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NATIONAL BREAST CANCER COALITION « a grassroots advocacy effort » 1707 L Street, NW, Suite 1060 Washington, DC 20036 CLINTON LIBRARY PHOTOCOPY PHOTOCOPY PRESERVATION JENNIFER L. KATZ Manager, Government Relations NATIONAL BREAST CANCER COALITION 1707 L Street, NW, Suite 1060 Washington, DC 20036 phone: (202) 296-7477 direct line: (202) 973-0595 fax: (202) 265-6854 e-mail: [email protected] NATIONAL BREAST CANCER COALITION grassroots advocacy effort.,» Nicole Robner 1 The National Breast and Cervical Cancer Early Detection Program AT-A-GLANCE 1999 Screening Quality Services Assurance Public Professional Education Education Outreach Partners Surveillance & Coalition Tracking & Development Follow-up "Over 1.2 million women have taken advantage of services provided through CDC's National Breast and Cervical Cancer Early Detection Program. Less than a decade old. this program now operates in every state in the country. providing recommended screening to low-income women. Yet we are still only able to reach 15% of the eligible population. As a nation. we must step up our commitment to reaching all women." Jeffrey P. Koplan. MD. MPH Director, Centers for Disease Control and Prevention U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention CDC CENTERS FOR DISEASE CONTROL AND PREVENTION Breast and Cervical Cancer Screening: Preventing Unnecessary Deaths Among Women An estimated 2 million American women will be diagnosed with breast or cervical cancer in this decade. Benefits of Screening and half a million women will lose their lives to these diseases. A disproportionate number or deaths will be Mammography is the best way to among women of minority and low-income groups. detect breast cancer in its earliest, Many or these deaths could be avoided by making most treatable stage-an average screening services available to all women at risk. Such of 1.7 years before the woman can screening measures could prevent approximately 15%- 30% of all dearhs from breast cancer among women over feel the lump. Mammography also the age of 40 and virtually all deaths from cervical cancer. locates cancers too small to be felt Excluding skin cancer. breast cancer is the most during a clinical breast examination. common cancer among American women and is second only to lung cancer as a cause of cancer-related The primary purpose of cervical death. An estimated 175,000 new cases or breast cancer screening-which is cancer among women will be diagnosed in 1999. and performed by the Papanicolaou (Pap) 43,300 women will die of this disease. test-is not to detect cancer but to The incidence of invasive cervical cancer has decreased significantly over the last 40 years, in large part because find precancerous lesions. Detection of early detection efforts. Even SO. an estimated 12,800 and treatment of such lesions can new cases of invasive cervical cancer will be diagnosed actually prevent cervical cancer. in 1999, and 4,800 women will die of this disease. In most cases, the earlier breast cancer is detected. the Cervical cancer screening also offers great benefits. better the survival rate. When breast cancer is For a woman found to have precancerous cervical diagnosed at a local stage. the 5-year survival rate is lesions or to have cancer in its earliest stage. the 97%. When breast cancer is diagnosed after it has likelihood of survival is almost 100% with timely and spread, the 5-year survival rate decreases to 21%. appropriate treatment and follow-up. CDC's National Breast and Cervical Cancer Early Detection Program Recognizing the value of screening and early to screening and follow-up services. increase detection, Congress passed the Breast and Cervical education and outreach programs for women and Cancer Mortality Prevention Act of 1990. This act health care providers. and improve quality assur- authorized CDC to provide critical breast and cervical ance measures for screening. Despite its success in cancer screening services to underserved women, screening more than a million women, with existing including older women. women with low incomes, and resources the NBCCEDP is able to screen only women of racial and ethnic minority groups. 12%-15% of the eligible population for these two Through its landmark National Breast and Cervical cancers. Cancer Early Detection Program (NBCCEDP). CDC The legislation for NBCCEDP does not authorize now supports screening activities in all 50 states. in CDC to pay for treating breast and cervical cancer. 5 U.S. territories, in the District of Columbia, and However. participating state programs have been through 15 American Indian/Alaska Native determined and creative in ensuring that treatment organizations. By October 1997. more than 1.5 million services are available for women diagnosed with breast screening tests had been provided by the NBCCEDP. cancer or cervical abnormalities. The availability of Fiscal year 1999 appropriations of approximately treatment sources reflects the extent of state and local S158 million enable CDC to establish greater access government support. the generosity of medical providers. and the commitment of communities. 2 CDC'S National Leadership Screening alone is not sufficient to prevent screening and diagnostic guidelines to all state-based unnecessarv illness and death. Essential technical and programs and assists states in evaluating their clinical scientific underpinnings must be in place at the services. national level to support state-based programs. CDC CDC recently evaluated how early derection programs collaborates with state health agencies. professional in seven participating states (California. Michigan. and voluntary organizations. academia. and other Minnesota. New Mexico. New York. North Carolina. rederal agencies to ensure that the following elements ind Texas) developed strategies to obtain resources are in place to serve as resources for states: not only tor diagnostic services. for which the Quality assurance. NBCCEDP provides funding, but also for treatment Program tracking and evaluation. services. which the NBCCEDP requires participating states :0 provide but cannot by law! reimburse. Professional education. Results or the study indicate that treatment had been Public education and outreach. initiated for limost all NBCCEDP clients in whom cancer was diagnosed. However. the programs pointed Ensuring Quality Screening and Follow-Up out that the approaches used to obtain these services Services for Women were short-term. labor-intensive solutions that Quality assurance is essential if screening for eariv diverted resources away from screening activities. detection is to be an effective tool for controlling As more women are screened by the NBCCEDP. cancer. To help ensure the quality of the screening participating health agencies and providers will and follow-up process. CDC has collaborated with the experience greater chailenges in obtaining sufficient American College of Radiology to improve and certify resources for treating women with breast and cervical the quality of mammography screening, developed cancer. CDC has expanded ITS case management guidelines on the evaluation of common breast services to help women overcome financial. logistical, problems. used program data to monitor health and other barriers to these services. However, more outcomes, and issued recommendations on a public formalized and sustained mechanisms need to be health response to the regulatory closure of cervical instituted to ensure that all women screened have cytology laboratories. In addition. CDC provides ready access to appropriate treatment and follow-up. Number of Screening Examinations Among NBCCEDP* Participants. FY 1991-1997 250.000 207.590 203.069 200,000 185,824 166.231 150.000 137.353 134.602 107 324 96.352 100.000 67,788 50,000 42.345 26.259 0 '91-'92 1993 1994 1995 1996 1997 '91- a 1993 1994 1995 1996 1997 Mammograms Papanicolaou tests Total = 721.666 Total = 351.813 Total examinations = 1,573,484 'CDC'S National Breast and Cervical Cuncer Early Derection Program. 3 Tracking Program Outcomes To better target critical screening activities, CDC Barriers to Screening works with states to collect critical information to monitor program progress in reaching women Fear. Women may be afraid to discover and derecting cancer. Since its inception. the that they have cancer. NBCCEDP has Provided over 700,000 mammograms to women. Cost. Many women cite cost as the Of this number. over 48.000 were abnormal. and reason they do not use early detection over 3.600 cases or breast cancer were diagnosed. programs. Many are not aware of the Provided over 850,000 Pap tests. availability of low-cost programs. Of these. over 25,000 were abnormal. and over 26.000 cases or precancerous lesions were Lack of Transportation. For many diagnosed. Over 400 cases of invasive cervical cancer were diagnosed. women who lack transportation. con- CDC also provides and tracks diagnostic evaluations venient location of screening facilities for women who have had abnormal results through is important. screening initiated by providers not invoived with the NBCCEDP. Communication Barriers. Communica- Public Education and Outreach: Eliminating tion styles and methods appropriate for Barriers to Screening one group may be inappropriate for another. CDC collaborates with health care professionals and organizations, human service and voluntary organ- izations. academia. and health agencies participating Lack of Physician Referral. Studies have in the program to address barriers to screening. shown that women are more likely to be screened if their physician recommends National Collaboration screening. Examples of CDC collaboration with national organizations include the following: Lack of Child Care. Some women need CDC collaborates with the American Cancer assistance with arranging child care to Society (ACS) to develop and disseminate be able to use screening services. comprehensive information on cancer prevention and early detection. Through CDC, ACS divisions have formed partnerships with state health departments to increase screening services to through the sale of Its Breast Cancer Awareness medically underserved women. CDC and ACS pink ribbon products. Since 1993. about 300 collaborate in many programmatic areas, including community-based programs in 49 states and establishing program infrastructure and public and Puerto Rico have received funding from Avon's professional education activities. program through the YWCA or the U.S.A. and A unique public-private partnership was NABCO to educate women about breast cancer established among CDC, Avon Products Inc., and to provide underserved women with access to the YWCA of the U.S.A., the National Alliance early detection services. Beginning in 1998, all of Breast Cancer Organizations (NABCO), and funding of community-based programs was the National Cancer Institute. Avon's Breast consolidated under the Breast Health Access Cancer Awareness Crusade has raised more than Fund administered by NABCO. $25 million for breast cancer programs nationwide 4 States Take Action to Educate Women hosting of prayer breakfasts. workshops and With CDC's leadership. state-based programs have forums. and pink ribbon teas: the distribution of made significant progress in building state and literature and pink ribbons: and the publication or announcements in religious builetins. in community partnerships to reach women about the addition. on Sundavs activities focusing n benefits or screening and early detection. Various screening awareness have been conducted with outreach activities have been designed to educate testimonies from survivors and educat: natiniks women and motivate them to be screened. For on breast health. example. The Cherokee Nation of Oklahoma is New Jersev's state health department :- developed in educational Videolin The collaborating with the University of Medicine importance :[ breast elf-examination and Dentistrv or New Jersey and the YWCA to American Indian women. Funded The reduce screening barriers by offering educational Avon Breast Health Access Fund. The Tue: outreach and access to screening. Program starf highlights three American Indian Lander make monthly visits to senior housing complexes survivors advocating for early detection manuen and other settings where women congregate (e.g., breast self-examination. beauty parlors and supermarkets) to present in educational program designed for minority women aged 50 and older and to schedule appointments for screening in a mobile mammography unit that comes to the site 2 weeks later. Percent Distribution of Screening Examinations Arkansas' "Hats Off to Health" is a light-hearted Among NBCCEDP* Participants. by Race/Ethnicity. but informative skit in which characters contront FY 1991-1997 reasons women often give for not having breast Mammograms Other Hisbanic cancer screening. Over 600 women have attended 5.2% 18.3% the program; surveys found that this nonthreatening American indian/ approach to breast cancer screening education was Alaska Native 7.0% effective in reducing perceived barriers to Asian mammography. 