Prairie Health Pharmacy Access Coalition

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Executive Summary

Prairie Health Pharmacy Access Coalition is a nonprofit in Kansas that gets medicine to rural residents in towns where the pharmacy has closed. A partner pharmacy fills prescriptions, licensed pharmacists consult by phone and video, certified technicians work under a pharmacist's video supervision where state rules allow and medicines are delivered or placed in secure pickup lockers in town. A medication assistance fund pays pharmacies directly for patients who cannot afford a prescription.

Rural pharmacies are closing across the country, and people in towns without one must drive an hour or more for a prescription. Those who skip doses get sicker, and avoidable hospital visits cost far more.

With this grant we will serve about 200 patients in Year 1 in 2 towns. We operate only through licensed pharmacists and pharmacies under state rules, we never give cash to patients and we call 911 in an emergency. We do not promise any outcome. We promise safe handling of medicine, respect for every patient and honest records.

Our Year 1 budget is about $241,500, growing to about $384,000 by Year 5 as we add sites, coaches and participants. Each year's budget is planned to balance, with a small surplus each year. We have 4 staff in Year 1 (an Executive Director, a Program Manager, a Pharmacy Technician and a part-time delivery driver) and 9 by Year 5.

We are asking the Prairie Health Access Foundation for $70,000 for a Pharmacy Technician, the medication assistance fund, the telepharmacy platform and delivery costs. Our other income and startup support cover the rest. These numbers are estimates based on the assumptions listed at the end of this proposal, and we do not promise any result beyond what we describe.

Company Description

Prairie Health Pharmacy Access Coalition is a nonprofit organization in Kansas. We are a registered charity with a volunteer board of directors, a written conflict-of-interest policy and a yearly budget the board reviews.

Our mission. No rural resident should go without medicine because the nearest pharmacy closed.

What we do.
- Operate telepharmacy sites where a licensed pharmacist supervises a certified technician by video.
- Deliver prescriptions to homes and to pickup lockers in towns without a pharmacy.
- Provide pharmacist consultations by phone and video on medicines and side effects.
- Offer a medication assistance fund that pays pharmacies directly for people who cannot afford a prescription.
- Help patients enroll in insurance, Medicare Part D and manufacturer assistance programs.
- Coordinate with local clinics, hospitals and doctors.

Our values. Respect for every participant, honesty with families and partners, safety first and a place for everyone who wants to belong.

What we do not do. We operate only through licensed pharmacists and pharmacies, and follow all state pharmacy rules. We do not give medical advice beyond what a pharmacist can provide. We do not sell medicines for profit or fill prescriptions without a valid prescription. We never give cash to patients. We call 911 in an emergency. We do not promise any outcome. We follow the rules of our partner sites and our insurer.

How we got here. A group of pharmacists, a rural nurse and a county commissioner began meeting after the only pharmacy in town closed. Residents were driving an hour for medicine and many skipped doses. We kept simple records of who needed help and what they could not get. This proposal asks for support to move from meetings after a pharmacy closed to a steady program with paid, trained staff and the materials to match.

Problem & Opportunity

Rural pharmacies are closing across the country, and people who live in towns without one must drive an hour or more to pick up a prescription.

Cost. Gas, lost work and, for many, the cost of medicine itself make it hard to fill prescriptions.

Access. Fewer pharmacies and fewer pharmacists mean longer drives, shorter hours and less advice on how to take medicines safely.

Safety and trust. Patients and clinicians want to know that medicines are handled safely and accurately by licensed professionals.

Missed benefits. People who skip doses or stop taking medicine get sicker, and avoidable hospital visits cost far more.

What we hear.
- A farmer says the nearest pharmacy is 70 miles away.
- A nurse says patients stop taking blood pressure medicine when the refill is too hard to get.
- A pharmacist says she can supervise a site she cannot be in by video.
- A grandmother says she rations her pills until the next trip to town.

We do not claim that a program can solve every challenge. We believe that a pharmacist on a screen, a locker in town and a ride to the door can keep medicine within reach.

Products & Services

Prairie Health Pharmacy Access Coalition gives rural residents without a nearby pharmacy a safe, welcoming place to get their medicines safely and on time.

