Banking on KC – John Yost
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John Yost of Pharmacy of Grace: Improving Access to Prescription Medication
Kelly Scanlon:
Welcome to Banking on KC. I'm your host Kelly Scanlon. Thank you for joining us. With us on this episode is John Yost, the founder of a new nonprofit called Pharmacy of Grace. John has a long history in the pharmacy and pharmaceutical business, and he has a pharmacy degree from KU. Welcome John.
John Yost:
Thank you, Kelly. It's my pleasure, and thanks for asking me.
Kelly Scanlon:
You founded Pharmacy of Grace to improve access to prescription medications, primarily for vulnerable populations, uninsured, underinsured individuals. What kinds of services do you offer in particular through Pharmacy of Grace?
John Yost:
Well, Kelly, we offer the same type of services that most community pharmacies do but our particular aim is treating managing chronic diseases, which oftentimes are fatal, if not manage. We of course have prescription services, which all pharmacies do, but our aim is on the uninsured patient. We can provide prescriptions for anyone that walks in the door, but we are focusing on uninsured population.
John Yost:
The second thing we have is health screening, which some pharmacies do that, but they're very simple blood pressure and blood glucose. Why that's important just recently, we were filming for a news station and Mercy and Truth had a patient of theirs come in for the broadcast and that particular patient. We didn't realize it had gone to the emergency department the night before with the blood glucose of 600, which is extremely high. Now, if they would've come into Pharmacy of Grace and we did a simple blood glucose monitoring, we would've caught that and possibly prevented that visit to the emergency department and that interruption in that patient's life. So that's why we're doing that.
John Yost:
Third thing is we will be offering immunizations. At the beginning it'll be primarily in the pharmacy, but our goal is to have a pharmacist that can be mobile and go out to different locations, such as schools or churches or businesses, any place that doesn't really have good access to immunizations. And we also want to eventually have mental health referrals and our staff will be training to be able to recognize that situation.
John Yost:
And then the last one, which is maybe the most important thing, is that we will be having counseling with each patient conducted by the pharmacist and the way our configuration is set up, we have rooms where the pharmacist actually sits down with each and every patient.
Kelly Scanlon:
And when you talk about counseling, you're talking about how to use the medication and how it will work best for them, that kind of thing. Right?
John Yost:
Absolutely. Every patient will know what they're taking, why they're it, how to take it, and maybe most importantly, what happens if you don't take it.
Kelly Scanlon:
Before you founded Pharmacy of Grace, you saw these issues from a number of different vantage points. You started for example, as a community pharmacist and then you opened your own pharmacy in Oklahoma, you sold that, and you began on the other opposite side where you were selling pharmaceuticals for Roach Labs in Topeka. And then you were a sales and operations director for the pharmaceutical industry. And then you became a pastor at Church of the Resurrection. So you've seen a lot in the industry, and as I said, you've seen it from many, many different perspectives. What inspired the idea for Pharmacy of Grace? What was it? What moment did you have that finally said, I need to do this?
John Yost:
It was a long journey. As you mentioned, I left the pharmaceutical industry in 2016 to become a pastor. And I went to work for Church of the Resurrection in their mission department. And my job was to develop mission trips in the United States. So I was in Columbus, Ohio at a little church called Church for All People. And I just stumbled on in the pastor's office this postcard, and it just stopped me. And I started reading, it said Charitable Pharmacy of Central Ohio, and actually, I think I almost got goosebumps when I read it. So I started asking, what is this? So after about 10 questions, they said, would you like to tour this? And so I said, sure.
John Yost:
They were serving a homeless population. They had counseling rooms and they'd take each patient in, talk to them about their medication. There were pharmacy students in there, there were techs, there were clerks, there were pharmacists and residents. Just a vibrant place to be. So I returned twice to learn more what they were doing and to serve. And then I came back and I was really busy in that job developing those trips, but I just couldn't get it out of my mind. It kept popping back. And so finally I said, okay, I need to really take action on this. So I did research, I discern and I prayed about it and then finally, 2018, I just had to do something about it.
Kelly Scanlon:
Let's talk about that. You decided to move forward with this idea in 2018, you formed a board and you applied for 501(c)(3) status, but then you've experienced a number of delays. Now, from what I understand, as of this date, you've received some grants that have allowed you to become operational, correct?
John Yost:
Yes, we have. Initially before COVID we had a couple initial grants from Reach Foundation and Church of the Resurrection, a small grant, and those allowed us to get our capacity up to speed, just all the things you need to really start operations. We paused and after COVID then we started receiving grants. We had significant grants from HealthForward, from Advent Health and then larger grant from Church of the Resurrection, which really allowed us to start in earnest to move forward to opening. And since then we had a amazing grant from the Centerline Foundation, which paid for the bulk of the renovations. Mercy and Truth gave us a grant to help with those renovations. So that was basically all paid for. Mariner Foundation, Dunn Foundation. And then just recently we received a grant from H&R Block Foundation, which paid for the rest of our equipment in the pharmacy.