3.0% Massachusetts Breast and Cervical Cancer Black. non-Hispanic 16.0% White. non-Hispanic Initiative has established partnerships with a 50 3^.. variety of community agencies already active in conducting outreach in racial and ethnic minority Papanicolaou Tests communities. Using a health circle model. groups Other/Unknown Hispanic 5.8% meet in spaces that are familiar, accessible. and 19.6% comfortable (e.g., homes. churches. and local American Indian/ agencies such as immigration offices). The health Alaska Native 3.3% circle model has proved especially successful in Asian promoting screening among older Southeast 2.7% Asian women. Black. non-Hispanic 13.9% White. non-Hispanic Washington. D.C.'s breast and cervical cancer 49.2% program has recruited a woman minister to work with Project WISH to raise breast health CDC's National Breast and Cervical Cancer Early Detection Program. awareness in the faith community. Over 20 activities have been implemented. including the 5 Partnerships for Cancer Control in Populations at Higher Risk Partnerships that tocus their prevention efforts on those at greater risk are essential for understanding and alleviating disparities. Both mammography and CDC funds the following partners to promote Pap tests are underused by women who are members screening among populations at higher risk: or racial and ethnic minority groups. have less than a high school education. are older. or live below the American Social Health Association poverty level. Association or Asian Pacific Community CDC funds 1 strong and effective network or partners Health Organizations that are well-positioned in communities 10 risk. These Bavior College of Medicine. Salud en Accion partners have developed projects that are rocused on Program underserved populations and cover a wide range of public and professional education interventions. For Institute for the Advancement of Social Work example. many projects are involved with developing Research low-literacy, bilinguai. and culturally appropriate Mauther Project for Lespians with Cancer educational materials that are used in diverse training and outreach programs and educational campaigns. National Asian .Vomen $ Health Organization The various interventions used by the different National Association or Community Health projects result in the common goal of increasing Centers access to and use of screening services for priority populations. National Caucus and Center on Black Aged. Inc. National Center for Farmworkers Health. inc. Professional Education: Enhancing Health National Education Association Health Care at the Source Information Network Professional education is designed to enhance the quality of care that women receive. Through National Hispanic Council on Aging education. the NBCCEDP has assisted a wide range of U.S. Conference or Mayors' Research and health care professionals-including physicians. Education Foundation nurses. radiology technologists, and cytologists-to The Witness Project better understand their key roles in the early detection of breast and cervical cancer. World Education In 1998. CDC's National Training Center provided two training programs and one self-study informational packet for health professionals. For 1999. CDC is developing a self-study packet on follow-up of abnormal findings from clinical breast examinations and mammograms and a workshop and self-study packet on evaluation-based work plans that will assist personnel in state and local health agencies and tribal organizations. For more information or additional copies of this document, please contact the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Mail Stop K-64, 4770 Buford Highway NE, Atlanta, GA 30341-3717, (770) 488-4751. Voice Information Svstem: 1 (888) 842-6355 Fax: (770) 488-4760 [email protected] http://www.cdc.gov/cancer 6 Acknowledgments Follow-Up and Treatment Issues in Funding for this study was from the Centers for Disease Control and Prevention, Division of the National Breast and Cervical Cancer Prevention and Control Cancer Early Detection Program The study was designed and implemented by a team of investigators from Batteile Centers for Public Health Research and Evaluation and the Study Results University of Michigan School of Public Health January, 1998 Research Team Goals of the Study Battelle Centers for Public Health Research University of Michigan To document strategies and methods used by and Evaluation: School of Public Health: states to obtain follow-up diagnostic services not covered by NBCCEDP funds. Lowell Sever, Ph.D. Paula Lantz, Ph.D. To document strategies and methods used by Martha Hare, Ph.D. Lisa Richardson, M.D., M.P.H. states to obtain treatment services for clients Cartyn Orians, M.A. Deb Macklem, M.Ed. diagnosed with CIN or cancer. Jane Schulman, Ph.D. To identify strategies that are perceived as successful or innovative in securing diagnostic and treatment resources. Flow of Follow-Up and Treatment Activities Research Questions Focus of Case Study What guidelines, policies or methods have been State Breast and developed and implemented by states to ensure Cervicel Cumm Screaming Diagnoss Treatment that women with abnormal screening results and Early Describes / women diagnosed with cancer or precancerous lesions receive diagnostic follow-up and treatment services? How is the component of the program that identifies and secures diagnostic and treatment Strangies . - Strumgies - help I I I - - - services organized? obtain disgnostic 1) - - to they - - What role do coalitions or other partnerships play? n - Research Questions Phases of the Study Phase I: Care set of data on 35 programs Have the methods or tacties being used to identify and secure diagnostic and treatment resources changed with time. and do they differ within the Phase II: In-depth case study of 7 states individual state programs or across programs? What are the key lessons learned regarding Phase III: Linkage study (in process)-Tumer diagnostic and treatment services in a program such registry data and program data from 3 states (CA, as the NBCCEDP? MI. NM) were linked to document timing of treatment initiation and initial course of cancer treatment What is a Case Study? Conducting a Case Study A case study seeks to understand the way in which a Determine Sales - Crime Car program. system. or organization works within its Projects Landuating Evenue for everyday setting Case in Date I the Study Collection It focuses on a particular problem, issue, or structure Email: Quantitue a Madel which is studied in relationship to the larger program. - be of Program Design Date Annuared Common Collection system. or organization Through Date - Research Collection While describing this relationship, the case study may or may not lead to conclusions about outcomes Purforms I Develop Date A case study uses all appropriate sources of Date Case Sandy Analysis Plan Analysis evidence - written, observational, and interview - that may be analyzed both qualitatively and quantitatively Case Study Selection Criteria Case Study States Provided screening for at least three years State Number of Breast Region Cancers Diagnosed Diagnosed 60 or more breast cancers since California 168 West screening began Michigan 249 Midwest Representative of the following stratification Minnesota 137 Midwest criteria: New Mexico 169 West Centralized versus decentralized programs Geographic region of United States New York 173 Northeast Urban/rural mix of the population North Carolina 106 South Racial and ethnic diversity among program clients Texas 307 South How Did We Conduct the How Did We Conduct the Case Study? Case Study? Contacted the coordinator for each of the seven Interviewed State BCCEDP Coordinator and programs to schedule site visits, and to obtain other staff who work with diagnosis and background information treatment issues Reviewed documents supplied to us by the state Interviewed local coordinators and providers program, such as organizational tables, reports in a variety of settings throughout the state and articles Interviews were tape recorded, transcribed, Traveled to each state and briefed state BCCEDP and entered into a word processing database staff regarding the project at the beginning of each state's site visit How Did We Analyze the Data and Write How Did We Analyze the Data and Write the Case Study State Summaries? the Case Study State Summaries? The Project PI and the Case Study Coordinator Using the analyzed transcripts, a member of the developed a codebook based on the research site visit team developed a state summary questions in the Case Study Protocol Each member of the site visit team reviewed the Using the codebook, the PI and Coordinator state summary worked together to achieve 80% inter-rater The summary was then sent to state program agreement on the use of codes for text, and then staff and other interviewees for review trained one other team member Reviewer feedback was incorporated into a All interviews were coded and entered into a text revised state summary analysis software Number of Interviews Case Study Results by State and Role Site visits were conducted February-June, 1997 TOTAL CA MI MN NM NY NC TX A total of 126 interviews were conducted State staff 58 13 4 11 4 , 10 7 A total of 192 people were interviewed Local staff 15 2 2 2 4 4 1 Screening = 3 6 & , 7 n 8 provider Dx or Tx provider 45 7 4 9 3 3 13 6 Advisory Board 10 : 1 J I 2 I Coalition member Other 4 . I 2 1 TOTAL 192 :7 16 12 21 14 49 23 Strategies Used to Ensure Provision of Strategies Used to Ensure Provision of Diagnostic and Treatment Services Diagnostic and Treatment Services Common Approaches at the Local Level: Common Approaches at the State Level: Bill insurance Assist clients in applying for Medicaid, Hill Burton Clients followed through use of tracking and funds, other assistance programs follow-up systems Referral to public hospital Requirements in contracts with providers Charity care, donated services Appeals to providers through state medical Case rotation societies, professional associations, etc. Reduced fees Negotiated payment plans Clients pay fee for service Additional Strategies Used by States General Findings Across States Blue Cross Foundation treatment fund CA" States have found supplemental funds (primarily for breast cancer diagnostic services) Race for the Cure fund MN* Women diagnosed with cancer who want to be State breast cancer programs NY* treated are receiving treatment Other state funds TX*, NC Strong reliance on providers to find resources Tobacco excise tax fund CA", MI Follow-up handled on case-by-case basis Providers of last resort NM, TX County indigent funds NM, TX funds used for breast services only General Findings Across States Strengths Women who need and want cancer treatment are Solutions, strategies and networks are tenuous receiving it and fragile Programs operate within changing health care Creative responses and strong partnerships have environments (i.e. growth of managed care) emerged at state, local and provider level Availability of state or foundation funds to Information lacking for many important issues: supplement Federal resources -payment source for diagnostic and treatment services -out-of-pocket expenses for women -impact of financial barriers on time delays/refusals Strengths Areas of Concern Centralized tracking systems work well Lack of financial support for diagnosis and treatment Program has had positive effect on tracking and Time and energy required for follow-up is tremendous follow-up in larger community Burden of follow-up has led to restrictions in number of women screened Several barriers to provider recruitment - low reimbursement rates (mandated by Congress) - lack of coverage for all diagnostic follow-up services - Cability for treatment - administrative burden of follow-up Areas of Concerns Areas of Concern Some women experience time delays or are lost to follow-up Categorical nature of program prohibits a more (especially in regard to cervical services) comprehensive approach to women's health A small number of women have refused cancer treatment Financial access is only one dimension of access to Coordinating diagnostic follow-up is greater burden than health care services. Many non-financial barriers arranging treatment impede follow-up care: Resources states have developed are short-term solutions, - logistical barriers (e.g. transportation, scheduling) and difficult to manage/administer - cultural barriers (e.g. language barriers, fatallstic attitudes, fear) - immigration issues Respondent Recommendations Conclusions of Case Study Program should pay for all diagnostic and treatment Strong response to provision of diagnostic follow-up services, or at least through definitive diagnosis and treatment services has emerged Allow state resources used for all diagnosis and Wide range of strategies is employed within states; treatment services to be counted in the 3:1 match effort at local level is tremendous Cover anesthesia and other affiliated services Responses that have emerged are administratively Increase reimbursement rate for services covered cumbersome and unstable; long-term solutions are Increase support for case management and community needed infrastructure Strong commitment to continued growth and success Universal health insurance of