-Based Immunization Delivery. http://www.pharmacist.com/pharmacy-based-immunization-delivery. Accessed May 25, 2014.4. American Pharmacists Association. Pharmacist Administered Vaccines. http://www.pharmacist.com/sites/default/files/files/Pharmacist_IZ_Authority_01_17_14.pdf. Accessed May 25, 2014.5. Steyer TE, Ragucci KR, Pearson WS, Mainous AG. The role of pharmacists in the delivery of influenza vaccinations. Vaccine. 2004;22(8):1001-6.6. Centers for Disease Control and Prevention (CDC). Place of Influenza Vaccination Among Adults-United States, 2010-2011 Influenza Season. MMWR Morb Mortal Wkly Rep. 2011;60(23):781-785.7. Goad JA, Taitel MS, Fensterheim LE, Cannon AE. Vaccinations administered during off-clinic hours at a national community pharmacy: implications for in-creasing patient access and convenience. Ann Fam Med. 2013;11(5):429-36

STUDENTS


SCPhA House of Delegates Summary

2014 Award Recipients NCPA New President Leadership Award: Patti Fabel, PharmD

McKesson Incoming President Award: Patti Fabel, PharmD Smith Drug Co. Incoming President Award: Patti Fabel, PharmD

Outgoing Chairman Award: Steve McElmurray, RPh

New Life Members Eugene Sawyer Eugene Whitley Dwight Odom

Election Results President: Patti Fabel, PharmD

President-Elect: William Wynn, PharmD Speaker-Elect: Kayce Shealy, PharmD

At Large Director: Michael Gleaton, PharmD Midlands Region Director: Bryan Amick, PharmD, MBA Low Country Region Director: Kristy Brittain, PharmD

Midlands Region Delegates: Betsy Blake, PharmD Brian Clark, RPh

Lynn Connelly, RPh Craig Harmon, RPh Megan Montgomery, PharmD

Lowcountry Region Delegates: Jeff Brittain, PharmD Don Neuroth, RPh Wayne Weart, PharmD

2014-2015 Junior Board Members Caroline Arnette Rebecca Bates Lauren Linder Swati Mahajan Amber Moore Arathi Pillay Ethan Sebring Caleb Staggs Brittany Thompson Chelsea Wilson Kelsey Woods Taylor Yates

Convention Happenings

Continuing education Programming SCPhA’s Annual Convention schedule offered something for everyone, and this year, we couldn’t have been more excited with the variety of presenters and topics that offered! Attendees learned about topics such as pharmacists as collab-orative partners, immunization, leadership in pharmacy HR management, social media effectiveness, legal issues affecting pharmacy practice, chronic pain and pain management, finan-cial planning, independent pharmacy ownership, SC’s response to the pre-scription drug epidemic, self-care and new drug information. A special thanks goes out to all of our fabulous presenters– Bob Davis, Paul Fleming, Patti Fabel, Bryan Ziegler, Katie Pen-nington, Jon Wallace, John Dohn, Phil Piercy, Christie Frick, Joseph Shenkar, Adam Roberson, Ronald Delfidio, Sharm Steadman, Ezra Riber and Wayne Weart.

As always, feedback was positive for each of these topics, and attendees left with knowledge that will be useful in their pharmacy environments!

Contest Winners This year, we decided to “up our game” by challenging participants to several contests. Congratulations to winners in all con-tests, and thanks to everyone who participated!

Selfie Contest Winner Kelly Clark

Roaring Twenties Costume Contest Winners:

Best Male– Terry Blackmon Best Male Student– Shelton Johnson

Best Female– Frances Connelly Best Female Student– Stacie Silvers

South University Named 2014 Self-Care Bowl Winner The Second Annual Self Care Bowl took place at this year’s conven-tion, and once again, it was a hit! Supported through a grant from NASPA, the challenge was hosted by Sharm Steadman, PharmD, RPh, and featured teams from pharmacy campuses across South Carolina. This head-to-head battle tested students’ knowledge base of self-care. SCPhA would like to thank all schools for participation, and would like to congratulate South University for being this year’s win-ner! What a fun and creative educational session this was for partici-


Convention Happenings

Continuing education Programming SCPhA’s Annual Convention schedule offered something for everyone, and this year, we couldn’t have been more excited with the variety of presenters and topics that offered! Attendees learned about topics such as pharmacists as collab-orative partners, immunization, leadership in pharmacy HR management, social media effectiveness, legal issues affecting pharmacy practice, chronic pain and pain management, finan-cial planning, independent pharmacy ownership, SC’s response to the pre-scription drug epidemic, self-care and new drug information. A special thanks goes out to all of our fabulous presenters– Bob Davis, Paul Fleming, Patti Fabel, Bryan Ziegler, Katie Pen-nington, Jon Wallace, John Dohn, Phil Piercy, Christie Frick, Joseph Shenkar, Adam Roberson, Ronald Delfidio, Sharm Steadman, Ezra Riber and Wayne Weart.

As always, feedback was positive for each of these topics, and attendees left with knowledge that will be useful in their pharmacy environments!

Contest Winners This year, we decided to “up our game” by challenging participants to several contests. Congratulations to winners in all con-tests, and thanks to everyone who participated!

Selfie Contest Winner Kelly Clark

Roaring Twenties Costume Contest Winners:

Best Male– Terry Blackmon Best Male Student– Shelton Johnson

Best Female– Frances Connelly Best Female Student– Stacie Silvers

South University Named 2014 Self-Care Bowl Winner The Second Annual Self Care Bowl took place at this year’s conven-tion, and once again, it was a hit! Supported through a grant from NASPA, the challenge was hosted by Sharm Steadman, PharmD, RPh, and featured teams from pharmacy campuses across South Carolina. This head-to-head battle tested students’ knowledge base of self-care. SCPhA would like to thank all schools for participation, and would like to congratulate South University for being this year’s win-ner! What a fun and creative educational session this was for partici-

SCPhA is pleased to announce that Pamela Whitmire received the Cardinal Health Generation Rx Champions Award at SCPhA’s 2014 Annual Convention. This award recognizes pharmacy professionals who have demonstrated excellence in community-based prescription drug abuse prevention, as well as outstanding efforts within the pharmacy community to raise awareness if this serious public health problem.

Pam is an advocate for patients who have suffered from prescription drug abuse but are working to break the addiction. She has provided numerous talks to students, healthcare providers, and law enforcement to educate about the dangers of prescription drug abuse as well as to clear up some common misconceptions about the treatments for drug abuse.

Pam is currently the Treasurer of SCPhA and serves as Parliamentarian at the House of Dele-gates. She was recently awarded fellow-status with APhA, demonstrating sustained service and contributions to that organization. She precepts students from multiple pharmacy schools in the state, and serves as an experiential coordinator with South University. All of this on top of being PIC at her place of employment. She is also a past president of SCPhA.

The Distinguished Young Pharmacist award was created in 1987 to encourage newer pharma-cists to become involved in association activities and civic projects, and to recognize one such pharmacist in each state for individual excellence and outstanding contributions.

This year’s recipient is Jeff Brittain, a committed citizen and early on committed himself to service with the United States Air Force upon graduation from pharmacy school. One of Jeff's greatest areas of work has been through his efforts to streamline IV dose preparation at MUSC. Through 2011 and 2012, the technology (DoseEdge) was implemented first in the MUSC Children's Hospital and the Hollings Cancer Center and later in other areas of the hos-pital where preparation of IV medications are made. In addition to Jeff’s work with DoseEdge, he has been active in many other safety initiatives at MUSC in relation to medication use, including his work with the implementation of computerized provider order entry (CPOE) and now the conversion to a new electronic health system (Epic). He was appointed as an Ad-junct Assistant Professor with the South Carolina College of Pharmacy in 2013 after evidenced contributions to the education of SCCP students and residents. Jeff serves as a resident pre-ceptor with the MUSC Pharmacy Residency Program and has been actively involved with the SCCP-MUSC chapter of Kappa Psi, the Charleston-based Kappa Psi Graduate Chapter and SCPhA.

"It is a great honor to be recognized among so many outstanding practitioners." -Jeff Brittain

The Excellence in Innovation award is a national award coordinated by the National Alliance of State Pharmacy Associations, and generously sponsored by Upsher-Smith Labora-tories, Inc. to recognize and honor a qualified pharmacist who has demonstrated significant innovation in their respective practice, method or service directly or indirectly resulting in improved patient care and/or advancement of the profession of pharmacy. This year’s recipient, Elliot Turner, deserves this award because he created his own position with Palmetto Health, a full time pharmacist working with doctors at Palmetto Health's Pa-tient Centered Medical Homes didn't exist before he created it. He has developed relation-ships with health care providers and patients; developed many of the protocols the PCMHs are following and is figuring out reimbursement models for pharmacists within the PCMH model. Due to his hard work, Palmetto Health has expanded his position, recently hiring two more part time pharmacists to help manage patient's medications within their PCMHs.

“I would like to sincerely thank SCPhA for this award. I am truly proud and blessed to be recognized by my peers in this way. I am also very honored to be in a list of award recipients as those who have previously received this award. I am so thankful to be part of an organization that is committed to pharmacy in South Carolina and thankful for the support I have received from my mentors and from this organization through the years. Again, thank you for this recognition.” - Elliot Turner


The Association is pleased to announce that Gene Reeder was awarded SCPhA’s 2014 Bowl of Hygeia Award. The Bowl of Hygeia is presented annually by participating pharmacy associations in each of the fifty states, the District of Columbia, Puerto Rico and the ten Canadian provinces. Recipients are selected by their respective association for their outstanding record of community service. The Bowl of Hygeia Award is sponsored by the American Pharmacists Association Foundation, The National Alliance of State Pharmacy Associations with support from Boehringer Ingelheim.

Dr. Reeder holds currently an appointment as Professor of Pharmacy at the Presbyterian College School of Pharmacy in Clinton, SC.

“I am truly honored, humbled and grateful to receive the Bowl of Hygeia Award. I am honored to be in-cluded among the many distinguished recipients of this award; humbled by what the Bowl of Hygeia personifies; and grateful to receive such a prestigious award.

While the Bowl of Hygeia is awarded annually to an individual pharmacist, it really belongs to all the people who contributed to that person's career and made his professional life richer and more fulfilling that he could ever have imagined. To my parents, teachers, colleagues, friends, and most of all my wife Nancy, I say a heart-felt thank you! “ -Gene Reeder

SCPhA is pleased to name Walter Hughes as 2014 Pharmacist of the Year, who is involved in all aspects of state and national legislative affairs and community service organizations.

Walter exemplifies the characteristics of this award. He is tremendously involved in both the pharmacy profession and his community. In addition to serving on numerous boards and organizations in the community, he also serves abroad through mission trips. He most recently helped with a Honduras housing project in February of this year. Walter is very involved on the legislative front, too. He has made numerous trips to both the state and federal legislatures lobbying on behalf of pharmacy. He rallies pharmacists in his area, too, to become involved in initiatives, such as sending emails at night about ways pharmacists can contact their legislator about MAC pricing.

"I would like to thank the South Carolina Pharmacy Association for the Pharmacist of the Year award. It is rewarding beyond measure to be in the company of such outstanding prior recipients. I would also like to thank all my fellow pharmacists, SCPHA CEO's, SCPHA staff, legal staff, and legislative consultants, with whom I have had the pleasure to work in many different areas throughout the years. I am blessed to have a wife and family who have been understanding and supportive in my involvement of the many issues facing pharmacy. The best award or reward we can have is the friendships we all share. You don't have to look far to find people helping our profession and the lives of those we serve. It has been a pleasure and a blessing to be surrounded by an incredible group of people. Thank you all." - Walter Hughes

SCPhA would like to congratulate Tonya Smith, 2014 Student Pharmacists of the Year. Tonya has been a tremendous student leader throughout her time at the South Carolina College of Pharmacy, MUSC Campus. She recently completed her fourth professional year and graduated in May 2014. Tonya has been actively involved in professional pharmacy organizations since her first professional year in the College. She became a member of the American Pharmacists Association Academy of Student Pharma-cists (APhA-ASP) during the fall of her first professional year and has held many offices, including Presi-dent, during her time in school.

