WHEREAS, the Community Health Network ("CHN") pharmacy costs have been steadily increasing and a budgetary shortfall of $3.9 million is anticipated for the current fiscal year; and
WHEREAS, this cost over-run can partially be attributed to services provided to persons who have not been seen by a CHN physician or received any other services from the CHN, also referred to as "out-of-network" services; and
WHEREAS, it is projected that 13,388 out-of-network prescriptions will be filled during the current fiscal year; and
WHEREAS, projections for the annualized costs of filling these out-of-network prescriptions are $400,000 for drugs and $80,000 for dispensing these drugs; and
WHEREAS, the CHN Outpatient Pharmacy has developed a strong clinical program supporting the CHN providers to insure that high quality of care standards are attained for all Network patients; and
WHEREAS, the CHN will provide the necessary outreach to inform these out of network patients and providers of this resolution and their access options; and
WHEREAS, arrangements will be made with CHN providers to insure access for these patients; and
NOW, THEREFORE, The San Francisco Health Commission hereby resolves to support the policy that the Community Health Network shall only provide pharmaceutical services to those patients referred by physicians participating in the Community Health Network and that an appropriate outreach program be developed to inform providers and patients of this change.
I hereby certify the foregoing Resolution was adopted by the Health Commission at its meeting of Tuesday, November 18, 1997.
Sandy Ouye Mori, Executive Secretary to the Health Commission