the NBCCEDP exists at state and local level Linkage Study - Linkage Study - Research Questions Research Questions What proportion of women identified through What are the components (surgery, radiation, selected states' BCCEDPs as having breast chemotherapy, hormonal therapy) of the or cervical cancer did not receive an initial initial course of cancer treatment for women course of treatment, based on registry identified through the BCCEDPs as having records? breast or cervical cancer? What characteristics of women and their cancers What characteristics of women and of their are associated with not receiving treatment? cancers are associated with the content of the initial course of treatment? Linkage Study - Linkage Study - Research Questions Research Questions What is the time interval between abnormal How does the information from the program screening and diagnosis? database compare with the corresponding What is the time interval between diagnosis information from the cancer registry database? and treatment? How do women screened through the program What characteristics of women and their cancers compare with all women in the registry with appear to be related to these time intervals? regard to patterns of diagnosis and treatment? CDC March 27, 1998 / Vol. 47 / No. 11 209 Imported Dracunculiasis - United States, 1995 and 1997 MMWR 211 Update: HIV Counseling and Testing Using Rapid Tests - United States, 1995 215 Strategies for Providing Follow-Up and Treatment Services in the National Breast and Cervical Cancer Early Detection Program - United States, 1997 MORBIDITY AND MORTALITY WEEKLY REPORT 218 World Health Day - April 7, 1998 219 Notices to Readers Imported Dracunculiasis - United States, 1995 and 1997 Dracunculiasis is a parasitic infection caused by a filarial worm (Dracunculus medi- nensis [i.e., Guinea worm)) that is transmitted through contaminated drinking water. Approximately 1 year after a person is infected, one or more meter-long adult female worms begin to emerge through the skin, often incapacitating the patient for ≥2 months. Despite a dramatic decrease in cases worldwide, dracunculiasis is still occa- sionally imported into the United States. Since 1995, two cases of dracunculiasis have been reported in the United States, both imported from Sudan. This report summa- rizes the investigation of these cases. Patient 1. A 9-year-old girl residing in Tennessee had emigrated from Sudan in Sep- tember 1995 (1). Before the girl left Sudan, a Guinea worm had emerged and had been extracted from her right lower leg. The lesion had healed when she arrived in the United States. After she had been in the United States for 3 weeks, another Guinea worm began to emerge from her left leg. Medical examination at a local health clinic revealed a string-like worm dangling from a lesion on her left leg, and she was re- ferred to an infectious disease specialist. The leg was secondarily infected and swol- len, and the girl was unable to walk. Despite antibiotic treatment, her cellulitis did not improve, and the lesion was surgically opened, drained, and debrided of pus, necrotic debris, and fragments of the Guinea worm. The patient was hospitalized for 2 weeks, requiring surgery to stretch a contracture of her ankle and to apply a skin graft to the wound. After outpatient physical therapy, she was able to walk without crutches. Patient 2. A 31-year-old woman residing in Connecticut had emigrated from Sudan in January 1997. In April 1997, she was evaluated at a university clinic for possible tuberculosis (TB). A radiograph revealed lung lesions consistent with TB and a worm- like calcification in her left chest. Physical examination revealed multiple, indurated, oval lesions 4-8 cm in diameter on both lower legs. The patient reported the lesions had been present for 1 year and were intermittently painful. She recalled that a long string-like worm had emerged from her leg during the previous year. Biopsy of the leg lesions revealed erythema induratum, consistent with Bazin disease, a cutaneous manifestation of TB. The patient had evidence of a dead and calcified Guinea worm in her chest and a history suggesting a live Guinea worm had emerged from her leg before she arrived in the United States. She also had pulmonary TB with a cutaneous tuberculid skin manifestation. Treatment with isoniazid, rifampin, and pyrazinomide U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Vol. 47 / No. 11 MMWR 215 HIV Counseling and Testing - Continued ing that persons who receive preliminary results understand the meaning of the result and prefer rapid testing (4). When additional rapid tests become available for use in the United States, the PHS will re-evaluate algorithms using specific combinations of two or more rapid tests for screening and confirming HIV infection. References 1. Kamb ML, Bolan G, Zenilman J. et al. Does HIV/STD prevention counseling work? Results from a multi-center randomized trial (Project Respect) [Abstract 01341 In: Program and abstracts of the International Congress of Sexually Transmitted Diseases. Seville, Spain: Association for Research in Clinical Microbiology, 1997:83. 2. CDC. HIV counseling and testing in publicly funded sites: 1995 summary report. Atlanta: US Department of Health and Human Services, CDC, September 1997. 3. George JR, Schochetman G. Detection of HIV infection using serologic techniques in AIDS testing: a comprehensive guide to technical, medical, social, legal, and management issues. 2nd ed. Schochetman G, George JR, eds. New York: Springer-Verlag, 1994. 4. Kassler WJ, Dillon BA, Haley C, Jones WK, Goldman A. On-site, rapid HIV testing with same-day results and counseling. AIDS 1997;11:1045-51. 5. CDC. Interpretation and use of the Western blot assay for serodiagnosis of human immunode- ficiency virus type 1 infections. MMWR 1989;38(suppl 7):S4-S6. 6. Stetler HC, Granade TC, Nuñez CA, et al. Field evaluation of rapid HIV serologic tests for screen- ing and confirming HIV-1 infection in Honduras. AIDS 1997;11:369-75. 7. Kassler WJ, Haley C. Jones WK, Gerber AR, Kennedy EJ, George JR. Performance of a rapid, on-site human immunodeficiency virus antibody assay in a public health setting. J Clin Mi- crobiol 1995;33:2899-902. Strategies for Providing Follow-Up and Treatment Services in the National Breast and Cervical Cancer Early Detection Program - United States, 1997 The Breast and Cervical Cancer Mortality Prevention Act of 1990* authorized CDC to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to increase screening services for women at low income levels who are uninsured or underinsured (1). Although the NBCCEDP covers most diagnostic serv- ices that women need after receiving an abnormal mammography or Papanicolaou (Pap) test result, the program does not reimburse for breast biopsies. In addition, the Act prohibits the use of NBCCEDP funds for cancer treatment. Participating health agencies must ensure that NBCCEDP clients receive timely, appropriate diagnostic and treatment services. In 1996, CDC began a case study to determine how early de- tection programs in seven participating states (California, Michigan, Minnesota, New Mexico, New York, North Carolina, and Texas) identified resources and obtained diag- nostic and treatment services. This report summarizes the results of the study (2), which indicate that respondents in these states reported that treatment had been initi- ated for almost all NBCCEDP clients in whom cancer was diagnosed. However, re- spondents also considered the strategies used to obtain these services as short-term solutions that were labor-intensive and diverted resources away from screening ac- tivities. In the seven states, NBCCEDP-sponsored screening services had been provided for ≥3 years, and breast cancer had been diagnosed in ≥60 women. The states were se- *Public Law 101-354. 216 MMWR March 27, 1998 National Breast and Cervical Cancer Early Detection Program - Continued lected to provide a range of geographic locations, a combination of urban and rural populations, and racial/ethnic diversity among program clients. Researchers con- ducted semi-structured interviews with 192 persons affiliated with the seven state programs. Of these interviewees, 120 (63%) were providers of screening, diagnostic, and/or treatment services; 58 (30%) were state program staff; and 14 (7%) were coali- tion members. Interviews included topics such as guidelines related to diagnostic and treatment services, strategies used to obtain and pay for services, level of effort re- quired to secure these services, and changes in strategies over time. Each interview was tape recorded and transcribed. Using a systematic scheme derived from the re- search questions, three researchers coded the same transcripts until an inter-rater agreement of 80% was reached. Thereafter, all transcripts were coded independently. Coding results were entered into text analysis software that sorts text from transcripts into sets of information, themes, and evidence relevant to the specific research ques- tions (3). The results reflect a synthesis of the interviewees' responses. Respondents described several strategies used to ensure necessary diagnostic and treatment services for women screened through the NBCCEDP. State-level strategies in all states included 1) computerized tracking and follow-up systems that used pro- gram surveillance data to identify and manage clients in need of diagnostic and treat- ment services; 2) provisions in contracts requiring screening providers to arrange for diagnostic follow-up and treatment before screening women; and 3) arrangements with provider groups and state professional associations for free or reduced-cost serv- ices for NBCCEDP clients. All states also had access to public or private funds to help support services not covered by the program; such revenue sources included state appropriations from general or tobacco tax revenues or funds from private founda- tions. These funds were available primarily for breast diagnostic services. Local strategies tailored to the needs of individual clients were used to obtain diag- nostic and treatment services. Common strategies reported by respondents included the following: providers billed public or private insurance plans; providers or local health departments helped clients apply for public assistance programs; providers re- ferred clients to public hospitals; county indigent-care funds and hospital community- benefit programs financed services; clients received services through individually negotiated payment plans; and clients paid reduced or full fees for services. Respondents strongly supported the continued growth of NBCCEDP and its goals but expressed several concerns. First, considerable time and effort were involved in developing and maintaining systems for diagnostic follow-up and treatment. Second, the process of identifying available resources within states for diagnostic and treat- ment services was considered labor-intensive. Third, the lack of coverage for diagnos- tic and treatment services negatively affected recruitment of providers and restricted the number of women screened. Fourth, respondents believed that an increasing number of physicians will not have the autonomy, because of changes in the health- care system, to offer free or reduced-fee services to NBCCEDP clients. Respondents reported that arrangements for treatment were made for almost all NBCCEDP clients who received a diagnosis of breast cancer or invasive cervical can- cer. Respondents stated that some women experienced time delays between screen- ing, definitive diagnosis, and initiation of treatment. State program officials reported that, according to 1992-1996 surveillance data, small numbers of clients in whom can- cer was diagnosed (i.e., from three to 13 women in each state) subsequently refused Vol. 47 / No. 11 MMWR 217 National Breast and Cervical Cancer Early Detection Program - Continued treatment. Because these clients were not interviewed, it could not be determined whether financial barriers contributed to their decisions to refuse treatment or their loss to follow-up. Respondents were concerned that the NBCCEDP did not provide funding for all diagnostic procedures and treatment for the diseases for which clients were being screened; approaches for delivering services were fragmented; and the process of ob- taining resources required substantial effort at the state, local, and provider levels. Respondents reported that the continuation of every strategy for diagnostic and treat- ment services beyond the next few years is uncertain. Reported by: PM Lantz, PhD, Univ of Michigan School of Public Health, Ann Arbor. LE Sever, PhD, Battelle, Centers for Public Health Research and Evaluation, Seattle, Washington. Program Svcs Br, Office of the Director, Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC. Editorial Note: During July 1991-March 1997, the NBCCEDP provided 576,408 mam- mograms to women aged ≥40 years, and 3409 cases of breast cancer were diagnosed. During this same period, the program provided 732,754 Pap tests; 23,782 cases of cer- vical intraepithelial neoplasia and 303 cases of invasive cervical cancer were diag- nosed. These totals included women referred