25-0258-RFP Pharmacy Benefit Services

Pinellas County seeks to contract pharmaceutical services to support eligible clients of the Pinellas County Health Program (PCHP) and the Healthcare for the Homeless Program (HCH). The successful proposer’s duties include, but are not limited to, managing a pharmacy network or overseeing pharmacy sites and pharmaceutical dispensing; providing network and prescription monitoring services; tracking pharmacy benefit eligibility and utilization; ensuring accurate documentation of eligible prescriptions; and verifying compliance with all applicable federal, state and local regulations.

Pinellas County (County) will establish a standard services agreement with a qualified pharmacy benefit manager (Proposer) to provide cost-effective, geographically accessible, and high-quality pharmaceutical services to eligible PCHP and HCH clients in accordance with the requirements and provisions stated herein.

The PCHP was established in 2008 by the Pinellas County Board of County Commissioners (Board) to provide accessible and affordable quality healthcare services for low-income (100% current Federal Poverty Level- FPL), uninsured individuals between the ages of 18-64 who do not maintain or are otherwise ineligible for, another type of medical insurance. Clients are eligible for PCHP as determined by the County’s certification staff using eligibility guidelines found at the following link: https://pinellas.gov/programs/pinellas-county-health-program/ PCHP primary care services are currently delivered countywide through five (5) medical home sites.

In addition to the PCHP, the County offers healthcare services for homeless individuals through HCH, a full-service Federally Qualified Health Center (FQHC) funded in part by a grant from the US Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA). HCH services are provided at the Bayside Health Clinic and various locations throughout the County via a 45-foot mobile medical unit and a smaller street medicine van. A third mobile clinic is expected to be online by the end of 2025. More information about HCH can be found at the following website link: Health Care for the Homeless Program - Pinellas County .

The clinics and mobile units are operated through a contract with the State of Florida Department of Health, Pinellas County Health Department (DOH Pinellas). As part of PCHP and HCH, qualifying individuals may receive primary care, wellness and prevention services, mental health and substance use services, nutrition education and counseling, health screenings, physical therapy, laboratory and specialty care services, and dental and pharmacy services. The goals of the programs are to reduce the use of the emergency room for non-emergent care, assist individuals in the maintenance of healthy lifestyles, and coordinate health services to improve health outcomes. In the calendar year 2023, PCHP saw 2,953 active clients, and the HCH program saw 4,913 clients.

Pharmaceutical services are an integral tool to support healthcare for our program clients. All PCHP and HCH clients are eligible for pharmacy services. In Fiscal Year 2023 (FY23), over 58,000 prescriptions (does not include restocks) were dispensed for program clients through the County’s contracted Pharmacy Benefits Manager (PBM). The County wishes to support a collaborative partnership to meet the pharmaceutical needs of PCHP/HCH clients in an effective and efficient manner.

One of the key goals of PCHP/HCH is to ensure the delivery of quality services while maintaining effective pricing controls for the program. The awarded proposer is expected to participate in and support cost-saving initiatives, to include: regular formulary reviews, lowest-price pharmacy utilization, 340b implementation and over-the-counter medication process controls.

PCHP and HCH also utilize a Prescription Assistance Program (PAP) contracted through Suncoast Health Council, Inc’s MedNet Program. The awarded proposer shall assist the County with transitioning clients to this program as appropriate. See link below for more information: http://suncoasthealthcouncil.org/current-programs/mednet-prescription-assistance-program/