Santa Cruz County pharmacy to close Friday after 62 years

July 31--SANTA CRUZ -- After 62 years, the Santa Cruz County-run pharmacy on Emeline Street will close Friday because of changes brought about by the Affordable Care Act. Some days the pharmacy, which abuts the bustling waiting room to the county's health clinic, doesn't fill any prescriptions at all.

The act looks to have sealed the pharmacy's fate. In 2014, the first year of the health care law, the pharmacy filled 70 percent fewer prescriptions, a drop from 40,737 in 2013 to 12,331, because of a significant reduction in MediCruz patients, most of whom are homeless or indigent. More patients, such as William Shelton of Santa Cruz, now get private insurance through the state's exchange program or qualify for Medi-Cal coverage.

"It was just convenient to pick up my medication where I saw my doctor," Shelton said earlier this week during a visit to the clinic. "But my coverage changed."

After the closure, the roughly 270 patients now served by the county's three clinics will use eight new contracted pharmacies including Horsnyder Pharmacy, Franks Pharmacy, Watsonville Pharmacy and five Walgreens. Patient costs aren't expected to rise, and the county expects to save about $526,000 annually through the closure. The savings is good news for the Health Services Agency, which recently learned it would be taking a $3.6 million annual cut from the state.

"We wanted to redesign our system in a way that would better serve the patients," said Amy Peeler, county chief of clinic services. "Instead of having our county pharmacy as their only option, we have contracts with pharmacies throughout the county to improve access."

More than 60 percent of county clinic patients live in the Watsonville area. If they couldn't pick up their medication on the same day, they'd have to wait to have (prescriptions) delivered to their homes through the mail or to the Watsonville clinic the next business day.

But Andre Meschi, the county's chief pharmacist, worries about those who do get treated at the Emeline Street clinic. Sending indigent patients elsewhere for medicine could mean more unfilled prescriptions and medications taken incorrectly, he said.

"The sooner you can get them between their appointment and a pharmacy, the chances of them starting the regiment correctly are higher," Meschi said.

Studies show that 20 to 30 percent of prescriptions for medications are never filled and that up 50 percent of medications are not taken as prescribed, he added.

"Some of the patients didn't have the $4 MediCruz copay, so I would put it in, otherwise, they'd have to jump through hoops to get it waived," said Stephanie Bokariza-Ivanov, a pharmacy technician who's worked at the county pharmacy for 26 years. "Now what's going to happen if they don't have the copay?"

The county is hiring a pharmacist coordinator to oversee its pharmacy partnerships.

To keep the pharmacy from closing, county pharmacy staffers pitched a model they said would raise revenue by expanding the federal 340B Program, which allows the county to buy deeply discounted medication, to Medi-Cal patients. The county would sell the medication to Central California Alliance for Health, which manages the county's health plan. The alliance would then bill the state at a higher rate to create profit. County health officials, however, called the idea precarious, saying it conflicted with state and federal laws.

Meschi said it'll be sad to see the old pharmacy windows shut for the last time Friday. His staff has already begun packing up the office and have unearthed remnants of the past.

"I used one of these and a typewriter when I first started," Bokariza-Ivanov said, showing off a Bates numbering machine before dusting off a Torsion balance. "There's a lot of unique things here that you won't find at other pharmacies."

The Emeline Street complex boasts a long history in health care. In 1877, a men's infirmary was built there, and in 1968, the new County Hospital was completed with 65 beds.

County Pharmacy Closing

--Patients will now go to Horsnyder Pharmacy on Soquel, Franks Pharmacy in Aptos and Watsonville Pharmacy and five Walgreens starting in October. --The county is hiring a pharmacist to coordinate its partnerships with the other pharmacists. Two part-time pharmacists lost their jobs. The chief pharmacist retired. Three pharmacy technicians found new positions with the county.

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