to the program for diagnostic evaluation of an abnormal screening result. The NBCCEDP internal estimates suggested that dur- ing this period only 12%-15% of uninsured women aged 40-64 years in the United States had been screened by the program (CDC, unpublished data, 1997). Screening alone does not prevent cancer deaths; it must be coupled with timely and appropriate diagnostic and treatment services. The Congressional mandate for NBCCEDP requires grantees to take all appropriate measures to ensure provision of services required by women who have abnormal screening results. CDC provides funds for case management to help these women access health-care services. To in- crease the comprehensive nature of the program, CDC recently approved the use of NBCCEDP funds for breast biopsies. The results of this study indicate that state health departments and their partners in the seven states had developed a wide range of strategies for diagnostic and treat- ment services in the absence of program resources. However, the time and effort re- quired to arrange and maintain these services diverted resources away from screening activities. This study was subject to at least two limitations. First, the results were based solely on the experience and opinions of informed professionals affiliated with the program and did not include the perspectives of NBCCEDP clients. Second, the results may not reflect the program experiences in other states. Case-study methods, how- ever, are an appropriate and well-accepted approach to gaining in-depth under- standing of complex programs in real-life situations (4). The validity of the findings was enhanced by developing standard instruments to guide the semi-structured inter- views, protecting the confidentiality of respondents' remarks, using interview tran- scripts for data analysis rather than relying on interviewer notes, and obtaining feedback concerning state summary reports from respondents. As more women are screened by the NBCCEDP, a greater burden will be placed on participating health agencies, providers, and other partners to obtain resources for breast and cervical cancer treatment. Case-management services will continue to be essential in helping underserved women overcome financial, logistical, and other bar- 218 MMWR March 27, 1998 National Breast and Cervical Cancer Early Detection Program - Continued riers to receiving these services. Other long-term solutions to ensure that women in the program receive necessary treatment services are being pursued. References 1. Henson RM, Wyatt SW, Lee NC. The National Breast and Cervical Cancer Early Detection Pro- gram: a comprehensive public health response to major health issues for women. J Public Health Management and Practice 1996;2:36-47. 2. Lantz PM, Macklem DJ. Hare M, Richardson LC, Sever LE. Orians CE. Follow-up and treatment issues in the National Breast and Cervical Cancer Early Detection Program: results from a multiple-site case study-final report. Baltimore: Battelle, Centers for Public Health Research and Evaluation, 1997. 3. Miles MB, Huberman MA. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thou- sand Oaks, California: Sage, 1994. 4. Yin RK. Case study research: design and methods. Sage: Newbury Park, 1989. Notice to Readers World Health Day - April 7, 1998 "Invest in the Future: Support Safe Motherhood" is the theme in the United States for World Health Day, April 7, 1998. In the United States, this day will focus on the continued importance of maternal health and opportunities to improve this aspect of women's health. Although the risk for women dying from pregnancy has decreased substantially during the past 50 years, the maternal mortality ratio for the nation has not decreased since 1982 (1). Approximately 50% of pregnancy-related deaths remain preventable (2), and the extent of morbidity associated with pregnancy is often unrec- ognized. Safe motherhood begins before pregnancy with healthy lifestyles that include good nutrition, physical activity, preconception care, and avoidance of harmful sub- stances. Safe motherhood continues with planned pregnancies; early, quality prenatal care; knowledge of warning signs of problems; and the delivery of a healthy, full-term baby with the minimum of necessary interventions. Postpartum support for women and their families in a positive, nurturing environment also is important. In 1998, in the United States, women can plan, carry, and deliver a pregnancy more safely than in the past. However, additional efforts need to be taken to make safe motherhood a reality for all women. Improved public health surveillance, prevention research, and prevention programs are needed to continue improving the health of women before, during, and after pregnancy and delivery. Examples include new sur- veillance methods to monitor and understand pregnancy complications; prevention research on the essential content of prenatal care; and prevention programs to ensure the adequate intake of folic acid by women of reproductive age to prevent neural tube defects (3). The World Health Day Advisory Committee of the American Association for World Health coordinates World Health Day activities in the United States. Additional infor- mation about special events and resource materials about World Health Day 1998 are available from the American Association for World Health, 1825 K Street, N.W., Suite 1208, Washington, DC 20006; e-mail: [email protected]; or from the World-Wide Web site: http://www.aawhworldhealth.org. Mammography or Mammography Referral sliding scale 200% FPL 250% FPL other Florida Alabama Alaska Mississippi (150% FPL) Kentucky Arizona CNMI Nebraska (up to 250% FPL) (no information) Arkansas Delaware New Mexico (185% FPL) California D.C. Colorado Hawaii Connecticut indiana Georgia Maryland Idaho Massachusetts Illinois Michigan Iowa Minnesota Kansas New Jersey Louisiana New York Maine Oregon Missouri Pennsylvania Montana Rhode Island Nevada South Carolina New Hampshire Utah North Carolina North Dakota Ohio Oklahoma Repub. of Palau South Dakota Tennessee Texas Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Vol. 25 No. 29 THE CANCER July 23, 1999 LETTER INTERACTIVE Copyright 1999 The Cancer Letter Inc. All rights reserved. Price $275 Per Year PO Box 9905 Washington DC 20016 Telephone 202-362-1809 Hearing Probes CDC On Cancer Treatment For Working Poor In Screening Program In Congress: Welcome to Oncopolitical Theater. In this episode, the players gather House Subcommittee in a hearing room of Rayburn House Office Building to discuss a bill that Postpones FY2000 aims to correct a paradox in the U.S. health care system: Markup; Porter Seeks The Centers for Disease Control and Prevention pays for breast 8% Increase For NIH and cervical cancer screening of low-income women. However, if cancers are found, women who have no insurance and don't qualify for Medicaid Page 4 are not assured treatment. Legislation pending in the House and Senate seeks to give additional In The States: money to state-run Medicaid programs to cover the care for these women. Michigan To Allocate (Continued to page 2) $50 Million Annually To Life Sciences In Brief: Page 5 Pazdur To Direct FDA Oncology Division; Ganz Awarded ACS Clinical Professorship Regulatory Agencies: RICHARD PAZDUR has been appointed director of the FDA Health Warnings Division of Oncology Products, effective Sept. 26. Pazdur has been a Sought On Cigars faculty member at the University of Texas M.D. Anderson Cancer Center Page 5 for almost 12 years, most recently as professor of medicine in the Division of Medicine and director of the division's educational programs. Pazdur is board certified in internal medicine and oncology. He served for five NCI Programs: years as the Associate Director of the Clinical Trials Administration at Hughes Institute Official M.D. Anderson, has been principal investigator on numerous trials, and To Head Cancer Biology has been a consultant to FDA. Pazdur received a B.A. from Northwestern Page 6 University and an M.D. from Loyola Stritch School of Medicine. He trained in internal medicine at Loyola University. and in oncology at Rush Funding Opportunities: Presbyterian-St. Luke's Medical Center. with hematology/oncology training Career Development at University of Chicago Medical Center. Pazdur succeeds Robert Delap, Award In Leukemia who directed the oncology division from 1995 to 1998. Delap was promoted Page 7 to deputy director in the agency's Office of Drug Evaluation V last spring (The Cancer Letter, May 29, 1998). Robert Justice, deputy director of the division, has served as acting division director since Delap's Obituary: promotion. Julie Beitz, medical team leader, has served as acting deputy Ernst Wynder, 77, director. In the division director's position, Pazdur will report to Robert Linked Smoking, Cancer Temple, director of the Office of Drug Evaluation I, and Rachel Page 8 Behrman. deputy director of ODEI. PATRICIA GANZ, director of cancer prevention and control research at the Jonsson Cancer Center at University of California, Los Angeles, was awarded an American Cancer Society Clinical Research Professorship. Ganz conducts research on (Continued to page 8) Click Here for Photocopying Guidelines Waxman's Lament: "So, What Subcommittee on Health and Environment of the House Committee on Commerce. Are We Arguing About?" Do the women who initiated treatment (Continued from page 1) complete it? Is the treatment delayed while health "This is not a large bill," said Rep. Anna Eshoo officials scramble to provide care? Is the care (D-CA), a co-sponsor of the bill (H.R. 1070) at a appropriate? hearing July 21. "This is not a bill that's directed "We know that 92 percent have initiated toward curing breast and cervical cancer. It doesn't treatment; that's all we know," said Lee, responding make a gigantic promise to people across the country. to a question from Rep. Michael Bilirakis (R-FL), I do think that within that context, we need to develop chairman of the subcommittee and a supporter of the the political will to get this done." bill. "We don't know if it's a full course, [but] they Not so fast! The traditions of oncopolitics require have initiated treatment." that before anything gets done, all players engage in As Bilirakis persisted, Lee responded with a ferocious wrangling over turf and data. something of primer in elementary statistics and data The first step is to find a brave soul willing to collection: deny that the problem exists-or at least to obfuscate "We have information on every woman's its existence: diagnosis. Date of diagnosis. Date when treatment "The most current program data indicate that initiated. The median is eight days, and there are 92 percent of the women diagnosed with breast or women in our data set whose treatment was initiated cervical cancer have initiated treatment," said Nancy over a year later. They are what we call in statistics, Lee, director of the CDC Division of Cancer sort of, the end of the curve." Prevention and Control, testifying before the "The median-half of the women-receive their subcommittee. treatment initiation within eight days. That's what "The remaining 8 percent refused the treatment, 'median' means. But there are women who are very have not yet initiated it, or are lost to follow-up," she far out. There aren't many of them, or the median said. "For women diagnosed with breast cancer, data wouldn't be eight." show a median of eight days between the cancer BILIRAKIS: "Well, why are they far out?" diagnosis and initiation of the treatment." LEE: "For a whole variety of reasons, and we This seemingly neutral bureaucratic statement don't have the information in our data set as to why proved to be a gold mine for members of the they are far out I do have a plane to catch to San Diego." Member, Newsletter BILIRAKIS: "At what time?" THE CANCER Publishers Association LEE: "At three-something. And I have a LETTER World Wide Web http:// conference call before then." www.cancerietter.com BILIRAKIS: "We have to vacate this room Editor & Publisher: Kirsten Boyd Goldberg before two 'clock." Editor: Paul Goldberg LEE: "Well, everybody is going to eat lunch, too; right?" The time was just shy of 11 a.m., and Lee's Editorial: 202-362-1809 Fax: 202-362-1681 ordeal was to continue for nearly another hour. PO Box 9905, Washington DC 20016 The committee's lack of sympathy for CDC E-mail: [email protected] or [email protected] could be attributed to heavy lobbying by the National Customer Service: 800-513-7042 Breast Cancer Coalition, a Washington-based patient PO Box 40724, Nashville TN 37204-0724 advocacy group that made the CDC bill its top legislative priority. In the Senate, the bill is estimated Subscription $275 per year worldwide. ISSN 0096-3917. Published to cost about $315 million over five years. The 48 times a year by The Cancer Letter Inc. Other than "fair use" as specified by U.S. copyright law, none of the content of this measure has not been scored in the House. publication may be reproduced, stored in a retrieval system. or This is the coalition's third attempt in as many transmitted in any form (electronic, mechanical, photocopying. years to push through the legislation. The measure facsimile, or