Taking Healthcare by Storm: Industry Insights with FARMacy WV

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Amanda Cummins, PA-C, and Carol Antonelli-Greco, DO, the co-founders of FARMacy WV.

Amanda Cummings and Dr. Carol Antonelli Greco discuss FARMacy West Virginia, a program combining healthcare with access to fresh, healthy food.  The initiative, spanning 10 years and over 40 sites, tackles chronic disease by offering patients locally grown produce and nutrition education, aiming to improve health outcomes while emphasizing the importance of food as medicine and navigating challenges such as funding, transportation, and patient engagement. 

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

Publication number QI-060625-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

 Hello everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director of Quality Insights, and today I am very excited because we are joined by the founders of Pharmacy, West Virginia, and that's spelled. F-A-R-M-A-C-Y so you can  see the play on words there.

We are joined by Amanda Cummings, PAC, and Dr. Carol Antonelli Greco. I'm going to be calling her Dr. Carol because that is a mouthful of a last name. Pharmacy. West Virginia is a unique program that integrates healthcare with access to fresh, healthy food, providing much needed support to communities in West Virginia.

We were just chatting before we started recording, and it is just common. Sense fresh, healthy food common sense. In this episode, we'll dive into the story behind Pharmacy West Virginia, the impact it's having on chronic disease management. The role of nutrition in improving health outcomes. We're also gonna be talking about successes of the program, challenges and future vision of this inspiring initiative.

Dr. Carol, Amanda, thank you very much for joining us today. Oh, you're welcome. Thank for having us. Thank for having us. Yeah. So how did the idea for Pharmacy West Virginia come about and what inspired you to start this unique healthcare initiative? I'll take that first. Dr. Greco and I both worked for a nonprofit free clinic in Wheeling, West Virginia, and about 10 years ago, we were having group appointments with diabetics who were, what we would call refractory to care.

They had double digit A one Cs, they were being readmitted, they were not  picking up pharmaceuticals on time, not making appointments on time. Lots of. Social determinants of health pieces and lots of variables to navigate. But we decided to tackle that by bringing these people together. And we began having group appointments with that particular cohort of patients.

And out of that, which we met weekly, we examined their feet weekly, and we also had a. Kind of like a tasting or snack time where we introduced all fresh, healthy produce or high protein snacks. And we were encouraging the patients to be mindful about what they were eating and when they were eating it.

And in doing so, it became very apparent that there was a lack of. Interest. And there was also a lack of familiarity with fresh produce. We  kind of like our hallmark moment, light bulb moment was when we had sliced up several different colors of peppers, red, green, yellow, orange, and we were encouraging the patients to close their eyes and can they taste the difference in sweetness or crispness?

Is there one they prefer, et cetera. And. One of the patients was wildly enthusiastic and said, I like these a lot. And we were like, great. You can do this at home. You can cut up fresh peppers. This is a good snack. You can do this. And she looked at us with sincerity and said, oh, I wouldn't even know how to get into a pepper.

And it was a moment for us as clinicians. Here we are in the exam room saying the same thing over and over again, encouraging people to eat healthy, do the right things with, you know unsaturated fats and all of the jargon that we learned to say. And she was, I. Using a language that was not how we would talk about fresh produce.

We don't get into fresh produce. You get into a bag of chips or a box of crackers or some processed food, but not fresh produce. Even the language surrounding her kind of like her food IQ was a lot lower than what we had expected, so. Through a grant, we were able to launch this idea in partnership with a group of local urban farmers grow.

Ohio Valley was the organization that we worked with in Wheeling, and we were able to kind of imagine this concept where patients, the bar was significantly lowered to give patients access to fresh produce  locally grown, fresh produce where they didn't have to purchase it or take that, that cost risk of purchasing the produce to be able to.

