The Joint Commission on Health Care received preliminary briefings from its staff on June 18 on two studies conducted as part of its 2025 workplan. Staff will present full briefings with policy options later in the year. Public comments on the initial background briefings may by provided by email (jchcpubliccomments@jchc.virginia.gov) or via mail (411 E. Franklin Street, Suite 505, Richmond, VA 23219) by close of business on June 27.
Access to pharmacy services: The Commission’s study directive charges staff to identify areas in Virginia that constitute pharmacy deserts and populations that are affected by lack of access to pharmacies, including how access to pharmacies has changed over time; identify factors that affect pharmacy access; and outline strategies to ensure access to pharmacy services, including strategies implemented in other states. Staff’s preliminary report pointed out the importance of pharmacy services in health care, and the benefits of community pharmacies; Commission members underscored the connection between access to a local pharmacy and medication adherence. The total number of pharmacies in Virginia has declined since 2014, and 28 localities have census tracts that are pharmacy deserts, defined as both low-income (with 20 percent or more of the residents living below the federal poverty line) and low access (with a pharmacy more than one, five, or ten miles away for areas designated as urban, suburban, or rural, respectively).
Further staff research will investigate low reimbursement rates for dispensing medications – a key factor identified as contributing to pharmacy closures – as well as opportunities for offering additional patient care services. Members also asked staff to investigate the proportion of Medicaid-covered individuals in pharmacy deserts and how residents without a nearby pharmacy are receiving prescriptions.
Transportation-related barriers to health care: Commission staff were tasked with outlining transportation barriers to health care and identifying strategies that could be implemented to address these barriers. In the preliminary briefing, staff noted that 6 percent of households in Virginia did not have access to a vehicle, and outlined alternatives to individual car trips; public transit options are available in certain localities, as are options such as deviated fixed-route paratransit, which allows some flexibility in regularly-scheduled transit services, and demand response programs, which provide curb-to-curb service. Federal law requires that transportation to medical appointments be made available for Medicaid beneficiaries; this service is provided through the Non-Emergency Medical Transportation Program, and covers members enrolled in both fee-for-service and managed care payment structures. Grant funding is also available through the Federal Transit Administration’s Enhanced Mobility of Seniors and Individuals with Disabilities Program (also known as the Section 5310 Program), which provides funding to meet transportation needs of older adults and people with disabilities when the transportation service provided is unavailable, insufficient, or inappropriate to meeting these needs. Funding can support capital or operating projects – for example, vehicle fleet expansion, or construction of accessible paths to a bus stop.
Commission staff noted that the system of programs is complex, and program restrictions may limit the use of services; existing programs are also stressed by increasing costs of operations and workforce recruitment and retention challenges. Commission members emphasized the lack of transportation options for residents in rural areas who do not have access to a vehicle, and noted that some rural EMS providers are stressed by residents’ use of their services for non-emergency transportation to medical care.
Staff will present full reports for each of these studies at the Commission’s October meeting, at which time there will be an opportunity to provide public comment on the specific policy options presented.
VACo Contact: Katie Boyle