| Community Budget Issue Requests - Tracking Id #1103 | |||||||||
| United Home Care Services, Inc. | |||||||||
| Requester: | Jose R. Fox | Organization: | United Home Care Services, Inc. | ||||||
| Project Title: | United Home Care Services, Inc. | Date Submitted | 1/11/2005 4:03:34 PM | ||||||
| Sponsors: | Rodolfo Garcia | ||||||||
| Statewide Interest: | |||||||||
| By the end of FY 01-02, Florida expended $1.8 billion dollars on medications for poor, elderly and disabled individuals. This constituted 17% of the entire Medicaid budget. While the elderly only comprise 13% of the population, they consume 34% of all prescriptions. Medications for the elderly are often prescribed by multiple physicians who are unaware that the patient is receiving medications from other treating physicians. The significant negative consequences of receiving multiple medications from multiple sources includes: polypharmacy, duplication of medications (and costs), contraindications and drug-to-drug interactions as well as increased probability of a "prescribing cascade", a phenomenon where adverse effects of a drug are erroneously diagnosed as a new illness for which more medication is prescribed, resulting in further polypharmacy. The sheer number of medications being taken, the high rate of cognitive impairment and memory problems as well as the biological and physiological sensitivity changes that increase exponentially with advanced age, make this population extremely at risk for unnecessary illness, disability and death due to medication related factors (3rd or 4th leading cause of death for individuals over 65). A Medication Management program to address these issues has been instituted at United Home Care Services under the prior year's funding protocol. The medication management program can be easily replicated statewide. | |||||||||
| Recipient: | United Home Care Services, Inc. | Contact: | Jose R. Fox | ||||||
| 5255 NW 87 Avenue, Suite 400 | Contact Phone: | (305) 716-0765 | |||||||
| Miami 33178 | Contact email: | jfox@unitedhomecare.com | |||||||
| Counties: | Dade | ||||||||
| Gov't Entity: | Private Organization (Profit/Not for Profit): | Yes | |||||||
| Project Description: | |||||||||
| The purpose of the program is to reduce medication-related illness and hospitalizations in frail elderly patients who receive home health care assistance through UHCS sponsored programs. UHCS has developed a protocol to: document all current medications, over the counter substances and home remedies for participating clients; conduct a systematized review using geriatric and age specific clinical criteria, the use of a pharmacy partner to identify potential pharmacological problems and identification of possible lower cost medication alternatives; development of recommendations and communication for collaboration with prescribing physicians to modify a client's medications as appropriate; to educate the client and family concerning their medication regimen and assess possible barriers to compliance, and establishment of outcome measures for program effectiveness monitoring. The first portion of the project was devoted to program development, establishing a working relationship with the pharmacy partner, and developing, testing and refining protocols, and conducting a pilot with a trial population. UHCS is currently actively enrolling clients in the program and expects to have between four and five hundred participants by July 1st, 2005. An additional year's funding is being requested to expand the number of clients enrolled, develop additional protocols for physician and client education as well as address follow up of specific compliance and adherence issues in the highest risk cases. | |||||||||
| Is this a project related to 2004 hurricane damage? | No | ||||||||
| Measurable Outcome Anticipated: | |||||||||
| Preliminary start up pilot trial data indicates that clients are taking a mean of almost 9 medications (range 2 to 17). Only a small percentage of these clients (12%) did NOT have any medication-related issues after the initial pharmacological review had been completed. More than 40% of the enrollees were prescribed Benzodiazepine's which is highly contraindicated in this age group. Another 5% have had "medication related" falls. Additional measurable outcomes will focus on: reduction of medication related hospitalizations; decreases in aggregate utilization of prescriptions and over the counter pharmaceuticals; increases in client/family understanding and compliance with medication regimens; and effectiveness of mechanisms for communicating with physicians regarding elderly client's specialized pharmacological needs. | |||||||||
| Amount requested from the State for this project this year: | $165,000 | ||||||||
| Total cost of the project: | $100,000 | ||||||||
| Request has been made to fund: | Operations | ||||||||
| What type of match exists for this project? | Private | ||||||||
| Cash Amount | $ | In-kind Amount | $15,000 | ||||||
| Was this project previously funded by the state? | Yes | Fiscal Year: | 2004-2005 | Amount: | $100,000 | ||||
| Is future-year funding likely to be requested? | Yes | Amount: | $150,000 | To Fund: | Operations | ||||
| Was this project included in an Agency's Budget Request? | No | ||||||||
| Was this project included in the Governor's Recommended Budget? | No | ||||||||
| Is there a documented need for this project? | Yes | ||||||||
| Documentation: | Medication use and the elderly, Health Affairs, Polypharmacy in Quality Care | ||||||||
| Was this project request heard before a publicly noticed meeting of a body of elected officials (municipal, county, or state)? | No | ||||||||
| Is this a water project as described in Section 403.885, Laws of Florida? | No | ||||||||