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What To Expect When You Are Expecting During COVID-19

Erika Cook, PharmD, MBA

 

First, there were the Baby Boomers who were born after World War II, then Generation X in the 60’s and 70’s, Generation Y in 80’s and early 90’s, and then Generation Z in the late 90’s and early 2000’s. We now introduce you to ‘The Coronials’. This new generation is the babies that were born during the global pandemic of 2020 from the novel COVID-19 virus and those babies that will result from months of quarantine and isolation.

I recently gave birth to my first child in May 2020. I was pregnant and worked through the height of the pandemic as a pharmacist in home infusion. I gave birth in a mask with only my husband in the room. I am now raising a newborn and returning to work while many things about this virus still remain unknown. Most pharmacists, especially pharmacist moms, are type A people that thrive off planning. COVID-19 has limited our ability to plan ahead. For example, your Amazon Prime package with diapers is not going to arrive in two days anymore. We do not know when daycare centers will re-open and what type of new precautions there will be. However, there is still something in our control.

Being an essential healthcare worker while pregnant is difficult. Here is what to expect while you are expecting during COVID-19 pandemic.

Pre-partum:

  • Working while pregnant: I worked up until I was 38 weeks pregnant at which time started quarantining at home based on my hospital’s policies. I wore a mask all day at work and had a sign on my door that I was practicing social distancing. I kept interactions to a minimum and used the phone and computer for communication whenever possible. Home infusion is not directly patient-facing so this allowed me to safely follow CDC guidelines for most of my pregnancy. I recommend you utilize the company’s resources such as reasonable accommodations, leave of absences, and employee assistance programs to ensure you are safe at work.
  • COVID Policies: Both my husband and I had to get tested for COVID (we both were negative). If either of us came back positive there would have been specific protocols in place during delivery. We took this time in quarantine very seriously. There have been possible findings of vertical transmission from mother to fetus (1). In addition, if my husband tested positive he would not have been allowed entrance into the hospital and I would have had to find an alternative birth partner who was COVID negative. I was only allowed one birth partner and no visitors during our hospital stay. I originally planned to have a doula with me during delivery. Due to hospital rules my husband communicated with her through FaceTime and text throughout the day. Discuss with your OBGYN your delivery options and what the hospital policies are.
  • Doctors’ appointments: By the time the United States started having positive cases of COVID I was seven months pregnant. At that time you start to have appointments every other week and then weekly. I had to attend these appointments alone. My OBGYN allowed me to FaceTime my husband during our third-trimester ultrasound. I know of other provider offices that did not allow this. This was initially stressful and emotional to not have my husband there to experience the heartbeat sounds and learn about our baby’s development but it soon became the norm. I recommend making your appointment first thing in the morning. This was not only helpful with my work schedule but it also ensured I was getting a clean room that no one had used yet.

Delivery:

  • You can expect to be waddling out of the car having contractions while hospital staff is obtaining your information at check-in while simultaneously taking your temperature in the lobby. My husband was not allowed to come in for a few hours until I was admitted to ensure I was far enough along. We packed enough for a week in case we happened to be there longer due to a cesarean section or other complications. We had a lot of bags and could only take one trip in! Once we were both admitted our hospital door was closed and we were not allowed to leave our room; not for better food because you don’t like the cafeteria food, not for a peanut ball because the hospital took away all birthing tools, and not even for the car seat. My birth plan included no pain meds or epidural. But after an initial 10 hours of labor with no birthing tools or doula that I planned to have I ceased and got the epidural. My son was born healthy 12 hours later and we were discharged from the hospital after our two-night minimum stay. I had a lot of anxiety about COVID going into labor but I cannot say enough positive things about the nurses, midwives, and doctors who made us feel incredibly comfortable and safe during our hospital stay.

Post-partum:

  • This is the period I had the most anxiety over. I was unsure of how we would introduce our family members to our son. This was the first grandchild for both our families and an important time in their lives well. Ultimately we had our families quarantine for two weeks prior to meeting our son and ensure they were symptom-free. However, I suggest you do whatever you feel comfortable with. I was nervous about breastfeeding and what resources I would have if I had difficulty. There have been some great resources online such as Kellymoms.com. I was able to take a breastfeeding course over Zoom prior to giving birth and I joined a local Facebook group with a certified lactation consultant that allows members to post questions. While these are unprecedented times quarantine has provided us the ability to stay at home and take in this time as a new family together. The pandemic has allowed us to slow down and enjoy this alone time.

Back to work:

  • Maternity leave: Each company’s maternity leave policy is different. I did not know how I was going to utilize my time until after our baby was born because I just couldn’t plan that far ahead not knowing what the trajectory was with COVID. My husband initially took two weeks of paid time off when our son was born. He went back to work but due to COVID he is working from home. This has been a challenge and a blessing. We may be a huge distraction during his conference calls with our son screaming in the background at times, but he can also help watch him in the morning so I can get ready or take him in the afternoon so I have a chance to eat lunch. I plan to take 12 weeks of maternity leave and then my husband will take 6 weeks of paternity leave. This way it extends our time home with him to get past some major leaps during 3-4 month growth spurt and then he can start daycare in the fall.
  • Breast feeding: While I am enjoying my time home learning to be a new mom I also look forward to getting back into a routine and going back to work. I plan to continue to breastfeed. It is a federal law that employers have to provide space and time dedicated to breastfeeding moms. I discussed this with my employer beforehand and I know going back to work these accommodations will be ready.

While we do not know what this virus will look like come the fall and if there will be a second wave I am now taking things day by day. Before I used to have my whole year planned out but having a baby during a pandemic has resulted in short term planning and adjusting to our new life day by day. The babies that entered the world in 2020 first saw the face of a doctor hidden behind a mask. Their first year of life may only involve car rides to the pediatrician. But it also may include daily walks around the neighborhood and nights in with their mom and dad. These babies will be known as Coronials and who knows what this generation will be known for. Will they be known as the greatest generation of the 2000’s? I do know that their parents who had to work during a pandemic because they are essential health care providers, and who had to deliver a baby in a mask and raise a newborn in quarantine are strong, caring, dedicated, and can face any obstacle.

Works Cited: 1. Egloff C, Vauloup-Fellous C, Picone O, Mandelbrot L, Roques P. Evidence and possible mechanisms of rare maternal-fetal transmission of SARS-CoV-2. J Clin Virol. 2020;128:104447.

