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Program Description Established by: National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Colorectal Cancer Control Program (CCRP)

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Presentation on theme: "Program Description Established by: National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Colorectal Cancer Control Program (CCRP)"— Presentation transcript:

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2 Program Description Established by: National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Colorectal Cancer Control Program (CCRP)

3 Goals Promote breast, cervical and colorectal cancer screening and early detection Provide access to quality breast, cervical and colorectal cancer screening services

4 Federal Laws Breast and Cervical Cancer Mortality Prevention Act of 1990 Established the NBCCEDP Breast and Cervical Cancer Prevention and Treatment Act of 2000 Established State treatment programs through Medicaid

5 State Laws Early Detection of Breast and Cervical Cancer Screening Program – Medical Advisory Committee – RCW 43.70.655 Related RCWs 74,04.050, 74.04,055, 74.04.057, 74.08.090, 74.08.090, 74.04.050, 74.04.057, 74.09.530, 74.09.510

6 State Rules Washington Administrative Codes (WAC) Breast and Cervical Cancer Treatment Program (BCCTP) - WAC 182-505-0020 Alien Emergency Medical (AEM) Program (WAC 388-424-0001 & 388-424-0006)

7 2012-2013 Funding Sources Funding Breast/CervicalAmount Federal BCHP4.3 million State2.8 million Susan G Komen for the Cure Affiliates 1.4 million Total B/C8.5 million Funding Colorectal Federal CRC- screening607,489 Combined Total9,107,489

8 Prime Contractors Citrine Health, Inc. PeaceHealth Southwest Medical Center Public Health Seattle & King County Health Department Spokane Regional Health District Wenatchee Valley Medical Center Yakima Health District

9 Public Health Seattle-King County Yakima Health District Wenatchee Valley Medical Center NW Spokane Regional Health District Breast, Cervical and Colon Health Program Service Delivery Network Map 2012-2013 PeaceHealth Southwest Medical Center WhatcomOkanoganFerryStevensPend Oreille Spokane Lincoln Douglas Grant Kittitas Chelan Snohomish King Pierce Lewis Pacific Grays Harbor Jefferson Clallam AdamsWhitman Garfield Asotin Columbia Walla Franklin BentonYakima KlickitatSkamania Cowlitz Clark Wahkiakum Thurston Mason Skagit San Juan Island Kitsap Citrine Health

10 Breast Health Services for Women AgePresentationIncomeServices Covered 40-64 Well woman Breast cancer symptoms Breast cancer findings < 250% FPL 251% - 300% FPL – available in most counties Breast cancer screening & diagnostics 18-34 Breast cancer findings (i.e. suspicious CBE) < 300% FPL available in most counties Follow-up CBE Breast cancer diagnostics 35-39Breast cancer symptoms < 250% FPL 251% - 300% FPL – available in most counties CBE Breast cancer diagnostics 65+Well woman Breast cancer symptoms Breast cancer findings <250% FPL Not eligible for Medicare Breast cancer screening & diagnostics

11 Cervical Health Services for Women AgePresentationIncomeServices Covered 40-64 Well woman Cervical cancer symptoms Cervical cancer findings < 250% FPL Cervical cancer screening & diagnostics 35-39 Breast cancer symptoms <250% FPL Cervical cancer screening & diagnostics 65+History cervical cancer findings (CIN2, CIN3) <250% FPL Not eligible for Medicare Cervical cancer screening & diagnostics for 20 years after pre cancer diagnosis

12 Colon Health Services for Men and Women AgePresentationIncomeServices Covered 50-64 Asymptomatic &  Average Risk  Increased Risk <250% FPL Colon cancer screening or surveillance & diagnostics 18-49 Asymptomatic & Increased Risk due to personal or family history <250% FPL Colon cancer screening & diagnostics 65-75Asymptomatic &  Average Risk  Increased Risk <250% FPL Not eligible for Medicare Colon cancer screening & diagnostics

13 Priority Populations Native Americans/Alaska Natives Asian and Pacific Islanders Hispanics Lesbian and Bisexual People with disabilities Women who have never been screened for breast or cervical cancer Men 50+ for CRC

14 Breast & Cervical Cancer Treatment Breast & Cervical Cancer Treatment Program (Medicaid – comprehensive) Alien Emergency Medical (AEM) Program (Medicaid) - limited care only

15 Colorectal Cancer Treatment No specific program for colorectal cancer treatment Referred to charity care and other organizations that may assist in paying for treatment

16 Reimbursement Prime Contractors sub-contract with many providers in their region Reimbursement is paid at the highest Medicare allowable rate regardless of location Reimbursement is specific to breast, cervical and colon cancer screening and diagnosis CDC limits some reimbursement rates CDC and BCCHP/MAC determine what procedures we can reimburse

17 Program Screens FY12 14,916 screened for breast and cervical cancer 1439 screened for colorectal cancer, 30 suspicious polyps removed

18 2013 Legislative session Assumption with HCR that all clients will be eligible for the exchange or expansion Governor’s budget eliminates state funding for our program by 2016 Phased out reduction plan for state funds: 28% FY 14 70% FY 15 Federal budget unknown

19 Health Reform Impact Technically: 70% of current clients will be eligible for Medicaid expansion (at 138% FPL or less) 30% of current clients will be eligible for the exchange (above 139% FPL)

20 Health Reform Impact What we know: 10% of eligible state population may not get insurance due to financial hardship

21 Health Reform -- Planning Community Health Worker Training System Partnership with HCA Connecting clients to services Playing the waiting game

22 Megan Celedonia, MES Manager, BCCHP Megan.celedonia@doh.wa.gov 360 236-3785 Megan Celedonia, MES Manager, BCCHP Megan.celedonia@doh.wa.gov 360 236-3785


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