Pharmacists as Health Planners

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Pharmacists have been actively involved with health planning ever since the days when planning was a responsibility of local health departments. As health planning broadened and the federal government began taking an active role in planning, the interest and participation of pharmacists grew correspondingly. Pharmacists worked closely with regional medical programs in carrying out the various RMPsponsored planning and educational activities. The enactmen t of comprehensive health planning legislation in 1966 provided the opportunity for pharmacists all over the country to work with state and local comprehensive health planning agencies. Pharmacist Nina Buell of Lewiston, Me began working with the Northern Michigan Comprehensive Health Planning Agency at the request of the Michigan Pharmacists Associabon. Lloyd Burton, of Tucson, AZ, a faculty member at the school of pharmacy and a long-time advocate of pharmacist participa tion in public health activities, was a major organizing force in developing a comprehensive health program in Arizona. Pharmacist Walter Morrison of Little Rock, AR, member of the faculty at the University of Arkansas School of Pharmacy, not only participated in comprehensive health planning agencies, but actively encouraged pharmacists across the nation to become more involved with health planning. Paul D. Naber, a pharmacist of Davenport, lA, was elected to the board of the Illowa (a region encompassing portions of 11linois and Iowa) Health Planning Council in 1973 and served as chairman of that agency's review committee. Subsequently, Naber was asked to become active in the Illowa Health Systems Agency as a pharmacist consultant on the agency's

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review committee. Robert M. Wilson, a pharmacist in We~t Palm Beach, FL, took a different approach. He went back to schoot received a Master of Public Administration degree, and took a job as a health planner with the comprehensive health planning agency in his community. The Health Planning and Resources Development Act of 1974 (P.L. 93-641) resulted in the eventual dissolution of the state and local comprehensive health planning structure and the creation of over 200 health systems agencies (HSAs). Pharmacists who were already working with comprehensive health planning agencies had the "inside track" when HSAs were organized and funded, since many of these HSAs developed directly from former local comprehensive health planning agencies. Immediately following the enactment of P.L. 93641, APhA advised state pharmaceutical associations to urge pharmacists to take active roles in local health planning so that HSAs might

have the benefit of pharmacists' experience in developing health plans. The state associations responded, and pharmacists became involved. In September 1978 the APhA Weekly published a short announcement asking pharmacists who were connected in any way with HSAs to send their names and addresses to the Association along with a short description of the nature of their activities. The response was encouraging-more than 200 pharmacists wrote from all parts of the country and from all types of pharmacy practices. Many of , the respondents provided short descriptions of their activities. Space does not allow a detailed review of all reports, but a few have been . selected as examples of what pharmacists are doing in meeting the health planning needs of their communities. • Joseph W. Pelham, of Norfolk, VA, is a mem ber of the board of the East Virginia Health Systems Agency (EVHSA) . Pelham's contributions to health planning have so impressed his colleagues that the January IFebruary 1979 EVHAS Newsletter highlighted his participation in community planning efforts and described his pharmacy practice, a pharmaceutical center in Norfolk. • Pharmacist Rick G. Schnatz works with physician Gerard Jebaily in a family practice center in Florence, SC. Schnatz offered his services to his HSA and was appointed to a task force on mental health, alcohot and drug abuse services. Mental health representatives, physicians, and patients also serve on the task force. Recommendations for the first-year health systems plan include drug abuse treatment and prevention programs as well as vocational rehabilitation services for alcoholics and drug abusers. In the coming years the task force will