John Yost:
So, we've received a lot of support, we're not quite there on the operation side, but we're getting close. We need about 150,000, by the end of our first year of operation, pays for everything, just to run the organization, the salaries and the supplies and that sort of thing. So we do need a little bit more money and we have a website, PharmacyofGrace.org that you can go to, and it has a donation button on there for anybody I'd like to donate.
Kelly Scanlon:
Where are you working from because I know that you are actually working on a facility in Wyandotte County right now.
John Yost:
We're almost complete with our renovations at the facility in Wyandotte it's at 721 North 31st Street, right across the hall from Mercy and Truth Medical Missions, and so we are in the final phases. Our opening date is July 11th, right now, if supply chain doesn't hit us. So we're almost done, it'll be a state-of-the-art pharmacy. It'll look a lot different than what most pharmacies look when you walk in the door. Most pharmacies, say you go to a chain pharmacy, you look back there you see the pharmacist and all these shelving and stuff. With us, it will be a waiting room and then there's three counseling rooms. And two of them are a one-on-one, one on two or three size counseling rooms. And one's a large room that can accommodate a family because in many cases the whole family comes to the doctor and then they come to the pharmacy. So you have to have a place where everyone can be. And so that's a lot different than most pharmacies you walk into.
Kelly Scanlon:
How will people find out about you, will you be working with partner organizations in the community?
John Yost:
Absolutely. Of course, we're right across the hall from Mercy and Truth. They recruited us into the building, so they're a very strong partner. We've been in contact with the Duchenne Clinic, SWOP Clinic, any of the clinics in the area we've already had contact with so they know that we're coming and they're anxiously awaiting us. We also have talked to organizations like El Centro and Avenue of Life, which each have their own specialty, but they have large populations of people that they serve. Medicine Cabinet who provides acute prescriptions. They're anxiously awaiting us because we're very close to some of their agencies they use. So yes, we're out in the community, we're talking to, really, as many people as we can.
Kelly Scanlon:
Set the scene for us about the critical need for an organization like Pharmacy of Grace. You mentioned earlier in our conversation that you're especially in tune with people who have critical illnesses, critical diseases, and the importance of trying to get them medication that can help turn things around for their lives. Set the scene for why this kind of an organization is needed, especially where's the greatest need in the Kansas City Area and why?
John Yost:
Before we even formed the board I spent a lot of time looking into this and actually I was interviewing someone we hired and they asked me, why'd you come to Wyandotte County. And so, as I did research, what I found... And it's recently just confirmed by the University of Wisconsin County Health Ranking Study, University of Wisconsin, they rank all the counties in the United States, so you can look at it by state. And they just recently came out and showed that Wyandotte County is ranked near the bottom in health outcomes, which that's quality of life and length of life. And they're ranked dead last in the State of Kansas in health factors, which that's education related to health and access to healthcare.
John Yost:
Pharmacy of Grace falls right in access to healthcare. And one thing I found is that a lot of surveys and research was done, but rarely did they just focus on prescription drug access, which to me was the missing gap. Because if you have a primary care provider and they're the greatest diagnostician in the world, they're excellent patients, they have a plan, they do all this work and they write prescriptions, their tool to treat chronic disease is typically prescriptions. And if they do all that work and then the patient can't get it, that's just all the work that made no difference, basically. The reason that it's so important in Wyandotte County, almost one in five people have no medical insurance, so if you look various sites it's 17 to 21% are uninsured. That's 28,000 to 30,000 people. And then 14% of the population of Wyandotte are diabetics, so that's over 23,000 people. Diabetes is a devastating disease if not managed because you can lose limbs, you can go blind and eventually you'll have organ shut down, which is fatal. And even our partner right across the hallway, diabetes is in their top five diagnosis. So the patients walking in that door.
Kelly Scanlon:
And that's the Mercy and Truth clinic you're talking about?
John Yost:
Yes, Mercy and Truth Medical Missions, which is right across the hall from where we'll be. Probably the most shocking figure to me when I was doing the research, which is really the sign that's not being managed are hospitalization rates. So in Wyandotte County, the diabetic patients are being hospitalized 31.9 per 10,000 population, which compares to the State of Kansas 16.9 per 10,000. So approaching double. When I first saw that, I thought is that right? And then I started looking at all these other disease states and they were pretty consistently that much higher. There are some reasons why that's happening and it's a national problem, but my guess is it's probably even greater in Wyandotte. And the national data shows that out of every 10 prescriptions written, two to three are never filled.
