Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

The Muskegon Prescription Assistance Center

Summer Pike, Brad Lich, Pamela Bolan, & Paula Sawyer
Organizational Strategic Plan Project
Ferris State University
Leadership in Nursing
Fall 2011

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

ABSTRACT

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

Muskegon Prescription Assistance Center

Assessment of External and Internal Environment

Trends
In the United States, the unemployment rate has almost doubled in only five years; it has
gone from 4.7% in July of 2006 to 9.1% in July 2011. The increasing unemployment rate is
evident in Michigan as well; at a rate of 10.9% Michigan is tied with South Carolina as having
the fourth highest state unemployment rate in America (Local Area Unemployment Statistics,
2011).
1.) Puerto Rico
15.5% in Jul 2011
2.) Nevada
12.9% in Jul 2011
3.) California
12.0% in Jul 2011
4.) Michigan
10.9% in Jul 2011
South Carolina
10.9% in Jul 2011
Muskegon County is no exception; the unemployment rate in Muskegon County is 2 percent
higher than the national average at 11.2% (Economy at a Glance, 2011).
It is nowhere better evident than in the data, to grasp the trickledown effect of an
economic hardship and its influence on our communities. The poverty level in Muskegon County
has also increased as a result of the increased unemployment rate. In 2009, a person living below
the poverty level in Muskegon County was joined by 18.6% of the community in Muskegon
County (State and County Quick Facts, 2011).

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

It is unfortunate, but everyone knows that with unemployment and poverty, comes the
reality of unaffordable health insurance. An increase in Muskegon Countys unemployment and
poverty rate was a definite precursor to an increasing number of people left uninsured in
Muskegon County, approximately 17.7% in 2009 (Health Insurance, 2011).
Forces
The poor and underserved person is frequently unable to pay for housing, food, childcare,
health care, and education. Difficult choices must be made when limited resources cover only
some of these necessities.
People are being forced to choose between whether to eat and live or not eat and die or
not get their medications filled and die or get their medications filled and live. It is not
uncommon for people to become noncompliant in taking their meds simply because they have no
choice. For example, a person may take medications other than the way they were prescribed in
order to have bottles last longer, or share medications with a spouse (Angell,2004).
Prescription drug costs are high and continue to climb. In 2004, "Americans were
spending $200 billion a year on prescription drugs, and that figure was growing at a rate of 12
percent a year" (Angell,p.1,2004). As the cost of prescriptions climb and as the economy
declines there is a definite need for prescription coverage assistance. The cost of healthcare,
particularly medications, is being shifted to the individuals instead of being covered by insurance
companies. Some employers are dropping healthcare benefits altogether (Angell,p.1,2004).
We would like to think that the increasing cost of prescriptions was related to the
production or continued research for better medication, however, there is much doubt that this is

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

the case. Consumer Health Organization Families USA reports that drug companies are spending
more than twice as much on marketing, advertising, and administrations then they do on research
and development (Act up, 2011). Drug companies profits exceed their research and
development expenditures (Act Up, 2011).
Unaffordable medication is a challenge that a prescription assistance center would have
to face. Drug companies have methods for poor and underserved people to obtain their
medications, but they must first figure it out through unadvertised loop holes. If more people
were to have access to these programs drug companies may eventually feel it in their profits. One
would think if drug companies are not willing to sell their medications cheaper, they will
definitely not be too excited to see agencies willing to jump their loop holes and get people
medications for free or at cost.
Another challenge a prescription assistance center might face is funding. In order to get
through the red tape you would need knowledgeable educated staff, however, clients are looking
to cut costs not add new ones. One program that was created by Muskegon Community Health in
2007, was a pharmaceutical access program, which used a AmeriCorps VISTA volunteer grant
from the Michigan Council on Crime (Muskegon Community Health,2011).
Insurance companies, hospitals, and doctors should all be very supportive of such an
agency. One hundred billion dollars a year is spent on hospital admissions related to nonadherence to medications resulting in an estimated 89,000 deaths per year. Think of the money
and lives that can be saved if patients were able to afford to stay on their medications
(Vanderson, 2010).

