Travis County Commissioners Court
March 17, 2009,
Item 17
>> 17 is to consider and take appropriate action on the request for Travis County to jane the know cea prescription dis-- to join the naco prescription discount card services and/or any other prescription card services.
we do note that this item may be taken into executive session under consultation with attorney depending on how the discussion goes.
morning.
>> good morning, judge, Commissioners.
sherri fleming, executive manager for health and human services and veteran service.
and I have with me anna alamagale who is the senior planner for health related issues.
you received a presentation two weeks ago regarding the naco prescription drug program, and so staff has provided you from our perspective our analysis of the program and we've given you several things in your backup.
we've given you certainly a memo describing the issue.
we've also given you a side by side comparison with another program that we'll talk briefly about in just a minute.
we've also given you a document that staff prepared, sort of analyzing the issue of the uninsured in our community and sort of the benefits of the program.
we also included in that document some discussion about suggested distribution outlets, if you were to consider a pharmacy card program.
we also included for you some examples of some of the pharmacy card programs that are already in place.
and then our contact with dallas and tarrant county, those counties are already doing the naco program.
so that's what you have in your backup.
so we can be as detailed as not as you would like.
but basically overall the program does require that you -- your continued membership with the national association of counties.
so despite the fact that there is no cost to the -- to our community for the use of the cards or to the court to pay for those benefits, there is a cost to you for your membership to the national association of counties.
and our last payment was a little over $14,000.
i do believe that the court just recently -- when I say recently, within the last three or four years, has renewed its membership or initiated its membership with the national association of counties and I do know you revisit that issue during the budget process every year.
in terms of looking at the program, there are very specific issues related to the contract that I won't go into, but that I'm sure legal will be able to answer your questions and so first and foremost I think those questions related to the actual content of the contract would have to be resolved.
but from a staff perspective, while the cards have an 800 number on them for residents who may have difficulty of some sort using the cards, it will bear our emblem.
so for that reason I believe I would feel some obligation to request that we have some resources here local so that folks could talk with us about what difficulties they may be able to have.
but the program is designed for residents to be able to call the 1-800-number if they have trouble and that our only responsibility, if you will, would be to ensure that the cards are available and that we maintain a supply of them.
but --
>> what is the 1-800-number?
whose number is that?
>> it is the --
>> cvs care mark.
the pharmacy.
it's cvs caremark.
it's a company name.
>> okay.
>> and their representatives are in place to answer resident concerns.
however, it is our practice to try to be responsive to our constituents and so certainly we would want to be able to provide some type of service if folks had questions about the cards.
and if you -- if you see the information we've gathered from two of the counties that we surveyed, there has been the allocation of resources for maintaining the inventory of the cards and also for marketing and keeping -- doing outreach so that the community is aware that the program exists.
>> all right.
>> sherri, what about the familywise community service partnership?
we're in that partnership already?
>> we are not.
the city of Austin has implemented that program.
we did make a request to the city of Austin to let us know what their experience has been and we haven't gotten that information yet.
i'm sorry, we don't have it for you today.
but the community centers in the city of Austin began using this program in the fall of last year.
so it may be a little bit early for them to know how it's going.
but you can see that that program does not require a contractual relationship.
it actually provides a benefit that's almost twice the benefit of the naco program.
but we will have access to the usage information in much the same way as we would with naco, meaning that we would know how many residents were using the program and how much savings they experienced from the use of that card.
>> so they have no running data right now for us to evaluate?
i'm saying the city of Austin.
>> we made the request, sir, we just have not gotten it.
>> so it's probably on its way, but they're waiting for the right time.
is the communitywise program available to everyone in the county or constituent?
at this point in time is the city using it?
what's the membership?
>> well, they're distributing it through their community centers, but much like our community centers, we can we could anticipate that some of our residents -- I couldn't say that it was probably broadly distributed because it's being distributed through the community centers within the city of Austin, but --
>> eligibility is county-wide?
>> eligibility would be for any person who wanted to use the card.
so for example, if you were to consider adopting that program, then we would be able to cover the county by adding the program to our community centers.
>> I guess I'm at a loss as to why if the familywise program costs less and gives more benefits, why wouldn't we just jump at the opportunity to participate?
>> yes.