John Yost:
There can be many reasons why people don't fill the prescriptions, but one of those is just say, can't afford it or they don't have access. Then the second thing, which is probably more important and almost equally shocking is that every prescription that's filled and taken by patients, one out of two of them are not taken as prescribed. So those two things, the estimate is costing the US healthcare system, $100 billion a year because people either can't get prescriptions or they're not taking them correctly. There's a whole host of negative outcomes that can happen. Sometimes it's worse if you're taking that incorrectly versus not taking it at all. So there is some light at the end of the tunnel there because there's data that show that pharmacists have 12 times more contacts with patients than primary care providers do. I view that as 12 times more opportunities because if you've ever got a prescription filled in, most of the pharmacies that we walk into, the typical scenario is the clerk is handing you the bag across the counter. And they say, do you have any questions for the pharmacist and everybody always answers no, I don't. So, that's a missed opportunity the pharmacist could interacted with that patient. So Pharmacy of Grace, we won't miss that opportunity because we won't hand the drug to anybody without the pharmacist talking to them.
Kelly Scanlon:
We were talking about, you still need donations, but are other ways our listeners can become involved with Pharmacy of Grace?
John Yost:
So the primary way people can get involved is to, number one, tell their friends about Pharmacy of Grace. We're on Facebook, we're on LinkedIn. They can forward our information, share their information with their friends, so that the word gets out there. And then if they do want to donate, as I said, you can go on our website, PharmacyofGrace.org, and there's a donate button. So those are probably the best ways right now.
Kelly Scanlon:
As you become operational and begin delivering your services, what vision do you have of success?
John Yost:
Well, Kelly, I think that goes back to why we're doing that. And I would say why I'm doing it, but our staff and our board we're all aligned on why we're doing this. It really reflects on the golden rule, treat people as you want to be treated, but even moreso if you look at, and I'll paraphrase this out of Jesus teaching in the Bible, he said that when I needed clothes, you gave me clothes. When I was thirsty, you gave me water. And when I was hungry, you gave me food. And when I was sick, you took care of us. And they said, well, master, when did we do that? And he said, well, when you take care of those most in need, you're taking care of us. So, that vision of taking care of people being the hands of Christ is our vision of success.
John Yost:
What that means clinically is that, we had a patient that was filming, I told you about, I believe that her blood glucose was 600. Well, if we would've had a blood glucose screen, we could have stopped that from happening potentially. Maybe she could have gone to work, or maybe she could have spent some time with her friends or family versus being in the hospital. So, that's a vision of success. Also, if a child asthma is controlled so they can go to school, that's success. If a patient has migraines and they can be prevented and go to work or go to school or go do whatever they need to do to be successful, that's success.
John Yost:
So it's really the hand up for the patient that's struggling. And we're focused on the uninsured, but it could be someone has the greatest insurance in the world, they just don't know how to take their medications. So, if we can help that patient that's successful, that's our vision of success. We'll have data to show that we're being successful because one question we'll ask if you me visited emergency department or hospital since the last time you're in here. And so, I mean, that's real basic, but hopefully the answer is no. But if it's, yes, that means, well, have you been taking your medication? And many times it's either I haven't taken it or my disease states getting worse. So it's really two basic answers.
Kelly Scanlon:
But what you are doing goes beyond controlling a disease or curing an illness, like you said, people can go to school. They can be in the classroom more frequently, they can go to work and earn a living. So there are many implications beyond the health issue when people don't have access to these medications.
John Yost:
Absolutely. Without access to medications, to immunizations, some of the fundamental immunizations people don't even think about because those are disease that couple generations have never experienced, but if you don't get vaccinated it can come back. So it's all about quality of life and keep people out there doing what they want to do to be successful.
Kelly Scanlon:
John, thank you so much for being our guest, for sharing this new organization that you are about to open the doors to. We really appreciate all the work that you're doing in the community and wish you the best of luck. Once again, PharmacyofGrace.org, you can go out there, you can donate, you can find out more about the services. And as John said, spread the word. Thank you so much.
John Yost:
Thank you, Kelly.
Joe Close:
This is Joe Close, president of Country Club bank. Thank you to John Yost for being our guest on this episode of Banking on KC. As a pharmacist, John understands how important it is for people to manage their chronic illnesses with medication. Lack of access to that medication is more than a health issue, it's a quality of life issue. It keeps people from school, work and caring for their families. It's economic toll on our communities and on the healthcare system itself is well documented. As the Pharmacy of Grace opens in Wyandotte County, we applaud John and his team for bringing affordable and sustainable access to prescription medications and pharmacy services to the Kansas City Area. Thanks for tuning in today. We're banking on you, Kansas City. Country Club Bank, member FDIC.