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

Environmental Support Capability

As of the census of 2000, there were 170,200 people, 63,330 households, and 44,267
families residing in the county. For the 2010 census, the number of people was 172,188 and the
rest of the data is not formatted or not available.
There were 63,330 households out of which 34.60% had children under the age of 18
living with them, 51.60% were married couples living together, 13.90% had a female
householder with no husband present, and 30.10% were non-families. 25.20% of all households
were made up of individuals and 10.40% had someone living alone who was 65 years of age or
older. The average household size was 2.59 and the average family size was 3.10.
The median income for a household in the county was $38,008, and the median income for a
family was $45,710. The per capita income for the county was $17,967. About 8.80% of families
and 11.40% of the population were below the poverty line, including 16.00% of those under age
18 and 8.20% of those ages 65 or over.
(http://en.wikipedia.org/wiki/Muskegon_County,_Michigan)
From this information it would appear that this area, although far from the poorest area in
state, could support a program that helped facilitate prescription assistance. It appears that the
neediest in this area are the very young and over 65 populations. It would take cooperation from
hospitals, clinics, doctors offices, and social programs. If we worked in conjunction with senior
programs and senior living complexes we would be more help to that generation.
For the young generation we would have to put the information out into WIC clinics,
commodities depot, community centers, daycares, and at schools. There are numerous websites
that have prescription assistance, but unfortunately most people who are uninsured also do not
have access to a computer and programs on the internet can be daunting.

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Similar Services
For the idea of a prescription drug assistance program, similar services was searched for
using google.com. The first website we found was www.pparxmi.org. This website helps
individuals find affordable drugs. The problem with this website is that it is not local and it is
difficult to navigate. We also found that this website is difficult to verify its authenticity; this can
lead to identity theft and the dissemination of personal medical information. The second website
we found was http://www.sav-mor.com/assistance_programs. This website is linked off of a
pharmacy website. These links linked to pharmaceutical company assistance programs. The
problem with this one is that would be hard for an individual to get their prescription drugs
because you need to jump through so many hoops to prove that youre in need, you also need to
find a pharmacy to accept your medications for you. The third website we found was
http://www.aaa1c.org. This website is a state sanction agency that assists the elderly. The
problem with this group is that it is centered in south east Michigan, which is far away from
Muskegon and the prescription assistance, comes from out of state and it also focuses on helping
individuals navigate Medicare prescription drug coverage.
After searching for a prescription assistance programs in Muskegon, Michigan it appears
to us that there is a need for a prescription drug assistance program. The first reason is there does
not seem to be an assistance program in this area and if there is, it is poorly advertised. Secondly
the prescription drug assistance websites we did find appeared to be difficult to use because they
are difficult to navigate, possibly predatory, and have some many hoops to jump through that a
normal person would have difficulty getting prescription drugs on their own. For these reasons
there is a need in the community to assist this vulnerable population.

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Our Mission Statement

The Muskegon Prescription Assistance Centers (MPAC) is a non-profit, community
based, prescription assistance program. Our mission is to increase availability of prescription
medications to those in the community who cannot afford their medication by providing free and
discounted medications to those in need.
The services MPAC provides will be accompanied by highly professional and dedicated
individuals. Those who work and volunteer at MPAC will not only strive to fulfill our mission
but will do it providing our service under our committed philosophy.
Our Philosophy

We believe that everyone, regardless of finances, should have access to needed

prescription medication in order to maintain their health.

We will support one another in serving our patients and in serving our community.

We communicate openly, honestly, respectfully and directly (Guiding Behaviors, 2011).

We trust and assume goodness in intentions (Guiding Behaviors, 2011).

We will serve together to steward the resources entrusted to us.

As MPAC serves the community, we are also committed to implementing goals that will

apply our philosophy.

Goals
MPAC goals will be publicly available as a way for the center to, not only inform our
donors, sponsors, and volunteers of our plans and commitments, but to also apprise the
community as well. Our goals currently include, but may not be limited to, the following:

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

Facilitate people's ability to obtain medication regardless of their financial means.