“It is with sincere gratitude that I accept this award from the South Carolina Pharmacy Association. I consider it an honor to be recognized as a leader among graduating student pharmacists throughout the state of South Carolina and would like to offer my sincerest thanks to the many people who have guided me throughout the past four years. I am thankful for my mentors and professors at the Medical Universi-ty of South Carolina and the South Carolina College of Pharmacy who saw and nurtured potential within me, who encouraged me to take on leadership positions within our profession, and who motivated me to see challenges as opportunities to grow and learn. I am especially grateful to the South Carolina Phar-macy Association for the opportunity to serve on the Junior Board and work closely with influential prac-titioners from across the state of South Carolina. I am also indebted to my mentor, Dr. Kristy Brittain, who models professionalism and leadership to those around her and who gave countless hours of her time mentoring, listening to, and teaching me. I am humbled to be chosen for this award and will strive to carry on the legacy of leadership left by pharmacists who have preceded me by continuing to serve our profession and Association throughout my career.”- Tonya Smith


Each year, Smith Drug Company proudly recognizes the Outgoing Presidents of the South Carolina Phar-macy Association. This award recognizes the Outgoing President and Board Chair for leadership, sacrific-es and contributions to the association.

This year’s recipient, Steve McElmurray was an incredible leader, and deserves this award for his service. During his year as president, Steve provided a strong foundation for leadership, and gave countless hours of his time and energy to the profession.

In addition to his role as President, Steve also initiated the All-Pharmacy Conference, a group who’s pur-pose is to bring together, in one place, academia, state pharmacy organizations, state government agen-cies, such as the SC Board of Pharmacy, DHEC, Medicaid, and the State Solicitor’s office, as well as federal agencies such as DEA, CMS Regional and the Social Security Administration to discuss all things related to pharmacy. These meetings have proven to bring pharmacy together for the purpose of enhancing the profession in a way that benefits both the profession and the patients you serve, boasting more than sixty attendees for each meeting!

The Ralph M. Wilkie Award was created four years ago to recognize an SCPhA member who has demon-strated dedicated service and commitment to furthering the development of this organization and its members. This year was the first year that this award has been given since it’s creation, and was deserv-edly given to Wayne Weart for his outstanding dedication to the pharmacy profession.

“I am truly humbled and honored to receive this award, and need to thank so many as I have truly been blessed to be part of this wonderful profession and to be recognized for doing what I know that I was called to do and what I consider my hobby. I first want to recognize my awesome Lord and Savior who gave His life so that we could be part of His Church and provided an example of how we are to serve one another. Then I want to thank my loving and supporting wife, Patricia, and my family who have always stood at my side and supported everything I have ever done. I also want to thank my students, residents, faculty colleagues and all of the wonderful dedicated healthcare providers that I have had the opportunity to teach, mentor, serve with and learn from over the past 40 years, I cannot think of any better group of people! I cannot forget the SCPhA Board of Directors who decided to provide this award and the one who it is named for, our dear friend, colleague and mentor Ralph M. Wilkie, who has provided such an example for each of us as he has served our profession and this Association for more than 60 years, Thank you brother Ralph; you have been and continue to be a mentor to so many of us here tonight. Thank you my fellow pharmacists and may God continue to bless each of you and our wonderful profession.“ - Wayne Weart

This year, a new award was created to recognize individuals who promote and encourage students or pharmacists to attain leadership positions and excellence in the practice of pharmacy through example as role model and mentor.

The first recipient of this award, and the pharmacist for whom the award is named – Ken Couch, RPh – personally exemplified the award’s criteria. Over the years, Ken has helped numerous pharmacists open their own pharmacy and has served as a resource for countless others. In addition, he was the President of SCPhA in 1983-1984, the 1978 Bowl of Hygeia award winner, the 1999 Pharmacist of the Year award winner, and has been recognized as a Fellow by APhA-APPM. He has consistently inspired and mentored future leaders throughout his illustrious pharmacy career and continues to do so each year by hosting many pharmacy students at the Smith Drug Company facilities in Spartanburg, SC.

“I am truly honored and humbled to have received an award for leadership and for the mentoring of future Pharmacists. During my years of Pharmacy practice I worked with five young people that choose Pharmacy as a career. Some years later my daughter also chose that path. I am very proud. I believe that I have a passion for the profession and want to instill that same passion in every young person that chooses that path.” - Ken Couch


Community Pharmacy Response to PCMA’s Medication Synchronization Opposition

TheNationalCommunityPharmacistsAssociation(NCPA)welcomestheopportunitytoprovidearesponsetothePharmaceuticalCareManagementAssociation’s(PCMA)June19th memo, which circulated argumentsagainstmedicationsynchronization.NCPAwouldliketoclarifythatPCMAhasdisseminatedextremelymisguidedinformationregardingmedicationsynchronizationlegislation.1 PCMAhasclaimedthatsuch legislationisa“mandate”thatwould“createanadministrativelycomplexsystem”and“increasecosts.” PCMA’spositionechoestheirargumentsmadeinresponsetomostpro-AmericansmallbusinessandpatientcarelegislationsupportedbyNCPA.In actuality, however, medicationsynchronization legislationsimplyprovidespatients withthe option tohavethepharmacycoordinateallof their chronic ormaintenancemedicationstobefilledonthesamedateeachmonth,tofacilitategreateradherence,andimprovetheirhealth.Again,NCPAwouldliketomakeclearthatthisisnotaone-size-fits-allmandate,butratherasharedclinicaldecisionbetweenthe patient,prescriber, and thepharmacist.Inaddition,theprogramhasbeenshowntoimproveratesofmedicationadherence2 3 andthus,lower overallhealthcareexpenditures.4 5 NCPAandthosesupportingmedicationsynchronizationlegislationacrossthenationstronglyopposethemisguidedcommentsmadebyPCMAandwillcontinuetosupportmedicationsynchronizationeffortsnationwideaslegislationthatimprovesthehealthoutcomesforpatientsonmultiplechronicmedications, whileloweringoverallhealthcarecosts.WehopethatPCMAwillchoosetodothesame.

NCPArepresentsAmerica’sindependentcommunitypharmacists,includingtheownersofmorethan23,000communitypharmacies,pharmacyfranchisesandchains.Together,theyemployover300,000full-timeemployeesanddispensenearlyhalfofthenation’sretailprescriptionmedicines.

• Medication Synchronization is NOT administratively complex for the PBM: PCMAclaimsthatmedicationsynchronizationisan“administrativelycomplexprocess,”eventhoughalladministrativeworkiscompletedatthepharmacyanddoesnotnecessitateanyinvolvementwiththePBM.NCPAwouldliketoclarifythatmedicationsynchronizationis aservicetargetedspecificallytowardspatientswhorequire long term maintenance of a chronic condition.Ironically,PCMArecognizesthebenefitsofsuchsynchronizationwhentheystate intheirmemo that “it may improvethecarecoordinationforpatientsbyaligningtheirphysician,pharmacistandhealthplaninimprovingpatient’shealthstatus.”

• Medication Synchronization is NOT a mandate on the patient, plan or PBM: PCMAincorrectlyreferstothemedicationsynchronizationbillasa“mandate.”Rather,thisbillwould give thepatientthechoice to opt-in tomedicationsynchronizationshouldtheprescriberandthepharmacistdeemitbeneficial andappropriateforthepatient.TheCentersforMedicare&MedicaidServices(CMS),thelargestpayerforhealthcareinthenation,hasseenthebenefitsofmedicationsynchronization,andisimplementingseveralpolicychangesthatwillhelpremovecurrentbarrierstotheprocess,reducewastefromunnecessaryfills,andensurethatbeneficiariesareonlyreceivingthemedicationstheyneed.AsofJanuary1,2014,MedicarePartDsponsorsarerequiredtoapplyadailycost-sharingratetomostprescriptionsthataredispensedforlessthana30-daysupply.Thisprovidesacommonsenseapproachwhenapatientisjuststartingoutonnewtherapyandmaynotrequireafullmonth’ssupply,orisattemptingtosynchronizetheirrefills.

• Pharmacy understands that not all medications should be synched: Itshouldbenotedthatsomemedicationsarenotappropriatetobeinasynchronizedrefillprogram.Forexample,“as-needed”(PRN) medications forpain,ormedicationsforacuteconditionssuchasantibioticsareexcludedfromsynchronization.Additionally,productssuchas eyedrops,insulin,glucosestrips, andinhalersposechallengesduetotheirpackagingandvariablequantities.Forthisreason,itisnotadvisabletoincludesuchmedicationsinacoordinatedrefillprogram.

• Medication Synchronization is beneficial to patient’s health and lessens the burden of multiple pharmacy visits:PCMAfailstorecognizethatthislegislationwouldbenefitthepatient. Medicationsynchronizationisparticularly beneficialwhenthe patientis initiallyprescribedanewmedicationthathas significantsideeffects,themedicationis frequentlypoorlytolerated,themedicationmayposedrug-druginteractionswiththeircurrentregimen,andwhenlessthanamonth’ssupplyoftheprescriptionsisclinicallyappropriate.Additionally,medicationsynchronizationwillimprovetheongoing


2

issueofmedicationwastewhenmedicationsarechangedduringamid-30daysupply.

• Medication Synchronization improves adherence and lowers overall healthcare costs: WhilePCMAclaimsthatmedicationsynchronizationwouldraisecosts,theprogramhasbeenshowntoimproveratesofmedicationadherence6 7 andthus,loweroverallhealthcareexpenditures.8 9 Uponthepatient’srequest, medicationsynchronizationprovidesthepharmacy withtheabilitytocoordinate a patient’sprescriptions,withouthavingtopayafullmonth’scost-sharingwhenlessthanamonth’ssupplyofmedication(s)isdispensedduringthesynchronizationprocessuntilallmedicationsareonthesamethirtyormoredaysrefillschedule.

1 MedicationSynchronization,A.8975/S6773,2014NYGeneralAssembly.2 "Pharmacy'sAppointmentBasedModel:APrescriptionSynchronizationProgramThatImprovesAdherence." APhA Foundation White Paper (2013):1-13.Web.14July20143 "Appointment-BasedModel(ABM)DataAnalysisReport." Prepared for Thritfy White Pharmacy (n.d.):1-8.Web.14July2014.4 CongressionalBudgetOffice. Offsetting Effects of Prescription Drug Use on Medicare’s Spending for Medical Services.N.p.,29Nov.2012.Web.14July2014.<http://www.cbo.gov/publication/43741>.5 "ThinkingOutsidethePillbox:SixPrioritiesforActiontoSupportImprovedPatientMedicationAherence." New England Health Institute (2013):1-5.Web.14July2014.6 "Pharmacy'sAppointmentBasedModel:APrescriptionSynchronizationProgramThatImprovesAdherence." APhA Foundation White Paper (2013):1-13.Web.14July20147 "Appointment-BasedModel(ABM)DataAnalysisReport." Prepared for Thritfy White Pharmacy (n.d.):1-8.Web.14July2014.8 CongressionalBudgetOffice. Offsetting Effects of Prescription Drug Use on Medicare’s Spending for Medical Services.N.p.,29Nov.2012.Web.14July2014.<http://www.cbo.gov/publication/43741>.9 "ThinkingOutsidethePillbox:SixPrioritiesforActiontoSupportImprovedPatientMedicationAherence." New England Health Institute (2013):1-5.Web.14July2014.


APhA Recognizes SCPhA Members for Excellence Two individual members of SCPhA were recognized at APhA’s National Conference in Orlando, FL earlier this year.

We would also like to recognize the Zeta Chapter of the South Carolina College of Pharmacy on winning The Phi Lambda Sigma Charles Thomas Leadership Challenge Grant. This grant focuses on recognizing and promoting leadership in the pharmacy profession, Congratulations to each of these recipi-ents!

I would like to thank each member of SCPhA for your support as I served as your President

this past year– what a rewarding adventure and experience!

The Convention was great and planned well by our staff at the Association. The pinnacle of

the year for me was to present the Ralph Wilkie Award to Wayne Weart, and then to an-nounce and present the new Ken Couch lead-

ership award with my colleague and dear friend Pam Whitmire to Ken Couch.

Many thanks! - Steve McElmurray,

SCPhA President 2013-14

SCPhA Secretary Pamela Whitmire was named as an APhA Fellow. This well-deserved honor recognized Dr. Whitmire’s sustained commitment and contributions to excellence in pharma-cy, active involvement and leadership in APhA, SCPhA and other profes-sional organizations, as well as active involvement and commitment to edu-cating practitioners and others. Long-standing member of SCPhA, Ralph Wilkie was named as Phi Lamb-da Sigma’s National Alumnus of the Year for 2014. This distinguished award is presented to Ralph for his exemplary leadership qualities in sup-port of the pharmacy profession.