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devote its attention to planning for mental health treatment in the area served by the HSA. • As chairman of the South Central Subarea Council of the Health Systems Agency of Southeastern Pennsylvania, David Bergman of Philadelphia also is a member of the intersubarea council committee of the HSA and chairman of the subarea council task force for reorganization. • Ronald Tom, PharmD, of Sacramento, CA, is not only president of the Sacramento Valley Pharmaceutical Association but also secretary-treasurer of the Sacramento County Health Council, a subarea council of the Golden Empire Health Systems Agency. He also serves on the nominating committee, the joint county advisory committee, and the family planning advisory board, all subcommittees of the subarea council. Tom's interest in long-term care led him to seek-and gain-an appointment on a task force to develop plans for long-term care for patients in the Sacramento area. • In Holyoke, MA, Richard W. Dudley, chief pharmacist of the Providence Hospital, is a member of the Western Massachusetts Health Planning Council, an HSA that constitutes a four-county area. He also serves on the Southern Valley health education committee and on a subcommittee concerned with postacute care. • David Forbes, PhD, associate professor and department chairman of pharmacy administration at the North Dakota State University College of Pharmacy, was elected to the board of directors of the Min-Oak HSA as a representative of a health professional school. Forbes currently is chairman of that HSA's health planning and development committee. In addition, the governor of North Dakota appointed Forbes to the state health coordinating council (SHCC), and he serves on the plan development committee. • Ronald Robertson, director of pharmacy service of the Crawford County Memorial Hospital in Van Buren, AR, has been active in health

planning "even back into the old CHP days," that is, prior to the enactment of the Health Planning and Resource Development Act . Robertson is active in the West Arkansas Health Systems Agency and has been elected to the governing body for a two-year term. He is the first pharmacist to serve on the governing body of that HSA. Robertson also is president of the Western Subarea Council of the West Arkansas Health Systems Agency . • James O. Johnson is a member of the governing body of the Western Arizona Health Systems Agency-one of the smallest in the country. In addition, he has been an active member of the Rate Review and Certificate-of-Need Committee. While serving on this committee, Johnson persuaded his colleagues to deny a certificate of need to two bankrupt hospitals located in the same community. Through his efforts and the efforts of the Rate Review and Certificate-of-Need Committee these two hospitals are

'Pharmacists are impressing their colleagues with the importance of pharmaceutical service as a component of comprehensive health care . ... I

macy, a task force was assembled on health planning consisting of pharmacists, consumers, health professionals, and health planners. The group met in cooperation with the six HSAs in the state and the State Health Planning and Development Agency to consider the current status of pharmacy practice in North Carolina, including numbers of pharmacies, pharmacist population, and drug-related needs of the people of North Carolina. Their efforts resulted in a series of recommendations and conclusions designed to make more efficient use of pharmacy manpower in improving the quality, quantity, and distribution of health care services in North Carolina. Copies of the task force report are available for $5.00 from the Sec- , retary of the North Carolina Pharmaceutical Research Foundation, UNC at Chapel Hill Pharmacy, Beard Hall, 200H Chapel Hill, NC 27541. These examples provide a good cross section of American pharmacists' involvement with health planning. Pharmacists are involved in all phases of HSA activities from subarea councils through task forces and committees all the way to serving on HSA executive boards. The experience has taught these pharmacists that in working with HSAs, i they are participating not only as I pharmacists, but as concerned citizens and health planners. By ! working closely with other health professionals, consumers, and proI fessional health planners, these pharmacists learn firsthand the problems and frustrations that face the health planning movement. At the same time, pharmacists are im- I pressing their colleagues in other " health organizations with the importance of pharmaceutical service as a component of comprehensive health care and the need to include this service as a necessary ingredi- I ent of any health care plan. I' -Richard P. Penna APhA Associate Executive Director for Professiona I Affairs

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now merging. The extensive legal maneuvers which transpired in this process highlighted the need for the state of Arizona to adopt a realistic certificate-of-need law. • If awards were given for pharmacists' participation in HSAs, the prize would have to go to the pharmacists of North Carolina. Through the efforts of the North Carolina Pharmaceutical Association, the School of Pharmacy at the University of North Carolina, and the North Carolina State Board of Phar-

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American Pharmacy VoI.NS19, No.4, Apr.1979/192