Add it to their diet. They were able to taste the foods in a prepared manner, learn to cook foods and prepare foods in a way that would make them more palatable. And also just be in community with other people with like diagnoses. So in the summer of 2016, we had a small cohort of. 25 patients that we debuted, we gave them $20 worth of fresh, locally grown produce.

We measured A1C pre and post program, lipid panels, pre and post program. And we did a survey that we really were trying to just better understand at that point what people were eating and where they were eating, but also born out of that food security and. Who's in the home and who are they taking care of in the home, if it's grand families, et cetera.

So we were birthed out of that moment where we recognized that there was not only limited access, but limited resources surrounding education to use the produce.  And that's what pharmacy aims to tackle. I really love that. And just for everyone at home, Amanda mentioned double digit  hemoglobin A1C and that's.

Diabetes that is very poorly controlled because that measures your blood sugar over several months, and that means  that individual's blood sugar is very high. Consistently. And  I feel like it's so interesting to really understand individuals perspectives and views around what they consider healthy eating.

It's almost like I don't do that healthy stuff, but maybe they don't really understand what that means. So I think that's really great that you introduced them. So what were some of the initial challenges you faced in setting up pharmacy and how did you overcome them? So, um. our initial challenge remains our constant challenge, which is funding sources.

Of course, like any small nonprofit, that's our biggest hurdle. In 2020, we, which was about four years after we started the program, we partnered with the WVU extension Family Nutrition Program, and we were able to expand through a very large Walmart grant that they had gotten at that point. We were able to expand to about 10 clinics throughout the state.

And. You know since that time we've been able to secure funding for, from various sources like philanthropic groups or different grants. And most recently we've been able to secure funding through Aetna. I.  And this has allowed us to expand greatly as of 2024 and into 2025.

And now we're at about 30 sites, plus 30 sites over the course of the state with additional sites being funded by other grant sources. So, again, funding remains a challenge and. We, in addition to the funding  we do face challenges that all healthcare facilities face, you know, all those social determinants of health, which prohibit patients from getting places.

Transportation is a big issue, especially in the state of West Virginia, and we do suffer from that Also. We also suffer from having patients staying engaged in the program. the program is 15 weeks and it's a responsibility. Patients are actually, questioned initially to see if they can get there for 15 weeks  to see if they have transportation or, viable source of someone to pick up their produce if they're not able to get there.

So we've tried a lot of different things to do to, . Help patients get there and feel like they're part of the program. And one of which is incentives. We use incentives instead of penalizing people. We incentivize people and we try to do weekly raffles. We supply weekly giveaways, like kitchen products and that kind of thing.

Well, we've had some sites that have actually. Provided gas cards for patients to keep them engaged and also to allow for that transportation issue to become overcome. So a lot of different things. Again, I think I, I guess the best way to sort of sum it up is that we suffer from the same difficulties as most healthcare facilities do in the state.

Yeah, absolutely. That's a huge issue.  so  I will say  we're now focused on making America healthy again, right? That's what the new administration is doing, and I would think this fits Pharmacy, West Virginia fits in perfectly with that plan.

So, as I said, you're focused on serving the community. How do you select the location for your services, and why are these locations in West Virginia so important?  Initially we were really you know, we were working within our, area.

We're in the northern panhandle of West Virginia and wheeling, and those first few years we expanded the free clinic, had satellite locations in a county south of us, and another county slightly below that. We realized there was a need there, and so we crept down a little bit and it was limited by our funding and availability of.

Whatever local farmers we could have, but really kind of around 2018, we partnered with the. West Virginia Department of Agriculture, and that was helpful to just expand our thoughts on local ag and the local ag economy and to keep produce hyper-local in these areas. And so from that time, we've count, usually sites come to us.

We haven't sought out anything. With the Walmart funding that we had in 2020, it afforded us a kind of a snowball effect and we were able to expand.  And we were able to offer the program to areas that, raised their hands and said we, we'd like to do that. We were getting a little bit of traction  like talking at the osteopathic conference or talking at the state PA conference.