otherwise) without prior written permission of the publisher. Violators risk criminal penalties and $100,000 damages. has 263 co-sponsors in the House and 41 in the Founded Dec. 21, 1973 by Jerry D. Boyd Senate. On the Health and the Environment The Cancer Letter Click Here for Page 2 July 23, 1999 Photocopying Guidelines Subcommittee, the bill has the support of 25 of the 30 Proponents VS. The "Undecided" members. The debates at the hearing were marked by a Facing a barrage of questions from the panel, striking absence of opponents of the measure. Lee acknowledged that the necessity to line up care Instead, proponents of the measure crossed swords stresses the screening program. with the undecided. The program screens only 12 to 15 percent of The latter camp includes the Administration and the eligible population, which means that about 11 the Susan G. Komen Breast Cancer Foundation. million women don't take advantage of breast and "The only information I have from the cervical screening, Lee said. Administration is what the CDC testified to this "Although states are currently meeting their morning," NBCC president Fran Visco said at the commitment to help women access treatment, hearing. Visco said the coalition is seeking White programs have told us of concerns regarding their House endorsement of the measure. "We have had ability to expand screening services to more women, discussions with them, but we don't have an answer," because the systems for obtaining care and treatment she said. "If the Administration refuses to endorse are becoming overburdened," Lee said at the hearing. this bill, NBCC will take it to task. They will hear "As long as the numbers of cancers diagnosed from members of NBCC." through the program remain at their current level, the The position described by the Komen burden should not be too great." she said. "However, Foundation required textual analysis. increased screening, which is our goal, is accompanied "Contrary to some accounts we have heard, the by increased numbers of cancers diagnosed, and Komen Foundation is not opposed to this legislation," many physicians who contract with programs are Susan Braun, president and CEO of the Dallas-based concerned about bringing more uninsured patients into group, said in her written testimony. "We are their care." concerned, however, that any treatment initiative This statement, too, proved to be a gold mine provides a comprehensive and effective solution and for the panel: reaches those most in need of assistance." "The fact of the matter is that only 15 percent This claim of neutrality notwithstanding, Rep. of eligible women are getting screened," said Rep. Rick Lazio (R-NY), the original sponsor of the bill, Henry Waxman (D-CA), a supporter of the bill. said his reading of Braun's testimony points to "Maybe it's because they don't have assurance that opposition to the measure. they would have treatment available; and maybe it's "I am, quite frankly, disappointed in the because a lot of resources that could be used for testimony of the Komen Foundation," Lazio said. "At screening have been diverted to try to [find] care. my request, my staff reached out to them months Are those factors important?" ago to discuss this legislation and any concerns they LEE: "I think the main factor is the level of our may have about the bill. Despite this invitation, they current resources [$158 million during the current did not bring any concerns to me or my staff, until fiscal year] that we have to give out to states don't yesterday, when I read their testimony. Please, don't allow more women to get screened." get me wrong, I am a strong supporter of the Race WAXMAN: "What percentage of the money for the Cure, and enjoy working closely with Priscilla has to be used to seek out treatment?" and Sen. [Connie] Mack [(R-FL)]. But I wanted to LEE: "We have never quantified that. I can tell register my disappointment over the lack of Komen you that additional funds we have allocated for case Foundation's response to my request months ago." management will augment some case management Eshoo, too, said she was having difficulty funds that are there." interpreting Braun's testimony. "I have a difficult time WAXMAN: "[Finding] treatment services connecting the dots," she said at the hearing. diverts resources from the program." Indeed, a reading of the Komen testimony LEE: "That's true. We have not quantified what submitted for the record is more consistent with proportion; how much that is, though." opposition than no position on the part of the WAXMAN: "And the lack of treatment services foundation: negatively affects the recruitment." -Komen advocates framing the problem LEE: "True." beyond the boundaries of the CDC screening WAXMAN: "So what are we arguing about?" program. "Insured women who have lost their Click Here for The Cancer Letter Photocopying Guidelines Vol. 25 No. 29 Page 3 coverage or have reached a lifetime maximum, hearing. "I know one woman who was diagnosed; particularly those being treated for a recurrence of she passed away the very next day after she found their breast cancer can be in need," Braun said in out she qualified for treatment. I know women who her submitted remarks. have used a balloon with water as a prosthesis. -"Need" can be defined as a need for bone "I know that I loaned many women some of my marrow transplantation and other experimental medication. It costs hundreds of dollars, and they procedures. "Women with healthcare coverage, but couldn't afford to buy it. So we share." with a policy that excludes some forms of treatment Physicians, too, have stories to contribute. may also be in need," Braun said. "The patients who come through the [CDC -Braun said that a study by Komen concurs program] are six months to a year out when they with the findings by CDC that "treatment was initiated come to see me," Stanley Klausner, a Long Island for the vast majority of women" diagnosed through breast cancer surgeon, said at the hearing. the program. "While imperfect and needing further "Sometimes the referral slip is yellow." resources, the system has been providing treatment for most women who need and want it," Braun said. -Braun's testimony points to a preference for Subcommittee Postpones a private sector solution to the problem. "Eight states Markup Of HHS Funding Bill have legislated breast cancer treatment funds, and The House Appropriations Subcommittee on local programs also exist," Braun said. "Pro-bono care Labor, HHS, Education and Related Agencies earlier is provided in many communities. In the case of this week postponed work on a fiscal year 2000 failure of these funding options, federal assistance funding bill that would have included NIH may be required." appropriations. -Medicaid may be an inappropriate program The markup of the appropriations bill was to for addressing the problem, Braun said, citing have taken place July 21. There was no indication variability in state Medicaid benefits. "Medicaid when legislators planned to take up the bill. participation is optional in the proposed bill," she said. Subcommittee Chairman John Porter (R-IL) has "States with limited funds in their Medicaid programs said that drafting a bill would be pointless because may be reluctant to cover care for people who would the budget allocation for the subcommittee is $11 otherwise be ineligible." billion below last year's appropriation (The Cancer Unlike Braun, NBCC's Visco said the problem Letter, July 9). can be framed narrowly and solved through Medicaid. Dave Kohn, a spokesman for Porter, said the "We are not asking you to put every woman subcommittee was planning to draft a bill that would who doesn't have insurance on Medicaid," Visco said have funded the departments at the same level as at the hearing. "We are asking you to enact legislation the current fiscal year by obtaining offsets for that completes an existing program. We are asking spending. Thus, the bill would not have exceeded the that women diagnosed through the CDC program be caps put in place by the Balanced Budget Act. "The made Medicaid-eligible at the same rate that they offsets have not materialized," Kohn said to The have to be eligible to get into the program. If they Cancer Letter. "We are in a hold pattern waiting to are eligible for screening. they should be eligible for see if the offsets can be obtained, and if not, funding Medicaid treatment." decisions would be made in the fall." If the screening bill is signed into law, NBCC The appropriation for NIH would have been will have to mobilize its grassroots constituencies to about an 8 percent increase over the Institutes' force state legislatures to take part in the Medicaid current budget, or about $16.9 billion, Kohn said. "Mr. program. While CDC admits to having no data beyond Porter still intends to shepherd through an increase "initiation" of treatment, NBCC has put together a for NIH that would be somewhere in the 8 to 9 percent horrifying armamentarium of anecdotal evidence. range," he said. "He has been clear in saying it would These include the testimony of Carolyn Tapp. be absolutely unacceptable to go backwards. We need president of Women of Color, a Los Angeles-based to increase resources for this type of research. He's support group of about 120 women. going to keep fighting for it." "Some of the women I know took six months to No action has been taken on NIH appropriations actually start their treatment," Tapp said at the in the Senate. The Cancer Letter Click Here for Page 4 July 23, 1999 Photocopying Guidelines THE BREAST AND CERVICAL CANCER TREATMENT ACT The NBCCEDP In 1990. Congress enacted the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) into law (P.L. 101-354), enabling states to provide breast and cervical cancer screening services to women with no other source of payment for such services. The program is administered by the Centers for Disease Control and Prevention (CDC), and works in partnership with state and local health agencies and other community partners to provide education, outreach. screening services, and follow-up care. NBCCEDP serves older women. women with low income, uninsured or underinsured women, and women of racial/ethnic minority groups who qualify. Congress appropriated $159 million for FY 1999 for the NBCCEDP. The program is now in all 50 states, the District of Columbia and 13 American Indian/Alaska Native organizations: however not all state programs are fully functioning. The Success of the Screening Program Since the NBCCEDP's inception through March 1998 it has: Provided mammography screening to 794,445 women aged 40 years and older: Found 56,119 (7%) abnormal mammograms; Diagnosed 4,137 cases of breast cancer: and Of those diagnosed with breast cancer, 3,350 were under 65 years of age - and ineligible for Medicare coverage. Current Approaches to Providing Treatment As enacted by Congress, the NBCCEDP provides funding only for screening services. Recently CDC agreed to cover diagnostic services- services necessary to determine whether or not a woman has breast cancer. However, there is still no federal funding to provide treatment services to the 3,350 women under age 65, who have been screened and diagnosed with breast cancer. The current system for treatment is an ad hoc patchwork of providers, volunteers, and local programs scrambling to find treatment dollars. Although health agencies at the state and local levels and breast cancer advocates have found creative ways to help women find treatment, these networks are overloaded and increasingly unreliable. Women are forced to rely on charity care, donated services, and bake sales to pay for their treatment. The lack of financial support for treatment is hurting the NBCCEDP. Time and effort required to arrange for treatment services have begun to divert resources away from screening activities. As a result fewer women are being screened-the program serves only 12% to 15% of age-eligible. uninsured women nationally. A Long-term Solution: Covering Treatment Costs Through the Medicaid Program The National Breast Cancer Coalition (NBCC) believes that women should not have to hold bake sales to fund breast cancer treatment. NBCC believes it is irresponsible to enact a federal program that promises to reduce the number of deaths from breast and cervical cancer and not guarantee federal funding for treatment services to women who have been screened and found to have breast or cervical cancer. Medicaid is the answer. Congress should allow states the option of providing women diagnosed with breast or cervical cancer through the NBCCEDP, Medicaid coverage for their disease. There is a precedent for covering participants in the NBCCEDP under Medicaid. In 1993. Congress created the Tuberculous Optional Benefit Program, making individuals who are infected with tuberculosis eligible for Medicaid. Summary of the Breast and Cervical Cancer Treatment Act The bill would establish an optional State Medicaid benefit for coverage of certain women who are screened and diagnosed with breast or cervical cancer under Title XV of the Public Health Services Act's NBCCEDP. To be eligible, women would have to satisfy the income and resource eligibility requirements established under NBCCEDP; be under the age of 65; have been diagnosed with breast or cervical cancer under the Title XV Program: and not otherwise have health insurance coverage. Women who qualify for NBCCEDP would be allowed presumptive eligibility for Medicaid coverage for the duration of the treatment of their breast and cervical cancer. States electing to provide breast and cervical cancer treatment as an optional benefit would receive an enhanced match to encourage participation in establishing this benefit. National Breast Cancer Coalition March 18. 