IhavespentthelastmonthonanacademiarotationatPresbyterianCollegeSchoolofPharmacy(PCSP).I’llbehonest-Ididnotplanondoinganacademiarotationmyfourthyear,butonewasonmyfinalschedule.Ithoughtaboutswitchingitforsomethingelse,butdecideditmightbenicetohaveachangeofpaceandslowthingsdownasmyfourthyearcametoanend.However,“slow”isnotawordIwouldusetodescribethisrotation.Idiscoveredthisinmyfirstweek.Ithasbeenaneye-openingexperiencetoseepharmacyschoolfromtheotherside.Asastudent,Ineverstoppedtoconsidertheworkthatwentintopreparingaclass,muchlessanentirecurriculum.Ihavehadtheopportunitytobeinvolvedindidactic,service,andscholarshipactivitiesonthisAPPEaswellastoseehowfacultyalsobalancetimeattheirpracticesites.

Amajorityofthisrotationhasbeenspentpreparingandfacilitatingactivitiesforbothelectiveandlabora-toryclasses.Ididnotrealizetheamountofworkthatwasrequiredtocompleteeventhesimplestofplansforstudents.Ispentasolidfourtofivehoursplan-ningalabactivitythattookstudentsalittleover75minutestocompleteandturnin,butIenjoyedtheas-signment.IhavealwaysbeenproudofthefacultyatPCSP.IhaveagreaterappreciationfortheworkofafacultymemberasIhaveexperiencedthatresponsi-bilityandtimecommitment.

Ihadtheopportunitytoattendfacultyandpharmacypracticedepartmentmeetings,aswellasserveasamemberofafacultysearchandcurriculumcom-mittee.Ievaluatedstudentpresentations,proctoredexams,andpreparedamanuscriptforsubmissiontotheAmericanJournalofHealth-SystemPharma-cists.WhileobservingpracticeatLaurensFamilyMedicine,Ilearnedmoreaboutcollaborativeprac-ticeagreementsandsawclassmatesworkwiththephysicians.Ithasbeenabusyfourweekswithnewopportunitiesforinvolvementindifferentprojects.

PCSPalwaysencouragesparticipationincommunityserviceactivitiesandhasitbuiltintothecurriculumandourmissionstatement.Theschoolisdevotedtoofferingtimeandservicewherethereareneedstobemet.Inadditiontolearningaboutthedidactic

sideofbeingafacultymemberIalsohadanopportunity to participateinMealsonWheelswithmyprecep-tor. As busy as facultycanbe,theystillcarveouttimefromtheirschedulestobepartofthatmissionandtrulypracticewhattheypreach.MealshadtobedeliveredtofourpeoplethatdayandeachofthemreceivedValentines.Itwasevidentfromtheirsmilesthattheyappreciatedusthinkingofthem.Smallthingsmakeabigdifference.

Overthepastmonth,Ihavebeenhumbledwithmyexperienceduringthisrotationandbelieveittakesaspecialpersontodothisjob.IamgratefulfortheeducationIhavereceivedatPCSPandcouldnotaskforbetterprofessorstohelpguidetheway.Beingpartoftheinauguralclass,ourteachershavehadanimmenseresponsibilitytobuildaninstitutionthatnotonlywillhelpshapethenextgenerationofpharmacists,butalsothatthey“raise”agenerationofstudentswithcharacter.Thankyouforthemanylessons. Forstudentsselectingtheir4thyearpharmacyexpe-riences,Irecommendpursuinghighqualityrotationsinvariousspecialtysettings.Findpreceptorsthatyouknowaregoingchallengeyou,encourageyoutouseyourclinicalskills,andpushoutsidethebox.Truegrowthhappensoutsideyourcomfortzone.Yourlastyearwillflybyinablinkofaneye.Youwilllearnmorethanyoueverdidintheclassroom.Makethebestofitandprosperwhereyouareplanted.

Elizabeth Horne, PharmD is a 2014 graduate of the Presbyterian College School of Pharmacy. A native of Ab-beville, South Carolina, Elizabeth received her Bachelor of Science in Chemistry from the University of South Caro-lina. She currently resides in Charlotte, North Carolina and is a pharmacist with CVS Pharmacy.

Academia APPE at PCSP: A Student’s Perspective

ElizabethS.Horne,PharmDPreceptor:JenniferN.Clements,PharmD,BCPS,CDE,BCACP

STUDENTS

Contact: Christa Hampton Director, Marketing [email protected] 864.582.1216

FOR IMMEDIATE RELEASE:

Smith Drug Company Selects Creative Pharmacist to Help Community Pharmacies Improve Patient Engagement and Increase Revenue

EVANS, GA – JULY 15, 2014 Smith Drug Company, one of the largest independent pharmaceutical distributors in the U.S. dedicated to independent community pharmacies, today announced its partnership with Creative Pharmacist. “The healthcare landscape continues to change dramatically. The shift from paying for a product to paying for the healthy outcome of the patient is squarely in front of each of our independent pharmacy customers,” said Ken Couch, RPh, President of Smith Drug. “By partnering with Creative Pharmacist, we can help our customers launch and build clinical services for their patients – services that have been proven to improve patient engagement, drive better medication adherence, and increase a pharmacy’s revenue.” The offering is available to all Smith Drug Company customers under the HealthWise Clinical Solutions program and will include a diabetes-only offering and an all-inclusive offering which features a high level of engagement from a Creative Pharmacist consultant. “Creative Pharmacist believes that by equipping the local, community pharmacist with the right tools and resources as well as supporting and empowering them with an engaged, knowledgeable consultant that the pharmacist will improve patient outcomes, insisted David Pope, PharmD, CDE, Chief of Innovation at Creative Pharmacist. “We are excited about our partnership with Smith Drug Company and we’re looking forward to working with their pharmacists to improve the overall health of their patients.” The two companies will kick-off the new partnership at the 20th annual Continuing Education & Trade Show event held July 24th-26th in Savannah, GA. About Smith Drug Company Based in Spartanburg, SC, Smith Drug Company was established in 1944 and is the oldest and largest division of the J.M. Smith Corporation. Smith Drug Company is the largest independent pharmaceutical distributor in the south dedicated solely to independent community pharmacies with distribution centers in South Carolina, Georgia and Arkansas. They provide daily drug distribution, and other related services, for customers in 22 states. For more information, please visit www.smithdrug.com. About Creative Pharmacist Founded by a pharmacist and a technology expert in 2008, Creative Pharmacist is the U.S. market leader in helping pharmacists launch clinical services within their community. They support hundreds of community pharmacists engage patients with chronic disease, such as diabetes, COPD, heart disease, and more. Their mission is to transform the community pharmacy marketplace by inspiring and empowering pharmacists to engage clinical pharmacy practice to improve both the health of their business and the health of their patients. For more information, please visit: www.creativepharmacist.com.



This is the seventh of a series of topics covering at-tributes that I believe will lead to greater success.

UNTAPPED OPPORTUNITIESThoseofyouwhoknowmethinkthatIsimplydrawplansandsellpharmacyfixtures.Overtheyears,IfeltthatIhadanobligationtolearnandpassalongallideasthatIthoughtwouldhelpIndependentPharma-ciesbecomemoreefficientandprofitable.So,herearesomeofmyobservationsthathavelittletodowithpharmacylayoutanddesign.AsItravelfrompharmacytopharmacyandlearnasIgo,Itrytorelayideasandconceptsthathaveprovedtobesuccessful.Whilemanyarestrugglingtostayinbusiness,othershavefoundwaystoreplacetheplummetingprofitmarginsderivedfromfillingtraditionalprescriptions.Nomatterhowmucheffortanddollarsarespentonlegislation,Ipersonallythinktherearealterna-tivesthatcangiveyoumorepersonalcontroloveryourdestiny.SomepharmacyownershavealreadysteppedoutsidetheircomfortzonetobecomemorethananRxdispensary.Federalandstatedollarshavebecomemorescarceandexpectationsofanevenplayingfieldisunreliable.

Bythesametoken,theIndependentPharmacyownerhasalonglistofopportunitieswaitingtobeseized.Weekendseminarsarebeingheldacrossthecountrythatpromoteaddingnon-health-relateddepartmentswhichIbelieveisthewrongpathtofollowunlessyouhavealargedrugstore.Therearesomanydollarstoresandotherretailersthatcarryawideselectionatlowprices.But,myprimaryreasonisthatittakesawayfromtheprofessionalimageofthesmallerin-dependentpharmacy.However,IdobelievethatboththeRxprofitsaswellasthenon-Rxvolumecanbeincreasedsubstantiallybyutilizingsomeunconven-tionaltools.Wehavebeentaughtthatthebestwaytocreateaprofitablebusinessisto“findaneedandthenfillit”.Duetospacelimitations,Icannotlistthemallbuthereareafewexamples:

1. Increasespaceallocatedtonaturalproductsandsupplements.Learnhowthesecaneitherhelporhindereachpatient’sRxregimen.Askcustomerswhatsupplementstheytake.Thepharmacistandstaff

mustbecomeveryknowledgeableabouttheproducts,makesuggestionsandutilizedirectmarketingtech-niques.Youcanstartwithjustafewitemsandbuildfromthere.

Ifyouhavethespacetodoso,Ialsorecommendso-calledcomfortitemsforbasicallyhealthypeoplewhohavelesssevereissuesthatcanberemediedbyusinglumbarsupports,neckbraces,specialpillows,cushions,etc.Thedepartmentcancreatehighim-pulsesalesifdisplayedproperlyandtheprofitmarginisusuallymuchhigherthanothercategories.

2. Ibelievethatthemostsuccessfulpharmacywillbecomemoreproactivewithitscustomers.Askquestionslike“Isthereanyoneinyourfamilythathasarthritis?”andyouwillusuallygetayes.Then,youcanrecommendaproductlikePenetran.Learnasmuchasyoucanabouteachpatient,theirfamilymembersandfollowupwithaphonecallafewdayslater.Surprisethem!

3. Ifyouarenotcompounding,Ithinkyoushouldandmarkettheserviceaccordingly.Ifyoumakeprescribersaware,quiteoftenyoucangetap-provaltoaltertheRxthatmayreducesideeffects,makemedicationsmorepalatableoreasiertotake.TheprofitmarginonacompoundedRxismuchhigh-erandyouwillgainbothcustomers’andphysicians’loyalty.Iamreferringtonon-sterilecompounding.Thisalonecancreatenewcustomersandreferralsbyphysiciansandveterinarians.Makesureyouunder-standthenewregulationsandhowthecertificationprocessworksinyourstate.

4. InadditiontohavingaprivateMTMroomwhereyoualsoadministershots,etc.Isuggestyouofferapplicablescreeningsanddiagnostictesting.Therearepharmaciststhatchargeasmuchas$100pervisitforvalue-basedservices.Manypreferapharmacytohelpthemwithlessseveremaladiesduetotheinconveniencetheyoftenexperiencewithaclinicordoctor’soffice.

5. SomePharmaciesarebeginningtohirepart-timeorfull-timenursewhileothersarehavinghealth

Creating a Competitive Strategy for Independent Pharmacy Success ByRolandThomas

PLANNING

Kelley Fuller Membership Coordinator

We’d like to introduce you to SCPhA’s newest staff member, Kelley Fuller!

Kelley was asked to join the SCPhA team to work as Membership Coordinator, and we think you will enjoy her just as much as we have over the last few months!

Full Name? Kelley Fuller

Where are you from? Born in Greer, SC

Where did you join us from? My last position was at the Navarre Beach Area Chamber of Commerce in Navarre Florida.

What do you like to do outside of work? Love watch-ing sports, (especially football), long walks, reading, and spending time with family.

Tell us about your family. Married (for 30 years this year) to Van Fuller who retired last year after 30 years in the Air Force. We have one child, Kyle, who is a 1Lt in the Air Force. Both Van and Kyle are Citadel grads and CE majors. We also have a canine kid, Kilo, a Standard Schnauzer.

What’s one challenge that you are looking forward to at SCPhA? Growing the membership. I believe we can do that if we are actively telling the SCPhA story, and letting pharmacists, technicians, and students know the importance of a united voice working to improve their profession.