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Why This Pharmacist Enjoys Her Side Hustle in Short-Term Rental Properties

By Dr. Rachel Gainsbrugh

Within my first few years working as a pharmacist, I knew that I wanted to find ways to generate passive income.  I wanted to dictate my schedule and my life.  Real Estate has been an interest of mine for years.  When I first started investing and managing short-term rental (STR) properties, I was hooked!

Traveling is truly a great way to de-stress, unwind, and escape the hustle and bustle of daily life.  However, travel accommodations can take up a huge chunk of a travel budget.  Thanks to short-term rentals, travelers can cut down on their expenses significantly, while enjoying some benefits that hotels could never offer.

My husband and I have had the pleasure of hosting various folks looking for comfortable, well-designed, accessible homes in our local town.  We have created a private, homey environment for travel guests.  Hosting has given us the opportunity to house diverse, interesting groups of individuals, such as travelers for business, work groups, those visiting families and relatives, resident doctors, engineering interns, golf teams, professionals looking for a comfy bed after a long day of training, airline pilots, government officials, cast and crew members working at Pinewood Studios, and those in need of relocation. We truly enjoy being hosts!!

Currently, we have both short-term and medium-term rental properties in our portfolio.

These are my top 5 reasons why I love Short-term rentals as my side hustle:

1)    Revenue Generation!!

Short term rentals generate about 3X the average revenue of a traditional long-term lease.  That’s right.  Read that again.  3X the average rent revenue!  This has helped pay down our mortgage on the rental property faster and accelerate our path to financial freedom.  Whether the rental is a cabin in the Smokies, a villa on the beach, or just a spare bedroom in your own home, short term rentals can provide a great opportunity for higher cash flow and financial freedom.

2)    Personal Use of Vacation home

If your rental is located in a resort or touristy area, you can use your own properties while on vacation.

3)    Upfront Payment

Short term tenants pay upfront through a platform (AirBNB, VRBO, etc).  Your guests pay PRIOR to showing up.  Long-term tenants that do not pay for a couple of months will need to be evicted and this can be a lengthy, stressful, and expensive process.

4)    Minimal Wear and Tear to your property (Surprised?!)

Because STRs are constantly in a state of readiness for guests, they are maintained at all times.  After each guest, our homes are cleaned and sanitized by our professional cleaning team.  In order to serve our guests and keep our 5-star rating, ALL maintenance issues are taken care of immediately and are not deferred.  Additionally, our guests tend to eat out or order take out quite a bit.  Therefore, there’s minimal use of our kitchen appliances.

5)    It can be A LOT of fun!

Once you buy a rental home, you can put your own personality into it!  For one of the homes, I went with a French Country Bohemian theme.  I really enjoyed the design process.  I’ve encountered some really neat treehouses, Harry Potter theme, Beachy theme, etc.  The customization and options to personalize these homes are endless.  We’ve enjoyed the process and have had the opportunity to serve a lot of great guests along the way.

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What Your Pharmacy Coworkers Need Right Now

What Your Pharmacy Coworkers Need Right Now
Compassion.
Patience.
Grace.
Palm Trees.
Not surprising, right? This Harvard Business Review article nails it for me. [I added the part about the palm trees.]
I was on a virtual call today and it was during the only 45 minutes I had to make dinner. That was our plan – I was going to make dinner and my husband was going to set it up, fix the plates, poor the milk, wash the hands, and clean the pans. I had my video off so everyone wouldn’t see me bouncing between the stove and fridge while stealing sips of wine from my favorite stemless glass. I’m not ready to launch my cooking show – yet. Then I heard my name, “Brooke – won’t you introduce yourself?” I jumped to
the laptop, switched on my video, smiled, and started talking. “Brooke – you’re muted.” [Of course.] I explained why my video was off and then remembered that virtual backgrounds allow you to pop in and out of the camera area. I chose a beautiful tropical scene. Wouldn’t that be nice in person, I thought? To
pop in and out of meetings by ducking behind some fake palm trees? We’re all experiencing new human behaviors right now. According to the HBR article, if someone is short with you, it’s probably not because they intended to be disrespectful or rude. If you now receive a strangely short email or text, it’s probably because they are responding to an exponential amount of
correspondence compared to before. With virtual meetings galore, we’re all invited into everyone’s home, and with that comes knowledge of all of their routines, childcare, and support systems. If someone has a babysitter or a grandparent watching their children, it’s probably because it’s available to them and they need it, not that they aren’t aware of curve flattening.
During my cooking-behind-the-palm-trees virtual meeting, someone suggested a group photo. I heard my name again – someone graciously remembered to call me back in from behind the trees so I would be a part of the photo. Wouldn’t that be nice in person, I thought? To include those who are kind of
here but who are momentarily distracted by life’s demands.
Compassion.
Patience.
Grace.
Today taught me that I could give a little more, too.
If we’re ever on a call together and you see palm trees, then yes – the wine is available and needed.

Brooke Griffin, PharmD, BCACP
Be.superheroic@gmail.com

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Pharma Leader, Pharmacist Mom talks about her PharmD career path in medical affairs

Monica Arora Sukhatme, PharmD
Pharmacist Moms Interview
April 1, 2020

1. What is your current role?  Executive Director & Head, MSL Team at Coherus Biosciences

2. Where did you go to school and what was your background/training? After completing my pre-
pharmacy training at Purdue University with a minor in Organizational Leadership, I attended a 3-
year accelerated PharmD program at Massachusetts College of Pharmacy & Health Sciences in Worcester, MA. After practicing as a clinical pharmacist in Chicago for 4 years, I obtained my post-doctorate through the Rutgers Pharmaceutical Fellowship Program where I worked in New Product Market Analytics at Daiichi Sankyo, and taught as an adjunct professor at the pharmacy school at Rutgers University

3. What are some of the important skills that someone in your role must possess? For a role in management & leadership within Medical Affairs, the most important skills include 1) An
understanding of the business, 2) A love for the science, and 3) A desire to communicate both of the above in a dynamic, concise and impactful manner

4. What are some of the biggest initiative(s) that you are working on? One initiative that seems to be a continuous journey is how to evaluate MSLs in a quantitative and measurable way. This is of course easy to do in the sales side of the business, where metrics include sales – but is more of a gray area on the MSL side. Other initiatives include maximizing impactful MSL insight gathering to support cross-functional teams and enhancing effective “soft skills” to effectively communicate the science
to healthcare practitioners