And of course people were interested in this, like it's an alternative to just. Almost becoming jaded in the, primary care world where you're saying the same thing over. You feel like you're saying the same thing over and over again, but nothing's being implemented. And this was an alternative for practitioners to say, what if we gave you the food and some education?

Could you do it then? And so we have maintained the model of allowing sites to come to us.  We know that 44 out of 55 counties in West Virginia are food deserts, and so there are some counties that don't have a grocery store within driving, like in a car, driving  let alone like, you know, access to public transportation or something like that.

So the need in the state universally is great. We have not necessarily targeted a specific area because it is  in many ways the problems that are true of one part of West Virginia are true in another part as well. So we allow those clinics or hospital systems, or FQHCs or independent practitioners to approach us.

And then we are  we've even worked with pharmacists who are  working, you know, within the  they have their own patient demographic that they serve and they recognize the value of being able to offer counseling for food and nutrition services too. So. The locations are important because we want buy-in from the clinic or the practitioner.

It isn't a food handout program, right? Like this is a prescription for produce. And so  having the validation that comes from a practitioner who is saying, in as much as I value giving you  and wanting you to take your whatever prescription, I think that you would benefit from having some more.

Healthful foods in your diet, and so it, it credits the idea that food is a part of medicine. Food is a part of health  and better living. So our biggest ask is that there's buy-in. When somebody comes to us and they wanna do a program, we want the practitionership to be solid as well.

I mean, that makes sense. And I love the prescription for produce because food is medicine most definitely. Right. What role does education play in promoting better nutrition and healthier lifestyle choices? And how does pharmacy West Virginia help inform individuals about the importance of food in managing their health?

So the educational component is one of our four pillars, and it's vital, really to the success of this program. And so what we do is we combine a nine week educational component, which is provided. Most sites by the West Virginia University Extension Family Nutrition Program. And like I said, it's a nine week course.

It starts usually within the first week or two of the program.  And it's probably a, fifth grade level that teaches basic nutrition and basic culinary skills, but it's really made for adult learning. It's an adult learning experience and does have a lot of history behind it.

To say that it works it's definitely been proven  over the course of about 20 years. I think of it, its existence. Education really helps patients discover and understand their chronic disease processes and how food plays an integral part in helping to heal the body. Most people  and you would not think this, but most people with type two diabetes, heart disease, obesity, hypertension, or high blood pressure, don't realize that they're suffering from a diet related disease, at least in part.

And just explaining that to them that their diet does affect their disease process is eye-opening for a lot of patients. So this education helps them to feel more confident in a lot of ways. Helps 'em to feel more comfortable in preparing produce to trying produce that they've never had before.

And then when they expand on that and go to the grocery store, they're more comfortable with actually buying produce that perhaps they hadn't bought before. Or a farmer's market in a farmer's market setting.    I think Amanda already mentioned this, they do receive a physical hands-on prescription that's written for one week supply of fresh produce, and they do exchange that prescription at the time of the produce pickup for the produce.

And what does that do? That drives home the fact that. That food is medicine and just like they take their prescription to the pharmacy and get their medicine for their diabetes or their high blood pressure, they're getting medicine to help these, disease processes in the form of produce.

So education is imperative for this program success. Yeah, absolutely. So you were talking a little bit about chronic diseases. Heart disease diabetes, West Virginia is some of the highest rates of these diseases in the country. So  you mentioned a little bit about diet, and maybe we'll get to that in the next question, but what do you believe are the other key factors contributing to these health challenges in the state?

So, yeah, of course the diet seems like glaringly obvious. It's like, well, if you eat better, you'll feel better. But, that's the tip of the iceberg. Like underneath that are so many social and environmental and  like even cultural pieces that we  it takes a while to begin to look at it from a different angle, especially when.

 You know, the way healthcare is often delivered, especially primary care  we're often treating a disease and we have sick visits. And when you have a disease, the idea of wellness is compromised at some, in some way. So regarding the cultural piece, West Virginia, like we mentioned  there are food deserts within this rural state.