1999 The Breast and Cervical Cancer Treatment Act H.R. 1070 Bill Summary The bill would establish an optional State Medicaid benefit for coverage of certain women who were screened and diagnosed with breast or cervical cancer under title XV of the Public Health Services Act's National Breast and Cervical Cancer Early Detection Program (NBCCEDP). To be eligible, women would have to satisfy the income and resource eligibility requirements established under NBCCEDP; be under the age of 65; have been diagnosed with breast or cervical cancer under the title XV Program; and not otherwise have health insurance coverage. Women who qualify for NBCCEDP would be allowed presumptive eligibility for Medicaid coverage for the duration of the treatment of their breast and cervical cancer. States who elect to provide breast and cervical cancer treatment as an optional benefit would receive an enhanced match to encourage participation in establishing this benefit. Page 1 of 5 HR 1070 IH 106th CONGRESS 1st Session H. R. 1070 To amend title XIX of the Social Security Act to provide medical assistance for certain women screened and found to have breast or cervical cancer under a federally funded screening program. IN THE HOUSE OF REPRESENTATIVES March 11, 1999 Mr. LAZIO (for himself, Ms. ESHOO, Ms. ROS-LEHTINEN, Mrs. CAPPS, Mrs. MORELLA, Mrs. KELLY, Mr. BROWN of Ohio, Mr. GEORGE MILLER of California, Mr. HORN, Mr. DIXON, Ms. PELOSI, Mr. LATOURETTE, Mr. WAXMAN, Mr. SERRANO, Mr. GILMAN, Mr. MALONEY of Connecticut, Mr. MEEHAN, Mr. WELDON of Pennsylvania, Mr. UNDERWOOD, Mr. SHOWS, Mr. ABERCROMBIE, Mr. MCHUGH, Mr. ETHERIDGE, Mr. SANDERS, Mrs. CLAYTON, Mr. WALSH, Mr. MCGOVERN, Mr. MCNULTY, Mr. FROST, Mr. NEY, Mr. OLVER, Ms. MILLENDER-MCDONALD, Mr. CROWLEY, Mr. SUNUNU, Mr. CLEMENT, Mr. STARK, Ms. CARSON, Mr. FOLEY, Mr. COYNE, Mr. LANTOS, Mr. INSLEE, Mrs. WILSON, Mr. SHERMAN, Mr. BALDACCI, Mr. BOEHLERT, Mr. LUTHER, Mr. HINOJOSA, Mr. DEFAZIO, Mr. QUINN, Mr. PRICE of North Carolina, Mr. RANGEL, Mr. WEYGAND, Mr. FORBES, Mr. MEEKS of New York, Mr. NADLER, Mr. BARRETT of Wisconsin, Ms. WOOLSEY, Mr. KUCINICH, Mr. KING, Ms. SLAUGHTER, Mrs. TAUSCHER, Mr. BILBRAY, Mr. THOMPSON of Mississippi, Mr. HINCHEY, Mr. KLECZKA, Mr. PAYNE, Mr. WYNN, Mr. JEFFERSON, Mr. SMITH of New Jersey, Mr. MASCARA, Mr. LOBIONDO, Mr. OBERSTAR, Mr. LEACH, Mr. RUSH, Mr. MATSUI, Mr. DINGELL, Mrs. EMERSON, Mr. FILNER, Mrs. MYRICK, and Ms. LOFGREN) introduced the following bill; which was referred to the Committee on Commerce A BILL To amend title XIX of the Social Security Act to provide medical assistance for certain women screened and found to have breast or cervical cancer under a federally funded screening program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. OPTIONAL MEDICAID COVERAGE OF CERTAIN BREAST OR CERVICAL CANCER PATIENTS. (a) COVERAGE AS OPTIONAL CATEGORICALLY NEEDY GROUP- http://thomas.loc.gov/cgi-bin/query/C?c106./temp/-c106UfCXeA 6/10/99 Page 2 of 5 (1) IN GENERAL- Section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended-- (A) in subclause (XIII), by striking `or' at the end; (B) in subclause (XIV), by adding `or' at the end; and (C) by adding at the end the following: `(XV) who are described in subsection (aa) (relating to certain breast or cervical cancer patients);'. (2) GROUP DESCRIBED- Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended by adding at the end the following: `(aa) Individuals described in this paragraph are individuals who-- `(1) are not described in subsection (a)(10)(A)(i); `(2) have not attained age 65; `(3) have been screened for breast and cervical cancer under the Centers for Disease Control and Prevention breast and cervical cancer early detection program established under title XV of the Public Health Service Act (42 U.S.C. 300k et seq.) in accordance with the requirements of section 1504 of that Act (42 U.S.C. 300n) and need treatment for breast or cervical cancer; and '(4) are not otherwise covered under creditable coverage, as defined in section 2701(c) of the Public Health Service Act (45 U.S.C. 300gg(c)).'. (3) LIMITATION ON BENEFITS- Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the matter following subparagraph (F)-- (A) by striking `and (XIII)' and inserting `(XIII)'; and (B) by inserting and (XIV) the medical assistance made available to an individual described in subsection (aa) who is eligible for medical assistance only because of subparagraph (A)(10)(ii)(XV) shall be limited to medical assistance provided during the period in which such an individual requires treatment for breast or cervical cancer' before the semicolon. (4) CONFORMING AMENDMENTS- Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended in the matter preceding paragraph (1)-- (A) in clause (x), by striking `or' at the end; (B) in clause (xi), by adding `or' at the end; and http://thomas.loc.gov/cgi-bin/query/C?c106:./temp/-c106UfCXe/ 6/10/99 Page 3 of 5 (C) by inserting after clause (xi) the following: `(xii) individuals described in section 1902(aa),'. (b) PRESUMPTIVE ELIGIBILITY- (1) IN GENERAL- Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by inserting after section 1920A the following: `PRESUMPTIVE ELIGIBILITY FOR CERTAIN BREAST OR CERVICAL CANCER PATIENTS `SEC. 1920B. (a) STATE OPTION- A State plan approved under section 1902 may provide for making medical assistance available to an individual described in section 1902(aa) (relating to certain breast or cervical cancer patients) during a presumptive eligibility period. `(b) DEFINITIONS- For purposes of this section: `(1) PRESUMPTIVE ELIGIBILITY PERIOD- The term presumptive eligibility period' means, with respect to an individual described in subsection (a), the period that-- `(A) begins with the date on which a qualified entity determines, on the basis of preliminary information, that the individual is described in section 1902(aa); and `(B) ends with (and includes) the earlier of-- `(i) the day on which a determination is made with respect to the eligibility of such individual for services under the State plan; or `(ii) in the case of such an individual who does not file an application by the last day of the month following the month during which the entity makes the determination referred to in subparagraph (A), such last day. `(2) QUALIFIED ENTITY- `(A) IN GENERAL- Subject to subparagraph (B), the term `qualified entity' means any entity that-- `(i) is eligible for payments under a State plan approved under this title; and `(ii) is determined by the State agency to be capable of making determinations of the type described in paragraph (1)(A). `(B) REGULATIONS- The Secretary may issue regulations further limiting those entities that may become qualified entities in order to prevent fraud and abuse and for other reasons. http://thomas.loc.gov/cgi-bin/query/C?c106:./temp/-c106UfCXeA 6/10/99 Page 4 of 5 `(C) RULE OF CONSTRUCTION- Nothing in this paragraph shall be construed as preventing a State from limiting the classes of entities that may become qualified entities, consistent with any limitations imposed under subparagraph (B). `(c) ADMINISTRATION- `(1) IN GENERAL- The State agency shall provide qualified entities with-- `(A) such forms as are necessary for an application to be made by an individual described in subsection (a) for medical assistance under the State plan; and `(B) information on how to assist such individuals in completing and filing such forms. (2) NOTIFICATION REQUIREMENTS- A qualified entity that determines under subsection (b)(1)(A) that an individual described in subsection (a) is presumptively eligible for medical assistance under a State plan shall-- `(A) notify the State agency of the determination within 5 working days after the date on which determination is made; and `(B) inform such individual at the time the determination is made that an application for medical assistance under the State plan is required to be made by not later than the last day of the month following the month during which the determination is made. `(3) APPLICATION FOR MEDICAL ASSISTANCE- In the case of an individual described in subsection (a) who is determined by a qualified entity to be presumptively eligible for medical assistance under a State plan, the individual shall apply for medical assistance under such plan by not later than the last day of the month following the month during which the determination is made. `(d) PAYMENT- Notwithstanding any other provision of this title, medical assistance that-- `(1) is furnished to an individual described in subsection (a)-- `(A) during a presumptive eligibility period; `(B) by a entity that is eligible for payments under the State plan; and `(2) is included in the care and services covered by the State plan; shall be treated as medical assistance provided by such plan for purposes of section 1903(a)(5) (B).'. (2) CONFORMING AMENDMENTS- (A) Section 1902(a)(47) of the Social Security Act (42 U.S.C. 1396a(a)(47)) is http://thomas.loc.gov/cgi-bin/query/C?c106:./temp/-c106UfCXeA 6/10/99 Page 5 of 5 amended by inserting before the semicolon at the end the following: `and provide for making medical assistance available to individuals described in subsection (a) of section 1920B during a presumptive eligibility period in accordance with such section'. (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 1396b(u)(1)(D)(v)) is amended-- (i) by striking `or for' and inserting for'; and (ii) by inserting before the period the following: or for medical assistance provided to an individual described in subsection (a) of section 1920B during a presumptive eligibility period under such section'. (c) ENHANCED MATCH- Section 1903(a)(5) of the Social Security Act (42 U.S.C. 1396b(a) (5)) is amended-- (1) by striking `an' and inserting `(A) an'; (2) by adding `plus' after the semicolon; and (3) by adding at the end the following: `(B) an amount equal to 75 percent of the sums expended during such quarter which are attributable to the offering, arranging, and furnishing (directly or on a contract basis) of breast or cervical cancer-related treatment services; plus'. (d) EFFECTIVE DATE- The amendments made by this section apply to medical assistance furnished on or after October 1, 1999, without regard to whether final regulations to carry out such amendments have been promulgated by such date. END http://thomas.loc.gov/cgi-bin/query/C?c106./temp/-c106UfCXeA 6/10/99 The Breast and Cervical Cancer Treatment Act of 1999 S. 662/H.R. 1070 Endorsing Organizations National Breast Cancer Coalition American Cancer Society National Association of Public Hospitals & Health Systems National Partnership for Women & Families YWCA National Women's Health Network Oncology Nursing Society Y-ME Arm in Arm Association of Women's Health, Obstetric, and Neonatal Nurses Rhode Island Breast Cancer Coalition Florida Breast Cancer Coalition The Breast Cancer Coalition of Utah Maine Breast Cancer Coalition American Medical Women's Association American Public Health Association California Breast Cancer Organizations Linda Creed Breast Cancer Foundation Wisconsin Breast Cancer Coalition Cancer Research Foundation of America American Society for Therapeutic Radiology and Oncology National Women's Law Center TABLE 1 National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Initiation of Treatment for Wamen Diagnosed with In Situ or Invasive Breast Cancer Minimum Data Elements' through March 31, 1997 11:46am Total Number of Total Number of Number of Number of Breas NBCCEDP Breast Cancers Breast Cancers Median Days Cancers with Funded Diagnosed with Complete from Diagnosis to Percent Initiated Pending/Missing Program Name Mammograms (InSitu/Invasive) Information Treatment Initiation Treatment (N=)³ Information⁴ TOTAL for NBCCEDP 594,436 4409 4242 10 95.8 (4064) 167 (35 Programs Combined)3 From-CANCER SURVEILLANCE BRANCH I The Minimum Data Elements (MDEs) are electronically submitted semi-annually (January 15 and July 15) to a data management contractor, who analyzes the data and submits a data file to the CDC. For example, the data used for this report were submitted on January 15, 1998 and included screening exams through September 30, 1997. The next data will be submitted on July 15, 1998 and will include screening exams through March 31, 1998. The interval of three and one-half months provides states time to prepare the data submission and gather information that may be missing. Routinely an additional six month interval is provided for completion of diagnostic follow-up and treatment information. 