Sarasota Health News

At the Community Pharmacy of Sarasota County, pharmacist Doris Twardosky reviews medicines with client Willie Ingram.

For the struggling, medicine and hope

David Gulliver - posted 9:15 pm Tuesday, July 14

It’s still minutes before the posted 9 a.m. opening, but the Community Pharmacy of Sarasota County has its first client of the day, and its director, Kim Chmielewski, has her first two challenges.

The client is Brian, a 50-year-old man in an Army ballcap. He has been getting free medications from a drug company’s charity program, but the company sold the drug’s rights to another firm, and the new owner demands a new application.

And the fluorescent light in the hall is out, there are no new bulbs and the budget is too tight and the day too busy to buy more.

So the day begins at one of the loosely knit groups that together make the safety net of health care for the estimated 47,000 county residents who lack insurance and regular health care.

The pharmacy opened in April 2008 in home in Nokomis, in the scruffy Palm Square shopping plaza. But it offers 1,750 square feet, enough for a waiting area, consultation rooms and rows of cabinets and shelves. And it’s on the county’s #17 bus route, important for a client base that runs from Newtown to North Port, which is where Willie Ingram lives.

The 45-year-old Army veteran showed up promptly at 9, looking fit enough to still be in the service.

Until May, he managed a branch of Florida Irrigation Supply, which did booming business during the real estate heyday. But when construction dried up, so did the branch offices and their jobs.

Even with his military service and a business degree, he can’t find work. On the advice of an employment consultant, he has “dumbed down” his resume so he doesn’t appear overqualified when applying for low-level jobs.

Ingram laughs a lot, usually in sets of three deep chuckles. But when he talks about the economy, he just shakes his head. “I’ve never seen it like this my whole life,” he said. “If you’re in a construction-related field right now, it’s a bad time.”

With no job and no insurance, he quickly ran out of his medications, Glucovance for diabetes and Toprol and lisinopril for his heart. Even so, it was difficult for him to come to the pharmacy. “It’s hard to go to the other side of the table. If it weren’t for my kid, I probably wouldn’t be here doing this now.”

The kid is Willie III, who just turned 4. Like his dad, he’s a Dallas Cowboys fan. He likes to wear his toddler-sized Cowboys helmet and pads, climb into his father’s lap and watch them play.

He’s still too little to understand dad’s plight, for which dad is grateful. “At this age, I can go to a dollar store and get him something with wheels on it, and he’s happy.”

Ingram sits down with Mavis Walker, one of the volunteers who run the pharmacy, who takes his application and begins to look for ways to find his medication.

The pharmacy is open to Sarasota County residents. Clients need to provide a driver’s license, proof of address, income verification and a tax return.

And that is Ingram’s first hurdle. A friend prepared his taxes, and he didn’t keep a copy of the return. Chmielewski appears out of nowhere and gives him the address and fax number of the IRS office where you can request a copy of your last return. She flits out, then reappears a few minutes later with a direct line to the office. Ingram picks up a phone and calls, but gives up after being on hold for 15 minutes.

Meanwhile, the bell keeps ringing as patients come and go. Summer is their busiest time, Chmielewski says, because that’s when Medicare drug plan patients tend to hit the infamous “donut hole,” when they’ve exceeded the coverage limit.

But to her surprise, seniors are not their biggest clients. “It’s the people between 45 and 60 who are really hurting, and that’s not what we expected when we opened,” she said.

Chmielewski,a former banker, has a windowless office in the back of the pharmacy. Most of the office furniture came from a car dealership that closed, except her L-shaped, faux-cherry desk is perhaps the only new furniture in the place.

A visitor notices, and she explains. She is petite and typing at the oversized salesmans desk was hurting her wrists. She asked the board for permission to get a new desk, which she pats on the side. “Scratch-and-dent sale. $179,” she says.