The complexity of. The entire state being, you know, labeled as Appalachia as opposed to  some of, some were even southern states and maybe even poorer regions, but not the totality of the state being engulfed in that Appalachian region. There are like really nuanced pockets of, transportation trouble that limit people from access to healthcare.  In some areas, people are driving 30 miles or we have a cohort that we've worked with for a couple years in Pocahontas County and from end to end, the county is like 120 miles, which is. Hours  of traversing and so transportation and limited access to transportation.

In some of our more challenging areas, there isn't transportation in the household. They rely on either family members outside of the household or neighbors or. Transportation services provided through the state or their insurance. And so limiting the access to affordable and easy travel  is something that we can't underscore enough.

 Additionally. When we are, when we really are trying to understand what people eat and where people eat limited resources, affects how the buying habits of patients. Because if you have a risk to take and you have a household to feed, whether you are feeding your children or your grandchildren, or even just and Your immediate family. If you have a limited budget and you are faced with buying something that you know, everyone will eat like three boxes of macaroni and cheese for a dollar, or making a risk with your budget and purchasing. Some fresh produce that you don't know what to do with and you don't know if everyone will like, it's a risk that most people can't take.

And so our goal is to lower that threshold so people can walk over that and realize, actually I do like broccoli, it turns out. And so taking away the financial risk associated with getting into cooking eating something that may or may not be.

Received well in your household is something that we have kind of neglected  in thinking about how that impacts the way people buy and ultimately how they eat. I dunno if Dr. Carroll wants to jump in more, she was talking about that point. Yeah. So there is a direct correlation between poor diet and nutrition and the prevalence of chronic disease.

I mean it's a one-to-one and, I don't, I hate to go into this now, but healthy food access has to be addressed by our lawmakers in the state, by insurance companies and by really by physicians or we're never gonna make West Virginians healthy. We have a 53% higher mortality rate for type two diabetes than the rest of the United States.

We have a 19 to 20% higher rate of mortality. From heart attacks and stroke than the rest of the United States. Here in West Virginia, one in six adults is food and nutrition insecure, and one in four children are food and nutrition insecure. And as Amanda said, food deserts are prevalent in our state.

We have over 44 counties out of 55 counties that have food deserts. And our poverty rate, which does obviously contribute to, our health is one of the four highest in the country. So when you talk about poverty, food deserts, food insecurity those are all things that can contribute to poor health.

And those are all things that we need to deal with in the state before we're gonna fix our problems medically. I, you know, you say, I hate to talk about that, and I don't think that was political at all, and I agree 110%. I was a physician practicing in West Virginia and I saw firsthand, I mean, I took care of patients in nursing homes, so I kind of saw.

Patients at the end of their chronic disease course. But I remember walking through capital market in Charleston in  the warmer months and seeing all those farmers and if we can connect those individuals who. Don't have access to produce to all the farmers in the state.

I mean it, it's like, I'm gonna say it again. It makes sense and  it make people healthier. So how does pharmacy work in practice? Can you describe the process that individuals go through when they come to you for care or support? We actually have tried to target diabetics. That's been our goal, or those at risk of developing diabetes.

So we take that into account. We have on, actually on our website, we have an enrollment, what we would say the enrollment criteria or the piece that we would like to target these specific patients. Do we want everyone to have access to healthy food? Absolutely. But because this is a health initiative to hopefully reduce chronic disease burdens specifically associated to diabetes, that's been our, that's where we've leaned in most recently.

So  we also want to be addressing the food insecurity, the nutrition insecurity piece, which is often you know, there's this intertwining relationship between. Malnutrition and poverty and food and nutrition, insecurity and chronic disease. And so we know that we want to we want to offer it to people who need it.