Decrease hospital admissions related to medication noncompliance

Collaborate with other medical professionals and services to provide smooth continuation
of pharmaceutical care.

Educate the community on the importance of medication compliance.

Objectives
To be successful at attaining our goals we must follow a process that supports these

goals. MPAC has come up with some solid objectives that we believe will allow the center to
develop and maintain a thriving foundation onto which it will grow. MPACs current objectives
include, but may not be limited to, the following:

To reduce the number of hospital admissions in the Muskegon area related to nonadherence to medication regimens by 20 percent within the agency's 1st year.

To provide information regarding the importance of medication compliance and the

dangers of sharing prescription medications at local community events in the Muskegon
area.

To establish a community prescription service so that all people in the target population
have equal access to prescription medication.

To incorporate a multidisciplinary approach to aid in the development and success of a

prescription assistance center through the use of physicians, nurse practitioners, nurses,
case managers, social workers, home care personnel, laboratories, and clergy.

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To evaluate the center on a continuous basis, including needs assessment and

measurement of process, economic, and outcome variables (Yoder-Wise, 2011).
Job Descriptions
As stated previously, services provided by MPAC will be delivered using highly

professional and dedicated individuals. Below is a listing of MPACs current positions that will
need to be filled in order to support our mission, philosophy, goals, and objectives.
1.) Doctor/Medical Director/CEO
General Responsibilities
The Medical Director will be responsible for the supervision of administrative, clinical,
and educational activities. The medical director will perform all of the tasks that are necessary
for the MPAC to provide efficient, high-quality, patient care.
Duties and Responsibilities

Supervise all professional and non-professional activities of MPAC, to assure that the
center is in compliance with the appropriate standards required by all governmental
agencies and conforms to the rules, regulations.

Set and implement all policies and procedures for MPAC.

Monitoring physician and patient satisfaction with MPAC including services, policies,
and personnel.

Assisting with orientation and educational programs for the medical and non-medical
community at large.

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Using other appropriate means to inform the staff and the public of activities and services
available through the Muskegon prescription assistance center.

Establish organizational relationships and assign duties and responsibilities to the MPAC
personnel, assist the personnel to effectively carry out those duties and responsibilities.

Perform quality improvement activities as directed by the governing board, department,

and/or committee.

Provide continuing education programs and encourage personnel to participate in

continuing educational activities.

Monitor clinical performance to assure compliance with the established standards,

policies, and procedures.

Be physically available on a day-to-day basis to help coordinate and monitor medical

services.

Qualifications

Is a licensed physician certified by the State Medical Board.

Is Board certified or be eligible to become certified.

Has experience or a strong desire to perform managerial functions for the management
and operation of MPAC.

2.) Nursing/ Program Director

General Responsibilities
The Nurse Program Manager is a bachelor degree prepared nurse who provides
administrative leadership, program management, staff supervision and direct patient care. The

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nurse director is responsible for developing and maintaining a program of excellence in clinical
practice, and quality service to the patients of the MPAC. The nurse director is responsible for
establishing and meeting quality care and service standards. Establishes program goals and
monitors performance. Manages the daily operations of this program, provides clinical
supervision covering the Muskegon prescription assistance center, and administrative
supervision to other staff. Requires clinical and management expertise and the ability to
coordinate efforts with area hospitals, pharmacies, doctor offices, and other allied health
professionals.
Duties and Responsibilities

Provides leadership by establishing goals, monitoring performance, and developing

policies and procedures.

Develops and promotes appropriate collaborative and consultative relationships with area
hospitals, pharmacies, doctor offices, and other allied health professionals.

Develops and implements appropriate clinical programs including identifying funding

sources, write grant proposals as needed and monitor grant commitments.

Develops and meets budget/volume projections by integrating cost containment and

maximizing revenue strategies into program planning and implementation.

Ensures appropriate billing practices at MPAC.

Manages the operations of MPAC and oversee adequate staffing, equipment, and
supplies.

Monitors patients and workflow, while making changes to improve patient access, patient
satisfaction and provider/staff efficiency and effectiveness.

