Cash is king in opioid treatment centers, new Vanderbilt policy center finds

The debut pilot study from the new Vanderbilt Center for Child Health Policy spotlighted the challenge in finding an opioid use disorder treatment that doesn’t require self-pay in four states, including Tennessee, particularly for pregnant women.

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‘Destiny’ brings indie pharmacy to Napier, alleviating the struggle for a ride to get an Rx

Karen Penley got tired of bumming rides to a pharmacy each month to pick up her prescriptions, so she leapt at the chance to transfer to a pharmacy with a delivery service.

Penley, who lives in the Napier community near downtown, resides in what’s long been a pharmacy desert. She switched to Pruitt’s Discount Pharmacy because it delivered from East Nashville.

Pharmacy deserts — or areas with limited access to an independent or retail pharmacy — closely align with low-income areas defined as food deserts, and have fewer retail choices compared to more well to-do communities, according to researchers.

But a community effort involving Neighborhood Health, the Metropolitan Development and Housing Agency, and Pruitt’s Discount Pharmacy has opened a small, but critical, pharmacy in a corner of Nashville that needs it.

The initiative got started because Penley spoke with Janet King, a community engagement manager who works in the Napier-Sudekum neighborhoods, about how the MDHA should talk to Shawn Pruitt about opening up.

And, on April 18, Penley got to help cut the ribbon at Napier Clinic at 107 Charles E. Davis Blvd., marking the opening day.

“I was fighting every month to get my medications. I did this for the community,” Penley said, beaming. “All because I mentioned it. I’m very excited.”

Karen Penley, standing in front of the pick-up counter at the new location of Pruitt’s Discount Pharmacy, suggested a city agency reach out to the pharmacy about opening up. She struggled to get to a pharmacy each month and worried about people who are sicker or have small kids. Photo/Holly Fletcher

The clinic was abuzz with energy and pride over the opening of a pharmacy not much larger than walk-in closets in some of the luxury houses being built in other parts of the city.

It’s a step toward making sure neighborhood residents have local access to amenities that are commonplace in other neighborhoods, leaders said.

The Neighborhood Health clinic offers dentistry and mental health services so leasing the space to Pruitt makes it a single destination for a community that is dealing with high rates of high-blood pressure and diabetes, said Mary Lawson, the clinic manager.

Researchers found pharmacy deserts were more common in low-income neighborhoods as well as segregated minority or black neighborhoods compared to areas that were predominantly white or integrated. Neighborhoods in Chicago without easy access to pharmacies increased in number in the early part of 2000s, according to a 2014 article published in Health Affairs.

Medication compliance is integral to treatment or management of chronic disease.

“You’ll never get well if you don’t take the medicines and you can’t get them,” said Pruitt.

Corey Bradley is the new pharmacist at Pruitt’s Discount Pharmacy in Neighborhood Health’s Napier clinic. Photo/Holly Fletcher

Pruitt had wanted to open his initial pharmacy in Napier, but wound up planting his first stake in East Nashville. The Neighborhood Health location is next to the Nashville Public Library – Pruitt Branch — which is named for his family.

“It’s very monumental for the family,” said Pruitt. “Karma and destiny have a way.”

The pharmacy won’t sell controlled substances — because “it’s not a drug desert but it is a pharmacy desert,” said Mary Bufwack, the former CEO of Neighborhood Health who still works on some projects.

»  Haslam: Tennessee’s health ‘a slow turning battleship’

It will sell a variety of common medicines for $4 without insurance. It accepts TennCare, Medicare, workers compensation and commercial insurance. In 2017, 56 percent of the people treated through Neighborhood Health were uninsured. A quarter are covered by TennCare or the Children’s Health Insurance Program.

There are plans to unfurl a banner that reads “Pharmacy Now Open” on the outside of the building to get the word out that people don’t have to venture too far out of the way to pick up medications. King wanted to make sure it would be in place before a street festival in early May.

Mary Bufwack, L, Karen Penley, Jim Harbison, Brenda Morrow, Freddie O’Connell and Shawn Pruitt, cut the ribbon at the new pharmacy on April 18, 2018. Photo/Holly Fletcher

A neighborhood resident walked in to talk to Corey Bradley, the new neighborhood pharmacist. She takes medicine for asthma and emphysema and nodded with approval when Bradley said her medications would be in stock.

She indicated she’d transfer to Pruitt’s after she finished the rest of the month’s allotment because a short walk will be easier than finding a way to get to the Walgreens at the intersection of Thompson Lane and Nolensville Pike.

The journal authors wrote that improving access to chain pharmacies, such as Walgreens and CVS, which frequently have retail clinics that offer preventive services “may contribute to improvements” in health.

Brenda Morrow, the chair of Neighborhood Health’s board, wants to go further.

She wants a Neighborhood Health clinic in each public housing complex.

“That’s where the people with the most needs are,” Morrow said. 

Tennessee’s gubernatorial hopefuls received 7 health care questions. Some answered.

What you’ll read about: BirdDog sent seven questions to the Tennessee governor hopefuls to illuminate policy stances on a range of health care topics, including outpatient treatment for substance abuse, balance billing, whether Medicaid expansion would be a priority, and whether the state and/or employers have an obligation to help with access to coverage.
Updated at 6 p.m. on 4.19.2018 to reflect additional responses.

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The TennCare work requirement bill isn’t just about work — it spotlights how lawmakers are bolstering the dependence on jobs for health care access

What you’ll read about: The state legislature is poised to instruct TennCare to negotiate a work requirement — an unprecedented approach to Medicaid eligibility that raises questions about what happens in times of an economic downturn and how to track hours as the number of people in gig-type jobs rises.

Implementing a work requirement in a state with stringent eligibility rules spotlights a central question the U.S. is grappling with: what happens if insurance is tied to employment, but not all employers offer affordable coverage?

The graphic above: TennCare covered 854,666 women in January 2018, compared to 621,708 men. Data from TennCare.

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