5. What are 3 predictions you have for the pharmaceutical industry in the next 10 years?
1. The MSL role will continue to grow. As information begins to come from a variety of sources,
the need for a scientific, fair-balanced exchange from a credible source within the pharmaceutical industry will accelerate
2. There will be greater scrutiny from assorted stakeholders (i.e. regulators, consumer advocacy groups, and payors) of pharmaceutical brand pricing, which will increase competitive pressure. As a result, this will increase market opportunity for high quality, cost-effective biosimilars
3. Currently, the U.S. subsidizes the vast majority of new drug development in the world. Drug development will eventually be increasingly global in nature with both costs and clinical trials
spread internationally

6. What has been one of the bigger setbacks in your career, and what lessons did you learn from that?
One of the bigger setbacks of my career was inaccurately assessing the corporate culture of a company I joined. In my early years, I didn’t give much thought to corporate culture – but it’s
important to know that the leader of the company sets the undertones of the corporate culture. And I dismissed my inner instincts which were telling me that the leader of that company and I were not on the same page. Thankfully, I am no longer at that company, but have learned that there are many types of personalities, which end up determining corporate culture. Make sure you find one that fits you!

7.Tell us about some of the biggest successes in your career and why are you most proud of them? I’ve
been fortunate to have many inspirational mentors throughout my career. During those times when I wasn’t sure which way to go, I have been grateful for my mentors’ advice and more importantly,
building my confidence by trusting that I’d eventually arrive to the answer myself My most memorable successes involve situations where I was able to bring teams together by taking
into consideration viewpoints from all members of the team. Success is much sweeter when applying the perspectives of a multidisciplinary team. Lastly – no matter the company, people are the most valuable resource. And I’ve also found success
through hiring individuals not based on experience (i.e. prior number of years in the role), but rather
based on potential (i.e. the motivation and perseverance to do the job). This, too, has yielded positive results for me so far.

8. What is some advice that you would tell your younger self or other pharmacists starting their careers? If you aren’t where you want to be in your career, I would say never stop exploring. Continue reading about the healthcare changes affecting patients and caregivers across your community, your country, your world. This will undoubtedly help you to find your passion and where you want to make a difference. Spend time talking to people in careers that interest you…but don’t take their word as the gospel. Follow your instincts and if you fail, try to fail fast. Move onto the next area that interests you. Sometimes finding what you really love is a just a process of elimination!

9. What does being a woman in pharmacy mean to you?  What I’ve found is that careers in pharmacy
offer many options, which is what most women want. Whether it’s retail, hospital staff, clinical-focused, nuclear, academia, or pharmaceutical industry, the options are abundant. To add to that,
most pharmacy careers offer geographical flexibility to move almost anywhere in the world (even when I was a hospital pharmacist, I remember getting an offer to move across the world to practice in Saipan, a U.S. commonwealth where a pharmacist degree from any state is recognized!).
But for me, I’m very happy with a career as a leader in field medical affairs – in addition to working with wonderful colleagues on a mission to bring cost-effective biosimilars to patients in a world
where costs continue to rise exponentially, I have the pleasure of working from home and having a flexible work schedule – with three kids under the age of 5, this is a gift!

10. What is your favorite quote? “Fortune favors the bold” (Apparently, there’s also an Italian version of
this which my friend uses frequently: “Luck kisses the brave”!)
11.  How do you believe becoming a BCMAS can impact one’s career? BCMAS raises the bar of a Medical
Affairs employee’s skillsets, which include heightened scientific acumen, ability to communicate the
science, and last but not least, understanding the greater impact medical affairs has on the overall business.
In the recent climate of concerns about off-label promotion, BCMAS certification remains focused on
training on the importance of a fair & balanced approach, which will further strengthen the
credibility and ethical leadership of medical affairs across the industry.

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Loving The Hustle (Danielle Plummer)

Hi Ladies!

Here’s my story. Thank you so much for sharing.

Danielle Plummer, PharmD 🙂

When I was growing up, I both listened to stories about my grandfather’s pharmacy in the mid twentieth century and also worked at my father’s independent pharmacy. With my family history, my interest in medicine and my love of making others feel well, I knew that someday I would become a third-generation pharmacist.

My journey to my current career followed a long and winding path which involved various roles including being a professional figure skater, a hotel manager, and a military spouse while I raised my three daughters. In 2016, I finally fulfilled my dream of becoming a pharmacist.

Retail pharmacy was extremely different when I was a teenager. Then, many pharmacies were owned by pharmacists, while Medicare Part D and PBMs did not exist. Today, large corporations, PBMs and insurance companies have too much power, but I still saw myself working in a retail environment. As an intern, my preceptors questioned my decision due to pharmacists having little control, but I assured them I knew what I was doing because I still would be able to counsel patients; however, after just a few years, it was time to move my career to another direction. My goal was to open a company which combined my experience as a pharmacist with my background as a hotel manager to resolve all the non-emergency medical needs for visitors in Las Vegas. I was fortunate to have a per diem hospital job while I built my company.

In 2019, I took a chance and left my job as a Walgreens RXM to form TeleMDcare, www.teleMDcare.com, a concierge service for tourists, which offers telemedicine, prescription services and delivery of DME. My dream of taking care of tourists from outside the retail box was realized when our first customer who was in town for CES left his medications in Germany. He was able to see a doctor via our app during a break from his meeting, and then had his prescriptions waiting for him at his hotel when the meeting was over. The days of having to get an Uber or taxi and go to an urgent care or hospital only to wait in line at a pharmacy were over!

When the Covid-19 pandemic took over this year, and telehealth became a household word, my company added a subscription service. This came about because we had as much demand for  our services from our local community as we had from tourists. I was surprised how many of my friends did not have health insurance! Our subscription service includes unlimited telemedicine visits with some prescriptions for a low, monthly price. We also have companies offering the plan as a benefit to their employees and give a percentage of each subscription to non-profits. Once travel resumes, we’re going to be relaunching our concierge service for travelers in Las Vegas and then expanding to other high tourism areas. I’m elated to be supporting the health of our community, even if it is not what I had envisioned when I was in school.