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Responsible for patient reception and encounter input.

Responsible for daily operations, policies and procedures.

Supervises and manages staff (interview, hire, train, assign work to, evaluate

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performance of, and, if necessary, discipline and recommend discharge of subordinates).

Provides clinical supervision to the MPAC staff.

Responsible to ensure that clinical care at MPAC are of high quality, in accordance with
applicable laws, regulations, pharmacy standards, and principles of professional ethics.

Develops and maintains relationships with city, state, and national health resources.

Maintains ongoing knowledge of legislative, social, and financial changes impacting

MPAC.

Serves as a consultant and resource to other staff and colleagues.

Prepare reports as required by funding agencies.

Qualifications

Bachelors or Masters prepared registered nurse with three to five years clinical
experience with concentration in a related field as determined appropriate by the CEO of
MPAC.

Three to five years management experience.

Experience with program management and evaluation.

Excellent organizational and communication skills.

Must demonstrate interpersonal skills sufficient to provide effective leadership.

Sensitivity and appreciation of class, ethnic, racial, and lifestyle differences.

Ability to work with diverse populations.

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Ability to develop and establish systems for operationalizing project objectives.

A current State of Michigan Registered Nurse License, BLS certified.

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3.) The Director of Corporate Finance & Foundation Relations

General Responsibilities
The Director of Corporate Finance & Foundation Relations would be responsible for
identifying, researching, and soliciting corporations and foundations whose funding objectives
align with our programs and services, and cultivate the resulting relationships with these entities.
This person would also be responsible for the day to day management of monies raised; this
includes foundation expenses and divvying out grant money. Finally, this person will manage the
group of volunteers responsible for the fundraising activities.
Duties and Responsibilities

Research foundations and corporations to approach for private funding and proceed as
needed;

Work with the CEO and Program Director to understand unmet needs and develop and
write proposals to secure private funding;

Work closely with program staff to develop program budgets for submission to funders;

Secure and submit follow up and final reports to foundations and corporations for both
unrestricted and restricted grant funding;

Work closely with program staff to report on spending in accordance with budgets
submitted at the end of each grant period;

Write letters of acknowledgement and thanks to corporate and foundation donors;

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Assist in drafting, editing and submitting proposals in response to federal, state, and other
sources of public funding Requests for Proposals;

Coordinate media campaigns including identifying media sources, preparing materials

and follow-up to publicize large grant awards and appropriately acknowledge corporate
and foundation donors;

Orchestrate and lead program site visits for potential corporate and foundation donors;

Maintain up-to-date records demonstrating the status of each proposal on the grant
slate, i.e. what proposals are pending, for how much, what has been awarded, what is to
be submitted, deadlines, etc.;

Present progress and status toward achieving fundraising goals monthly basis to the CEO,
and quarterly basis to the Board of Directors.

Prepare monthly financial statements for multiple clients

Prepare month end adjusting journal entries

Reconcile balance sheet accounts on a monthly basis

Oversee financial statement preparation of entry level accounting staff

Review client financial statements and provide feedback to client

Manage own workload by monitoring projects/return deadlines, frequent daily contact

with client administrators and/or managers in assessing project status and problems
encountered

Maintain regular communication and interact directly with client personnel on accounting
information, due dates, deadlines, and other compliance matters keeping them informed

Recognize potential

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Interact pleasantly with funders, board members, potential donors and other community
representatives;

Demonstrate excellent written and verbal communications skills through written

documents and in-person presentations;

Maintain strict confidentiality regarding all donor records and giving histories, prospect
research and identification, board member information, client/consumer information and
other confidential agency information problem areas in projects and discuss with
appropriate company personnel

Qualifications

A Bachelors Degree; a Masters degree in a relevant field is preferred

Three years experience in grant writing in a non-profit development environment or a

related field is required;

One year experience in accounting for a business or nonprofit organization.

Management experience for a small group or business.

Excellent organizational, interpersonal, oral and written communication skills are

required.

Ability to manage multiple projects and priorities; Proficiency in MS Word, Excel and
PowerPoint.