So far, what’s been your favorite thing to do with SCPhA? I have not had any experience working in a pharmacy related field (other than being hired in high school to do inventory and clean shelves at my local pharmacy). So it has been interesting learning a different “jargon” and understanding the challenges facing the profession.


professionalswhospecializeindifferentfieldsthatdiagnoseandhelpcustomersfindsolutionstoallkindsofhealthissues.Thishelpsmakeyourphar-macyadestinationandlaysthegroundworkforunlimitedopportunitiesthatcanoffsetthedeclin-ingprofitintraditionalscripts.

6. Useasmanyresourcesasyoucantoimprovepatientawarenessthatyourpharmacyismuchmorethanadispensary.AlthoughIamatruebelieverinhavingadrive-thruwindowwhenpossible,youcaninfluencepeopletocomeinsideifyouofferthemenoughreasonstodoso.

7. IamnoexpertinmarketingtechniquesbutIdobelievedirectmarketingisessentialtodayandtherearesourcesavailablewithexpertiseininitiatingeffectivemarketingtechniques.Wordofmouthcanbeoneofthemosteffectivemarketingtoolsanditcostyounothing.

Ibelievethattheroleofthepharmacistwillcon-tinuetoincreaseandthischangingtrendprovidesanexcellentopportunityfortheindependentpharmacy.94%ofrespondentsinaConsumerRe-portsSurveyindicatedtheypreferanindependentpharmacyoverchainsandbigboxstores.Mostoftheirreasonswerebasedonservicesandhowtheyweretreated.Ithinkindependentpharmaciescanbecomemoreprofitablebytakingadvantageofuntappedresources,manyofwhichareoutlinedinmynewhandbook“IndependentPharmacyStepstoGreaterSuccess”thatcanbepreviewedatAmazon.com

Inthenextarticle,Iwilloffermyviewsregardingthe“boutiquepharmacy”thathasbeenpromotedbysomepharmacydesignfirms.

Roland G. Thomas is a Pharmacy Planning Spe-cialist with Rx Planning Solutions – a division of Display Options in Charlotte, NC. Roland has had the privilege of working with pharmacists all over the Southeast United States, planning and design-ing pharmacies for over 40 years. Independent and multiple location owners have relied on his expertise in this field.


Membership Level Information and Benefits Basic Friend Leader Visionary Preferred pricing for all SCPhA events X X X X Legislative advocacy X X X X Networking opportunities X X X X Palmetto Pharmacist, bimonthly X X X X Small Doses, weekly X X X X Access to Pharmacist Mutual programs X X X X RxAlerts X X X X Preferred/reserved seating at events X X X Name listed in Palmetto Pharmacist X X X Custom Tervis Tumbler upon signing up X X X Level Designation Nametag Ribbon at all major events X X X SCPhA bucks (To be used towards CE Escape, Spa Weekend or Convention) $25 $50 $100 Name/company listed on SCPhA website X X Name/company listed on sponsor signs at major events X

Vested Membership Pricing Change: If you have been considering becoming a vested member, it is best to act now! The cost for this level has been $2,000, but it is going to increase to $2,500 on October 1st, 2014. Take advantage of a vested membership today and never have to pay dues again!

It is almost time to renew your membership in SCPhA!

Renew today at www.scrx.org!2014 Membership ChangesRenewal Date changes: our membership year will no longer be Sept. 30-Oct. 1. Each member will be up for renewal on their anniversary date. Your anniversary date is defined as the date that your membership was processed by SCPhA.

Automatic Membership Renewal (annually): available to everyone! You must opt in to take advantage. It is not an automatic feature.

Automatic Draft (monthly): this option is available for Pharmacist or Associate level memberships and above. You must opt in to take advantage. It is not an automat-ic feature.

Text Alerts: in order to reach more members, we hope to be able to implement text message communication. Messages would only be sent if there was an urgent need or important update. This will typically be in regards to current or upcoming legislation. Standard text and data rates apply.

Membership Levels:

Join or renew today at www.scrx.org! Questions? Contact SCPhA at 803.354.9977 or [email protected].


Where would you prefer to have your HIPAA training?

Option A Option B

Yep. That’s what we thought. Get your HIPAA training online, 24 hours a day, 7 days a week with SCPhA’s on-line HIPAA training program.

Assessing Your Pharmacy’s HIPAA Policies & Procedurescreated by Craig Burridge, MS, CAE, CEO, South Carolina Pharmacy Association

Goals and Objectives:1. Identify the laws covering confidentiality and their lead up to HIPAA.2. Recognize the standard principles governing confi-dentiality as it relates to patient records.3. Identify the need for and responsibilities of a pri-vacy officer and workforce training requirements.4. Differentiate between the proper uses and disclos-ers of protected health information and permitted uses and disclosures.5. Recognize when authorization is necessary for protected information.6. Identify the requirements for the distribution of Privacy Practices Notices.7. Know how to develop an electronic protected health information policy.8. Recognize how to mitigate and notify affected individuals in case of a breach of protected health information.9. Identify the expanded HIPAA requirements under the Health Information Technology for Economic and Clinical Health Act (HITECH)

Fees:SCPhA Members: $15\Non-Members: $25Please note that this is required in order to obtain 2 hours of CE Credit.

The South Carolina Pharmacy Association is accredited by the Accreditation Coun-cil for Pharmacy Education as a provider of continuing pharmacy education. This home study is approved for 2 contact hours of continuing pharmacy education credit (ACPE UAN: 0171-0000-13-074-H03-P). This CE credit expires 8/08/2016.

Register online at www.scrx.org, or follow the QR code to the right!

Make the right call. join SCPhA at one of our events this fall!

Register today at www.scrx.org! Questions? Contact SCPhA at 803.354.9977 or email Laura Reid, Dir. of Events, at [email protected].

Pharmacy Nights 2014

September 23 -- Columbia, SC October 14 -- Charleston, SC October 28 -- Florence, SC November 11 -- Rock Hill, SC

December 2 -- Aiken, SC

CE Escape December 5-7, 2014

Omni Hotel Hilton Head Island, SC

SE Girls of Pharmacy Leadership Weekend

January 16-18, 2015 Omni Grove Park Inn

Asheville, NC

2015 January 13 -- Greenville, SC January 27 -- Columbia, SC

February 3 -- Charleston, SC February 10 -- Florence, SC


Make the right call. join SCPhA at one of our events this fall!

Register today at www.scrx.org! Questions? Contact SCPhA at 803.354.9977 or email Laura Reid, Dir. of Events, at [email protected].

Pharmacy Nights 2014

September 23 -- Columbia, SC October 14 -- Charleston, SC October 28 -- Florence, SC November 11 -- Rock Hill, SC

December 2 -- Aiken, SC

CE Escape December 5-7, 2014

Omni Hotel Hilton Head Island, SC

SE Girls of Pharmacy Leadership Weekend

January 16-18, 2015 Omni Grove Park Inn

Asheville, NC

2015 January 13 -- Greenville, SC January 27 -- Columbia, SC

February 3 -- Charleston, SC February 10 -- Florence, SC


July 28, 2014 Dear Provider, The attached Adult Immunization Standards of Practice document describes the roles and responsibilities for all providers who see adult patients in an effort to increase vaccination rates in adults. Vaccination coverage rates in adults have remained consistently low over many years. We know we can do better in South Carolina. We need your help. Research shows that most adult patients are willing to get a vaccine when it is recommended by their provider. We encourage you to adopt the Adult Immunization Standards of Practice in your own practice to increase uptake of adult vaccines in South Carolina. The Adult Immunization Standards of Practice guidance document describes the four steps that every provider should be taking to encourage their adult patients to get vaccinated:

1. Screen adult patients for vaccination status at each visit 2. Recommend the needed vaccines to their patients at each visit 3. Administer the needed vaccines, or refer the patient to a provider who is able to vaccinate 4. Document the vaccination in the patient’s charts and if possible, submit this information to the South

Carolina Immunization Registry

Resources to help implement these recommendations are available from a variety of sources. The Centers for Disease Control and Prevention (CDC) has developed materials and resources to help providers implement the standards including information sheets that can be distributed to patients, provider scripts for talking about immunizations with adult patients, and many others. These resources can be found at the following link: http://www.cdc.gov/vaccines/hcp/patient-ed/adults/for-practice/standards.html. Other resources are available from these organizations:

• The National Adult and Influenza Immunization Summit: http://www.izsummitpartners.org/adult-immunization-standards/.

• Immunization Action Coatition: http://www.immunize.org/ • CCME Alliance for Medical Excellence:

https://www.thecarolinascenter.org/default.aspx?pn=AllianceforMedicalExcellence • DHEC - CDC Adult Immunization Schedule: http://www.cdc.gov/vaccines/schedules/hcp/imz/adult-shell.html

The Adult Immunization Standards of Practice is supported by a variety of national medical organizations including the American Academy of Family Physicians and the American College of Physicians and public health organizations such as the National Association of City and County Health Officials and the Association of Immunization Managers. Should you have questions or need additional assistance, please contact the DHEC Immunization Division at 803-898-0406. Respectfully, Leanne Bailey, RN, MPH Immunization Division Director


Reports and Recommendations

Public Health Reports / March–April 2014 / Volume 129 115

Recommendations from the National Vaccine Advisory Committee: Standards for Adult Immunization Practice

National Vaccine Advisory Committee

The Advisory Committee on Immunization Practices (ACIP) makes recom-mendations for routine vaccination of adults in the United States.1 Standards for implementing the ACIP recommendations for adults were published by the National Vaccine Advisory Committee (NVAC) in 20032 and by the Infectious Diseases Society of America in 2009.3 In addition, NVAC published a report in 2012 outlining a pathway for improving adult immunization rates.4 While most of these documents included guidelines for immunization practice, recent changes in the practice climate for adult immunization necessitated an update of exist-ing adult immunization standards. Some of these changes include expansion of vaccination services offered by pharmacists and other community immunization providers both during and since the 2009 H1N1 influenza pandemic; vaccina-tion at the workplace; increased vaccination by providers who care for pregnant women; and changes in the health-care system, including the Affordable Care Act (ACA), which requires first-dollar coverage of ACIP-recommended vaccines for people with certain private insurance plans, or those who are beneficiaries of expanded Medicaid plans.5 The ACA first-dollar provision is expected to increase the number of adults who will be insured for vaccines. Other changes include expanding the inclusion of adults in state immunization information systems (IISs) (i.e., registries) and the Centers for Medicare & Medicaid Services Meaningful Use Stage 2 requirements, which mandate provider reporting of immunizations to registries, including reporting of adult vaccination in states where such reporting is allowed.6 For the purposes of this report, provider refers to any individual who provides health-care services to adult patients, including physicians, physician assistants, nurse practitioners, nurses, pharmacists, and other health-care professionals.

While previous versions of the adult immunization standards have been published, recommendations for adult vaccination are published annually, and many health-care organizations have endorsed routine assessment and vaccina-tion of adults, vaccination among adults continues to be low.7–15 Several barriers to adult vaccination include:

• Lackofhealth-careproviderandpatientknowledgeabouttheneedforvaccinating both healthy and high-risk adults.

• Medicalmanagementofacuteandchronicillnesses,whichusuallyreceivespriority over preventive services.

• Someprovidersnotofferingvaccinesorofferingonlyasubsetofvaccinesrecommended for adults, and many adult patients unaware of their rec-ommended vaccines.


116 Reports and Recommendations

Public Health Reports / March–April 2014 / Volume 129

• Private and public payer payment for vaccinescomplicated for providers, and not all those who vaccinate adults are recognized as providers by third-party payers.

• Medicaresettinglimitsoncoverageforvaccinesbased on the type of plan. For example:

° Fully reimbursed vaccines through Medi-care Part B are limited to vaccines against influenza, pneumococcal, tetanus-diphtheria (Td) (as part of wound management but not routine booster doses), and hepatitis B (for certain intermediate and high-risk groups such as patients with end-stage renal failure or diabetes).16

° Medicare Part D provides limited coverage for the remainder of vaccines recommended for adults, often requiring significant out-of-pocket costs to patients (e.g., zoster vaccine; tetanus, diphtheria, and pertussis vaccine; and routine booster doses of Td vaccines).16

° Vaccines included in Medicare Part D plans are pharmacy or drug benefits rather than medical benefits. Because most medical pro-viders are not enrolled as pharmacy providers, receiving reimbursement for these vaccines is a challenge. Many providers, both medical and nonmedical, experience complexities in dealing with billing processes and the level of payment for Part D claims. Pharmacist vac-cinators are established providers for Part D vaccines but are still challenged by coverage variability in insurance plans.