>> when the other program came, I wasn't necessarily pushing them, but they made it sound so simple on the phone that I had a hard time thinking -- I had a hard time concluding that this is not something that we should do.
but you're saying there is better news.
>> yes.
>> instead of going with the national association of counties card, familywise community service is even better.
>> yes.
>> and no contractual --
>> we can get the legal take on the naco deal, but you're saying familywise is not even a contract.
>> no.
there's not even a contract.
>> and let me ask you this then.
let's say that we hand out 500 cards at our community centers.
are we obligated to know the names and addresses of those 500 people?
>> no.
>> we just hand them a card?
>> we canned them a card.
-- we hand them a card.
there's a similar system whereby folks who might have questions would call an 1-800-number and deal with the familywise program versus Travis County.
now, the difference may be -- I'm not sure our especially brem would be on those cards -- our emblem would be on those cards.
>> it can be an emblem that we choose our their emblem.
i think also maybe to your point about then how do we track usage and zip codes?
is that when you prescribe -- when you receive a prescription the pharmacy will ask you for your address as well as zip code and that information would be entered into the familywise database.
that way we could pick up usage by zip code, but not individual information.
>> just by zip code.
>> correct.
>> we wouldn't be required to keep the information, but if we wanted to, we had access to it is what I'm hearing.
>> yes.
>> so pretty much the same -- part of the research that staff had been doing on the naco program sort of revealed this project and actually the local director of familywise then made herself known to us so that we could ask some of these questions.
so we certainly can obtain more -- even more materials on this program if that's something that we're interested in.
>> can you do this for me?
this request.
can you check and see if there is an existing program with familywise folks that covers county-wide within the state of Texas?
right now I see we're looking at city of Austin, but we may want to get to our clinics, but is there a county program -- that covers everything within the jurisdiction of the county?
>> so is there a county that's currently using the familywise program?
we can certainly find that out.
>> the same concept as the naco, but a different type of head on it.
which is the familywise.
so see if that exists anywhere instead of this piece meal -- not piecemeal.
in other words, what I'm envisioning happening maybe city by city by city within a county may end of trying to deal with this when we may can get the whole shebang, the whole pie if it exists somewhere else or is it possible for it to exist for making sure all the resident of Travis County are eligible.
>> we will be happy to find that out.
if the court were interested in implementing that program, then that would be the final piece on the eninventory county being covered because right now the city of Austin is completely covered by this.
>> they're already doing this.
the other comment I would make, judge and Commissioners, is that it's our understanding in talking with some of the merchants who also have prescription card programs that the pharmacies.
while this would be an added resource, many of the programs, for example, h.e.b., cvs, cal greens, those cieps -- walgreen's, those types of things, they have their own programs and they have the ability to do that analysis right there for the -- our constituents to determine which program would give them the best possible discount.
>> that's great flexibility.
>> is a membership fee required?
>> there's no membership fee.
>> is a membership fee required by these folks?
>> familywise is a foundation that wants to assure that people have access to prescription drugs.
>> so it's no fees attached as far as Travis County is concerned.
>> no, sir.
>> just wanted to lay that out.
>> and you would have the continued flexibility to continue the program or not at your own discretion as opposed to having it tied to membership in a particular organization.
>> does this exist anywhere else other than -- do we know of any other entity in the state of Texas that is under this type of foundation?
>> yeah.
we would have to find out that for you, Commissioner Davis.
>> I'm trying to find out somebody that has a track record.
i hear Austin is doing it and there may not be any data available, but there may be someone in the state of Texas that's already doing it.
>> according to familywise, there is participation through the state of Texas indigent health care, but I'm not sure exactly how that plays out and what the information is.
but we're happy to research that.
>> that would be good.
>> thank you.
>> why can't we find out from the city of Austin what resource investment has been required so far?
>> I think that's among the questions we've submitted to them.
yes.
>> all right.
and can we get that answer by next Tuesday?
>> we will let them know we need it by next Tuesday.
>> thank you.
>> so in terms of legal implications, we'll get that when we go into executive session?
>> yeah.
>> okay.
anything else on this item at this time?
>> no, judge.
i think that's it.
i think we've exhausted it.
>> okay.
appreciate that work, y'all.
>> thank y'all.
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Last Modified:
Tuesday, March 17, 2009 1:35 PM