Around the same time that I left my job at Walgreens, I received an email from the HER Foundation asking followers what they are doing to support International Hyperemesis Gravidarum (HG) Awareness Day 2019. I had HG with each of my three pregnancies, but moved on with my life knowing that I’m lucky and forever grateful to have three healthy, happy daughters. I came across www.hyperemesis.org during my third pregnancy and was relieved to know I wasn’t alone. I was even a test subject in the HER Foundation’s first clinical study, which resulted in finding the gene which codes for HG, so receiving this email brought back a flood of memories.

When I was pregnant, there was no possibility I would have let anyone take a photo of me. I literally looked and felt like death. With a quick glance of #hyperemesis gravidarum on Instagram, I saw that women today are not afraid to post pictures of themselves with HG, and I admire how brave they are. To my dismay, however, I discovered that treatment has barely improved since my first pregnancy almost 22 years ago. Almost every time I work a shift at the hospital, there are women in our ER for excessive vomiting and dehydration, and I’ve had several ER doctors call me for advice.

I also remember when TPNs were first mentioned in pharmacy school, and was dumbfounded to learn that I went through my three pregnancies completely malnourished when options for nutrition existed. If it’s possible to get nutrition through a tube, then why didn’t I get any during my pregnancies?

The combination of seeing pictures on IG, knowing the absence of nutrition I received when I had HG, and recognizing the lack of development in research and treatments for HG over the last two decades all prompted me to take action. I honestly believe that if this were a man’s disease we would’ve made progress, so in May 2019, I launched a blog to support women with HG, www.hgpharmacist.com. I also became a board member of the HER Foundation in December 2019, and today I’m excited to officially announce the launch of my HG Consulting business, offering support and medication management to women with nausea and vomiting in pregnancy. My mission is ensuring that every one of these women are treated with dignity and receive the best medical care possible throughout their pregnancy. My dream is to find the causes and treatments for HG, so that in the future, we will look back and see HG as a disease of the past. Please follow me on social media and contact me to be a guest on my blog or YouTube channel, or to share your experience or advice with NVP, info@hgpharmacist.com. For more information on either of my companies, go to www.teleMDcare.com and www.HGPharmacist.com.

Thank you for all the support from our amazing group of Pharmacist Moms!

Danielle

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A Tale of 2 MSL Board Certifications.

Author: Jill White PharmD, BCMAS

A Tale of 2 MSL Board Certifications: What You Should Know – Part 1

According to the Accreditation Council for Medical Affairs (ACMA) the Medical Science Liaison (MSL)
profession has exploded to over 3000 MSL’s across the country and is still growing. This number is
inclusive regardless of the name du jour from an individual company to include: Regional Scientific
Director, Clinical Liaison, Thought Leader Liaison, Field Medical Director etc. With the growing number
of professionals and one of the most varied entry experience requisites of any career field all funneling
into a single job description it was certain that the time would come that a board certification would be
needed. Several years ago many did not believe that it would be possible to have a certification that
broadly sweeps small and large organizations and everything in between including all therapeutic areas.
However, that is no longer debatable as two companies have found a way to make this board
certification possible, testing examinees on everything but the science. ACMA and The Medical Science
Liaison Society (MSLS) have different board certification credentials and the question becomes which is
the right one for each MSL. This two-part series endeavors to compare both certifications equipping
professionals to make that decision for themselves.

‘MSL board certification is here, testing everything but the science.’

ACMA launched their accredited board certification program over 3 years ago; those who pass will
garnish the BCMAS credential or are deemed Board Certified Medical Affairs Specialists. In contrast the
MSLS made their program available earlier this year following a reported two-year collaboration process
– and after passing the MSL professional will be entitled to the credential MSL-BC.

Certification vs. Certificate
Both are official board certifications, not certificate programs – meaning the idea isn’t to simply learn
about being an MSL the goal is to prove you know what the credential specifically implies, BCMAS
leaning towards overall medical affairs (MA) and MSL-BC focusing on the MSL career specifically. One
credentialing note of differentiation here: there is an amount of verbal diarrhea when it comes to who’s
the first this or which company has the only that, and both credentialing bodies claim to be the world’s
first and/or only ‘fill in the blank’. However, after careful investigation it appears the BCMAS is the only
accredited board certification while MSL-BC does not appear to be accredited – though nearly 2 dozen
respected leaders in medical affairs were apart of the credentialing examination collaboration process (if
you are attached to the organization and have more complete information please don’t hesitate to
reach out for a correction as this specific point was hard to ascertain).

Taking the Exams

ProctorU is utilized by both organizations for proctoring of the exam and both are completed under
timed conditions following an identity verification process. Either way you will be watched and recorded
while sitting for the test. The MSL-BC allows up to 4 hours for the 140-question multiple choice exam (of

which 125 count toward your mark). BCMAS allows up to 3 hours for their four-section exam which
includes multiple choice, true/false, select all that apply and case study formatted questions totaling
between 90-100 questions. Each of the certifications require you to complete CE and/or retest every
few years to keep the board certification current. MSL-BC requires this be accomplished every 3 years
while BCMAS has an every 5 year requirement.

A Note about the Credentialing Organizations

Notwithstanding and beyond the scope of this review but for completeness, both the MSLS and ACMA
are worthy non-profit organizations with outstanding missions, prestigious boards of governors and
either (or both) is a great choice for a professional membership regardless of which board certification
you choose. A yearly membership to ACMA is approximately 2/3 the cost of MSLS ($200 vs. $290), but
the outward appearance is that MSLS is a more active society and the membership includes the newly
published digital MSL Journal. A quick search of Linked In will show a splattering of the newly developed
MSL-BC professionals while a similar inquiry will find a larger number of those with the BCMAS
credential many of whom are in more leadership medical affairs positions (the larger number no doubt
due to the fact that BCMAS is for all of MA not specifically MSL’s and has been around for an extended
period of time comparatively). During this same search you will find a handful of over achievers who
have added the MSL-BC to their already certified BCMAS.

Part 2 of this short series will dive deep into the specifics of each of the certifications, including detailed
descriptions of both programs, cost of the certification and exam fees and who is eligible to sit for each
exam (spoiler alert: it is not the same group of test takers). Individual career development paths is
discussed specific to each credential and how board certification is impacting organizations on a macro
level.

*A note from the author: I penned these articles while waiting for my exam results from BCMAS. It
should be stated that all attempts were made to write an unbiased review article, however, only going
through 1 of the certification programs and exams may have made it more difficult than expected. To be
fair, I will gladly prepare and sit for the MSL-BC if the MSLS would like a follow up article after the fact –
please contact me.

