For seniors who benefit from the Medicare Part D plan, reenrolling this past fall was more of a chore than ever, especially since some had to recalculate their costs to avoid the dreaded "doughnut hole" of 2006. Drug plans changed, medicines were added to and dropped from formularies, premiums went up and down, and seniors were once again caught in the middle.

To help meet some of the anticipated challenges, the University of California, San Francisco (UCSF) Pharmacy School has developed a program to help seniors with their drug plan decisions. Entitled "Partners in D," the program is expected to run for 3 1/2 years and will be geared toward training tomorrow's pharmacists in the most effective ways to handle Part D questions as they arise. Along with 6 other schools of pharmacy in California that will partner in the program, the school will incorporate training on Medicare Part D into pharmacy student curricula. The students will then instruct their fellow professional health care students in the fields of medicine and nursing.

The program will also enable pharmacy students to help seniors make informed decisions when choosing their Medicare Part D plans, with a special focus on underserved communities—low-income and non-English-speaking seniors in particular. The university will reap the benefits of its multicultural student body by using their various ethnic backgrounds and language skills to reach these seniors with Medicare information relevant to the state's diverse population.

"Partners in D" was the result of a pilot outreach developed by students at the pharmacy school and directed by Marilyn Stebbins, PharmD; Helene Levens Lipton, PhD; and Tim Cutler, PharmD; all of the Department of Clinical Pharmacy at the school. Together, they took part in outreach events in Sacramento and San Francisco designed to assist low-income and non- English-speaking Medicare recipients with making their Part D decisions. Students at the school wanted to extend the program statewide.

Dr. Cutler explained, "The students recognized that there's a huge problem with Medicare Part D, especially when dealing with the most underserved seniors." He stated that, in the initial pilot outreach program, nearly 2500 seniors benefited from the students' and faculty expertise on Part D, especially those with cultural and language barriers. The pharmacy school has an ethnically diverse student body, and they were able to reach out to many of these seniors in their own languages.

Dr. Stebbins noted, "We discovered that many non-English-speaking populations [are wary of] the system and others outside their culture. They respond better to students from their own cultures than they would with translators. They were thankful to have someone explain the Part D benefit to them on their own level."

Dr. Cutler also noticed the positive response to their outreach. "When [the seniors] hear ‘Part D,'they panic and get angry. They think we're trying to sell them a plan. But when they realize that we're there to help them, it's amazing to watch their faces change and see how grateful they were that we could help them understand." The researchers conducted pre-and post-outreach surveys, and the response so far has been overwhelmingly positive.

Dr. Lipton said that the school provides its students with cultural competency and health literacy training so they can better help Medicare beneficiaries understand their options. She explained that "the students were really the driving force behind this program. We felt a tremendous need to get out of the classroom and the pharmacy and into the community and help those who needed it most—those in the lower-income and multilingual populations."

The Amgen Foundation also recognized this need. Based in Thousand Oaks, Calif, the nonprofit foundation distributes grants to regional and national nonprofit organizations that support its mission of improving individual's lives through science and innovation. Drs. Lipton and Stebbins investigated the grant and applied for it during the summer of 2006, and the foundation approved their request in October. The pharmacy school was awarded $3.7 million to help fund the "Partners in D" program. The grant allows for the program to expand in scope and extend statewide. One of the key elements of the grant is the research needed to determine the overall success of the program and make evidence- based changes in it as it unfolds.

Jean Lim, president of the Amgen Foundation said, "'Partners in D'represents the essence of what our foundation stands for: advancing education, improving quality of care and access for patients, and creating sound communities. We support this program because it clearly takes full advantage of a diverse student body and encourages a spirit of collaboration."

One of the primary benefits the grant will bring to the program is greater Internet access; students rely on laptop computers during outreaches to access accurate information quickly, and the added funding will help them assist seniors in sorting out their Medicare options while in the field.

Dr. Cutler stressed the importance of reaching Medicare seniors on their levels and understanding their problems with the program. "People who come to us have complicated issues, or they don't understand the program? we've identified individuals that didn't even know they were in Medicare or Medicaid, or that their coverage could change from one year to the next. We try to help them understand the challenges and take a proactive stance."