• Medicaid vaccination coverage and authorizedvaccines vary by state, with some states cover-ing only a subset of vaccines recommended for adults by ACIP. Medicaid coverage of ACIP-recommended vaccines is further complicated by the Supreme Court decision allowing states to opt out of increased Medicaid coverage.17

• Out-of-pocketcoststopatientsareaknownbar-rier. For example:

° While the ACA removed out-of-pocket costs for many privately insured people, not all provid-ers and patients are likely to be aware of this provision.

° Some providers may not be eligible for reim-bursement under some health insurance plans because they are not authorized as in-network providers for vaccination services.

° Many adults remain uninsured.

National Vaccine Advisory Committee

ChairWalter A. Orenstein, MD, Emory University, Atlanta, GA

Designated Federal OfficialBruce G. Gellin, MD, MPH, National Vaccine Program

Office, U.S. Department of Health and Human Services, Washington, DC

Public MembersRichard H. Beigi, MD, MSc, Magee-Womens Hospital, Pitts-

burgh, PASarah Despres, JD, Pew Charitable Trusts, Washington, DCPhilipS.LaRussa,MD,ColumbiaUniversity,Departmentof

Pediatrics, New York, NYRuth Lynfield, MD, Minnesota Department of Health, St.

Paul, MNYvonne Maldonado, MD, Stanford University, Stanford, CAJulie Morita, MD, Chicago Department of Public Health, Chicago,IL

Charles Mouton, MD, MS, Meharry Medical College, Nash-ville, TN

Amy Pisani, MS, Every Child by Two, Mystic, CTWayne Rawlins, MD, MBA, Aetna, Hartford, CTMitchel C. Rothholz, RPh, MBA, American Pharmacists

Association, Washington, DCThomas E. Stenvig, RN, PhD, MS, South Dakota State Uni-

versity College of Nursing, Brookings, SDLitjen (LJ)Tan,PhD,MS, ImmunizationActionCoalition,OakPark,IL

Catherine Torres, MD, State of New Mexico, Santa Fe, NMKasisomayajula Viswanath, PhD, Harvard School of Public

Health, Boston, MA

Representative MembersSeth Hetherington, MD, Genocea Biosciences, Cambridge,

MAPhilip Hosbach, Sanofi Pasteur, Swiftwater, PA

Liaison RepresentativesJon Kim Andrus, MD, Pan American Health Organization/

World Health Organization, Washington, DCScott Breidbart, MD, MBA, America’s Health Insurance Plans,

New York, NYRobert S. Daum, MD, CM, U.S. Food and Drug Administra-

tion, Vaccines and Related Biologics Products Advisory Committee,Chicago,IL

Charlene Douglas, PhD, MPH, RN, Advisory Committee on Childhood Vaccines, Fairfax, VA

Kristen R. Ehresmann, RN, MPH, Association of Immuniza-tion Managers, Rockville, MD

Paul Etkind, DrPH, Association of County and City Health Officials, Baltimore, MD

Paul Jarris, MD, MBA, Association of State and Territorial Health Officials, Arlington, VA

David Salisbury, CB, FRCP, FRCPCH, FFPHM, United King-dom,DepartmentofHealth,London,UK

John Spika, MD, Public Health Agency of Canada, Ottawa, ONJonathanL.Temte,MD,PhD,Centers forDiseaseControl

and Prevention, Advisory Committee on Immunization Practices, Madison, WI

Ignacio Villaseño, MD, Health Ministry of Mexico, Mexico City, Mexico

continued on p. 117


NVAC Update on Standards for Adult Immunization Practice 117


• Patientsmayseemanydifferentproviders,includ-ing specialists who may not be vaccine providers. The presence of multiple providers of health services may complicate coordination of care and reduce the likelihood that patients’ vaccination needs are routinely assessed and needed vaccines are offered.

Despite these barriers, a number of strategies have been shown to improve receipt of adult immunizations. One of the most important predictors of vaccination receipt among adults is a health-care provider’s recom-mendation and offer of vaccine during the same visit. The importance of a provider recommendation for vac-cination has been demonstrated repeatedly.18–22 Other approaches shown to increase vaccination coverage include patient and provider reminder/recall systems; provider assessment and feedback about vaccination

practices; use of standing orders or protocols; reduc-ing patient out-of-pocket costs; worksite interventions with on-site, actively promoted vaccination services; and other community-based and health-care system-based interventions implemented in combination.21

The need to review and revise earlier standards is based on several factors:

• Emphasisontheroleofallproviders,evennon-vaccinating providers, to assess immunization status and recommend needed vaccines was not included in earlier adult immunization standards documents and is generally not included in clini-cal training programs.

• Community vaccinators and pharmacists areincreasingly recognized as integral to achieving higher adult vaccination rates.

• Relianceonelectronichealthrecords(EHRs)isincreasing and there are meaningful use incen-tives for eligible medical providers to enter patient immunization information into IISs for Medicare and Medicaid EHR incentive payments.

• Achangeincommunicationstrategiesforeducat-ing and contacting patients, with the availability of the Internet and social media, is underway.

• Newopportunities are affordedby theACA toprovide vaccination within the shifting landscape of vaccine financing. There is also a shift in pay-ment models away from fee-for-service toward payment for better outcomes of care.

• Federal funds for immunizationprograms thathad been used for underinsured children may become available for purchasing vaccines for uninsured adults as the number of children insured for vaccines increases due to implemen-tation of the ACA.

As such, the NVAC recommends that the Assistant Secretary for Health promote the use of the 2013 updated NVAC Standards for Adult Immunization Prac-tice by all health-care professionals and payers in the public and private sectors who provide care for adults.

STANDARDS FOR ADULT IMMUNIZATION PRACTICE

Every health-care provider, in all settings, has a funda-mental responsibility to ensure that all patients are up-to-date with respect to recommended immunizations. The purpose of the Standards for Adult Immunization Practice, which are summarized in the Figure, is to provide guidance to adult health-care providers across the spectrum of health care. This section addresses the

National Vaccine Advisory Committee (continued)

Federal Ex Officio MembersVito Caserta, MD, Health Resources and Services Administra-

tion, Rockville, MDRichard Church, PharmD, Indian Health Service, Rockville,

MDMarion Gruber, PhD, U.S. Food and Drug Administration,

Rockville, MDIris Mabry-Hernandez, MD, MPH, Agency for Healthcare

Research and Quality, Rockville, MDRick Hill, DVM, MS, U.S. Department of Agriculture, Ames, IAJeffrey A. Kelman, MD, MMSc, Centers for Medicare & Med-

icaid Services, Washington, DCRichard Martinello, MD, U.S. Department of Veterans Affairs,

West Haven, CTJustin Mills, MD, MPH, Health Resources and Services Admin-

istration, Rockville, MDBarbara Mulach, PhD, National Institutes of Health, Bethesda,

MDAnne Schuchat, MD, Centers for Disease Control and Preven-

tion, Atlanta, GAAngela Shen, ScD, MPH, U.S. Agency for International

Development, Washington, DCCOLScottA.Stanek,DO,MPH,U.S.DepartmentofDefense,

Washington, DC

National Vaccine Advisory Committee Immunization Infrastructure Working GroupCarolyn Bridges, MD, Centers for Disease Control and Pre-

vention, Atlanta, GAJulie Morita, MD, Chicago Department of Public Health, Chicago,IL

Walter A. Orenstein, MD, Emory University, Atlanta, GA (NVAC Chair)

Mitchel C. Rothholz, RPh, MBA, American Pharmacists Association, Washington, DC

Thomas E. Stenvig, RN, PhD, MS, South Dakota State Uni-versity College of Nursing, Brookings, SD

Litjen (LJ)Tan,PhD,MS, ImmunizationActionCoalition,Oak Park, IL (NVAC Adult Standards Review WorkingGroup Chair)

Catherine Torres, MD, State of New Mexico, Santa Fe, NM




Figure. Summary of 2013 National Vaccine Advisory Committee’s standards for adult immunization practices

Audience Summary of standards

All providers • Incorporateimmunizationneedsassessmentintoeveryclinicalencounter.

• Stronglyrecommendneededvaccine(s)andeitheradministervaccine(s)orreferpatienttoaproviderwhocanimmunize.

• Stayup-to-dateon,andeducatepatientsabout,vaccinerecommendations.

• Implementsystemstoincorporatevaccineassessmentintoroutineclinicalcare.

• Understandhowtoaccessimmunizationinformationsystems(i.e.,immunizationregistries).

Non-immunizingproviders • Routinelyassesstheimmunizationstatusofpatients,recommendneededvaccine(s),andreferpatienttoanimmunizingprovider.

• Establishreferralrelationshipswithimmunizingproviders.

• Followuptoconfirmpatientreceiptofrecommendedvaccine(s).

Immunizingproviders • Ensureprofessionalcompetenciesinimmunizations.

• Assessimmunizationstatusineverypatientcareandcounselingencounterandstronglyrecommendneededvaccine(s).

• Ensurethatreceiptofvaccinationisdocumentedinpatientmedicalrecordandimmunizationregistry.

Professionalhealth-care-relatedorganizations/associations/health-caresystems

• Provideimmunizationeducationandtrainingofmembers,includingtrainees.

• Provideresourcesandassistancetoimplementprotocolsandothersystemstoincorporatevaccineneedsassessmentandvaccinationorreferralintoroutinepractice.

• Encouragememberstobeup-to-dateontheirownimmunizations.

• Assistmembersinstayingup-to-dateonimmunizationinformationandrecommendations.

• Partnerwithotherimmunizationstakeholderstoeducatethepublic.

• Seekoutcollaborationopportunitieswithotherimmunizationstakeholders.

• Collectandsharebestpracticesforimmunization.

• Advocatepoliciesthatsupportadultimmunizationstandards.

• Insurers/payers/entitiesthatcoveradultimmunizationservicesshouldassuretheirnetworkisadequatetoprovidetimelyimmunizationaccessandaugmentwithadditionalvaccineprovidersifnecessary.

Publichealthdepartments • Determinecommunityneeds,vaccinationcapacity,andbarrierstoadultimmunization.

• ProvideaccesstoallACIP-recommendedvaccinationsforinsuredanduninsuredadultsandworktowardbecominganin-networkproviderforimmunizationservicesforinsuredadults.

• Partnerwithimmunizationstakeholdersandsupportactivitiesandpoliciestoimproveawarenessofadultvaccinerecommendations,increasevaccinationrates,andreducebarriers.

• Ensureprofessionalcompetenciesinimmunizations.

• Collect,analyze,anddisseminateimmunizationdata.

• Provideoutreachandeducationtoprovidersandthepublic.

• Worktodecreasedisparitiesinimmunizationcoverageandaccess.

• Increaseimmunizationregistryaccessandusebyvaccineprovidersforadultpatients.

• Developcapacitytobillforimmunizationofinjuredpeople.

• Ensurepreparednessforidentifyingandrespondingtooutbreaksofvaccine-preventablediseases.

• Promoteadherencetoapplicablelaws,regulations,andstandardsamongadultimmunizationstakeholders.

ACIP5AdvisoryCommitteeonImmunizationPractices

roles of all providers with regard to immunizations, including the role of all providers to conduct routine assessment of vaccination needs for their patients, recommend needed vaccines, and either administer

needed vaccines or, for providers who currently do not stock all recommended vaccines, refer patients to places where they can get recommended vaccines.