A final note, I am not affiliated nor a member of either the MSLS or ACMA Society at this time but would consider either a great choice.

 

A Tale of 2 MSL Board Certifications: What You Should Know – Part 2

Part 1 of this series demonstrated the Why, What and Who of MSL board certification programs. This
part will complete the story with How, How much and what the impact of these credentials mean to
MSL professionals across the country.

BCMAS Certification
Associated preparation for each exam varies greatly. The Accreditation Council for Medical Affairs'
(ACMA) BCMAS certification fee (more on that later) comes along with access to their learning
management system (LMS) which includes 20 self-paced online training modules. These modules cover
every aspect of the medical affairs organization and include details such as the pharmaceutical
industry’s history (it can be traced back to German universities and organic chemistry) to drug
development and approval process to medical device to pharmacovigilance. Each module starts with a
pre-quiz then repeats this quiz as a post-quiz allowing the user to follow their learning progress. All 20
post-quizzes must be passed prior to sitting for the certification exam with ProctorU. ACMA suggests
that the process can take between 3-4 months depending on the amount of time devoted to studying
the material but provides 6 months access to the program’s contents. Each of the 20 modules will take
approximately 2 hours to complete and a bonus is that a handful of the modules are eligible for CME/CE
for MD’s and PharmD’s.

Who can sit for the BCMAS exam?
ACMA states that all the information needed to pass the BCMAS exam is contained within the 20
modules and they allow anyone who holds an “MD, PharmD, PhD, DO, MBBS, DNP, NP, PA, BPharm,
PsyD, or other relevant degree from an accredited college, university or institution” to apply for the
credential with or without relevant work experience in the pharmaceutical industry. Some test takers
would argue, however, that without time in industry even given the 20 modules passing the exam is not
an easy achievement. However, once passed the BCMAS credential may help those unable to break into
the medical affairs world have a chance at a coveted position.

MSL-BC Certification
Conversely, the Medical Science Liaison Society (MSLS) takes a different approach to exam preparation
and the needed qualifications to sit for the test. There is no LMS that provides an education or question
bank to coincide with your studying as you prepare for the exam. Certainly, this is in part due to the
reduced fee (again, more on that later) required by the credentialing body. The MSLS does provide a 5-
page detailed overview of the “three content areas, 14 tasks, and 60 steps” which will be tested over. In
addition, 1½ pages of reference links accompany the overview referencing websites and include pages
from the FDA, PhRMA, OIG and a couple of their own reference guides.

Who can sit for the MSL-BC?
To take the MSL-BC you must prove that you have worked as an MSL or MSL manager for over 1 year.
This is done via an application to test and job history is verified per the MSLS website – this is not a
credential that an aspiring MSL can achieve. However, a terminal degree is not required for the
application to sit for the certification as only a bachelor’s degree is necessary. One caveat is that test
takers should be prepared for the exam prior to submitting their application to receive an authorization
to test (ATT) as once the ATT is provided to the test taker it is only valid for 3 weeks. After taking the
exam it may take up to 3 weeks to have your test results for the MSL-BC vs 3-5 business days for BCMAS.

Associated fees
Many pharmaceutical companies are encouraging their MSL’s to garner one of these certifications for
their own professional development, or credentialing is also being done as a team and when either of
these are the case most organizations will allow the MSL to expense the cost of the program. However,
other MSL professionals are on their own to foot the bill for credentialing and enhancing their own
career marketability which makes cost of greater importance. The BCMAS fee is $1999 and includes up
to 4 exam fees in the case of needing a re-exam while the MSL-BC costs is $550 for non-MSLS members
or $450 for members and does not include any re-exam fees (retakes are $400 and $300 each
respectively).

Which is the best option?
There are many considerations when deciding between the 2 credentials available to MSL’s and though
their approaches are different, both are rigorous and should be respected. If one is an MSL through and
through and the possibility of moving into another role besides MSL manager isn’t appealing then MSL-
BC may be the best choice. Some people, for personal reasons, are not willing to relocate to the
company’s home office and therefore many internal medical affairs positions are not an option. There
are many executive and distinguished MSL’s who are approaching 20 years of field medical work and can
harness this experience to mentor newer MSL professionals; these are certainly candidates for MSL-BC.
Others MSL’s may find cost a factor in which case $550 is more palatable than $1999; or perhaps one
appreciates an organization who will only allow a current member of the profession to sit for the
certification, again another instance that MSL-BC would be a good fit.
In contrast, if an MSL ‘s career development may include other positions within medical affairs then
BCMAS would be a more appropriate choice for the credentialing. Moreover, if cost is not a factor and
an LMS with detailed learning modules to house exam preparation is desired (versus reviewing
overarching objectives and filling in personal learning gaps) then BCMAS is certainly a better option.
Lastly, with no previous MSL experience or if an accredited board certification is preferred then BCMAS
is the only option.
Five years ago, the idea of credentialing Medical Science Liaison’s from varying educational backgrounds
working for dozens of different companies each of which require slightly different activities from the
MSL professional was an unheard-of feat. Now, regardless of company or therapeutic area MSL’s have options of which board certification they would like to carry behind their name. Not only is it not
unheard of, but MSL credentialing is positioned to become the deciding factor for hiring managers
between otherwise similarly qualified candidates — over time it will most likely become a standard in the
field.

*A note from the author:

I penned these articles while waiting on results from my BCMAS exam. It should be stated that all
attempts were made to write an unbiased review article, however, admittedly only going through 1 of
the certification programs and exams may have made it more difficult than expected. To be fair, I will
gladly prepare and sit for the MSL-BC if the MSLS would like a follow up article after the fact – please
contact me.

A final note, I am not affiliated nor a member of either the MSLS or ACMA Society at this time but
would consider either a great choice.

References:

About Us. Available at: https://acmasociety.org/about-us/ accessed 4/20/20.
BCMAS Program Information. Available at: https://www.medicalaffairsspecialist.org/board-certified-
medical-affairs-specialist-program/program-info/ accessed 4/19/20.
MSLS Board Certification. Available at: https://www.themsls.org/msl-board-certification/ accessed
4/20/20.
MSLS 2020 Member Benefits Guide. Available at:
https://cdn.ymaws.com/members.themsls.org/resource/resmgr/member_guide/member_guide_updat
e-march_2.pdf

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Networking and grit help Missouri female-owned pharmacy expand

Melody Savley, R.Ph. has been a pharmacist since 1980. She started out managing pharmacies within grocery stores, and she and her husband eventually opened their own grocery store with a retail pharmacy inside it. They sold their grocery store and started focusing exclusively on growing their pharmacy business in 2004, and eventually expanded beyond retail pharmacy, and into specialty and long-term care. Here, Melody – owner of Alps Pharmacy, Alps Specialty Pharmacy and Alps Long Term Care Pharmacy, all in in Springfield, Missouri – shares key insights into her journey as a pharmacy business owner.