And so we ask that  as the clinicians refer patients in or consider who would be  a patient who would benefit that these two things are mostly taken into highest account.  Is the patient nutrition insecure? Are they under the us poverty guidelines, do they have Medicaid, Medicare?

Like, can we reach a targeted population that needs this, that cannot afford it otherwise, and are they a diabetic or at risk of becoming a diabetic? Additionally we do take into hot other chronic diseases as well. So we primarily put that burden on the clinician of the, or clinicians at the clinic that we are working with, and we ask them to refer patients in.

That involves a conversation. We expect the clinician to be engaging with the patient and saying, Hey, I, I think that this might be another layer to begin to help you feel empowered and also to help you, make some changes that you wouldn't have otherwise been able to make. And so the clinician has the conversation initially with the patient, and then the patient is referred in.

 We have at each location what we call a clinical liaison or a clinical champion. This is sort of our contact, our pharm, like for when pharmacy, West Virginia is working to set up a program or maintain a program, we have a clinical liaison at each site. That person is. Very functionally, the boots on the ground person, they are making sure that the right patients are referred in.

Like if we have someone who is really. You cannot get there. There's a transportation barrier. Maybe they're not the best patient to be coming for a 15 week program where they're gonna have nine weeks of in-person education, for instance. Like, how do we serve that person? We need to think about that differently.

This may not be the right avenue for that person, so we want the right patients referred in Additionally.  We collect this data with pre and post program biometric data and also these surveys. And so we ask that the clinical liaison person be responsible for that collection in terms of making sure everybody does it, but also inputting it into a HIPAA compliant software program that we program are partner with West Virginia University Office of Health Services Research.

So we aggregate that data across the state. It's all input. HIPAA protected, you know, no patient identifiers into the system so that we can see what's working, what's not working, what's our, collective A1C reduction across the state. And then each program can have their individualized data.

So our boots on the ground clinical liaison person is really. The one making this work at each site. So patients are referred in and they are, given all the infra upfront information, it's gonna start on this day. This is what's expected of you. You're gonna show up, you're gonna get $25, we want you to just eat this.

 There aren't a whole lot of other qualifiers in terms of, we don't say. Now don't go home and make zucchini bread with that zucchini. No, this is just supplemental produce for their diet. So however they eat it we want to be giving them a variety of produce that is new and oftentimes maybe.

 Differ than what they've eaten in the past. And so we are working with the Department of Ag to standardize what $25 a week looks like across the board. We ask our local farmers to supply $25 a week for each patient. Mostly that looks like a variety of five to seven different things.

And the idea is that they can incorporate this $25 into the, at least. One to two meals a day for the next seven days. So it's supplying produce, injecting produce into their diet daily over the next week. We want it to last. We want it to be working so our, farmers know that we partner with the Department of Agriculture to identify these local growers and then pair them up with the clinic.

So we have our liaison, we have our farmer, and finally the educator is the person who usually is from the extension services in the state. And it's a standardized nine week educational program that Dr. Greco mentioned. So when we're setting up a program, often the clinic comes to us and says, Hey, we'd like to do a pharmacy, and then our goal is to sort of network and get these pieces in place for that clinic.

We encourage a lot of autonomy. We know that not everywhere in West Virginia is exactly the same, and mostly we believe these clinics know how to serve their area's best. They know their demographics, they know what might not work for them. And so we encourage a lot of autonomy after we get the initial pieces in place.

Our expectation is that we are running programs during the West Virginia growing season. They're getting a diverse.  And robust arrangement of produce each and every week that they're being educated from a farming ag level where the farmer's present and saying like, yeah, I grew these in the high tunnel, or I mulched my beds when I grew these, or whatever, varying degrees.

And then they're having a sit down adult second grade reading level education experience that is hands-on and targeted to address nutrition and also how it overlaps with chronic disease. It is a comprehensive program.  I love all the entire  way it's set up. So what are some of the standout successes of the program so far?