1. Standards for all providers, including those who do and do not provide immunization servicesPart of routine clinical care for all providers should include an assessment of their patients’ immunization status and a recommendation to the patient and/or the patient’s caregiver for needed vaccines. Assessment and recommendation can be accomplished through the following practices:

a. Emphasize the importance of immunizations during patient encounters, incorporate patient assessment of vaccine needs into routine clini-cal practice, and document vaccination status in patient medical records. IISs and EHRs should be referenced as sources of data about a patient’s vaccine history.

b. Strongly recommend all immunizations that patients need.

c. Provide all recommended vaccines to patients who need them at the time of the visit. If the vaccines are not given or, if the provider does not have the vaccines in stock, refer the patient to a vaccine provider known to be able to provide the recommended vaccinations. Because vaccine uptake is much higher among patients when the vaccine is recommended and offered at the same visit, providers who are able to stock vaccines for their patients are strongly encouraged to do so.18

d. Ensure that they, and their practice staff, are up-to-date on their own vaccinations per ACIP health-care personnel vaccine recommendations23 and consistent with professional guidelines. Examples of current professional association guidelines include the following:

i. The American Nurses Association (ANA) has a longstanding policy supporting immu-nizations for nurses and all people across the life span. ANA believes that nurses have a professional and ethical obligation to be immunized because it protects both the health of the nurse and the health of his/her patients and community.8

ii. The National Association of County and City Health Officials (NACCHO) urges health-care employers and local health departments to require influenza vaccina-tion for all staff members as a condition of employment.9

iii. The American Pharmacists Association rec-ommends that its members be up-to-date on immunizations as a professional standard.10

iv. The American Medical Association’s policy supports the vaccination of health-care pro-fessionals against communicable diseases to prevent transmission to their patients.11

v. The Infectious Diseases Society of America recommends that all health-care workers be fully immunized according to ACIP recommendations.12

vi. The American Academy of Physicians Assistants recommends that physician assis-tants (PAs) should be immunized against vaccine-preventable diseases for which health providers are at high risk. Doing so not only protects PAs, but also protects patients by preventing provider-to-patient transmission.13

vii. The American College of Physicians rec-ommends that all health-care providers be immunized against influenza; diph-theria; hepatitis B; measles, mumps, and rubella; pertussis (whooping cough); and varicella (chickenpox) according to ACIP recommendations.14

viii. The American College of Obstetricians and Gynecologists (ACOG) recommends that College Fellows have an ethical obligation to follow recommendations for vaccination themselves and other safety policies put into place by their local or national public health authorities, such as the Centers for Disease Control and Prevention (CDC) and ACOG.15

e. Implement systems to:

i. Incorporate vaccination assessment into routine care for outpatients.

ii. Identify patients for needed vaccines based on age, risk factor indications for vaccina-tion, and prior vaccination history.

iii. Incorporate vaccination assessment and appropriate vaccination of hospitalized patients and those in long-term care facili-ties with recommended vaccines, especially influenza and pneumococcal vaccines.

iv. Ensure follow-up for needed vaccinations after hospital discharge.

f. Educate patients about vaccines they need using understandable language, including the vaccine information statements for those vaccines covered bytheVaccineInjuryCompensationProgram.




g. For providers in states that include adult immu-nization records in their state IIS or registry, understand how to access the IIS as a source to check for vaccines that a patient has already received or should have received. Checking the IIS at each patient encounter reduces the likeli-hood of unnecessary vaccinations and provides information about receipt of other vaccines and whether the patient has appropriately completed the vaccination series as recommended.

2. Standards for non-immunizing providersBecause data show that (1) patients are more likely to get vaccinated when vaccines are recommended by trusted health-care professionals and (2) vaccine uptake is higher when vaccine is provided at the same time, primary care providers are strongly urged to stock and provide all recommended adult vaccines. Providers whose facilities are unable to provide certain immunizations (e.g., medical specialists’ offices, which do not routinely provide vaccines for adults) still have a significant role in ensuring that their patients receive needed vaccines. Non-vaccinating providers should:

a. Routinely assess whether their patients are up-to-date on recommended vaccinations, strongly recommend said vaccines, and refer patients to vaccine providers for needed vaccines.

b. Establish patient referral relationships with vac-cine providers in their area.

i. Ensure that referral location does not create other barriers for the patient.

1. Ensure that the vaccine provider offers the recommended vaccines, and that the provider is eligible for payment by patient’s insurer to minimize out-of-pocket costs for the patient and any delay in vaccination.

2. Provide information to the patient dur-ing the visit about which vaccines are needed, including a prescription when necessary and the contact information for the vaccination referral location.

ii. Ensure appropriate follow-up of vaccine receipt by the patient at the patient’s next visit, and encourage the vaccine provider to document vaccination (e.g., in the IIS and/or the patient’s medical record) and with the patient’s primary care provider, if known.

3. Standards for immunizing providersAll providers who have a role as a primary source of health care for patients should stock all ACIP-recom-mended vaccines for adults. Standards for all providers who immunize adults include ensuring professional competencies in knowledge of vaccine recommenda-tions, vaccine needs assessment, vaccine administra-tion, vaccine storage and handling, documentation of vaccination, and communicating information about vaccination to the patient’s medical home.

a. Observe professional competencies regard-ing immunizations by ensuring that vaccine providers:

i. Are up-to-date on current ACIP vaccine recommendations, appropriate vaccine administration techniques, and vaccine storage and handling guidelines.

ii. Have up-to-date, culturally competent materials for patient counseling about the benefits and risks of vaccinations.

iii. Are knowledgeable regarding valid contra-indications, adverse events, and reporting of adverse events.

iv. Use correct vaccine administration techniques.

v. Are knowledgeable about which vaccines may be administered at the same visit to reduce missed opportunities for vaccination.

vi. Have systems in place and training for appropriate response to adverse event(s) that may occur after vaccination, including severe allergic reactions.

vii. Have staff who are educated in appropriate vaccine storage and handling systems and vaccine monitoring in their practice.

b. Assess and strongly recommend vaccinations dur-ing every patient care and counseling encounter.

i. Written vaccination assessment protocols are available and implemented after appro-priate staff training.

ii. Protocols or standing orders are used (when appropriate for the setting and patient type) to administer routinely recommended vac-cines, and protocols are kept up-to-date.

iii. Staff competencies in vaccine needs assess-ment, counseling, and vaccine administra-tion as part of standing orders or protocols are periodically assessed.

iv. Reminder recall systems are in place to remind providers and patients about




needed vaccines and to ensure that vaccine series are completed to optimize vaccination benefits.

c. Ensure receipt of vaccination is documented.

i. Record receipt of vaccination in the patient’s EHR.

ii. Provide a record of vaccines administered to patients, either written or electronic.

iii. Use the IIS to record administered vaccines in states that allow adult vaccination infor-mation to be entered into the registry.

iv. If the vaccinator is not the patient’s primary care provider, then communicate vaccine receipt with the patient’s primary care provider, if known.

4. Standards for professional health-care-related organizations, associations, and health-care systemsStandards with respect to immunizations include:

a. Integrate educational information on immuniza-tions into professional training, including training of students in undergraduate and postgraduate training programs. This training includes support for incorporating modules on immunization into medical, nursing, and pharmacy schools, as well as allied health profession curricula.

b. Provide resources and assistance for providers to implement protocols or standing orders, where feasible, and other systems changes to improve routine assessment of vaccine needs and vaccination.

c. Encourage their members, trainees, and students to ensure that their own vaccinations are up-to-date as a standard of the profession.

d. Assist their members, employees, trainees, and students in remaining current regarding ACIP immunization recommendations by providing updates through routine communications and continuing education.

e. Make educational materials for patients regard-ing vaccine recommendations available to their memberships.

f. Partner with community organizations, such as immunization coalitions or vaccine advocacy groups, to improve public awareness of adult immunizations.

g. Participate in collaboration opportunities with other members of the immunization community (including public health, public and private medical, nursing and pharmacy services provid-

ers, patient advocacy, health systems, and other entities).

h. Offer modules to help providers assess and improve adult vaccination coverage of their patients as a measure of quality improvement within clinical practices.

i. Provide resources to assist providers in imple-menting and operationalizing immunization services within their practices, including helping providers understand the payment for vaccines based on insurance type and benefit design (e.g., private insurance, Medicare Part B, or Medicare Part D).

j. Provide resources (i.e., forms and other tools)for collecting and sharing best practices among adult immunization stakeholders.

k. Advocate public policies that support these adult immunization standards.

l. Insurers/payers/entities that cover adult immuni-zation services should ensure that their networks are adequate to provide timely immunization access and augment with additional vaccine providers, if necessary (e.g., public health depart-ments, pharmacists, and worksites).

5. Standards for public health departmentsPublic health departments may provide vaccination services and, in that role, public health professionals should adhere to the standards of their profession. Additionally, the professional associations that rep-resent public health professionals and public health departments (e.g., Association of State and Territorial Health Officials, NACCHO, Association of Immuniza-tion Managers, and the Council of State and Territorial Epidemiologists) should promote adherence to the standards of the public health profession, particularly as they relate to adult immunizations. Public health has additional roles in assessing immunization program needs and the impact of vaccination programs, includ-ing educating the public and providers about immuni-zations. These additional roles include the following:

a. Determine community needs and capacity for adult immunization administration and barriers for patient access.

i. Work toward decreasing disparities in immunization access based on factors such as race/ethnicity, insurance status, poverty, and location (e.g., rural areas or medically underserved areas).

b. Develop policies and/or regulations (legislation) that promote high vaccination rates and reduce




immunization barriers for adult patients and their providers.

c. Immunization programs should collaborate with existing public health programs that provide clini-cal services, such as sexually transmitted disease control programs, substance abuse treatment ser-vices, and tuberculosis control programs to incor-porate vaccine administration and recordkeeping.

d. Ensure professional competency by providing or supporting education to adult health-care provid-ers on routine adult immunizations.

e. Maintain surveillance for vaccine-preventable diseases to recognize potential disease outbreaks or problems with vaccines and to assist in the control of vaccine-preventable diseases in the event of outbreaks.

f. Collect, analyze, and disseminate available data on vaccine coverage to the public and health-care providers in their jurisdiction to identify andaddress gaps in coverage.

g. Provide resources and assistance for vaccine providers to implement protocols or standing orders, where feasible, and other systems changes to improve routine assessment of vaccine needs and vaccination.

h. Provide best practice examples to health-care providers and collaborate with providers in implementing these best practices.

i.Providesubject-matterexpertisetotrainandedu-cate vaccine providers and their staff on vaccine recommendations, proper storage and handling, and proper vaccine administration.

j.Collaboratewithproviderstoassistinimplement-ing and operationalizing immunization services within their practices.

k. Partner with professional medical, pharmacy, nursing, and other provider organizations; health-care networks; community organizations; and advocacy groups (e.g., mental health services, dia-betes educators, asthma educators, correctional facilities, and substance abuse providers) to:

i. Increase awareness and knowledge of adult immunizations and methods to reach rec-ommended target populations for immuni-zation; and

ii. Educate their members and trainees regard-ing immunizations.

l. Provide outreach and education to the public and providers about vaccines.

i. Collaborate with professional medical, pharmacy, nursing, and other provider organizations; health-care networks; com-munity organizations; business and civic groups; and advocacy groups (e.g., mental health services, diabetes educators, asthma educators, correctional facilities, and sub-stance abuse providers) to:

1. Increase public awareness and knowl-edge of adult immunizations and reach recommended target populations for immunization.

2. Provide culturally competent public education through appropriate venues, including the use of social media and ethnic media.

m. Work toward including adults in all state IISs, reduce barriers to including adult vaccination records in IISs, and ensure that IISs meet new standards of EHR interoperability to track and maintain adult vaccination records.

n. Expand access to and provide training for IISs to all adult health-care providers.

o. Provide access to all ACIP-recommended vaccinations.

i. Ensure capacity to provide all ACIP-recom-mended vaccines and immunization services for insured and uninsured adults.

ii. Work toward becoming an in-network pro-vider for immunization services for insured adults.

p. Ensure preparedness for, and investigate and work to control, outbreaks of vaccine-preventable diseases when they occur. Managing these out-breaks should include activities such as creating, maintaining, and practicing emergency prepared-ness plans for vaccine responses to outbreaks such as pandemic influenza.

q. Demonstrate accountability and good stewardship of public financing for vaccines.

r. Communicate information about vaccine short-ages, when they occur, to providers and the public.

s. Communicate information on vaccine recalls and vaccine safety issues to providers and the public.

t. Promote adherence to applicable laws, regula-tions, and standards among adult immunization stakeholders.




CONCLUSION

The environment surrounding adult immunizations has changed dramatically since the last Standards for Adult Immunization Practices were issued by NVAC in 2003.2 These updated and revised Standards for Adult Immunization Practice represent a continued effort by NVAC to advance action to improve adult immuniza-tion coverage rates in the U.S. aligned with its 2011 report, “A Pathway to Leadership for Adult Immu-nization: Recommendations of the National Vaccine Advisory Committee.”4 With these Standards, NVAC provides a concise description of desirable immuniza-tion practices that will improve the provision of adult immunizations in the U.S. As an evolution of the work from the National Adult and Influenza Immunization Summit established by CDC, the Immunization Action Coalition, and the National Vaccine Program Office, these revised standards have been widely reviewed by major professional organizations andother partnersin adult immunization. NVAC recommends that the Assistant Secretary for Health promote the use of these updated Standards for Adult Immunization Practices by all health-care professionals and health-care systems in the public and private sectors who provide and pay for care for adults. NVAC firmly advocates that all providers follow these Standards and believes that these Standards will be useful to inform immunization practice and immunization policy development.