  • Don’t underestimate the power of networking 

Melody, who’s also the immediate past president of the Missouri Pharmacy Association and participates in Cardinal Health’s Women in Pharmacy initiative, says that getting out from behind the counter – and networking with fellow pharmacy owners – is what first gave her the idea to expand into specialty and LTC.

“We have always made it a point to attend industry events and conferences where we can expand our knowledge and learn ways to improve our business. We go to Cardinal Health’s Retail Business Conference every year, and we attend the National Community Pharmacist Association (NCPA) annual conference every year, too. It was through networking at those events that I first learned that specialty pharmacy and LTC were good opportunities to expand our pharmacy footprint,” she said.

  • Understand that different pharmacy models require different approaches

When it came to launching her specialty pharmacy business, Melody started out slow, running it out of her retail pharmacy – but quickly realized that that model wasn’t ideal.  

“Specialty pharmacy requires extreme customer service – when physicians’ offices call us, they want to talk to someone with specialty pharmacy experience, immediately.  We realized we needed highly trained staff with a specific understanding of the unique needs of specialty pharmacy and specialty patients. We moved our specialty pharmacy to a closed door model, and hired a person to help us with marketing. We get a lot of prescriptions through that part of our business now.”

  • Find creative ways to navigate reimbursement challenges

Melody acknowledges that in today’s environment, reimbursement challenges can make starting a specialty pharmacy business a particular challenge. She says that many insurance plans require patients to get their specialty pharmacy prescriptions filled through a PBM – and Medicare DIR (direct and indirect remuneration) fees made it very challenging to cost effectively fill specialty scripts for Medicare patients. 

These reimbursement challenges can certainly be deflating – to a business owner’s drive and to a pharmacy’s bottom line. Overcoming challenges like these takes grit, determination and a good amount of networking and creativity. 

For example, Melody got to work, researching the Federal 340B Drug Pricing Program — which allows healthcare organizations that serve a disproportionate number of uninsured and low-income patients to access outpatient medications at discounted prices.  When she realized that 340B prescriptions aren’t impacted by Medicare DIR fees, she started actively pursuing opportunities to fill specialty prescriptions for patients served by local healthcare providers who participate in the 340B program.

Melody’s diligence in finding a way to grow her specialty business has also paid off in other ways. Filling 340B prescriptions provides Melody and her team the chance to make a meaningful difference in the lives of low-income patients who are dealing with chronic and often life-threatening diseases – patients who can really benefit from a personal, face-to-face relationship with a community pharmacist they trust.  

  • Up-front investments can yield faster, long-term growth

“When we started our specialty pharmacy business, we started small. We took the opposite route when opening our LTC pharmacy,” said Melody. “We made big investments, up front, into all the equipment we’d need to grow our LTC business, fast.”

For Melody, that meant a $400,000 investment in a medication packaging robot; and the investment in a full time marketer to promote Alps Long Term Care Pharmacy directly to local nursing homes and assisted living facilities. And, just as networking first inspired Melody to expand into specialty and LTC, she has found that it’s been instrumental in growing both of those businesses, too. For example, when she attended the Missouri Assisted Living Association Conference, she met a local psychiatrist with whom she created an alliance, to fill his patients’ prescriptions and offer hands-on services to support medication compliance.

The Cardinal Health Women in Pharmacy initiative brings together female pharmacists like Melody – from all career stages – to share ideas, seek inspiration and develop mentoring relationships that can empower them to grow their businesses and their careers. To learn more about getting involved with the Women in Pharmacy initiative, contact womeninpharmacy@cardinalhealth.com or visit www.cardinalhealth.com/womeninpharmacy.

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This Is Not a Post About a Life-Disrupting Virus…And It’s Not About a Couch

We bought a couch!

What an exciting event in an adult’s life, right?  When you think about it, for most families, this only happens a few times. I can still remember the gold couch my parents passed down to me in college. Later when I rented my first studio apartment, my first purchase was a ‘deluxe’ futon. Buying a couch is a special event because we can all bond over having our fair share of hand-me-down couches and convertible sofas.

Buying a couch, in a style and colors that you choose, says something to the world. It says, I have a job! It says, I am ready for company and cozy evenings! It says, I am graduating to another level in adulthood! Why can’t adults have milestones, too?

But this is not a post about a couch. It’s about a family, who in a very simple and complex way, got lost. We drifted from our couch. Being busy became the new norm, we hit bottom, and we had to find our way back to the couch.

Let me take you back to the Fall, loooonnnng before we knew anything about a life-disrupting virus.

Our family is comprised of 2 parents with fulfilling careers, 2 school aged active children, and 1 very large lap dog named Rufus.

We work hard and play hard. We love funny TV shows, family movie nights, and sharing sections of the Tribune on lazy Sunday mornings. 

We also love to be active. All four of us play sports and produce way more laundry than necessary. When our kids were smaller, my husband and I had been very careful not to overextend ourselves. Up until recently, we had been very good about setting boundaries and only signing the kids up for 1-2 activities. We used to have the kind of balance that all of those parenting articles suggest.

Without much warning, our little darlings started having opinions and interests outside of our parameters. None of the parenting books tell you what to do when your child says their interested in everything!

I don’t have to tell you that we were weak and we allowed them to sign up for an embarrassing number of activities each last Fall. The park district staff all recognize me. I’m the one with the purse full of snacks. I’m the one on her laptop trying to send more one email while they swim and skate their laps. I’m the one hustling in the lobby for carpool deals. We were busy every night of the week and most weekends. We stopped watching TV; we rarely had time for family movie night, and we watched the Sunday Tribune form a pile in the corner of the dining room. In early November, we hit our breaking point. We became burned out. It wasn’t fun anymore. My son said, ‘Do we really have to go tonight? I just need a break.’ So we made a pact – we would finish Fall, and take back downtime. Take back couch time.

We only had one problem. Our couch was terrible. 

Let me explain.  

