UIC Tends to the Underserved in CommunityHealth Partnership

For nearly three decades, CommunityHealth, the country’s largest free medical clinic, has provided health care services to Chicago’s uninsured population. And for about 15 years, UIC College of Pharmacy has played a key role in helping the clinic deliver vital pharmacy services to those patients.

UIC has been there since the start of the clinic’s efforts to provide medication services. The clinic’s fi rst pharmacy partner, UIC is the only college to help in the establishment of MedAccess, CommunityHealth’s pharmacy; today, UIC’s involvement continues, with two UIC clinical pharmacists serving at CommunityHealth.

The partnership not only bolsters CommunityHealth’s capabilities; it also helps UIC deliver on its mission of service, said Dr. Sandra Durley, PharmD ’02, who’s shepherded UIC’s involvement at CommunityHealth since the beginning.

“As a public institution, we have an obligation to improve the health of the community,” she said. "We can do it within the four walls of the institution. But I think it makes a broader statement when we are actually out in the community taking care of people."

Dr. Durley, senior associate director for ambulatory care pharmacy at UIC, served on CommunityHealth’s board of directors from 2008 to 2016 and led the college’s involvement with the clinic starting in 2005. She currently serves on CommunityHealth’s alumni board.

DR. SANDRA DURLEY

Having a clinical pharmacist gives the patient more one-on-one time with a provider and helps them understand better their disease state and … manage their condition much better.

History

CommunityHealth launched in 1993, after founder Dr. Serafi no Garella, then at St. Joseph Hospital, glimpsed the size of Chicago’s uninsured population by surveying door to door. Today, CommunityHealth relies on philanthropy and volunteer hours from over 350 physicians, nurses, pharmacists, and other health care providers to deliver more than 15,000 medical and dental visits yearly.

Along the way, CommunityHealth opened a second clinic in Englewood (the original clinic is in West Town), later closing that location when the Affordable Care Act Medicaid expansion brought coverage to more people in the area. (CommunityHealth serves only those who slip through the insurance network’s gaps and are uninsured.) The clinic also expanded its services, including establishing a pharmacy, MedAccess, in 2007 and adding clinical pharmacists in 2012.

UIC College of Pharmacy, and Dr. Durley, played a key part in both efforts.

Dr. Nazia Babul

The organizations’ partnership began as a feasibility study. CommunityHealth, in 2005, wanted to replicate a South Carolina program that delivers donated pharmaceuticals to rural populations, adapting it for an urban center. Due to legal considerations, UIC wasn’t able to donate medications or fi ll prescriptions for CommunityHealth, but Durley wanted to stay involved. “I personally have an interest in helping underserved communities,” she said. “So I remained engaged with them … in an advisory capacity.”

Durley and UIC colleagues worked with Judith Haasis, then executive director of CommunityHealth, to transform the clinic’s unoffi cial dispensary into a licensed pharmacy — a requirement for many drug donors. Durley and colleagues advised CommunityHealth on funding sources, along with operational and legal considerations. The Otho S.A. Sprague Memorial Institute provided a grant to build the pharmacy. One of the UIC advisors, Ray Trafi cante, BS ’72, who owned his own pharmacy, even helped design the fl oor plan, while UIC College of Pharmacy law professor Edward Rickert provides pro bono legal advice.

Today, MedAccess gathers medication donations from six partner institutions, offering services 60 hours per week and fi lling around 33,000 prescriptions yearly.

The pharmacy makes a big difference for patients, Durley said. Most companies donate medications only if recipients are uninsured. Establishing lack of insurance for individual patients takes a lot of paperwork that can be difficult for patients, but those in CommunityHealth’s system go through extensive means testing to ensure that they meet criteria. So, companies can just donate to MedAccess in full confidence.

Beyond the pharmacy

In one of Durley’s major efforts on the clinic’s board, she pushed UIC to get involved in clinical pharmacy at CommunityHealth.

“After we opened the pharmacy, that gave patients access to medication, but it didn’t really give patients access to the clinical pharmacy services we’re able to provide here at UIC,” Durley said. So, Durley took the head of UIC’s Department of Pharmacy Practice at the time, Dr. Jan Engle, PharmD ’85, to visit CommunityHealth and see first-hand the need for clinical support.

Dr. Jennifer Marcelo

Engle agreed, and in 2012, the college began funding two clinical pharmacists to each serve two days a week at CommunityHealth (with two additional days at UIC pharmacies and one day for academic duties). Drs. Nazia Babul and Jennifer Marcelo, PharmD ’09, filled the spots, with Dr. Jewel Younge, PharmD ’17, stepping in for Marcelo in 2018.

These pharmacists work frequently with patients facing chronic conditions like diabetes and hypertension, helping them manage and adapt their medication regimens.

“Sometimes a patient that’s newly diagnosed with diabetes may have an overwhelming experience because it requires so many lifestyle changes, not just medication, but you need to change your diet, you need to exercise,” said Durley. “The clinical pharmacists teach the patients about the disease and then help them manage the medications.”

Award-winning pharmacists

The clinical pharmacy partnership has been a success. The pharmacists launched the interdisciplinary Diabetes Care Group in 2013 and the Hypertension Care Group in 2017, among other initiatives. They have also conducted studies of their work, including a poster presented at the Annual American Pharmacists Association Meeting. This study linked a statistically significant reduction, in comparison to standard of care, in A1c levels for patients who participated in diabetes visits with the pharmacists.

CommunityHealth has recognized that work, too, awarding Dr. Babul, who serves on CommunityHealth’s Associate Board, the 2019 Volunteer Fundraiser of the Year Award. She shared the Visionary Award with Marcelo in 2017 at CommunityHealth’s annual gala. That award, which recognized the founding of the Diabetes Care Group, was particularly meaningful, Babul said, as they were the first pharmacists to receive it. In 2013, Babul and Marcelo shared CommunityHealth’s Pharmacist of the Year Award.

Dr. Jewel Younge

Their work has meant a lot to CommunityHealth’s patients, said Dr. Fatima Khaja, PhD ’14, codirector of pharmacy operations at the clinic. CommunityHealth’s primary care physicians have limited time and can’t give patients, especially those with “high-needs” conditions like diabetes, the education they need.

“Having a clinical pharmacist gives the patient more one-on-one time with a provider and helps them understand better their disease state and … manage their condition much better,” Khaja said.

Patients, in feedback collected by CommunityHealth, agreed. “How I started was very bad. I was shy, but I was helped by her [Babul],” said Juana (translated from Spanish by CommunityHealth). “Everything with my diabetes and blood pressure is getting better. I have a lot of confidence and trust in her."

In turn, the work has been meaningful for UIC’s clinical pharmacists. “I’m very fortunate that this program is part of my job,” said Younge, who first became aware of CommunityHealth from its work at the Englewood clinic. “I wanted to get involved because their mission is a great mission. … It has been better than I could have dreamed or imagined.”

Overall, UIC’s involvement with CommunityHealth continues to pay off for both institutions, Durley said. The clinic serves as an experiential practice site for UIC students and residents, and providing clinical pharmacist services at CommunityHealth also spreads awareness of what clinical pharmacy and UIC can do.

“It’s a great opportunity for students to learn how to provide services for patients in underserved communities,” Younge said. “I think that’s one of the biggest benefits with being involved with this organization.”