The National Vaccine Advisory Committee (NVAC) voted in favor of this report at the September 10, 2013, NVAC meeting. Initial drafts of this document were developed by a National Adult and Influenza Immunization Summit writing commit-tee including Anu Bhatt, Carolyn Bridges, Karen Donoghue, ColumbaFernandez,RebeccaGehring,LauraLeeHall,DonnaLazorik,Marie-MicheleLeger,TriniMathew,DebbyeRosen,MitchRothholz,LitjenTan,andLaDoraWoods.

REFERENCES 1. Centers for Disease Control and Prevention (US). Advisory Com-

mittee on Immunization Practices [cited 2013 Dec 2]. Available from:URL:http://www.cdc.gov/vaccines/acip/index.html

2. Poland GA, Shefer AM, McCauley M, Webster PS, Whitley-Williams PN, Peter G; National Vaccine Advisory Committee, Ad Hoc Working Group for the Development of Standards for Adult Immunization Practices. Standards for adult immunization practices. Am J Prev Med 2003;25:144-50.

3. PickeringLK,BakerCJ,FreedGL,GallSA,GroggSE,PolandGA,et al. Immunization programs for infants, children, adolescents, and adults: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2009;49:817-40.

4. National Vaccine Advisory Committee. A pathway to leadership for adult immunization: recommendations of the National Vaccine Advisory Committee. Public Health Rep 2012;127 Suppl 1:1-42.

5. Department of Health and Human Services (US). The Affordable Care Act and immunization [cited 2013 Dec 6]. Available from: URL: http://www.hhs.gov/healthcare/facts/factsheets/2010/09 /The-Affordable-Care-Act-and-Immunization.html

6. Centers for Medicare & Medicaid Services (US). Meaningful use stage 2 [cited 2013 Dec 6]. Available from: URL: http://www .cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html

7. Adult vaccination coverage—United States, 2010. MMWR Morb Mortal Wkly Rep 2012;61(04):66-72.

8. American Nurses Association. Policy statements [cited 2013 Dec 2]. Available from: URL: http://anaimmunize.org/Main-Menu-Category/Policy-and-Advocacy/Policy-Statements/default.aspx

9. National Association of County and City Health Officials. State-ment of policy: influenza vaccinations for healthcare personnel. November2012[cited2013Dec2].Availablefrom:URL:http://www.naccho.org/advocacy/positions/upload/12-14-Influenza-Vax-for-Healthcare-Personnel.pdf

10. American Pharmacists Association. Guidelines for phar-macy-based immunization advocacy [cited 2013 Dec 2]. Available from: URL: http://www.pharmacist.com/guidelines-pharmacy-based-immunization-advocacy

11. American Medical Association. Policy E-9.133: routine universal immunization of physicians for vaccine-preventable disease [cited 2013 Dec 2]. Available from: URL: http://search0.ama-assn.org /search/pfonline/?chkCEJ=CEJ&query=E-9.133

12. Infectious Diseases Society of America. Actions to strengthen adult and adolescent immunization coverage in the United States: policy principles of the Infectious Diseases Society of America. Clin Infect Dis 2007;44:1529-31.

13. American Academy of Physician Assistants. Immunizations in chil-drenandadults[cited2013Dec2].Availablefrom:URL:http://www.aapa.org/uploadedFiles/content/About_AAPA/Governance /Resource_Items/08-Immunizations.pdf

14. American College of Physicians. American College of Physicians calls for immunizations for all health care providers [cited 2013 Dec2].Availablefrom:URL:http://www.acponline.org/pressroom /hcp_vaccinations.htm

15. Committee on Ethics. Committee opinion no. 564: ethical issues with vaccination for the obstetrician-gynecologist. Obstet Gynecol 2013;121:1144-50.

16. Government Accountability Office (US). Medicare: many factors, including administrative challenges, affect access to Part D vacci-nations[cited2013Dec6].Availablefrom:URL:http://www.gao .gov/products/GAO-12-61

17. National Federation of Independent Business v. Sebelius. Roberts CJ, Slip Opin. at 50.

18. Influenza vaccination coverage among pregnant women—2011–12 influenza season, United States. MMWR Morb Mortal Wkly Rep 2012;61(38):758-63.

19. WinstonCA,WortleyPM,LeesKA.Factorsassociatedwithvaccina-tion of Medicare beneficiaries in five U.S. communities: results from the racial and ethnic adult disparities in immunization initiative survey, 2003. J Am Geriatr Soc 2006;54:303-10.

20. JohnsonDR,NicholKL,LipczynskiK.Barrierstoadultimmuniza-tion. Am J Med 2008;121(7 Suppl 2):S28-35.

21. Guide to Community Preventive Services. Increasing appropriate vaccination[cited2013Nov15].Availablefrom:URL:http://www.thecommunityguide.org/vaccines/index_inactive.html

22. Centers for Disease Control and Prevention (US). Pregnant women and flu shots: Internet Panel Survey, United States, November 2012 [cited2013Dec2].Availablefrom:URL:http://www.cdc.gov/flu/fluvaxview/pregnant-women-2012.htm

23. Shefer A, Atkinson W, Friedman C, Kuhar DT, Mootrey G, Bialek SR, et al. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60(RR07):1-45.


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Thefutureofqualitypatientcarereliesonlearningfromthesuccessstoriesandbestpracticesoftodayinordertoshapethehealthcaresystemoftomorrow.SixMedicareplanswererecentlyacknowledgedbythePharmacyQualityAlliance(PQA)forexcel-lenceinmedicationsafety,basedontheCentersforMedicare&MedicaidServices’(CMS)StarRatings.TheChineseCommunityHealthPlanofCalifornia,Humana’sMedicareplaninIllinois,andfourKaiserPermanenteregions(California,Colorado,HawaiiandtheMid-Atlanticregion)wererecognizedfortheirachievementofa5-starratingonthePQAmeasuresofmedicationsafetyandappropriateusethatareincludedintheCMSStarRatingProgramforMedicareplans,aswellasachievementofatleasta4.5-starsummaryplanrating.Thesixawardeesspoketothebestpracticesthatcontributetotheiroutstandingmedicationmanagement,andultimatelyensureoptimalmedicationoutcomes.

Withtheadventofnewqualityincentivestructuresputinplacethroughfederalgovernmentprograms,healthplansandPBMsarebecomingincreasinglyfocusedonmedicationusequality.Pharmacistscancontributemeaningfullytothequalitygoalsoftheseorganizationsasamemberofavirtualintegratedcareteam.OfthefifteenqualitymeasuresusedbyCMStoevaluateMedicarePartDplansin2014,fiverelatetomedicationsafetyandadherence.Thesemeasuresaccountfornearly50%ofagivenPartD

sponsor’sstarrating,andrepresentapotentialimpactareaforpharmacistintervention.Infact,inasystem-aticreviewofinterventionstoimproveadherencetomedicationsforcardiovasculardiseaseanddiabetes,Cutronaetal.foundthatinterventionsinapharmacyconductedbyapharmacistimprovedmedicationadherencemorethananyotherprofessionalinanyothersetting.

Thisrepresentsatremendousopportunityforphar-macies.Buttotakeadvantageofthisopportunity,pharmacistsmusttransitiontheirapproachfromamindsetofqualitymeasurementresistance,toqualitymeasurementengagement.Tofacilitatethistransitiontobecominganengagedpartner,manycommunitypharmaciesareusingEQuIPP,theElectronicQual-ityImprovementPlatformforPlans&Pharmacies.EQuIPPisaperformanceinformationmanagementplatformthatprovidesunbiased,benchmarkeddataonthequalityofmedicationusetobothhealthplansandcommunitypharmacies.Itallowspharmacistsatanindividualstoreorcorporatelevel,toseeexactlyhowindividualpharmaciesareperformingonthemedicationusequalitymeasuresthatmattertopay-ors.

Theuniquepositionofpharmacistsinthecommunitysettinggrantsenhancedpatientaccessandexcellentopportunitiesformedicationmanagement.Pharma-cistsareincreasinglyviewedasakeycollaborative

Pharmacists as a Critical Member of the Integrated Care TeamBySamuelStolpe,PharmD,PQADirector,QualityStrategies;

andMariaScarlatos,PharmD,PQAExecutiveFellow

PQA


partner.Managingthequalityofmedicationuseisnowarecognizedcomponentofensuringoptimalcare.Collabo-rationonsharedqualitytargetsandgoalsconnectsphar-maciestootherpartnersalongthecarecontinuum.

Pharmaciesarenotexemptfromqualitymeasurement.HealthplansandPBMsarealreadymovingforwardwithincentiveandpenaltyprogramsforpharmaciesbasedonqualityperformance.Pharmacistsareanintegralpartofthesolutionstomeetpayors’qualityneeds.Beingproac-tiveinthisnewqualityenvironmentisamust.Movingforward,pharmacistsshouldlooktoinitiatedialogue,es-tablishandnurturerelationships,andseekopportunitiestodeliverpoint-of-careinterventionsthatdrivequality.Pay-orsarenottheonlyhealthcareorganizationswithqualitygoals.Otherhealthcareorganizationshaveperformancemeasuresthattheyareaccountableforthatcanbedirectlyinfluencedbypharmacists.Inadditiontomakingcontri-butionstohealthplanqualitygoals,pharmacistscanreachouttolocalAccountableCareOrganizations(ACOs),andPatientCenteredMedicalHomes(PCMHs)tolookforcol-laborationpoints.ExamplesofareasthatpharmacistscanimpactincludeACOmeasuresofmedicationreconciliationandinfluenzaimmunization,orhelpingthemreachqual-itymeasuregoalsrelatedtocholesterol,A1Cs,andbloodpressurethroughappropriatemedicationmanagement.Ofthe33qualitymeasuresafederalMedicareSharedSav-ingsProgramACOhastomeet,atleast11ofthemcanbeinfluencedbycommunitypharmacists.Focusshouldbecentralizedoninterventionsthatdrivespecificgoals;com-municatingwaysinwhichpharmacistsinfluencethesafeandeffectiveuseofmedicationsandreachthesegoalswilllaythefoundationforthepharmacist’sroleinintegratedcareteams.

References:1. Pharmacy Quality Alliance. PQA Recognizes Six Medicare Plans for Excellence in Medication Use and Safety Based on CMS’ Star Ratings [Press release]. http://pqaalliance.org/images/uploads/files/Press%20Release%202014_QualityAward.pdf. Accessed June 30, 2014.2. Cutrona S, Choudhry N, Shrank W, et al. Modes of delivery for interventions to improve cardiovascular medication adherence. The American Journal Of Man-aged Care [serial online]. 2010;16(12):929-942. Available from: MEDLINE, Ipswich, MA. Accessed June 30, 2014.3. Center for Medicare and Medicaid Services. ACO Quality Measures. http://www.cms.gov/Medicare/Medi-care-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/ACO-Shared-Savings-Program-Quality-Mea-sures.pdf. Accessed June 30, 2014.

Fraud, Waste and Abuse Manual

Why waste your precious time starting something from scratch? Get help creating your Fraud, Waste, and Abuse Manual for your pharamcy by purchasing our starting template today!

This manual outlines the regulatory envi-ronment and essential elements of a com-pliance program and, in Part II, includes sample policies and procedures that may be useful to pharmacies in developing or updating their compliance programs. Be-yond this manual, however, each pharmacy must undertake a detailed risk assessment and self-audit to ensure that its particular compliance program is properly tailored to its business.

Pricing:SCPhA Members $195

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Pharmacyisaprofessionthatiscommittedtoservingpa-tients.Pharmacistsareentrustedbythepublictoconsid-erthewelfareofhumanityandreliefofhumansufferingastheirprimaryconcernsandareexpectedtomaintainthehighestprinciplesofmoral,ethical,andlegalconductatalltimes.Whenstudentsmatriculateintopharmacyschool,theypledgetoupholdtheselongheldtraditions.Inordertobesuccessfulinpharmacyschool,ourstu-dentsmakeacommitmenttotheprofessionofpharmacy,tooneanotherandtopreparingthemselvestoprovideexcellentcarefortheirfuturepatients.