How the program works.
1. Registration. Patients register by phone or with help from clinic staff and choose pickup or delivery.
2. Prescriptions. Doctors send prescriptions to our partner pharmacy, which fills them.
3. Pharmacist review. A licensed pharmacist reviews each prescription and consults with the patient by phone or video.
4. Delivery and lockers. Medicines are delivered or placed in a secure pickup locker in town.
5. Telepharmacy. Where state rules allow, a certified technician works under a pharmacist's video supervision.
6. Assistance. A fund pays pharmacies directly for medicines for patients who cannot afford them.
7. Follow-up. Staff check in with patients about refills and side effects.

What a typical session looks like. Participants arrive and check in with a staff member, settle in together, work on the day's activity in small groups and finish with a short talk about what went well. Staff praise effort, correct mistakes kindly and make sure no one is left out.

Staff. Our pharmacists and technicians hold current licenses or certifications, pass a background check, complete our training and are paid for their time.

Access and fairness. Programs are free. Services are free to patients, except for the medicine itself. We welcome every rural resident and offer help in English and Spanish.

Market Analysis

Who we serve. Rural residents in our service area who live far from a pharmacy and have trouble getting medicine. Eligibility is where a person lives and a valid prescription, and no one is turned away for lack of insurance.

How we estimate need. We cannot count every young person who could benefit, so we plan from what we can see. In our meetings we heard from many residents who had stopped taking medicine because of distance. Clinics told us that many more patients have trouble getting medicine than we can reach. For Year 1 we plan to serve about 200 participants at 2 towns. By Year 5, with more staff and sites, we plan to serve about 600.

Where participants come from.
- Clinics, hospitals and doctors.
- County health departments and senior centers.
- Churches and community groups.
- Patients who tell a neighbor.

Who else benefits. Patients take medicine as prescribed. Clinics see better outcomes. Communities avoid costly emergency visits.

What the numbers mean. Every number here is a patient who picked up her medicine in her own town. We keep our early counts modest and honest so we can do the work well.

Competitive Landscape

What young people can find today, and how we are different.

1. Chain pharmacies. Convenient where they exist and closing in small towns. We fill gaps.

2. Mail-order pharmacies. Convenient and slow for urgent needs. We deliver locally.

3. Clinic dispensing. Helpful for some medicines and limited in scope. We work with clinics.

4. Hospital pharmacies. Serve patients of the hospital. We serve the community.

5. Driving to town. Costly and hard for many. We bring medicine home.

What makes us different.
- Licensed pharmacists supervising by video.
- Delivery and secure lockers in towns without a pharmacy.
- A medication assistance fund paid to pharmacies.
- Help with insurance and assistance programs.
- Coordination with local clinics.

Why this gap matters. Existing programs do good work, and most serve people who can already pay or who live close to them. The people we serve are the ones left over: they live in the wrong neighborhood, have the wrong schedule or have no one to ask. We are built to reach them.

We have spoken with clinics, county health departments and other pharmacy access programs to make sure we are filling a gap and not duplicating services. Their letters of support are in the attachments.

Marketing & Sales Strategy

How young people and partners will find us.

Reaching young people.
- Clinics and doctors. We will give staff a short referral form and a named contact.
- County health departments and senior centers. We will share flyers and information.
- Churches and community groups. We will talk with leaders who know patients.
- Local radio and newspapers. We will share clear information on how to register.
- Word of mouth. Patients tell neighbors.
- A simple website and a phone line with a text option.

Reaching staff and sponsors.
- Recruit pharmacists and technicians through pharmacy schools, licensing boards and rural clinics.
- Offer an orientation, a background check and training in safety, privacy and respectful practice.
- Give partners a short report each quarter with counts of participants and what they said.

How we decide who joins. We use a simple sign-up form and enroll participants in the order received, with priority for those with the greatest need and for people new to the program. We keep a waiting list when the program is full.

What we watch. Sign-ups, attendance, prescriptions filled, patients on time with refills and how many participants return for a second season.

Operations Plan

How the program will be carried out.

Timeline for Year 1:
- Months 1 and 2 (July and August): Hire the staff, buy equipment and materials, finalize the waiver, consent form and privacy policy with our attorney and sign site agreements.
- Month 3 (September): Sign agreements with a partner pharmacy and open the first town site.
- Months 4 to 10: Fill and deliver prescriptions, provide consultations and manage the assistance fund.
- Months 11 and 12: Survey patients and clinics, report to funders and plan Year 2.

Space. We work from a partner pharmacy and small town sites with secure lockers, provided by towns at low cost.