Have you ever had a beater car? A car that only exists to bring you from Point A to Point B? A car that isn’t really your style because you just need it to function?

Well a close friend gave us some advice before we had kids. He pulled us in close and said, ‘You don’t need a beater car, you need a beater couch.’ And boy was he right!

A couch that could withstand the daily abuse of 2 overtired parents, 2 small kids, and 1 large lap dog. A couch that isn’t really your style but you just need it to function? 

Needless to say, we took his advice and 11 years later, our couch really deserved retirement. It wasn’t even comfortable anymore. You would sit on it and your whole body became angry. My husband refused to use it and Rufus chose the floor.

It was time for a new couch. 

We discussed layouts and colors. We made critical decisions like: how big is too big and is surround sound really important? [sidenote: yes, apparently, it is].

We decided to try for a Black Friday deal. We asked the grandparents to babysit and my husband and I mapped out a list of stores, coupons in hand. We had a plan. We were going to get a new couch.

After shopping at the stores and sitting on all of the couches, we found one! It’s a beautiful, long gray couch with chaise at one end. I don’t have to tell you that we fell in love with the most expensive couch we tried at the only store that wasn’t offering a black Friday deal. We chose quality and comfort over getting a good price. We explained to the kids that instead of a family vacation this year, we would enjoy year-round comfort away from the hustle and bustle of the outside world. I’m not sure they’re convinced. [sidenote: until recently]

Winter break was amazing. All of our activities halted, except for ice hockey because that rink never closes [exception: life-disrupting viruses]. We lounged. We napped. We snuggled. We watched movies and played video games and made memories. Don’t get me wrong – there were plenty of fights, especially over who gets the chaise, but for the first time in a long time, we relaxed. Even Rufus joined us.

Buying a couch made me think about parenting and the privilege to sign up for multiple activities. Buying a couch reminded me of how lucky we are to have 2 healthy kids who want to be off the couch. Buying a couch made me incredibly thankful that our savings didn’t need to go towards a new furnace or appliances. Buying a couch made me question, Who are we kidding? We may fall into the same busy trap. After all, we want our kids to be involved. To fall in love with an activity or an art. We want to be active adults, too. I surmise that when we hit our breaking point again, at least we’ll have a comfy place to land. [sidenote: or when we encounter life-disrupting viruses].

This is not a post about a couch. It’s about a family who got lost and found their way back to their couch.    Well, at least until next Fall.

Brooke Griffin

Be.superheroic@gmail.com

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An Interview with medical affairs and medical science liaison leader Dr.Monica Gautam

  1. What is your current role?  

After a long, successful career as a leader in the biopharmaceutical industry at Amgen Canada, I became an entrepreneur. Currently, I am the president and owner of COMPASS Medical Affairs Consulting Inc and Co-founder of Medical Affairs Canada. I also teach at the Faculty of Pharmacy at the University of Toronto.

  1. Where did you go to school and what was your background/training?

I completed my BSc in Pharmacy from Dalhousie University in Halifax then worked as a community pharmacist for a few years. I then went on to complete my PharmD at the University of Toronto at a time when there were less than 20 PharmD graduates in Canada. Afterward, I worked at the Hospital for Sick Children and set up the pharmacy services for dialysis and Nephrology.

  1. What are some of the important skills that someone in your role must possess? 

Above any specific skill, I believe being honest, transparent and authentic is important to establish credible, trusting relationships. In my opinion, being kind and willing to assist others are investments that will always be beneficial.

Creative problem solving has been a skill that I have developed over the years and continue to utilize daily. It has helped me immensely in strategic functional and brand planning, team leadership and as an entrepreneur focused on uncovering and addressing biopharmaceutical companies’ complex problems.

Communication (verbal, written and active listening) has been critical in every role I have had over my 25-year career. It is an essential skill to establish meaningful, professional relationships, to effectively navigate difficult conversations and to positively influence others. As an Adjunct Lecturer at the University of Toronto and instructor at Medical Affairs Canada, being able to be an engaging presenter and to effectively tell memorable stories, help learners understand new concepts and master content.

Flexibility and resilience have been important skills, especially during ambiguous times as a business owner and innovator. Being able to quickly adapt to new situations and bounce back from setbacks and disappointments are essential to move my ideas forward and have the courage to take risks.

  1. What are some of the biggest initiative(s) that you are working on?

Over the past 3 years through COMASS Medical Affairs, I have been involved in several national Medical Science Liaison (MSL) Benchmarking initiatives to characterize operational norms, trends and challenges within Canadian biopharmaceutical companies.

Recently, Medical Affairs Canada partnered with the ACMA to bring BCMAS certification to Canadian experts. Additionally, I am continuing to develop engaging and practical training to develop industry knowledge and critical skills for Medical Affairs professionals. We recently launched the Accelerated Training Program as well as a contract Medical Affairs service. Forging new ground at a national level can be daunting at times, but more importantly, it is exciting and truly addresses a need in the marketplace.

  1. What are the 3 predictions you have for the pharmaceutical industry in the next 10 years?
    1. Medications will become increasingly complex and personalized
    2. Machine learning to identify new medications or therapeutic options
    3. Big data will be essential to enable outcome-based patient care
  1. What has been one of the bigger setbacks in your career, and what lessons did you learn from that?

Several years ago, I was asked to take on a field-based management role and I really didn’t understand the need for me to make a lateral career move as I felt I was ready for the more senior opportunity. I saw this as a setback and reluctantly accepted the opportunity.

What I did not realize at the time, was that senior leaders had a career plan for me that was beyond my own expectations. This was a very important lesson and one that stays with me today. I was stuck on achieving my own plan at my pace and failed to slow down and be open to different opportunities. I learned that no experience is a bad experience and that lateral moves within a business are an essential way to increase your professional value.

  1. Tell us about some of the biggest successes in your career and why are you most proud of them?

I am most proud of my decisions to move from hospital clinical practice to the biopharmaceutical industry as well as the decision to start my own companies. These stand out to me because I had the courage to take a risk while I was happy with my role in order to explore a completely new career path. I did this without the fear of failure.

As I reflect on my career, I am also proud of being able to grow a high functioning and well-respected Medical Affairs team from 4 to almost 40 professionals. Above all else, I am honored to have mentored many individuals and helped to launch and develop the careers of so many wonderful and talented people.

