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The Cattaraugus County Legislature's Senior Service Committee has agreed to send a resolution to the full body next week that could change the county's nursing homes pharmacy contract.

The resolution, to be presented for immediate consideration at Wednesday's County Legislature session, is based on a set of recommendations from the consulting firm Health Care Solutions of Western New York.

Michael Edbauer of Health Care, told the committee that the county's nursing homes are not using a simple format for clinical or formulary -- a list of approved medications -- guidelines. In addition, there is no system to track physicians' drug recommendations, and some doctors might not be aware of the costs of the drugs they prescribe.

In an inconclusive analysis of the number of drugs per patient, both the Pines of Machias and the Pines in Olean appeared to have a higher-than-expected number of patients with nine or more prescriptions, with the Olean facility exceeding the Machias one.

Edbauer was quick to point out after the meeting that this number may or may not include drugs or over-the-counter medications recommended on an as-needed basis and that this aspect of the pharmacy procedures needs further analysis.

Health Care Solutions' report of general observations of the nursing home pharmacy procedures since March projected savings for the county of $140,000 to $200,000.

The firm recommended drafting a request for proposals for a new pharmacy contract, establishing clinical guidelines and disease protocols to curb costs and monitoring procedures. The higher amount could be saved if an optimum contract is negotiated, Edbauer said.

Several committee members agreed to sponsor a resolution that could begin the second phase of Health Care Solutions' work on those tasks by May 1 at a cost of about $24,000. The firm was paid $9,000 for the first phase.

The county budgets about $813,000 for its pharmacy expenses. The cost of the county's one-year contract with Buffalo Pharmacy was not immediately available. It is up for a two-year renewal or cancellation by July 31.

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