Safety and privacy.
- Medicines are handled only by licensed pharmacists and certified technicians under state rules, with secure storage and records.
- Lockers use secure codes and cold storage where needed, and patients are told how to take their medicine by a pharmacist.
- Every staff member and volunteer passes a background check and completes safety training.
- Staff work in pairs or in view of others whenever participants are minors or in a vulnerable situation.
- We keep an emergency plan at every site, and participants complete an emergency contact form.
- We keep records private, share them only with a participant's permission or as the law requires and follow a written policy.

Equipment. We buy about $14,000 of equipment once at the start: secure medication pickup lockers ($8,000), cold storage and delivery coolers ($3,000), telepharmacy video and security equipment ($3,000). Later years replace or add a few items.

Staffing. In Year 1 I serve as Executive Director. The Program Manager, paid $46,000 a year, manages sites, delivery and partners. The certified Pharmacy Technician, paid $38,000, supports filling and consultations. A part-time delivery driver, paid $20,000, delivers medicine. We add technicians and drivers as we add towns.

Management & Organization

Dr. Susan Ortiz, Executive Director. I lead the organization, report to the board and am responsible for budgets, partnerships and reporting. I came to this work as a rural pharmacist who watched patients drive an hour for a prescription. I will complete the training we require of our technicians so I understand the program from the inside. (Replace this paragraph with your own background.)

Staff. The Program Manager manages sites, delivery and partners, and a certified pharmacy technician and a part-time delivery driver work with patients. Each passes a background check. These positions are part of our grant request.

Board of directors. Our volunteer board includes a pharmacist, a rural nurse, a farmer, a banker who serves as treasurer, an attorney and a county commissioner. The board meets every other month, approves our budget and reviews our safety plan. No board member is paid, and members with a conflict of interest step out of related decisions.

Advisory partners. A clinic director, a pharmacy school professor and a county health director give guidance twice a year.

Staffing and pay in this plan: Executive Director, paid $54,000 a year; program Manager, paid $46,000 a year; pharmacy Technician, paid $38,000 a year; delivery Driver (part-time), paid $20,000 a year.

Milestones Narrative

Our goals, how we will measure them and when we plan to reach them.

Year 1 outcomes (July 2027 through June 2028):
- Serve about 200 participants at 2 towns.
- Run at least two full seasons and a summer session.
- Have at least 85 percent of participants attend most sessions.
- Have at least 80 percent of participants return for a second season.
- Receive positive feedback from at least 90 percent of families who answer our short survey.

What we count and how.
- Participants enrolled, sessions and games attended, from our records.
- Skills learned and goals met, from the coach's checklist.
- Equipment issued and returned, from our log.
- Participant and family feedback, from a short, confidential form.
We report what we find, including what did not work, and use it to improve.

Growth over five years.
- Year 2: About 300 participants at 3 towns.
- Year 3: About 400 participants at 3 towns.
- Year 4: About 500 participants at 4 towns.
- Year 5: About 600 participants at 5 towns.

Learning along the way. At the end of each quarter, the director and the board review the numbers and decide whether we are on track. If we are behind, we will adjust our outreach, our sites or our schedule before asking for more money.

After the grant. By Year 5, grants make up about 58 percent of our budget, down from about 64 percent in Year 1, as partners and donors give more. We will keep building those relationships every year.

Funding Request

What we are asking for, and how the money will be used. Our request: $70,000 from the Prairie Health Access Foundation for a Pharmacy Technician, the medication assistance fund, the telepharmacy platform and delivery costs, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Pharmacy Technician salary, $38,000.
- Other: Medication assistance fund paid to pharmacies, $12,000.
- Other: Telepharmacy platform, $8,000.
- Travel: Medication delivery costs, $12,000.

Other money in the program. This request is about 46% of our Year 1 grant income. Other grants and the income lines below pay for everything it does not cover.

Year 1 budget: about $241,500, planned to balance with a small surplus (about $9,700 after the yearly wear on equipment). Year 1 money coming in: Grant Revenue $153,500; state Rural Health Funding $56,000; health System Partners $24,000; individual Donors $8,000. Year 1 costs: executive Director $54,000; program Manager $46,000; pharmacy Technician $38,000; delivery Driver (part-time) $20,000; pharmacist Services Contract about $30,000; medication Delivery Vehicle Costs about $8,000; telepharmacy Platform about $8,000; medication Assistance Fund about $12,000; training about $3,000; administration and Insurance about $10,000; about $5,200 a year for the wear on equipment.