2 The total number of breast cancers diagnosed include some women referred to the NBCCEDP for diagnostic evaluation of a non-NBCCEDP funded screening exam. 3 Women who did not initiate treatment either refused treatment, were lost to follow-up, or died. 4 Breast cancer cases have pending or missing information on one or more of the following variables: date of diagnosis; date of treatment initiation; or status of treatment initiation. T-425 P.02/13 F-585 5 Programs include AK, AZ, AR, CA, CO, CT, FL, GA, IL, 1A, KS, LA, ME, MD, MA, MI, MN, MO, NE, NJ, NM, NY, NC, OH, OK, OR, PA, RI, SC, TX, UT, VT, WA, WV, WI 5/5/98 TABLE 2 National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Initiation of Treatment for Women Diagnosed with In Situ or Invasive Breast Cancer Minimum Data Elements through March 31, 1997 Program with ≥ 40 Cases of Breast Cancer :46am Total Number of Total Number of Number of Breast Number of Breast NBCCEDP Breast Cancers Cancers with Median Days Percent Cancers with Program Funded Diagnosed Complete from Diagnosis to Initiated Pending/Missing Name Mammograms (InSitu/Invasive) Information Treatment Initiation Treatment (N=) Information AR 5,652 54 52 10 96.1 (50) 2 From-CANCER SURVEILLANCE SURVE BRANCH CA 50,767 489 478 11 93.1 (445) 11 CO 20,485 119 117 13 99.1 (116) 2 MD 35,788 314 305 11 96.7 (295) 9 MA 14,038 207 182 13 97.3 (177) 25 MI 58,473 435 424 0 94.3 (400) 11 MN 26,375 217 215 8 97.7 (210) 2 +7704884759 MO 24,041 143 140 8 96.4 (135) 3 NE 2,950 79 78 8 91.0 (71) 1 NM 47,613 244 244 18.5 95.9 (234) 0 NY 59,573 397 397 25 94.2 (374) 0 NC 42,191 274 269 11 94.0 (253) 5 OH 10,254 121 121 8 95.9 (116) 0 T-425 P.03/13 F-585 PA 5,593 48 43 13 100 (43) 5 5/5/98 TABLE 2 (continued) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Mar-05-98 Initiation of Treatment for Women Diagnosed with In Situ or Invasive Breast Cancer Minimum Data Elements through March 31, 1997 Program with ≥ 40 Cases of Breast Cancer 11:46am Total Number of Total Number of Number of Breast Number of Breast NBCCEDP Breast Cancers Cancers with Median Days Percent Cancers with Program Funded Diagnosed Complete from Diagnosis to Initiated Pending/Missing Name Mammograms (InSitu/Invasive) Information Treatment Initiation Treatment (N=) Information SC 30,192 227 206 10 98.5 (203) 21 TX 71,662 526 514 4.5 97.9 (503) 12 From-CANCER SURVEILLANCE BRANCH UT 5,918 43 41 0 100 (41) 2 WA 12,812 71 61 8 90.2 (55) 10 WV 32,063 214 198 7 99.5 (197) 16 WI 10,860 40 36 10.5 97.2 (35) 4 +7704884759 T-425 P.04/13 F-585 5/5/98 TABLE 3 National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Initiation of Treatment for Women Diagnosed with In Situ or Invasive Breast Cancer Minimum Date Elements through March 31, 1997 May-05-99 11:46am Program with < 40 Cases of Breast Cancer Program Total Number of NBCCEDP Total Number of Breast Cancers Name Funded Mammograms Diagnosed (InSitu/Invasive) AK 989 8 AZ 1,495 13 CT 1,302 8 From-CANCER SURVEILLANCE BRANCH FL 1,535 14 GA 6,234 31 IL 1,102 6 IA 416 5 KS 785 7 LA 174 1 ME 872 3 +7704884759 IN 2,549 11 OK 1,328 15 OR 1,115 11 RI 1,269 7 VT 979 7 NOTE: Median days from diagnosis to treatment initiation and the proportion who have initiated treatment are not calculated because the total T-425 P.05/13 F-585 number of breast cancer cases are too small to produce statistically reliable information. However, those breast cancer cases are included in the overall NBCCEDP measures reported in Table 1. These states are still in the start-up stage and have been screening for approximately two years as of March 31, 1997. 5/5/98 May-05-99 11:47am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.06/13 F-585 Article Strategies for Follow-Up and Treatment Services in State Breast and Cervical Cancer Screening Programs Paula M. Lantz, PhD Lisa C. Richardson, MD, MPH Debra J. Macklem, MEd Lisa R. Shugarman, BA University of Michigan School or Public Health Arm Arbor. Michigan Donna B. Knutson, MSEd, CHES Canters for Disease Control and Prevennon, Division of Cancer Prevention and Control Atlanta Ceorgia Lowell E. Sever, PhD Barrette Centers for Public Health Research and Evaluation Searcle, Washington This report describes strategies used to provide diagnostic follow-up and treatment services to low-income women screened through the National Breast and Cervical Cancer Early Detection Program. he Breast and Cervical Cancer Mortality Prevention Act, enacted by 11 the U.S. Congress in August 1990 (Public Law 101-354) authorized funds for a national screening program for breast and cervical cancer for medically underserved women.¹ This program-the National Breast and Cervical Cancer Early Detection Program or NBCCEDP-is admin- istered by the Centers for Disease Control and Prevention (CDC). The goal of this large public health initiative is to reduce the morbidity and mortality associated with breast and cervical cancer in the United States. The NBCCEDP is implemented through cooperative agreements with qualifying health agencies that provide free or low-cost screening to uninsured or underinsured low-income women, develop and disseminate public and professional education strategies. establish qualiry assurance systems, engage in surveillance and evaluation activities, and develop coalitions and partner- ships.² To date, the health departments of all 50 states, the District of Columbia, 4 U.S. territories, and 15 American Indian and Alaska Native ribes or tribal © 1999 by the Jacobs Institute organizations have received support for comprehensive Breast and Cervical of Women's Health Pubtished by Hiservier Science inc Cancer Early Detection Programs (BCCEDPs). The age and income eligibility 1049-3867/99/$20.00 requirements for screening services vary across the programs, but all programs PII S1049-3867(98)00027-9 42 WOMENS HEALTH ISSUES VCL 9. NO. 1 JANUARY/FEBRUARY 1999 May-05-99 11:47am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.07/13 F-585 target high-priority groups, for example, older women, women in racial and ethnic minority groups, women with disabilities, lesbians, and women who live in rural or other hard-to-reach areas. Through September 1997, more than 1.5 million free mammograms and Papanicolaou smear tests were provided through the NBCCEDP.³ The pro- gram also covers a number of follow-up diagnostic procedures, including diagnostic mammography, breast ultrasound, surgical consultation, fine nee- dle aspiration of the breast, and colposcopy Because or limited resources, however, program funds have not been available to cover all of the diagnostic tests that women may need for follow-up of abnormal screening results and to reach a defininve diagnosis (including excisional breast biopsy. stereotactic localizanon for breast biopsy, or needle core breast biopsy). In addinon, the federal legislation prohibits the use or national program funds to pay for treatment services for women diagnosed with cervical intraepithelial neoplasia (CIN) or for any component of treatment for breast or cervical cancer, including surgery, radiotherapy, chemotherapy, normonal therapy. and breast Through September Despire these restrictions in funding diagnostic and treatment services are 1997, more than 1.5 recognized as essential components of this screening iniriative Federal legis- million free lation requires that participating programs ensure that women with abnormal screening results receive definitive diagnoses and that they have access to mammograms and timely and appropriate treatment services for CIN or cancer if needed, Papanicolaou smear regardless of their ability to pay. Participating health agencies are expected tests were provided to build collaborations and partnerships with hospitals and community-based organizations to obtain access to and resources for diagnostic. treatment, and through the NBCCEDP. support services.² Anecdoral information reported to CDC suggests that participating agen- cies are indeed finding innovative and interesting ways to secure diagnostic follow-up and treatment services for women in need², however, this aspect of the NBCCEDP has not been assessed in depth or systemancally. Thus, we underrook a three-part study TO document and investigare the strategies and approaches that state BCCEDP, have implemented to secure diagnosne follow-up and cancer treatment services for chents in the absence of federal dollars for these activities: 1) a descriptive study of the general strategies and activities regarding diagnostic and treatment services in 35 BCCEDPs; 2) an in-depth case study of 7 of the 35 state programs5; and 3) documentation of cancer treatment services received and the timing of these services by linking information from 3 state BCCEDPs with dara from population-based tumor registries. In this report, we present the results from the first study component METHODS All 35 state BCCEDPs that received federal funding for a comprehensive screening program before October 1, 1996 (and thus had significant experience dealing with clients in need of diagnostic follow-up and treatment services) were selected for study.² Data were collected with the assistance of 18 CDC program consultants, who are Adanta-based staff who provide rechnical assistance to and serve as federal haisons with the state programs. A standard- ized data collection form that consultants could self-adminisrer as part of their general dunes was designed and pilot tested. The form was used to document state-specific information on the organizational structure of the screening program, mechanisms for notifying women of results, and strategies for securing diagnostic and treatment services for clients in need. Written instruc- tiens for completing the form and 3 3-hour training session were provided. Consultants completed a form for each of their assigned states in the sample LANTZ ET AL STRATECIES IN CANCER SCREENING PROGRAMS 4' May-05-99 11:47am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.08/13 F-585 (ranging from 1 TO 3 states per consultant), using their knowledge of the State program and available materials and documents. They also discussed specific issues in their routine technical assistance calls with states if clarification from the state program was needed. Completed forms (N = 35; 100% response rate) were forwarded to University of Michigan research staff along with any relevant written documents. RESULTS One way in which ail state programs work to ensure that needed follow-up diagnostic tests and treatment services are received is bv tracking chenrs using program surveillance dara. State programs have designed and implemented a variety of management information systems to track women through the processes of screening, diagnostic fullow-up, and treatment initiation. In addinon, at the time of our data collection, most states had written guidelines or protocols for screening providers for notifying women of screening results States are required to and for tracking women needing diagnostic services after an abnormal report to CDC the date screening result (Table 1). In addition, 89% of states had written guidelines for that cancer treatment ensuring that women receive defininve diagnosne follow-up sen ices, and 77% had written guidelines for ensuring that women ininate treatment for breast or was initiated for cervical cancer or CIN. Similarly, most states had written guidelines or defined breast or cervical cancer. protocois for providers regarding appropriate clinical pathways for diagnostic follow-up (S6% for breast diagnostics and 83% for cervical diagnosnes), whereas fewer states had developed protocols for appropriate treatment pathways (69% for breast cancer, 66% for cervical cancer, and 60°. for CIN). States are required TO report to CDC the dare that cancer treatment was ininared for women diagnosed with breast or cervical cancer Even those states without written guidelines or protocols regarding how women should get from an abnormal screening result to treatment have implemented surveillance systems that include the treatment initiation date. Some state programs document additional information about treatment For example. our results suggest that 21 state programs (60%) were routinely documenting each client's mitial course of cancer treatment, and of these programs, S (23%) were documenting the content of treatment beyond the initial course Five state programs (14%) were documenting how each client's cancer treatment was funded, although none were collecting information on out-of-pocket expenses for diagnostic or treatment services. State-level resources used to fund or TO provide diagnosne and treatment services 9 women in the absence of federal program dollars for these acnviries are listed in Table 2 The more common strategies were appeals through the state medical society for physicians to volunteer or donate procedures and referral of clients to designated providers (such as state-funded cancer centers, teaching hospitals. and public hospitals). Several states receive funding for diagnostic and treatment services from their legislatures. This funding comes from state appropriations provided through general public revenue or tobacco excise tax revenue In some of these states, funds are provided exclusively for women screened through the BCCEDP, in other states, the funds are available to all citizens who meet state-established eligibility criteria for services. In some states. the funds are restricted to