Are there any particular moments or milestones that you're particularly proud of? Well, number one is we are celebrating year 10 of our program this year. So we consider that as a small nonprofit to be a huge success. We've been able to stay alive for 10 years. We've been able to expand I said over 30 sites, but if you include the HRSA funded sites for probably over 40 sites in the state right now in roughly about 28 counties.

So. We consider that a huge success for a small nonprofit that's being run essentially right now by two people that are volunteering their time. So that's number one. Number two, if you look at our results we have at multiple years had a 0.9 reduction in hemoglobin A1C level. So basically hemoglobin A1C level is a diabetic marker that we look at roughly over every three to four months to see how a patient is maintaining their blood sugars with their medications or in this case with their healthy food.

And that in a 15 week program is significant because a lot of diabetic drugs can't even say that they can do that. So we consider that a major success. We have also seen that patients with some of our, well, Amanda already explained to you that we do surveys pre and post program also. And we have seen that patients really maintain that, that hemoglobin A1C after the program's over and again, how is that done?

That's done, we think, most of all, through the education that patient has received and also through the support of the provider.  We really  again, one of our pillars is to. Have a strong patient provider existence there that helps to continue on with support and affirmation and, continuation of the patient's health journey after the program.

So maintaining that hemoglobin A one CII that level it is really a success for us. We've shown through our surveys that patients have. They eat less fast foods. They eat less outside of the home. They're cooking more inside of the home. They have less food insecurity within the, in the home, and  they're essentially more comfortable with shopping for produce now than they were prior to the program.

So, you know, when they go to a grocery store, they go to a farmer's market, they're more likely to purchase produce that  they'd not had before. They were uncomfortable with preparing before. Amanda mentioned the  HIPAA protected software that we're using now. we just changed our software program in 2024, and this really has improved our data collection and we've seen more positive results in 2024 than before.

Just, I think because of the way we're collecting the data we've seen more weight loss, we've seen more decrease in blood pressures. Which we were not particularly looking at, but  we did start to look at in 2024. We say these are successes  for this program. And something that we've not been able to measure is the community environment that we create through these small groups that exist.

During the educational component, patients are able to get together and they do a, you know, it's about a 15 to 20. Patient group. So they're able to interact and socialize and they bond with each other and they provide almost a support group for each other. Over the course of that 15 weeks another success that we have been really.

Excited about and are just, hoping that it continues on over the years, is that we actually are helping to support our local farmers and growers.  We're supporting  the economy of West Virginia really. And we've, again, we have surveyed farmers and growers and they've told us that the guaranteed income that they make from this program has allowed them several things.

One, to some have been able to increase their numbers of employees and been able to hire additional employees. And the guaranteed income is an outlet for them that this, program provides an outlet for them to be able to sell their produce, which, they may not have otherwise had.

and I said before, it's a guaranteed income. We pay them half of the program upfront in that first week, and we pay them the second half. Midway through the program, regardless of whether or not the patient shows up that week to pick up their produce, they're guaranteed that income for the, the entirety of the program.

So many successes. And you mentioned 10 years, which is amazing. And during the last 10 years, we know we went through a pandemic, the COVID-19 pandemic. So I'm very curious how the pandemic impacted pharmacies operations and how did you adapt the program to meet the changing needs of the community during that time?

so the pandemic was really when we began to expand so much because that was just timed d well, with the grant. And initially we weren't sure what, you know, would this still go on? We adding like at least 12 additional sites in 2020. And it was potentially the whole, thing could have just been totally stagnated, but ultimately there were some.

State regulations with farmers' markets just for safety reasons in terms of packaging and how you were allowed to prep things, and especially including tastings. So our program normally is set up like a farmer's market and there's fresh produce on the table, oftentimes in the parking lot of the clinic, and this is the pharmacy, right?

And so patients are encouraged to step up to the table and they might see a little sign in front of a big bin of tomatoes that says, heirloom tomatoes take four this week. And the next spin might say, zucchini take three and they go down the line. They pick out what produce they want. We do not have a packaged CSA type of form.