One-time startup costs. Startup costs of $24,500 are paid once from startup money, not from the yearly budget: $8,000 for secure medication pickup lockers; $3,000 for cold storage and delivery coolers; $3,000 for telepharmacy video and security equipment; $3,000 for attorney review of the patient agreement, pharmacy agreement and privacy policy; $1,800 for flyers, signs and a simple website; $2,200 for technician certification, training and background checks; $3,500 for first insurance payment.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($24,500), the cash the program uses before it balances (about $0) and a cash cushion of about $57,300, which is about three months of Year 1 costs. In all, that comes to $82,000. We start with $8,000 from our founding board and $76,000 in startup support from a health foundation and a rural hospital, $84,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $241,500 in Year 1 to about $384,000 in Year 5. Grants are planned at $153,500, $180,000, $188,000, $215,000 and $224,000 in Years 1 to 5. Other income grows: state Rural Health Funding from $56,000 to $88,000; health System Partners from $24,000 to $48,000; individual Donors from $8,000 to $24,000. Our surplus is planned at about $9,700 in Year 1, about $12,200 in Year 2, about $14,000 in Year 3, about $16,600 in Year 4 and about $18,900 in Year 5. We grow from 2 towns to 5 by Year 5, adding a part-time coach for each new site.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $72,800, at the end of Year 1. Some grant payments and partner payments arrive after we bill, so we plan for about $9,660 owed to us at the end of Year 1.

Cost per patient. In Year 1, our total costs are about $1,159 per patient served, which includes setting up the program. By Year 5, with more patient served and a trained team in place, that falls to about $609 per patient.

After the grant. State rural health funding, corporate sponsors and individual donors grow every year, so grants become a smaller share of our budget. Participants and families share their stories, and businesses can sponsor a team or a season by name. We will look for partnerships with schools and the city that want a safe, free pharmacy access option for every child.

Risks and how we will handle them:
- An injury. Certified coaches, proper equipment, groups matched by age and skill, a written emergency plan and insurance.
- A site is no longer available. We keep agreements with more than one site and a plan for bad weather.
- A coach leaves. We keep a list of trained backup coaches and share lesson plans.
- Low attendance. We adjust sites, times and rides based on family feedback.
- A privacy problem. We follow a written policy, use secure systems and train every staff member and volunteer.
- A grant ends. We keep savings and grow partner and donor support each year.

If you are just starting. A new organization can begin before it has its own 501(c)(3) status through a fiscal sponsor: an established nonprofit that receives grants for you and passes them to your program, usually for a fee (commonly around 5% to 10% of the grant, sometimes more; ask before you agree). Another way is to start smaller: one neighborhood, a handful of patients and a small team, tracked carefully. Strong results from a small start make larger grants easier to win.

Appendix Notes

Documents to attach with this proposal:

- Your IRS 501(c)(3) determination letter, or your fiscal sponsor agreement.
- Your most recent financial statements and your current year budget.
- A list of your board members and what each one does.
- Signed letters of support from partner schools, agencies and sites.
- Your site agreements and your insurance certificate.
- Your consent, waiver and privacy policy.
- Your safety plan and background check policy.
- Your program outline and schedule.
- Quotes for equipment and materials.
- Resumes for your Executive Director and key staff.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Grant Revenue: $153,500 in Year 1, growing to $224,000 in Year 5.
- State Rural Health Funding: $56,000 in Year 1, growing to $88,000 in Year 5.
- Health System Partners: $24,000 in Year 1, growing to $48,000 in Year 5.
- Individual Donors: $8,000 in Year 1, growing to $24,000 in Year 5.
- Pay (a full year, per person, including payroll taxes and workers' compensation): executive Director $54,000; program Manager $46,000; pharmacy Technician $38,000; delivery Driver (part-time) $20,000.
- Other yearly costs in Year 1: pharmacist Services Contract $30,000; medication Delivery Vehicle Costs $8,000; telepharmacy Platform $8,000; medication Assistance Fund $12,000; training $3,000; administration and Insurance $10,000. These grow between 4% and 6% a year.
- Equipment: $14,000 at the start, then $2,500 to $3,500 a year.
- Startup costs: $24,500, paid once from $84,000 in startup money.
- Participants served: about 200 in Year 1, growing to about 600 in Year 5. Sites: 2 in Year 1, growing to 5 by Year 5. Prescriptions are filled and delivered every weekday, with lockers available around the clock.
- About 4% of each year's income is still owed to us at year end.
- Tax: none, as a nonprofit.
- Every dollar amount is an estimate. Replace them with your own quotes and real budget.

Startup Costs