She is the pharmacy’s sole paid employee. Pharmacists like Doris Twardosky, behind the counter that morning, donate their time, as do Walker and Linda O’Shea, taking applications, Bill Tennant, taking questions in the waiting room, and Len Olen, a pharmacy tech helping in the stockroom.

With a $100,000 annual budget, the pharmacy has dispensed or lined up $1.1 million in medications for its clients. It has 440 regular clients so far in 2009, not counting people it refers to other programs.

It gets its much of its medicines from physicians, who donate samples, Twardosky says. But they can only accept unexpired medicines, an often-overlooked rule, she said. Some donations also come from families who somehow have the presence of mind to donate the medications of a relative who has died. Once, she said, a family donated an expensive, injectable medication that is never available as a sample. “Little miracles happen here all the time,” she said. “That’s what we’re here for.”

The other major source is via some 4,900 different charity programs at the various drug manufacturers. About half require the patient to have an advocate, like the pharmacy or a doctor.

Back in the consultation room, Ingram is making progress. One discount drug plan will offer him a 90-day supply of Toprol for $37. But the manufacturer’s charity program will supply it for free, if Ingram can call the IRS and get that return.

“The key here is for us to give you as much as we can for free,” Kim said.

“I’m on the phone,” he says. “As soon as I put my boy down for his nap.”

By 10:30 a.m., his interview and paperwork are finished, save for the tax form. “Alright, Willie,” Kim says.

The pharmacy doesn’t have the expensive Glucovance. But Twardosky knows it is a combination of the generics glyburide and metformin, which it does carry. She also dispenses a small supply of the heart medications, enough to cover Ingram until he can get into the drug maker’s charity program.

She hands over the medicines to Ingram and they talk for a few minutes about dosages, safety and side effects. He goes to pay, but there is no fee, and he’s amazed. “I never knew places like this existed, “ he tells the small crowd in the waiting room.

Then he goes down the hall to a water cooler, pours a cup and gulps his pills.

And Chmielewski solves her light bulb problem by swapping out a bulb from above a rarely used back door.

---

To learn more about the Community Pharmacy of Sarasota County, visit its website.