  1. What is some advice that you would tell your younger self or other pharmacists starting their careers?

Pharmacy is such a wonderful profession and offers such diverse career opportunities. However, when I was a new graduate, the career path I expected to follow was not the same as the one I achieved, mainly because I was unaware of all the possibilities.  I now have the great fortune to regularly interact with pharmacy students, residents and recent graduates. I urge them to seek mentorship, explore their options, be willing to try new things and take calculated risks. Finally, I strongly encourage them to explore and understand their differentiating interests, talents, and strengths and to create and practice their personal value story.  You have to be your own advocate!

  1. What does being a woman in pharmacy mean to you? 

To me, being a woman in pharmacy is more than just being able to balance career and family. It is about having the confidence in my clinical skills to be willing to learn and develop related business skills. The combination of clinical and business is powerful and can lead to many challenging and highly fulfilling pharmacy career options. Sharing my career stories and learnings may inspire other women in this profession and to me that is a success.

  1. What is your favorite quote?

 “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.” – Maya Angelou

  1. How has becoming a BCMAS impacted your career? 

I just recently earned BCMAS and I am so excited to be a part of setting a high standard of excellence for Medical Affairs professionals. I believe the full impact of BCMAS and the goals of Medical Affairs Canada have not yet been realized which is exciting for the future!

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Guidelines for Pharmacists in Community Pharmacy

COVID-19 Pharmacist Moms Group Special Task Force

TASK FORCE COMMITTEE

  • Hillary Blackburn, PharmD, MBA 
  • Jennifer Gershman, PharmD, CPh
  • Brooke Griffin, PharmD, BCACP
  • Sandra Leal, PharmD, MPH, CDE, FAPhA
  • Bhavana Mutha, RPh, BCMAS
  • Suzanne Soliman, PharmD, BCMAS 

TASK FORCE GUIDELINES

Background

Pharmacists and pharmacy technicians are front-line access points for patients in the medication use process. They calmly fulfill their roles optimizing medications at every juncture of the health care journey; yet, in times of an unprecedented medical crisis, pharmacists also need to care for themselves and their teams. Their vitality is crucial in order to keep providing high-quality direct patient care to their beloved communities. According to the Edelman Trust Barometer Report, the public is most likely to trust health care professionals and authorities — like doctors and hospitals and the World Health Organization (WHO) — to handle the virus effectively, followed by employers. Pharmacists are in a great position as one of the most trusted and accessible healthcare professionals to help educate patients about coronavirus. Staying up-to-date with CDC and WHO guidelines are imperative to provide the most accurate drug information to patients and other healthcare professionals.

Guidance

The Pharmacist Moms Group put together a multi-stakeholder Coronavirus disease 19 (COVID-19) task force, including community, health-system, industry, academia, and associations to create a guidance document for pharmacists who are providing direct patient care in the midst of the COVID-19 pandemic. The following measures are intended to protect the pharmacy team and their immediate families from spreading COVID-19.

The following are recommendations of the task force:  

  • Operations: 
      1. It is highly recommended to temporarily halt in-person pharmacy transactions if possible. Limiting contact to drive-through, delivery, or curbside service, if available, is also highly recommended. 
      2. For in-person pharmacy interactions, it is best to maintain at least a 6-foot distance with patients, when possible.
      3. Wash hands frequently with soap and water for at least 20 seconds and avoid touching your face. (https://www.cdc.gov/handwashing/when-how-handwashing.html)
      4. If available, use personal protective equipment (PPE) such as gloves and a mask (any protection is better than no protection).
      5. Disinfect all surfaces frequently including door handles, credit card machines, and counters.
      6. Keep the door of the pharmacy closed or limit the number of customers in the store at the same time.
      7. Do not touch the keypad at the pharmacy until it is disinfected. Encourage patients to complete their entire keypad transactions themselves. If the patient requests help, wear gloves for any keypad assistance.
      8. Provide proper spacing between patients. Make sure patients are 6 feet apart. 
  • Personnel:
      1. Create back-up personnel plans if team members are not able to come to work.
        1. Be aware of how to contact any floater pools for your company (pharmacists or technicians).
        2. Identify local “PRN” staffing companies in your local area and establish a connection before you need one.
        3. Inquire management about procedures when there are work absences
        4. If possible, consider hiring a temporary part-time cashier.
  • Encourage Patients to: 
      1. Use a drive-through, delivery, or curbside service, if available.
      2. Use their own pen when signing for a pick-up of a prescription. 
      3. Obtain 90-day fills and med sync to avoid additional trips to the pharmacy.
  • At the end of the workday: 
    1. Wash your hands before leaving the pharmacy.
    2. Use hand sanitizer when you enter your vehicle.
    3. When you come home from the pharmacy remove your shoes and change your clothing before entering the main living areas in order to protect your family. Wash and disinfect your clothing and hampers as per CDC guidelines.
    4. Wash hands with soap and water for at least 20 seconds as soon as you come home after removing clothing.
  Additional Guidance:
  • Stay informed of the COVID-19 outbreaks and status in your area.
  • Stay up-to-date on the management of COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
  •  Be flexible with other pharmacies who are low in supplies and with patients who are requesting transfers.
  • Be aware of other local pharmacy’s actions (change in hours, precautions, etc).
  • Create an emergency contact list for who needs to be reached if the pharmacy is exposed that includes the state board of pharmacy.
  • Communicate with your pharmacy team and patients about any updates – do not assume they are aware as recommendations are changing rapidly.
  • Help your pharmacy team and patients understand their upper respiratory symptoms. Fever, cough and difficulty breathing should require them to stay at home.
  • Create a list of back-up child care and reach out to them before you need it. 
  • Think about your own wellness. What does that mean to you? Now is the time to ask for support from friends and family. Enlist the help of businesses that could supply meals and groceries. Outsource tasks that would cause additional stress (yard work, house maintenance, dog-walking). Make sure to take breaks at work to eat, try to get enough sleep, and exercise when you can.
National Resources
  • U.S. Small Business Administration (SBA) is offering low-interest federal disaster loans up to $2 million to manage revenue loss and expenses in states that have declared a state of emergency. https://www.sba.gov/disaster-assistance/coronavirus-covid-19
  • WiFi. Some companies have announced that they will offer free WiFi services to help cope with education, work, and health needs. Using a search engine, search “Free WiFi COVID-19” for companies in your area. https://www.everyoneon.org/find-offers

Other Resources (variable by state): http://www.211.org/services/covid19

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