Welvista CEO Juanita Wright knows that many South Carolinians do not understand what it is like to have a chronic illness and be unable to afford medications. For others, the stark reality is that, without help, they have no way to obtain lifesaving medications like albuterol or insulin. Instead of telling patients what insurance will not cover, Welvista’s representatives can focus on making sure they receive their medications and know how to take them correctly.
Headquartered in Columbia since 1991, Welvista endeavors to make sure no South Carolinian goes without prescription medications and that children in underserved areas receive much-needed dental care. Juanita says the 501(c)(3) charitable organization originated via the Palmetto Project, another nonprofit initiative that promotes partnerships between public and private entities to improve quality of life in South Carolina.
Juanita served on the board for 19 years before taking the administrative helm. Initially, the group intended to have three branches — dental, medical, and legal — with the goal of trying to procure doctor visits and diagnostic testing for underserved patients. Welvista now focuses solely on prescriptions and pediatric dental care. Because pharmaceutical companies turned out to be so generous in response to requests for donated medications — nine pharmaceutical companies send monthly shipments — Welvista’s mail-order pharmacy is one of the largest in the nation.
Debbie Kinder, RPh, chief operating officer for the Medication Assistance Program, oversees about 50 dedicated staff members, who work with Director of Pharmacy David Ouellet and Director of Patients Services Cheryl O’Grady. An impressive, large robot dubbed “Edward” helps fill many prescriptions. A computerized system directs Edward to count the appropriate number of pills for each prescription, place them into a bottle, and automatically cap, label, and deposit each bottle in an alphabetically organized bin. Pharmacy technicians and pharmacists verify the prescriptions before and after they are filled, then they send them to the shipping department.
“We fill anywhere from 1,000 to 1,500 scripts a day,” Debbie says, “almost all of which are all 90-day fills.” In 2021, 263,391 prescriptions were sent to 20,683 patients, nearly $169 million worth of medications. Closed to the public, the pharmacy fills only mail-order prescriptions and is not able to offer controlled substances.
Many medications come from Direct Relief, an international humanitarian aid organization based in Santa Barbara, California. Recognizing the need to offer generic medications in its formulary, Welvista budgets more than $2 million each year to acquire those drugs. Debbie says that one place in Tennessee does donate a small percentage of generic medications, but Welvista must incur the cost of most generic drugs. Its other biggest expenditure is shipping, which averages about $750,000 per year.
“We ship directly to the patient’s door,” Juanita says, “because most of our patients don’t have access to transportation.” Many patients take several different medications. Without this assistance, some would have to decide between purchasing food and lifesaving drugs. In order to qualify, clients of Welvista’s pharmaceutical service must reside in South Carolina, have no health insurance, and fall between zero and 250 percent of the federal poverty level. There is no application fee and no cost for filled prescriptions.
Patient advocates are available at Welvista’s headquarters to help prospective clients complete the paperwork required to receive services. In addition, advocates are stationed at Lexington Medical Center; MUSC Health Columbia Medical Centers, formerly Providence Hospital both Downtown and Northeast; Tidelands Georgetown and Waccamaw Hospitals. A newer component to the community advocacy program is a prison-release program, served by advocate Rob Korn.
Juanita says, “Prisoners have such a need to have medications provided to them upon release because they have everything done for them while they’re incarcerated.” Rob collaborates with Access Health, a group funded by the Duke Endowment and the South Carolina Hospital Association, and SC Thrive to find medical homes for these individuals. SC Thrive helps patients navigate the process of eligibility screening.
“Recidivism is such a big problem,” Debbie says. “So many of these people are on mental health drugs. We’ve upped our mental health drugs in the hope that we are going to take care of more of them.”
One of the persistent problems that Welvista faces is receiving incomplete applications for prescription assistance. On average, the group receives 130 applications per day. Pending applications slow down the process.
Georgia Famuliner, RN, chief operating officer for the Dental Assistance Program, Smiles for a Lifetime, has a similar dilemma getting parents to sign a consent form that is required annually to provide dental care to pediatric patients.
“It’s at no cost to the parent, but the hardest problem I have is getting them to sign on the dotted line. It’s taken time. It took years to build trust, getting some kids in, and having those parents share with other parents.”
Smiles for a Lifetime opened its first pediatric dental center in 2001 in Allendale County with funding from the Duke Endowment Foundation and the Sisters of Charity Foundation of South Carolina. Now, in addition to Allendale, centers are located on school grounds in Dillon, Clarendon, and Hampton counties. Since its inception, the program has served 19,661 children and provided more than 115,000 restorative fillings. In 2021 alone, Georgia says, about 3,000 children received care.