	At the Community Pharmacy of Sarasota County, pharmacist Doris Twardosky reviews medicines with client Willie Ingram. For the struggling, medicine and hope David Gulliver - posted 9:15 pm Tuesday, July 14 It’s still minutes before the posted 9 a.m. opening, but the Community Pharmacy of Sarasota County has its first client of the day, and its director, Kim Chmielewski, has her first two challenges. The client is Brian, a 50-year-old man in an Army ballcap. He has been getting free medications from a drug company’s charity program, but the company sold the drug’s rights to another firm, and the new owner demands a new application. And the fluorescent light in the hall is out, there are no new bulbs and the budget is too tight and the day too busy to buy more. So the day begins at one of the loosely knit groups that together make the safety net of health care for the estimated 47,000 county residents who lack insurance and regular health care. The pharmacy opened in April 2008 in home in Nokomis, in the scruffy Palm Square shopping plaza. But it offers 1,750 square feet, enough for a waiting area, consultation rooms and rows of cabinets and shelves. And it’s on the county’s #17 bus route, important for a client base that runs from Newtown to North Port, which is where Willie Ingram lives. The 45-year-old Army veteran showed up promptly at 9, looking fit enough to still be in the service. Until May, he managed a branch of Florida Irrigation Supply, which did booming business during the real estate heyday. But when construction dried up, so did the branch offices and their jobs. Even with his military service and a business degree, he can’t find work. On the advice of an employment consultant, he has “dumbed down” his resume so he doesn’t appear overqualified when applying for low-level jobs. Ingram laughs a lot, usually in sets of three deep chuckles. But when he talks about the economy, he just shakes his head. “I’ve never seen it like this my whole life,” he said. “If you’re in a construction-related field right now, it’s a bad time.” With no job and no insurance, he quickly ran out of his medications, Glucovance for diabetes and Toprol and lisinopril for his heart. Even so, it was difficult for him to come to the pharmacy. “It’s hard to go to the other side of the table. If it weren’t for my kid, I probably wouldn’t be here doing this now.” The kid is Willie III, who just turned 4. Like his dad, he’s a Dallas Cowboys fan. He likes to wear his toddler-sized Cowboys helmet and pads, climb into his father’s lap and watch them play. He’s still too little to understand dad’s plight, for which dad is grateful. “At this age, I can go to a dollar store and get him something with wheels on it, and he’s happy.” Ingram sits down with Mavis Walker, one of the volunteers who run the pharmacy, who takes his application and begins to look for ways to find his medication. The pharmacy is open to Sarasota County residents. Clients need to provide a driver’s license, proof of address, income verification and a tax return. And that is Ingram’s first hurdle. A friend prepared his taxes, and he didn’t keep a copy of the return. Chmielewski appears out of nowhere and gives him the address and fax number of the IRS office where you can request a copy of your last return. She flits out, then reappears a few minutes later with a direct line to the office. Ingram picks up a phone and calls, but gives up after being on hold for 15 minutes. Meanwhile, the bell keeps ringing as patients come and go. Summer is their busiest time, Chmielewski says, because that’s when Medicare drug plan patients tend to hit the infamous “donut hole,” when they’ve exceeded the coverage limit. But to her surprise, seniors are not their biggest clients. “It’s the people between 45 and 60 who are really hurting, and that’s not what we expected when we opened,” she said. Chmielewski,a former banker, has a windowless office in the back of the pharmacy. Most of the office furniture came from a car dealership that closed, except her L-shaped, faux-cherry desk is perhaps the only new furniture in the place. A visitor notices, and she explains. She is petite and typing at the oversized salesmans desk was hurting her wrists. She asked the board for permission to get a new desk, which she pats on the side. “Scratch-and-dent sale. $179,” she says. She is the pharmacy’s sole paid employee. Pharmacists like Doris Twardosky, behind the counter that morning, donate their time, as do Walker and Linda O’Shea, taking applications, Bill Tennant, taking questions in the waiting room, and Len Olen, a pharmacy tech helping in the stockroom. With a $100,000 annual budget, the pharmacy has dispensed or lined up $1.1 million in medications for its clients. It has 440 regular clients so far in 2009, not counting people it refers to other programs. It gets its much of its medicines from physicians, who donate samples, Twardosky says. But they can only accept unexpired medicines, an often-overlooked rule, she said. Some donations also come from families who somehow have the presence of mind to donate the medications of a relative who has died. Once, she said, a family donated an expensive, injectable medication that is never available as a sample. “Little miracles happen here all the time,” she said. “That’s what we’re here for.” The other major source is via some 4,900 different charity programs at the various drug manufacturers. About half require the patient to have an advocate, like the pharmacy or a doctor. Back in the consultation room, Ingram is making progress. One discount drug plan will offer him a 90-day supply of Toprol for $37. But the manufacturer’s charity program will supply it for free, if Ingram can call the IRS and get that return. “The key here is for us to give you as much as we can for free,” Kim said. “I’m on the phone,” he says. “As soon as I put my boy down for his nap.” By 10:30 a.m., his interview and paperwork are finished, save for the tax form. “Alright, Willie,” Kim says. The pharmacy doesn’t have the expensive Glucovance. But Twardosky knows it is a combination of the generics glyburide and metformin, which it does carry. She also dispenses a small supply of the heart medications, enough to cover Ingram until he can get into the drug maker’s charity program. She hands over the medicines to Ingram and they talk for a few minutes about dosages, safety and side effects. He goes to pay, but there is no fee, and he’s amazed. “I never knew places like this existed, “ he tells the small crowd in the waiting room. Then he goes down the hall to a water cooler, pours a cup and gulps his pills. And Chmielewski solves her light bulb problem by swapping out a bulb from above a rarely used back door. --- To learn more about the Community Pharmacy of Sarasota County, visit its website.