Over 28 years and $529,000 in grants awarded, Fox Family Foundation has gained a deep respect for the story of Senior PharmAssist’s (SPA’s) success. One might describe SPA’s effectiveness by ticking through an impressive snapshot of these metrics: the large, diverse number of participants served; improved health outcomes for participants; and a reduction in unnecessary and costly hospital utilization.

SPA touches more than 2,000 Durham residents annually—the majority over age 60—across its 4 main areas of service:

• Medication management with clinical pharmacists
• Direct financial assistance to qualified seniors so that they can pay for medication
• Tailored referrals to other valuable community and governmental resources (such as medical transportation, in-home aid services, and Medicare subsidies)
• Medicare insurance counseling to ensure understanding of enrollment, claims, and benefits—all of which leads to better medical and prescription coverage decisions, and therefore improved health for beneficiaries.

In sum, SPA helps older adults with limited income by building a relationship with them, focusing on their needs, becoming a part of their care team, and looking at both social and medical needs to improve health outcomes.

This comprehensive model works. SPA, through multiple evaluation projects, has demonstrated a reduction in emergency department visits as well as hospitalizations by one-third among SPA participants.

Another way to summarize the effectiveness of SPA is to look at the way SPA asks and tracks functional assessment questions. SPA Executive Director Gina Upchurch explained, “We ask people a question that’s become a national standard – we ask them to rate their perceived health: ‘How would you rate your health?’. And then the next question is ‘Compared to one year ago, would you say your health is about the same, somewhat worse, significantly worse, a little better or much better?’ And after people have been in our program for two years, those perceived health assessments improved. Even though they’re aging, they experience their health as improving.”

One could also point to the ways in which SPA is nationally recognized for its deep expertise in both medication management and maximizing the benefit of Medicare. SPA staff, volunteers, and participants have helped inform Congress and other policymakers on how Medicare can be improved. And, in 2022 and 2023, SPA working with Duke colleagues and others received a grant to replicate SPA’s model in other parts of the state.

However one chooses to illustrate SPA’s success, what Upchurch and her team most like to communicate about SPA is that, over the span of 30 years of work, they have built thousands of trusted relationships in the Durham area and beyond with participants, care partners, collaborators, other service providers, and volunteers.

Initially, many SPA participants come to the organization for counseling on Medicare enrollment, benefits, and claims. Once engaged with SPA’s Medicare counseling, participants often find they qualify for other programs as well. Sometimes these new SPA participants turn down additional assistance—both out of humility and out of respect for people whom they think “might need it more.” But most importantly, those older adults will have made contact and forged a new relationship with the organization. Once that relationship begins, SPA staff and volunteers undertake the delicate and critically important task of learning about each participant. The goal is to touch all areas of care offered by SPA over the course of what is usually three visits per year sprinkled with phone calls in between.

For SPA’s 30th anniversary (opened doors in June 1994), in addition to offering thanks to all the leaders and advisors who guided the organization to this occasion, the team is looking ahead at more ways to do good work based on a solid foundation of all these accomplishments. “It’s taken a long time to get the attention and credibility that we have now. We want to keep telling true stories, authentic stories about our participants’ experiences. Having real life experiences and being on the ground seeing that our staff and volunteers do such an excellent job with people—learning constantly and being able to take what we’re learning and sending it up to policymakers because we believe Medicare should be better—it all gives you a sense of hope.”