It's our goal is that they have some autonomy of choice over what they're picking, and they're also learning. Oh, this is, this tomato needs to sit on the window seal for two days because it's a little green on the bottom or whatever. I pick what tomatoes I want when I go to the grocery store. And so we want patients to have that experience that it isn't just a, again, it's not a food distribution, it's not a pickup sort of program.

However, with COVID that whole touching piece was really.  Where some of the regulations became difficult to navigate and so we had to switch to prepared boxes. And this just felt it felt awkward to us because our goal was to really give this hands-on education piece and to really encourage people to step up to the table and.

And learn these pieces about where their produce is coming from and, to touch it and to have that secondary learning experience. But during Covid, that wasn't what was afforded. And so we had pre-packed boxes where patients picked up their produce and took it home.

And although that was what was. Necessary during that time, we were glad to go back to having, a table full of produce  and bringing patients to the table to kind of have that,  that purchasing power or that experience. But overall covid we remember it in some ways as fondly as someone can for the pandemic, but it did, allow us to really network well over Zoom with many of our locations. And we reached farther with that otherwise we were meeting in person in many instances. And so the expansion of that that kinda, that Teleservice was really  we were really appreciative of that opportunity.

And it has, since then, that's predominantly how we meet. We still maintain our Zoom meetings with most of our counties. That's the silver lining. Yeah. So looking ahead, what are your hopes for the future of pharmacy West Virginia? Are there any plans for expansion or new initiatives you'd like to see implemented in the coming years?

 So in order for this program to continue to grow and expand, we need a sustainable funding source. I mean, that's the bottom line. And up till recently we thought Medicaid was gonna be our answer. We're not so sure right now  because of the future of Medicare is sort up in the air. I'm sorry, Medicaid is up in the air.

So we're looking to,  maybe market ourselves more through insurance companies. We feel like that's maybe our potential to expand at this point. Until then, we're gonna have to rely on grants. We're gonna have to rely on, philanthropic groups.  But that gets, I. Old, you know, and we can't expand by relying on philanthropic groups.

To do that, we need a sustainable source. So on our wishlist is that we find a sustainable source for this program so that we are able to grow and expand throughout the state. And our ultimate stretch goal is to be able to provide this program to any West Virginian who qualifies any West Virginian, not just select, communities, sort of select clinics. There's always room for expansion. We have ideas. One of our ideas to be able to make this a year round program after the West Virginia growing season, which really is only about 15 weeks long we could go to fresh frozen food through grocery stores to maintain this program through the winter months  and then reopen it again in the spring.

There's been lots of data that shows that prescription produce programs work to help control chronic disease and prevent chronic disease. Lots of data has come out through Tufts University and Harvard Law to show that. And, we feel like we are part of the answer, at least, to helping Chronic disease burden in the state. again, our stretch goals are many, but we think it's doable.  We just need a lot of cooperation, again, from our lawmakers, from our insurance companies and from all those entities that, are involved in the health of West Virginians? I would agree.

I mean  I think  president Trump passed RFK with ending chronic disease. And you have the answer here, so like, I get it, you know, we're screaming it from the rooftops here that we need to fund this program. It works.  We know it works. It's good in, in so many different ways.

And I really hope that we can make that happen. If people wanna find out more about pharmacy West Virginia, how can they do that? So we have a lot of videos, we have a lot of history, have a lot of data. It's all on our website, pharmacy wv.com, F-A-R-M-A-C-Y wv.com. All of our information from the last 10 years is on that website.

There's also contact information there that you can directly contact us if you're interested in starting a program or interested in, finding out about a program that may be close to you. That's probably the best way. Yes, and I encourage everyone out there who is interested to do that.

Dr. Carol Antonelli, Greco, Amanda Cummings, thank you so very much for being with us today and I wish you the best of luck and success for your program. Thank you. Thank you so much.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

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So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.