1. California Colorectal Cancer Coalition (C4) Sandra Robinson, MBA Vice President Board of Directors, C4 Director, California Colorectal Cancer Control Program “Our mission is to save lives and reduce suffering from colorectal cancer in all Californians.” reduce suffering from colorectal cancer in all Californians.

2. C4 Mission Statement: To save lives and reduce suffering from colorectal cancer in all Californians

3. C4 plans to fulfill this mission by: Implementing strategies to reduce disparities in CRC screening, diagnosis, and treatment among underserved populations in California Increasing capacity for colorectal cancer screening Advocating for CRC screening programs to serve uninsured and underinsured populations

4. The Beginning - The Dialogue Summit Californians Taking Action to Conquer Colorectal Cancer: a Dialogue for Action –In San Diego, June 1–2, 2006. The Dialogue attracted more than 130 people. The goal of the summit was to establish a new a 501(c)3 coalition to address the CRC screening rate in California. –The California Colorectal Cancer Coalition (C4) was formed in 2007 – First Board of Directors meeting held January 2007

6. Steps Taken Identifying the Board of Directors Drafting the By Laws and Articles of Incorporation Filing Articles of Incorporation for 501c3 Non-Profit status and incorporation Developing the Mission Statement and Objectives Identifying the first activity as a Board to increase CRC screening

7. The Ingredients Our mix of participants: –Originally: legal and public relations. (now a gap) –Currently: clinicians, academics, survivors, public health administrators, legislative staff, advocates. (smart, dedicated volunteers) Regular meetings held with action items reviewed and ongoing projects discussed. A strong shared mission and goals among the Board Members – “Get Californians screened for CRC”. A forum for sharing ideas and best practices to increase CRC screening. The key role of ACS involvement and integration with the state organizations (government and stakeholders). The remaining problem - a reliable, steady revenue stream/source.

8. California’s Challenge – What Drives Us 38.8 million population 2014* Almost 12 million currently enrolled in Medicaid 6.6 million Californians in 2013 were uninsured, with 4.1 million lacking coverage for at least a full year. California's uninsured rate fell by as much as 40% in 2014**, (to roughly just under 4 million) in large part because of expanded coverage under the Affordable Care Act. At least 1 million is undocumented. *http://quickfacts.census.gov/qfd/states/06000.html **California Healthline Report: California Uninsured Rate Fell by as Much as 40% Under ACA, Thursday, February 26, 2015

9. CRC Screening Rates in California In 2012, Behavioral Risk Factor Surveillance Survey (BRFSS) - 64% of Californians over age 50 reported being up to date with CRC screening according to U.S. Preventive Services Task Force (USPSTF) guidelines. Persons with income at or below 250% of the Federal Poverty Guidelines (FPG) – 52% Hispanics – 46% Uninsured – 26% 2014 FQHC CRC screening rate - 34.8%* *http://bphc.hrsa.gov/uds/datacenter.aspx?year=2014&state=CA

10. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

11. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

12. California Pilot Project: Colorectal Cancer Community Screening - Improving access to colorectal cancer screening and treatment for the uninsured and underserved A Joint Venture Championed by

13. 13 Pilot sites applying these models: Alameda County –Pilot FIT screening program at ACMC’s Internal Medicine clinic –Expand pilot to consortium clinics and develop OA’s network of volunteer GI teams at non-profit hospitals to provide added capacity Sacramento County –Identify and develop resources before piloting a CRC screening program –Potential pilot program with Kaiser Permanente and student-run clinics Los Angeles County –Pilot screening program with FIT at Venice Family Clinic’s eight sites –Expand FIT screening program at East Valley Community Health Center –Broaden network of volunteer GI teams at private hospitals and endoscopy centers Stanford University Community (Santa Clara County) –Implement FIT screening at Stanford’s two affiliated free clinics –Establish OA-type model at Stanford Medical Center with volunteer GI teams Orange County –Expand GI network and services at AccessOC (two GI days held in 2011, expanding in 2012)

14. Stakeholder meetings with Partners April 26, 2012 Colorectal Cancer Roundtable Meeting: Objectives: Establish strategic ways that organizations throughout the state can work together to reduce the burden of colorectal cancer. Establish regional plans to implement the colorectal cancer objectives of California’s Comprehensive Cancer Control Plan, 2011-2015 – Sponsored by California Dialogue on Cancer (CDOC State Cancer Plan). March 2015 ACS 80% by 2018 Stakeholder Meetings Colon Cancer Screening Initiative 80% by 2018: What it will take to get there Los Angeles and Oakland March 2015 Roundtable in San Diego Requirement of 2014 C4 grant – conduct County wide meeting for Council of Community Clinics attended by Clinic Medical Directors.

15. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

17. Grants Program 2013 LA Care Health Plan $5000 Patient Navigator to increase FIT screening San Diego NHC $5000 Comprehensive approach to increase FIT CRC screening (in-reach) UC Davis$7500 Train Peer Navigators for patients with newly diagnosed colon cancer UC San Francisco$4500 Develop FIT use videos in 10 languages Celilia De La Hoya Cancer Center $5000 FIT testing paired with breast cancer screening

18. Grants Program 2014 Grants to FQHCs NHC San Diego$5000 Operation Samahan$5000 San Ysidro Health Center$10,000 Cecilia De La Hoya Cancer Center $5000 These FQHC grants received C4 and ACS on site training to increase colorectal cancer screening through FIT testing Project Access San Diego$8000 This grant was to coordinate the FIT screening and follow up of + FIT with free colonoscopies. Have an Annual County Colorectal Cancer Roundtable UC Davis Cancer Center $7175 Expand the previously funded We Care Peer Navigation to two local tribal nations

19. Grants Program 2015 Clinica Sierra Vista – Fresno, CA - $8,000 Increase CRC screenning rates through FIT tests and Education. White Memorial Medical Center, Los Angeles, CA-$5,910 Educational material and FIT tests distributed through EWC (BCCEDP) program. Focus on Hispanic and Korean population. Vista Community Clinic – Vista, CA - $7,300 Patient education materials San Diego County Medical Society Foundation – San Diego, - $10,000 Increase CRC screening for high risk populations with focus on Latino and African American Males

20. Grants Program 2015 Community Health Systems – Moreno Valley Family Health Center – Moreno Valley, CA - $6,000 Provide iFOBT tests for high risk population Neighborhood Healthcare – Escondido, CA - $10,000 Increase CRC screening rates to 65% in 3 clinics Methodist Hospital of Southern California – Arcadia, CA - $5,250 Community education and screening events distributing FIT tests Linda Vista Health Center – San Diego, CA - $5,000 Education and clinic in-reach to increase out-reach and follow up for FIT test return

21. FIT Test purchase strategy Statement of Purpose: A request for proposal to provide Fecal Immunochemical Tests (FIT) in collaboration with C4 to selected California Federally Qualified Health Centers to help increase their colon cancer screening rate. To support Grant funded FQHCs.

22. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

23. Advocacy Efforts to Date Six annual C4 Sacramento Lobby days have occurred in March to pass a resolution to make March Colorectal Cancer Awareness Month. Lobby days educated the legislators on the burden of colon cancer in their districts. 2016 Lobby Day will focus on colonoscopy co-pay bill and March CRC Awareness Resolution.

24. Advocacy Need Bill requiring health insurance companies to cover the cost of colonoscopies for people 50 and over if their fecal screening tests are positive. –Modeled after Oregon HB2560

25. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

26. Putt for Your Butt

27. Undy Run/Walk On line donations Personal donations Truck Show

28. C4 Projects Partnerships Grants Program Advocacy Fundraising Education

29. Educational opportunities Grand Rounds Webinars Community stakeholder meetings Meetings with the Legislators Our website

30. Thank You Please visit our website: http://www.cacoloncancer.org/