A safe space for the disadvantaged

Pictured: Pharmacist and co-owner Sarah Kozusko with Kokum Soolee Ironchild, who runs the coffee bar.

When pharmacists think about improving medication adherence, they often focus on email reminders, follow-up calls and patient counselling. But for Sarah Kozusko, pharmacist and co-owner of Queen City Wellness Pharmacy in Regina, Saskatchewan, the answer is far more basic: ensuring every one of her patients has food, shelter and safety.

Originally profiled in CFP’s 2025 Changing Face of Pharmacy report, Kozusko is ensuring her patients have their essential needs met even before they focus on healthcare services.

“We need to be looking at health from Maslow’s hierarchy of needs,” she says, noting that until people have basic food, shelter and security, they can’t be thinking of anything beyond that. “If your patients are coming in without these basic things, they’re not going to remember medications or doctor’s appointments. They can only function at the level their hierarchy of needs allows.”

When she became co-operator and manager in 2018, Kozusko transformed the 3,500-square-foot downtown pharmacy into a healthcare hub geared to those who fall through the cracks of the healthcare system. “I started providing services for whoever walked through the door, and more and more of them were from marginalized communities,” she says. The lack of shoes and weather-appropriate clothing, along with frequently missed appointments, were telltale signs that these patients were struggling.

Six years later, she and her team have made Queen City a place where community members—often homeless, struggling with addiction, or navigating mental health issues—not only feel comfortable filling their prescriptions and getting healthcare advice, but also can count on finding psychological support, housing resources and even food.

Health care + living essentials

In fact, what started out with staff offering fruit and fresh sandwiches for hungry patients has evolved into a program providing up to 200 meals a day. “We work with a non-profit to secure meals and have constant donations of food,” says Kozusko. “Someone donated an oven recently so we can warm up a Sheppard’s pie or frozen lasagna and pizzas from the local food bank too.”

Instead of a cosmetics area or large traditional frontshop, the pharmacy features a coffee bar with bistro tables and chairs. A woman affectionately known as Kokum (the Cree word for grandmother) and her granddaughter staff the area and ensure everyone is fed and feeling comfortable. Kozusko says it isn’t just about filling stomachs but about creating connections, which then opens opportunities to remind patients about upcoming appointments or other services they could be making better use of.

With a team of 11 full-time and 10 part-time staff, Kozusko is able to provide a host of services outside of standard pharmacy offerings, including a clean needle exchange program, methadone dispensing and onsite mental health counselling. The pharmacy is part of an ongoing research study with The Wellness Wheel to do point-of-care HIV and syphilis testing—an effort that has uncovered significant community need, with 15% of tests coming back positive for syphilis and 5% for HIV. “Once they know they have these conditions, they can work with us to be treated.”

Through cultivating relationships with government and advocating for what her patients need, Kozusko was able to secure funding for an onsite social worker twice a week and a part-time nurse practitioner. Having a social worker on site is important to alleviate the “trauma and anxiety” that some patients experienced in the past when trying to access social services themselves, she says. Plus, pharmacy staff can meet with these patients right after appointments to help them get organized for what’s next, including setting up pharmacy services as needed.

The nurse practitioner in the pharmacy has been a huge asset as well because she can help address issues beyond the pharmacists’ scope, including wound care. “Nurses and pharmacists are a really good team because we’ve got complementary skills,” says Kozusko. The pharmacy also works with public housing coordinators, offers Narcotics Anonymous meetings onsite after pharmacy hours and has a pastor come in twice a month to speak to patients looking for spiritual guidance.

As many of Queen City’s patrons don’t have jobs or secure housing—let alone a valid health card—billing for services isn’t always feasible. “We certainly make enough to pay our bills and our staff, but we work more like a non-profit here,” says Kozusko, noting that any excess money goes right back into community initiatives to help patients.

“Our patients are very complicated, so I employ more pharmacists than the average store would,” she says. “But our success has been in following the community’s need and being responsive with our services, which change as needed.”

Getting patients back on track

While she admits her approach isn’t the ideal business model for generating profit, she stresses it shouldn’t discourage other pharmacies from offering even a few services to disadvantaged community members. Every little bit helps.

Beyond practicing to the full extent of her practice scope, she says nothing is more rewarding than helping a patient who was barely surviving get back on track with their health. Some have even returned to the pharmacy as employees and remain on staff today.

Unfortunately, some patients cannot be helped. Some never overcome their addictions and die from overdose or other health complications. To protect the wellbeing of her staff, Kozusko has prioritized clear boundaries, including encouraging time for work/life balance and ensuring mental health experts are available for counselling sessions as needed. “Even if we helped someone stay safe for six hours today, that’s awesome,” she says. “Everyone who walks through our doors knows that we see them and care about them.”

This article is reprinted from CFP’s 2025 Changing Face of Pharmacy report, mailed to more than 14,000 community pharmacies in Canada in November 2025. A pdf version is also available.