ThecompellingmottoatPresbyterianCollege(PC)is“Whileweliveweserve”.Wefeelthismottocapturestheessenceoftheprofessionofpharmacyandthecom-mitmentthatpharmacistsmaketoservingtheircom-munitiesandtheirpatients.Startinganewpharmacyschoolalsorequirescommitment-acommitmentoftime,acommitmentofresources,andacommitmentoffaith.Weareproudthatwehavereceivedtremendoussupportandfaithfromourstudents,faculty,staff,thesurroundingcommunities,PCAlumni,donorsandtheSouthCaro-linapharmacycommunityasawhole.Onbehalfofthemanysupportersofourprogram,itiswithgreatpridethatweannouncethatthePresbyterianCollegeSchoolofPharmacyhasbeenawardedaccreditationstatusbytheAccreditationCouncilforPharmacyEducation(ACPE).ACPEisthenationalagencyforaccreditingpharmacyeducationprograms,andtheirBoardofDirectorshasspentthepastseveralyearsrigorouslyreviewingPCSPandevaluatingitsprograms.

OuraccreditationreviewprocessbeganinJanuaryof2010whenACPEgrantedPCpre-candidateaccreditationstatus,allowingustoopenourdoorstoourfirstclassinthefallof2010.InJune2011,wewereawardedcandi-datestatusallowingPCstudentstograduateandbeeli-gibleforlicensureasaregisteredpharmacist.Twoyearslater,ACPEawardeduscontinuedcandidateaccreditationstatus.Andnowfinally,inJulyof2014,wehavereceivedaccreditation.

Wedevelopedtheprogramin2009basedonamission.Thatmission;“ToimprovethehealthofSouthCarolin-iansandsocietyingeneralbydevelopingstudentswithanunwaveringethicalfoundationwhowillpositivelyimpactthedeliveryofqualityequitablepharmacycare;whowilldedicatetheirlivestocommunityservice;andwhowillprovideenlightenedleadershipinaddressingthehealthcareneedsofadiversepatientpopulation”hascontributedtoourphilosophyofbeing“notjustan-

other”pharmacyschool.Thegoalsfromdayoneweretodevelopaqualityeducationthroughourcurriculumandtoprovideservicetoourcommunitythroughcreationofanenvironmentthatwouldbringtolifethephrase“CarefortheCommunity”andexemplifythebesttraitsofahealthcareprofessional.Ourcurriculumisbasedonrigorandrequiresdecision-makingandproblemsolving.Stu-dentsaretaughtwithahands-onapproachbyfacultywhoprovideanevidence-basededucation,withanemphasisonresearchinquiryand,mostimportantly,apersonalmentor-manneredtouch.

PresbyterianCollege’smotto“whileweliveweserve”canandshouldbeadoptedbyallhealthcareprofession-als.Ourstudents,facultyandstaffdedicatethemselvestoservingthecommunitieswheretheyworkandlive.Wetakeprideinourabilitiestoprovidehealthcareandothercommunityservicethroughamyriadofofferingsfromlocalhealthfairs,tovisitingnursinghomes,tofillingprescriptionsandcounselingpatientsforourlocalandupstatefreemedicalclinics.Ourstudentsandfacultyhaveembracedthetruemeaningofcaringfortheirfellowcitizens.

AccreditationcomesontheheelsofthegraduationofourfirstclassatPC.InMay,76studentsreceivedtheirdoctoralhoodatourinauguralgraduationceremony.ThisgraduatingclasswascomprisedofstudentsfromallacrossthecountrywhochosetostudyintheUpstateandourcommunityisdirectlybenefitingfromtheirbeinghere.Infact,68percentofthegraduatingclasshasac-ceptedjoboffersintheUpstateofSouthCarolinawheretheywillprovideoutstandingcaretopatients.

WehaveworkeddiligentlytoensurethatourschoolofpharmacywouldbeawardedaccreditationstatusbyACPE,andthatourstudentsandfacultywillcontinuetoberecognizedfortheirincredibleachievements.Every-oneinvolved–PCstudents,faculty,staffandfriendsofPC–madethismonumentalstepofachievingaccredita-tionstatuspossible.Wearehonoredandproudtothankthemfortheirhardwork,supportandunwaveringdedica-tiontoaprogramthatissuretochangethelivesofmany.

Accreditationisnotourfinalgoal.WewillcontinuetoeducateourstudentssotheycanbethenextgenerationofpharmaciststodevelopandleadthewayforinnovativepharmacyhealthcarepracticesintheUpstate.Ourjobisnotdone,itisjustbeginning!

Presbyterian College School of Pharmacy Update By Cliff Fuhrman, PhD, RPh, Dean

PCSP


FINANCIAL FORUM

inancial orumThis series, Financial Forum, is presented by Pro Advantage Services, Inc., a subsidiary of Pharmacists Mutual Insurance Company, and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

WHILETHEIDEAOFRETIREMENTHASCHANGED,CERTAINFINANCIALASSUMPTIONHAVEN’T

We’veallheardaboutthe“newretirement”,themixofworkandplaythatmanyofusassumewewillhaveinourlivesoneday.Wedonotexpect“retirement”tobealllei-sure.Whilethisisbecomingaculturalassumptionamongbabyboomers,itisinterestingtoseethatcertainfinancialassumptionshaven’treallychangedwiththetimes.

Inparticular,therearetwofinancialmisconceptionsthatbabyboomerscanfallpreyto–assumptionsthatcouldprovefinanciallyharmfulfortheirfuture.

#1)Assumingretirementwilllast10-15years.Previ-ousgenerationsofAmericansplannedforretirementsanticipatedtolastonly10-15years.Today,bothmenandwomenwhoreach65cananticipatearound20additionalyearsoflife.It’simportanttonotethatthisisjustanaver-age;aquarterofpeoplereaching65willlivebeyond90andtenpercentwillliveanotherfiveyearsormore.

However,someofusmaylivemuchlonger.Thepopula-tionofcentenariansintheU.S.isgrowing–theCensusBureaucounted53,364folks100yearsorolderin2010andshowedasteady5.8percentriseincentenarianssincethepreviouscountin2000.Italsonotesthatbetween1980and2010centenariansexperiencedapopulationboom,witha65.8%riseinpopulation,incomparisonto36.3%overall.

Ifyou’rereadingthisarticle,chancesareyoumightbewealthyoratleast“affluent.”Andifyouare,youlikelyhavegoodhealthinsuranceandaccesstoexcellenthealthcare.Youmaybepoisedtolivelongerbecauseofthesetwofactors.GiventhelandmarkhealthcarereformsoftheObamaadministration,wecouldseeanotherboostinoverallAmericanlongevityinthegenerationahead.

Here’sthebottomline:everyyear,thepossibilityisincreasingthatyourretirementcouldlast20or30years…orlonger.Soassumingyou’llonlyneed10or15yearsworthofretirementmoneycouldbeabigmistake.

Manypeopledon’trealizehowmuchretirementmoneytheymayneed.ThereisarelationshipbetweenMiscon-ception#1andMisconception#2…

#2)Assumingtoolittlerisk.Ourappetiteforriskdeclinesaswegetolder,andrightfullyso.Yettheremaybeadangerinbecomingtoorisk-averse.Holdingontoyourretirementmoneyiscertainlyimportant;soisyourretirementincomeandqualityoflife.Therearethreefinancialissuesthatcanaffectyourqualityoflifeand/orincomeovertime:taxes,healthcarecostsandinflation.Overtime,even3-4%inflationgraduallysapsyourpurchasingpower.Yourdollarbuyslessandless.

Here’sahypotheticalchallengeforyou:fortherestofthisyear,youhavetoliveontheincomeyouearnedin1999.Couldyoumanagethat?

Thisisanextremeexample,butthat’swhatcanhappenifyourincomedoesn’tkeepupwithinflation–essentially,youenduplivingonyesterday’smoney.

Taxesmaybehigherintheyearsahead.Sotaxreductionandtax-advantagedinvestinghavetakenonevenmoreimpor-tancewhetheryouare20,40or60.Healthcarecostsareclimbing–weneedtobepreparedfinanciallyforthecostofacute,chronicandlong-termcare.

Asyouretire,youmayassumethatanextremelyconserva-tiveapproachtoinvestingismandatory.Butgivenhowlongwemaylive-andhowlongretirementmaylast-growthinvestingisextremelyimportant.

Noonewantsthe“RipVanWinkle”experienceinretirement.Nooneshould“wakeup”20yearsfromnowonlytofindthatthecomfortofyesterdayisgone.Retireeswhoretreatfromgrowthinvestingmayriskhavingthisexperience.

Howareyouenvisioningretirementrightnow?Hasyourvisionofretirementchanged?Isretiringbecomingmoreandmoreofapriority?Areyouretiredandlookingtoimproveyourfinances?Regardlessofwhereyou’reat,itisvitaltoavoidthecommonmisconceptionsandproceedwithclarity.

Pat Reding and Bo Schnurr may be reached at 800-288-6669 or [email protected].


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GAMECOCK/USC MERCHANDISEOfficial collegiate licensedmerchandise forsale.T-shirts,carflags,tailgategear.Allde-signedbyaSCPharmacist.PleaseemailDanielBundrickatgamecocktees@aol.comorcall/text803.603.8622.Originaldesigns,unique,edgynewdesignstoo.Alsolookforourtwomobilestores, our huge vans that go to events andfootballgames.Checkusoutonlineatwww.carolinagamecocktees.com STORE FIXTURES/PLANNING

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THERAPY MANAGEMENT?Contact:BryanZiegler,PharmD,MBA,PharmacyServiceConsulting,LLC Phone:(803)269-6333 Email:[email protected]:MTMeducation,Identifi-cationofMTMOpportunities,StaffTraining,WorkflowAnalysis,BusinessAnalysis

PHARMACY OPERATIONS CONSULTANTPharmacistsinterestedinchangingyouexistingdesign and operation of your pharmacy - letthebest in thebusinesshelpyoumake thosechanges.Contact:PaulJ.Hyer,Jr.,RPh,PDat843-814-2542orwriteto301S.MagnoliaSt.Summerville,SC29483.

PHARMACIST SEEKING EMPLOYMENTSouthCarolina Licensed Pharmacistwouldlike to work in an independent pharmacy,prefer small-town setting. TimMcKittrick704-585-6690

FOR SALE: MORTAR AND PESTLESSetof8ScheringPharmaceuticalCorporationcommemorativebronzed-likemetalmortarandpestles,datedfromthe late1960sand1970s.Theyhavebeenondisplayinourindependentpharmacy inFlorence,SC for over 40years.We know thosewho are familiarwith thesewill appreciate themandwant them for theircollections. They are all about 4 inches tallby4incheswide.Theyareingoodcondition.Call 843-992-0981withoffer, plus$30 ship-ping.Nightsandweekendscall843-669-7439oremailgalehdixon@sc.rr.com

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♦ South Carolina Board of Pharmacy/licensing matters

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Jon A. Wallace, B.S.Pharm., J.D.

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BOOKS FOR SALEChristianBookAvailableatAmazon,BarnesandNoble,andetc.ItisCalledChoices(ThesecrettoMakingWiseChoices)byCarolynGaultwifeofpharmacistHoraceGaultJr.Thebookisaboutourmomentsinhistoryaswefacechoicesthatareconfusing,inoutrapidlychangingculture.TheproceedswillgotoMissiontotheWorldtohelpmissionariesandtheirfamilies.

OXYGEN EQUIPMENT18-Portableoxygencylinders,1devilbissoxygenconservator,1-5literconcentratorinvacare,7-oxygenregulators,1-Salterlabsul-trsonicoxygenindicator.Call864-843-9207,libertyfamilypharmacy$500.00


“When you go from four locations to 20 in 10 years, it takes far more than computer software. QS/1 has been a very valuable strategic partner in Long’s expansion. Working together the various QS/1 products give us the information we need to make decisions for individual stores or all locations. QS/1 has made us more efficient and given us the ability to give our

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©2014 J M SMITH CORPORATION. QS/1, NRx, PrimeCare, and SystemOne are registered trademarks and MSM is a trademark of the J M Smith Corporation.

866.929.9067 www.qs1.com

august september 2014

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