Proficient in analyzing financial statements and accounting transactions

Proficient in work paper and file maintenance techniques

Proficient in Excel and Word, QuickBooks, Creative Solutions experience preferred

Proficient in oral and written communication skills

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Highly organized

Ability to work independently and in a team setting

Detail and goal oriented

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4.) Case Manager

General Responsibilities
A case manager is knowledgeable and able to collaborate with other services, obtaining
assistance based on client's financial needs.
Duties and Responsibilities

Performs financial and pharmaceutical assessments.

Collaborates with pharmacist, pharmaceutical companies, and physicians.

Assists and educates clients on how to obtain pharmaceutical products.

Qualifications

MSW required with at least 2 years of experience in a healthcare setting preferred.

5.) Pharmacist
General Responsibilities
The pharmacist is responsible for collaborating with case managers and physicians to
maintain a safe and attainable medication regimen for clients along with educating the
community on safe pharmaceutical practices.
Duties and Responsibilities

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Reviews clients list of medications

Acts as a resource for case managers pharmaceutical inquiries.

Organizes educational materials for clients, agency staff , and community

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Qualifications

State licensure with PharmD degree required. Five years of experience preferred.

6.) Nursing
General Responsibilities
Nursing will work in partnership with the medical director, program director, pharmacist,
and all other relationships within MPAC to see patients efficiently and to provide nursing care.
Vital signs, history, basic laboratory procedures, administration of medication, and assistance
with simple procedures will all be part of her/his responsibility.
Duties and Responsibilities

Assist the medical director, program director, pharmacist, and all other relationships
within MPAC as needed.

Weigh patients and take their blood pressure and other vital signs; take patient medical
history.

Prepare patients in the consultation/assessment room.

Perform simple lab tests such as urine dipsticks, finger stick glucose, PT/INR levels, etc.

Administer medications and injections as prescribed by their primary care provider

and/or the medical director.

Running Head: MUSKEGON PRESCRIPTION ASSISTANCE CENTER

Provide patient instruction and educational materials as needed.

Ensure complete and proper documentation of all patient care and instruction in patient
medical records.

Qualifications

Current Michigan registered nurse license.

7.) Volunteer
General Volunteer Qualifications

Academic background in public health, social work, public administration,

pharmaceuticals, or any other related health care field preferred

Microsoft Office proficient; ability to do research independently on internet

Ability to write clearly and concisely

Must have a commitment of at least eight (8) hours per week

Strong communication skills

Competency in languages other than English strongly preferred but not required

Patient Support Volunteer

General Responsibilities
MPAC patient support volunteers have the unique opportunity to work with patients
personally. It will be the volunteers responsibility to greet the patients, help them fill out
paperwork, and help them feel welcomed from the moment they arrive. Patient support

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volunteers will ensure that patients move through their visit with ease and be sure that the
patients understand each part of the process.
Qualifications

A desire to serve others and the gift of hospitality

Be able to communicate great warmth while at the same time maintain professional
boundaries with regard to confidentiality, personal space, and levels of comfort.

Administrative Volunteer
General Responsibilities
MPAC administrative volunteers serve a behind-the-scenes role by accomplishing special
projects. An administrative volunteer could help with various tasks that aid in daily clinic
activities such as making reminder phone calls to patients, making patient charts, entering data in
our system, organizing/tidying up the waiting room, and stocking and organizing items donated
to the clinic and other clerical tasks.
Qualifications

Organized and attentive to detail

Enjoy clerical and administrative duties

Comfortable taking initiative to complete special projects

Patient Intake Volunteer

General Responsibilities

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Patient intake volunteers assist patients while they are in our clinical areas.
Responsibilities includes: escorting patients in the clinical area, checking patients in, obtaining
patient data such as weight, height, blood pressure, and vitals. Patient intake volunteers work
alongside the nursing staff to get patients checked into their consultation/assessment room. Other
services include: straightening up consultation rooms and preparing the room for the next patient.

Qualifications

Familiarity with the intake process including taking information about prescriptions,
temperature, allergies, vitals, and chief complaints.

