Click Here for A Pharmacists Guide to Pandemic Preparedness. Email Jef Bratberg, PharmD at jefbratberg@yahoo.com with any questions and concerns.

In the midst of all of the holiday hustle and bustle during the month of December, there was also much happening in regards to the topic of Health Care Reform in the Senate. Following months of debating, political posturing and negotiations, the Senate passed the Patient Protection and Affordable Care Act (H.R. 3590) in a vote of 60-39 on December 24th. According to www.opencongress.org, this bill is expected to expand healthcare coverage to 31 million currently uninsured Americans through a combination of cost controls, subsidies and mandates. Not surprising but much to the chagrin of many, bipartisan support was not achieved. Following Congress’ recess, this will remain a hot topic with continued negotiations and more debating in conference committee starting in early January in order to resolve the discrepancies that exist between this Senate bill and the House bill (The Affordable Health Care for America Act- HR 3962) that was approved back in early November.

A couple of concepts to highlight from the Senate bill include:

• A limited national health insurance plan with coverage provided by private insurers designed to lower the number of uninsured Americans
• A requirement that most Americans purchase insurance (or risk financial penalty)
• Enhanced medication therapy management (MTM) services are included in the final language

There are several key differences between the Senate and House bills and those differences must be addressed before legislators can vote on final passage. Cost is one factor that will be a likely discussion point. According to the Congressional Budget Office, the Senate bill is expected to be less expensive ($848 billion compared to more than $1 trillion). Also, the Senate Bill did not include certain issues such as importation or allowing the government to negotiate Medicare Part D prices. The House bill includes many concepts and much language that will cause significant changes to Medicare Part D and also includes a public insurance option that could provide a pathway for a government-run system in the future. Senate Democrats would ideally like conference committee to not deviate from the hard-won language in the current Senate bill but there’s always the possibility that final legislation could be based on language from both bills during the coming months and conference committee process. It will likely be an interesting political debate to continue in the coming weeks so please stay informed!

For more information on both bills, go to the
Healthcare Leadership Council website:
Also, the Government Affairs tab of the APhA website (www.pharmacists.com) is a great source of information.

Over the course of six weeks in November and December, 19 pharmacists, 4 pharmacy technicians, and 11 pharmacy students participated in 112 of 421 clinics that resulted in over 120,000 Rhode Island schoolchildren receiving the H1N1 vaccine. These clinics were an incredible undertaking by RI Responds that is being looked at by other states as a successful model for pandemic response.

The Department of Health is now expanding H1N1 vaccination after receiving an additional 100,000 doses of vaccine. Healthcare providers enrolled in the H1N1 vaccine program should prioritize adults through age 64 with chronic medical conditions, young adults through age 24, school-aged children who missed their first doses of vaccine at their schools, and caregivers of infants younger than 6 months old for office-based vaccination.

January bodes well for those who are interested in immunizing adults over 18, and/or helping in other ways at several types of clinics.
Four options exist:

1. Clinics for children 9 years of age and under will start again on January 11th, based in elementary schools. Those who have completed the RI Responds / Medical Reserve Corps (MRC) training can help with drawing up doses, crowd control, observation, and other jobs. www.riresponds.org
2. Most towns and cities in Rhode Island will be opening POD's, or points of dispensing (vaccination, in this case), to provide vaccine to their citizens. POD's are planned locations, most of them schools, that are approved from the Department of Health to give medicines and vaccines to all of their municipalities' citizens in an emergency. If you are interested in immunizing adults at your local POD, contact the emergency manager for your city or town.
3. Community pharmacies have also been receiving H1N1 vaccine - continue to promote, educate, and offer this, and other, immunizations at your store.
4. Healthcare workers and first responders will have the opportunity to receive the H1N1 vaccine through the Healthcare Service Region (HSR) in which they work. Each of Rhode Island’s 10 HSRs will hold an H1N1 vaccine point-of-dispensing (POD) clinic for healthcare workers and first responders the weekend of January 9, 2010. The department of Health is expanding vaccination through these POD clinics to any licensed healthcare professional, such as dentists, podiatrists, and mental health workers, and to their clinical staff. This also includes pharmacists and likely pharmacy staff! You can not only receive your vaccine if you haven't yet, and also help as an immunizer, observer, crowd control, or assist with dose preparation.
   http://www.health.ri.gov

As always, www.health.ri.gov and other internet, newspaper, and radio outlets will be heavily advertising these sources for H1N1.