“When we opened the center in Allendale, I went to the local dentist — I knew him; he was my dentist — and I said, ‘I don’t really want to take this job with the program if I’m going to be in competition with you, and he said, ‘You won’t be. With the majority of them, I might clean their teeth and find 10 cavities, and they don’t come back to my office.’” When Georgia checked in with her dentist six months later, she found that the Smiles program had had no effect on his dental practice.
“I’ve come to understand in the 20 years that I’ve been doing this that if you don’t have a toothache, the population we serve just really doesn’t grasp why it’s important to get your teeth cleaned every six months,” Georgia says. Having 15 dentists who commute from Beaufort, Florence, Charleston, and Columbia to work with the centers’ full-time dental assistants and office staff is crucial to the success of the program.
If teachers realize that a student has a toothache, they can refer the child to the school nurse, who checks to see whether that child’s consent form for Welvista is current. If it is, the child can be treated immediately.
Education is also an essential component for students, along with positive reinforcement. Children learn from kindergarten how to brush their teeth properly, and they receive praise from dental staff when their exams reveal no cavities.
Georgia remembers when a little girl received her own toothbrush and toothpaste for the first time at Smiles for a Lifetime she asked, “Will that be mine?”
“I just looked at her, and it was kind of an eye-opener for me, and I said, ‘Sure, when you come, we are going to give you paste and floss,’ and she said, ‘But I don’t have to share it with anybody?’ and then we realized when talking to her that she and her brothers were sharing a toothbrush at their house.”
Smiles for a Lifetime aims to break the cycle of poor dental health. Juanita says one 16-year-old with perfect, beautiful teeth came into a dental center because her parents wanted to have all her teeth extracted. They had suffered the pain of losing their own teeth to decay, so the parents did not want their daughter to experience similar anguish. After refusing to extract her teeth, the dentist assured the parents that their daughter would be fine if she continued to practice good oral hygiene.
“I think sometimes people are embarrassed,” Georgia says. “With us, it’s not about judgment. I don’t care what their mouth looks like today and why it got that way. We just want to fix it and make them healthy.”
“We take so many things for granted,” says Juanita. “This is not a third world country. This is South Carolina. It’s in our own state that we have this type of poverty.” The only way to change this pattern, she says, is health education, and she believes that teaching children about dental health will encourage a cycle of improvements in general health when those children become adults. “If I had dental health centers across the state, perhaps chronic illness in adults would decrease.”
Welvista’s ultimate goal is to decrease visits to emergency rooms and to lower hospital readmissions through preventive care. It is an expensive proposition.
On Juanita’s fourth day on the job, Welvista received a $250,000 donation of insulin, and the next morning, one of the pharmacists told her that a refrigerator had malfunctioned, rendering all of the insulin unusable. Juanita placed a stressful phone call to the supplier, who was very understanding and kindly replenished the insulin supply via overnight shipping. Then she quickly organized a fundraiser to purchase better refrigerators.
“I told the people I need refrigerators that are smart refrigerators that do everything: I want them to call me, I want them to text me, I want them to email me. If they’re not feeling good, I want to know immediately,” Juanita says. So now, Juanita and Debbie frequently get alerts in the middle of the night from one of the six refrigerators. Once a compressor caught fire, and the lead pharmacist was able to call the fire department in time to save the medication and prevent further damage to the building.
An Easter fundraiser, the Ladson Boone Chapman Charity Easter Egg Hunt, is planned for April 3 at Juanita’s family lake home in Chapin. In addition to a Champagne buffet for adults, the event will feature egg hunts and train rides throughout the 10-acre property, rubber duck races, a silent auction, pictures with the Easter Bunny, and a butterfly release. Reservations are required, at a cost of $150 per family. Children will receive prizes for various activities, including one special egg containing gold Sacagawea dollars. Juanita includes it in memory of her grandfather, who generously gave silver dollars for prizes at Easter egg hunts he staged on Marion Street in Columbia.
Welvista on May 7 will celebrate the Kentucky Derby at Oakbrook Farm in Ridgeway. Lavish food and drinks, including mint juleps, will be served, and prizes given for the most dapper gentlemen and the prettiest hats.
Supporters enjoyed SPLASH on March 24,
a charity gala fundraiser at Myrtle Beach, featuring a runway show of swimwear and resortwear by Tara Grinna, a Welvista Board member. The group hopes to offer this event around the state.