Advertisements

In order to help facilitate acquiring positions for MPAC we developed an example flyer
which will help to promote applicants into applying for the job of the MPAC Nurse/Program
Director (see Appendix A). In order to get an idea of how much it would cost to run our flyer in a
credible journal we looked up quotes from three nursing journals for a comparison (see
Appendix B).

Another way we thought we could advertise would be to place our flyer in brochures at
local medical centers, doctors offices, health clubs, and emergency departments. Fed Ex printing
has tri-fold brochures that start at $1.06 per brochure. A billboard promoting MPAC and our
open position could be another avenue to take for advertising.

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ROUGH REFERENCES
Partnership for Prescription Assistance (2011).
Find a Free or Discounted Drug Program. Retrieved September 14, 2011, from http://www.pparxmi.org/
Sav-Mor Drug Stores (2011). Patient Drug Assistance Programs. Retrieved September 14, 2011, from
http://www.sav-mor.com/assistance_programs
The Senior Alliance. (2011). Prescription Drug Assistance Programs. Retrieved September 14, 2011, from
http://www.aaa1c.org/consumers/resource13.htm
Muskegon community heath project. (n.d.). Pharmaceutical access program. Retrieved September 11,
2011, from http://mchp.org/aboutus/pap.html
ACT UP. (2010, April 20). LINKS HIGH DRUG PRICES TO ADVERTISING, PROFITS, AND ENORMOUS
EXECUTIVE SALARIES. In Off the Charts: Pay Profits and Spending by Drug Companies. Retrieved
September 11, 2011, from http://www.actupny.org/reports/drugcosts.html
Angell, M. (n.d.). The truth about drug companies. In The New York Review of Books. Retrieved
September 11, 2011, from http://www.nybooks.com/articles/archives/2004/jul/15/the-truth-about-thedrug-companies/
Vanderson, . (2010, April 20). The High Cost of Medical Noncompliance. In One med Place. Retrieved
September 11, 2011

Economy at a Glance. (2011, September 9). Retrieved September 11, 2011, from United States
Bureau of Labor Statistics:
http://www.bls.gov/eag/eag.mi_muskegon_msa.htm#eag_mi_muskegon_msa.f.P
Guiding Behaviors. (2011). Retrieved September 18, 2011, from Trinity Health:
http://www.trinity-health.org/body.cfm?id=25
Health Insurance. (2011, June 6). Retrieved September 14, 2011, from U.S. Census Bureau:
http://www.census.gov/hhes/www/hlthins/data/acs/up-to-138-pov.html
Local Area Unemployment Statistics. (2011). Retrieved September 11, 2011, from Unites States
Bureau of Labor Statistics: http://www.bls.gov/lau/
State and County Quick Facts. (2011, June 3). Retrieved September 14, 2011, from U.S. Census
Bureau: http://quickfacts.census.gov/qfd/states/26/26121.html
Yoder-Wise, P. S. (2011). Leading and Managing in Nursing. St. Louis: Elsevier.

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Appendix A

Appendix B
Journal
American Nurse
Association

Size
Full page
2/3 page
1/2 page
1/4 page
1/8 page
Journal of Professional Full page
Nursing
1/2 page
1/4 page
Journal of Holistic
Full page
Nursing
1/2 page
1/4 page

Add/Flyer Pricing
1x
2x
$5485
$5065
$3510
$3335
$3250
$3180
$1910
$1795
$985
$900
$960
$940
$730
$710
$605
$600
$575
$550
$400
$380
$275
$260

6x
$4795
$3250
$3120
$1690
$845
$950
$700
$595
$525
$360
$245

12x
n/a
n/a
n/a
n/a
n/a
$920
$670
$585
$495
$340
n/a

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Appendix C
Organizational Chart Muskegon Prescription Assistance Center
Center Medical
Director

Dr. John Smith

Program Director
Jane Doe RN, BSN, MSN

Case Manager

John Doe MSW

The Director of
Corporate Finance &
Foundation Relations

Susie Que

Volunteers

Pharmacist
Sara Smith, PharmD

Nursing

Bob Barker, BSN