Links to resources for patients

Below are some resources for the following barriers to health that may be useful reference information at the bedside, should you and/or your patient find it relevant/necessary. You can use the links below as a shortcut to each section.


Food Security

Housing

Medication Adherence:

Transportation


Food Security:

You can refer patients to a dietitian/nutritionist
 (health insurance will pay for this service only if patients have specific diagnoses such as diabetes, malnutrition, renal failure, etc.

Food Bank

School programs, school meals, after school feeding programs, backpack programs, Community gardens, community-soup kitchens

Community Garden Guide 

Meals on Wheels & Senior Meal Programs  

Supplemental Nutritional Assistance Program (SNAP) 
Offers nutrition assistance to millions of eligible, low-income individuals and families and provides economic benefits to communities

Just Harvest -

Fresh Access
Enables shoppers to use their food stamps to buy fresh, nutritious and locally-grown food. 

Housing:

Section 8 Info:

http://portal.hud.gov/hudportal/HUD?src=/topics/housing_choice_voucher_program_section_8

http://www.sectioneightapplication.com/apply/PA?gclid=m

To File for Section 8 Housing, people should first contact their local housing authority: Pittsburgh Housing Authority http://www.hacp.org/
200 Ross Street Pittsburgh PA 15219 Phone: (412)456-5012 Fax: (412)456-5027
Allegheny County Housing Authority 625 Stanwix Street 12th Floor Pittsburgh PA 15222 Phone: (412)355-8940 Fax: (412)355-8954

For support with housing discrimination:
Fair Housing Partnership of Pittsburgh 2840 Liberty Avenue, Suite #205 Pittsburgh PA, 15222 P: (412) 391-2535 F: (412) 391-2647 http://www.pittsburghfairhousing.org/intakeform.asp (to file a complaint)
Free Legal Repsentation if Case Goes to Court: Neighborhood legal services association http://www.nlsa.us/services/services.html Allegheny County 412.255.6700 Beaver County 724.378.0595 Butler County 724.282.3888 Lawrence County 724.658.2677

Medication Adherence:

Four general themes that impact medication adherence:

  1. Cost

    1. Issues

      1. Can the patient afford the medication?

        1. Co-pays

        2. Insurance access

        3. Generic vs brand name

      2. Consider number of meds (10 meds x $15 copay = $150 a month!)

      3. “Donut hole” for Medicare

    2. Potential solutions

      1. $4 drug plans (see below)

      2. Cut down on # of meds when possible

      3. Consider switching meds for similar action but cheaper

  2. Education

    1. Issues

      1. Understanding why the medication is important

      2. Understanding how to take the medication (i.e. BID vs TID dosing, with or without food, etc)

      3. Health literacy level

      4. Brand name vs generic name awareness (and knowing their medication list)

    2. Potential solutions

      1. Ask the patient questions about their understanding in a non-judgemental way

      2. Use teach-back

      3. Do health literacy screening

  3. Cultural factors

    1. Issues

      1. Misinformation and assumptions about medication safety (e.g. patients fearing IUDs given rumors about uterine rupture)

      2. Adverse reactions/side effects and perception of these

    2. Potential solutions

      1. Ask patients (non-judgementally) their perceptions of their medication if they seem resistant

      2. Educate honestly about adverse reactions but also understand that some patients will refuse certain medications

  4. Physical barriers

    1. Issues

      1. Ability to open pill bottle

      2. Ability to use an inhaler or syringe/needle

      3. Ability to swallow pills, especially large ones

      4. Organizing pills into a pill box

    2. Potential solutions

      1. Consult with diabetic educator or pharmacist for patient education on how to use certain medications and devices

      2. Consult with occupational therapy for physical barriers

Tips:

Simplify regimen Learn which medications are costly, check pricing http://www.drugstore.com/

Look up health plan formularies

Consult pharmacists if available

Use generics

Pill-splitting when appropriate

Use free medical samples with caution

Take time to explain, build trust


Bottom line:

* Get help from your social worker (if available) or case manager regarding medication assistance

* Search, Google to access formularies, price comparison (www.goodrx.com)

* Call pharmacies to “run or put through the prescription” in order to know exact copay/cost to the patient


Additional resources


Patient-assistance programs


Patient-assistance programs (also called PAPs) are sponsored by companies that make prescription medicine. Each company has its own rules about who qualifies for its PAP. In many cases, patient will need to show that he/she does not qualify for private or public health insurance (such as Medicare or Medicaid). Patient may also need to prove that his/her income is below a certain level. The social worker and Falk/Presby pharmacist could often assist with the application process. http://www.needymeds.org/ http://www.rxassist.org/ http://www.togetherrxaccess.com/


$4 plans

http://www.walmart.com/cp/4-Prescriptions/1078664 https://www.gianteagle.com/Pharmacy/Savings/4-10-Dollar-Drug-Program/Generic-Drug-Program/


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See full document for more information:

http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20R/PDF%20RxForAffordabilityHelpingPatientsCope.pdf


Our job is to identify patients with transportation issues but refer to a social worker for assistance (if available) is recommended Do not hesitate to make a phone call (to the agency, to the social worker) on your patient’s behalf (it will go a long way) 

Travelers’ Aid 
With help of the United Way, provides travel assistance, including veterans, to-be moms, CYF, children, etc.
http://www.travelersaidpgh.org/ (explore the link to see the many programs available)
Medical Assistance Transportation Program (MATP) 
Provides free advanced tickets for bus, subway, incline as well as reimbursement for bus and private car. Riders must be residents of Allegheny County and have PA Medical Assistance card
ACCESS
Operated by Port Authority, it is a shared-ride, door-to-door service for people who cannot ride buses or light rails either some of the time or all of the time. Application and verification of disability are required. Operates through all of Allegheny County plus points 1.5 miles outside the county.
650 Smithfield Street Centre City Tower, Suite 440 Pittsburgh, PA 15222
412-562-5353 (also to schedule a ride too) Office Hours: 8:00 a.m. to 4:30 p.m., Monday through Friday

Transportation for seniors:  
ACCESS 65 PLUS 412-562-5353; OPT 412 562 5385
Port Authority Transit Senior ID Card 412-442-2000
Additional resources for those with special needs as well as resources not otherwise mentioned: