Maryland Cigarette Restitution Fund Public Health Grant at Johns Hopkins New Pathways for Care: A Model for Delivering Prostate Cancer Screening to Men in Need Charlotte Neuhaus, MHS Program Manager Community-based Research Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins November 12, 2003

Age-adjusted Prostate Cancer Rates in Baltimore City, 1999 Per 100,000 population Source: Maryland Cancer Registry,

Prostate Cancer Screening Practices, Baltimore City, Males over Age 40 Source: Maryland BRFSS, 2001 Have you ever had a PSA test? When did you have your last PSA test?

Baltimore City: Significant Facts  25% of residents have no health insurance.  African-Americans twice as likely uninsured.  57% of uninsured men age >40 report having no health coverage in over 5 years. Source: City of Baltimore, 2000 Source: Maryland BRFSS, 2001

The Community-based Research team is dedicated to cancer prevention and control through innovative community-based programs and research. Mission Statement

Public Health Grant: Goals  Implement new model for community-based cancer education, screening diagnosis and treatment.  Reduce prostate cancer disparities in Baltimore City.  Improve access to prostate cancer screening.  Leverage existing resources through partnerships to increase men’s access to other health services.

Public Health Grant: Who We Are  Johns Hopkins partnership with 7 organizations: 5 community-based organizations, a community- based health provider, and a historically black university.  Recruited and trained staff from communities to: – Increase community awareness about prostate cancer – Outreach and provide education – Ensure informed decision-making prior to screening,  Provide prostate cancer screening, diagnosis, and treatment services to eligible men.

Plan Overview Prevention, Education, Screening  Develop and expand community infrastructure for cancer awareness and screening  Sites – Credible presence in the communities and a commitment to cancer prevention and control  Assess individual community needs through a qualitative and quantitative methods  Screening methods – Prostate: PSA & DRE

Delivery of Services Region A Region B St. Clare Medical Outreach Van Urban Medical Institute

Plan Overview Diagnosis and Treatment  Individuals with suspicious and/or positive cancer screening results: - For those with health insurance, covered via their existing health insurance plan - For those without health insurance or who are underinsured and meet eligibility requirements, covered via Federal/State medical assistance programs

Plan Overview Diagnosis and Treatment (cont’d)  For those without health insurance or who are underinsured and do not meet eligibility requirements for Federal/State medical assistance programs, covered via the CRF/JH Diagnosis and Treatment Program

A New Roadmap: Pebbles in the Road  New pathway for providing care  Budget cuts  Interface with – 7 partners – Baltimore City Department of Health – Baltimore City Cancer Coalition – Department of Health and Mental Hygiene – Clinical providers  Serving as health insurer, health educators, case managers, outreach workers, patient navigators

Necessary Components for a New Pathway  Community capacity building – CLAM  A shared vision for health promotion  Sustainable service programs in the community  Clear and honest communication

Public Health Grant Progress  Total educated20071  Total screened 1101 – FY04 Screening Goal by June 30, – Total screened since July, 2003 (FY04) 200 Case management  Number of men provided with diagnostic and treatment services for prostate cancer 56  Diagnosed with prostate cancer6

On the Road: Maintaining Success