Even with Medicaid and other insurance programs for the medically indigent, many Americans still lack coverage and adequate access to basic health care services. Safety net clinics represent any number of medical operations, often ambulatory but some tertiary care facilities aimed to provide access to care to individuals who are at-risk and/or reside in primarily underserved areas. They derive their funding to operate from any number of sources including grants from the Health Resources Services Administration (HRSA) and from private foundations. They might charge patients a small fee based upon a sliding scale built around the patient’s wealth/income or provide some or all services free of charge. Some safety net clinics arise from or have affiliations with a Federally Qualified Health Center (FQHC).

Pharmacy services might be formally housed within these clinics or be provided by contract through community pharmacies or ambulatory pharmacy clinics through various mechanisms such as the 340B program. Managers of these pharmacy services must be acutely aware of the health care disparities often faced by patients of these clinics and likewise be effective managers of pharmacy services given that these services often will be provided on tight budgets and to patients suffering with multiple comorbidities and having difficulty to afford high-cost medical care.

Kauffman et al examined the challenges faced by patients in a free clinic and an FQHC in the same geographic region.¹ The themes from their study suggest that patients with diabetes face an emotional struggle associated with having the disease, that they feel on their own to care for themselves, would highly desire a personal and caring relationship with their pharmacist, and that they highly value pharmacists’ expertise in diabetes care. They suggest that pharmacy managers train all pharmacy personnel to help patients develop mechanisms for coping with their disease and be proactive and opportunistic in finding ways to ameliorate patient burdens while also preserving the pharmacy’s resources.

Additional information about Applications in Safety Net Clinics can be found in Pharmacy Management: Essentials for All Practice Settings, 4e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Kauffman Y, Jonkman L, Lupu A, Connor S. Exploring the value of clinical pharmacy services for patients with diabetes in safety net clinics. Res Social Pharm Adm. 2013;9:770-776.