paying for breast cancer services (primarily for diagnostic rests). A wide range of strategies and activities organized at the local level (ie, county, city or individual clirucal facility) were being used to provide diag- nosnc and treatment services to women in the absence of program dollars for these activities (Table 3). The most common strategies used at the local level include referrals to designated providers who have agreed to serve program 14 WOMEN'S HEALTH ISSUES VCL 9. NO I JANUARY/FEBREARY 1999 May-05-99 11:48 From-CANCER SURVEILLANCE BRANCH +770 759 T-425 P.09/13 T Table 1. PREVALENCE OF WRITTEN GUIDELINES FOR NOTIFICATION, TRACKING. AND SERVICE DELIVERY IN STATE BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAMS (N = 35) Does the State Program Have Written Guidelines for Yes No Notifying women of screening results? Breast carcer screening results 32 (91%) 3 (9%) Cervical cancer screening results 32 (91%) 3 (9%) Breast cancer diagnostic test results 31 (89%) 4 (11%) Cervical cancer diagnostic test results SI (89%) 4 (11%) Tracking women needing follow-up services? Breast cancer diagnostic services 35 (100%) 0 Cervical cancer diagnosne services 34 (97%) 1 (3%) Breast cancer treatment services 32 (91%) 3 (9%) Cervical neoplasia treatment services 32 (91%) 3 (9%) Cervical cancer treatment services 32 (91%) 3 (9%) Ensuring women receive needed diagnostic services? Breast cancer diagnostic services 31 (89%) 4 (11%) Cervical cancer diagnostic services 31 (89%) 4 (11%) Ensuring women initiate needed treatment? Breast cancer treatment services 27 (77%) 8 (23%) Cervical neoplasia treatment services 27 (77%) 8 (23%) Cervical cancer treatment services 27 (77%) 8 (23%) Defining appropriate paths for diagnosne follow-up and treatment? Breast cancer diagnostic services 30 (86%) 5 (14%) Cervical cancer diagnostic services 29 (83%) 6 (17%) Breast cancer treatment Services 24 (69%) 11 (31%) Cervical neoplasia treatment services 21 (60%) 14 (40%) Cervical cancer treatment services 23 (66%) 12 (34%) clients for free or at a reduced COST, assistance to clients in applying for Medicaid, or referrals to other government-spansored insurance programs. Another common strategy is the use of funds from local foundations, charitable organizanons, or corporate sponsors. Several different strategies that involve clinicians or providers (in hospi- tals, clinics, community health centers, and local health departments) were used to secure diagnostic and treatment services for program chents (Table 3). Many providers donate services or provide other types of charity care, offer services at a reduced fee, negotiate payment plans with clients, and write off diagnosic and treatment services as bad debt. In half of the states, a formal or informal system exists for rotating referrals for services not covered by program funds among providers in one or more locales. More than to different strategies or activities were named as being used to secure diagnostic and treatment services for BCCEDP clients in need. These strategies, in the order of frequency with which they were named, were: 1) reduced fee-for-service or a sliding-fee scale for services. 2) negoriated pay- ment plans between providers and clients; 3) in-kind chantable contributions of providers (including hospital indigent care programs); 4) assistance in LANTZ ET AL STRATEGIES IN CANCER SCREENING PROGRAMS 45 May-05-99 11:48am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.10/13 F-585 Table 2. USE OF STATE-LEVEL STRATEGIES TO PROVIDE DIAGNOSTIC AND TREATMENT SERVICES IN THE NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM (N = 35) Number of State Programs Using Strategy to Provide. Diagnostic Treatment Strategies Organized and/or Administered at State Lenel Services Only Services Only Bath Services Not Used Organization of charity care/in-kind donation 3 (9%) 0 15 (43%) 17 (18%) of services at state level Referral of clients to state-funded cancer center 0 0 5 (14%) 30 (86%) Referral of chents to other designared providers - 1 (3%) 1 (3%) 13 (37%) 20 (57%) who have agreed to serve program Client assistance in applying for Medicaid or 0 0 10 (29%) 25 (71%) other state program Indian Health Service funds 0 0 8 (23%) 27 (77%) Race for the Cure funds 6 (17%) 1 (3%) 1 (3%) 27 (77%) Other Komen Foundation funds 3 (9%) 0 0 32 (91%) Blue Cross Foundation funds 0 1 (3%) 0 34 (97%) Ceneral public revenue in fund 6 (17%) 0 4 (11%) 25 (71%) Tobacco excise tax revenue in fund 1 (3%) 1 (3%) 1 (3%) 32 (91%) applying to Medicaid or a state-sponsored insurance program; 5) referral to a designated cancer center or a publicly funded medical facility providing indigent care; 6) use of state appropriations for diagnostic or treatment services, or both: and 7) use of funds raised through a Susan G Komen Breast Cancer Foundation Race for the Cure. State programs collaborate with a variety of public and private agencies and organizations in their attempts to bring diagnostic and treatment services to BCCEDP chents. Collaboranng agencies include state health and human service agencies, county and city health departments, the Indian Health Service, the American Cancer Society, the National Cancer Institute's Cancer Information Service, state and local medical societies, state hospital associa- Table 3. USE OF LOCAL-LEVEL STRATEGIES TO PROVIDE DIAGNOSTIC AND TREATMENT SERVICES IN THE NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM (N = 35) Number of State Programs Using Strategy to Provide Diagnosta Treatment Serategies Organized and/or Administered at Local Level Services Only Services Only Both Services Not Used Referral of clients 9 designated providers 0 0 25 (71%) 10 (29%) Client assistance in applying for Medicaid or 2 (6%) 1 (3%) 22 (63%) 10 (29%) other state program Race far the Cure funds 3 (9%) 0 6 (17%) 26 (74%) Other private foundation funds 3 (9%) 0 11 (31%) 21 (60%) Assistance from local American Cancer Society 1 (3%) 0 5 (14%) 29 (83%) County money in fund 0 0 3 (9%) 32 (91%) -Donation of services or charity care (including 1 (3%) 1 (3%) 32 (91%) 1 (3%) indigent care programs) Reduced fee-for-service 2 (6%) 0 27 (77%) 6 (17%) Negotiated payment plan 0 1 (3%) 31 (89%) 3 (9%) Services written off as bad debt 0 0 25 (71%) 10 (29%) System for rotating referrals 1 0 16 (46%) 18 (51%) 46 WOMEN'S HEALTH ISSUES VCL 3. NC ! JANUARY/FEBRUARY 1999 May-05- 11:49am From-CANCER SURVEILLANCE BRANCH +77048 4759 T-425 P.11/13 F nons, private foundations. local corporations, churches and synagogues, YWCAS, and community health centers. In Maryland, a centralized response organized at the state level was implemented to ensure that women screened for breast and servical cancer receive all needed diagnostic and treatment services. In July 1992, the Mary- land legislature allocated funds for the Maryland Breast and Cervical Cancer Diagnosis and Treatment Program. This program. funded through general public revenue and robacco tax revenue, provides a means by which women can receive free breast and cervical cancer diagnostic tests and treatment services. Providers under contract with this fund offer a wide range of diagnostic and treatment procedures for women meeting specific eligibility crireria. This state-funded program is not restricted to women screened through the BCCEDP. although the eligibility criteria are sumilar By contrast, the Minnesota BCCEDP does not have access to state funds to supplement the federal program. Rather. the Minnesota program has devel- oped a relationship with the Susan G. Komen Breast Cancer Foundation Race for the Cure in the Twin Cities. The majority of the money raised in this annual Multiple strategies are walking/running fundraising event is allocated to the Minnesora Breast and being used to ensure Cervical Cancer Control Program to pay for breast ultrasounds and outpatient that program clients breast biopsies for women throughout the state This strategy involves a receive essential parmership between the state health department and a private foundation in an attempt to secure breast diagnostic tests for program clients This strategy. diagnostic and treatment however, does not provide resources for the treatment of breast cancer, cervical services. cancer, or CIN, and, in fact, only half of the breast biopsies received by program clients are paid for through Race for the Cure funds U Korn, personal communication, June 1997). To secure addinonal crucial services for program clients, the Minnesota BCCEDP also refers women to Medicaid or Minnesota- Care (a state-sponsored health insurance program for low-income people) and negotiates payment plans, reduced fee-for-service, or charity care for individ- ual cases. DISCUSSION Through the NBCCEDP. low-income uninsured and underinsured women receive important clinical prevenuve services: breast and cervical cancer screening. These women, however, are among those with the fewest resources 8 pay for diagnostic follow-up tests or for treatment services for a subsequent diagnosis of CIN, cervical cancer. or breast cancer. The NBCCEDP's gual a reduce morbidity and mortality from breast and cervical cancer cannot be realized unless women with abnormal screening results receive a definitive diagnosis and receive prompt and efficacious therapy for cancer or precancer- ous lesions. The NBCCEDP does not cover all the diagnostic services that clients may need, and It covers no treatment costs at all. Our study of 35 state screening programs shows that muluple strategies are being used to ensure that program clients receive essential diagnostic and treatment services. Some strategies use centralized funds administered at the state level (eg. state funds appropriated by the legislarure or funds raised through parmerships with private founda- tions). Other strategies are decentralized and informal, reflecting parmerships and collaborative arrangements that have been worked out at the level of a community or a within a single health care institution. There is great reliance on providers of diagnostic and treatment services B offer NBCCEDP chents different types of charity care, reduced fets, or long-term payment plans. Many of the strategies or approaches on which state programs rely to provide diagnostic and treatment services involve some charge (either full fee or a LANTZ ET AL STRATECIES IN CANCER SCREENING PROGRAMS 47 May-05-99 11:49am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.12/13 F-585 reduced fee) to the client. The number of BCCEDP clients being charged for follow-up tests and treatment services, the amount of these charges, and the degree to which financial barriers contribute to time delays or refusals for care are not known. Approaches providing diagnostic and treatment services vary greatly across states. This IS not surprising. given the different sociopolitical environ- ments of the states and the different ways in which they have organized or structured their BCCEDPs.³.⁹ Strategies and tactics also vary within states Communities and individual facilities within a state have access to different resources, and health service delivery systems vary across regions of a state. Thus, local programs within the same state have devised different means of providing diagnostic and treatment services to their clients. At the time of this study, some state programs did not have any written guidelines or protocols for clinical providers for tracking clients or for ensuring the initiation of follow-up or treatment services. The NBCCEDP-sponsored programs are required to have an acrive medical advisory committee or consultant that approves clinical protocals/guidelines and provides oversight to the quality of the services being delivered. The CDC recommends that NBCCEDP-sponsored programs use clinical practice guidelines established by nationally recognized organizations as a basis for developing chrical protocols for their programs. Some state programs were in the process of designing or approving such guidelines at the time of our study. The results of this study are limited in several ways. We do not have detailed information regarding the history behind the development of certain policies or the strengths and weaknesses of various strategies or tacties. We also do not have information regarding the effort or resources required to implement various strategies or the efficacy or specific approaches. In addition, while we have identified a wide variety of activities that are underway to provide women with diagnosne follow-up and treatment services, these results do not tell us if women are actually receiving the services they need in a umely fashion. Yes the results of this study can answer important questions about the NBCCEDP and the need for its participating health agencies to obtain resources for some diagnostic tests and for all treatment services. This research represents the first systematic look at how state health agencies are working to provide NBCCEDP clients the diagnostic and treatment services that the program does not cover. In addition, this study sheds light on how a large federal program has been implemented at the state and local levels and how funding restrictions in the federal program have been addressed in innovative ways by collaborating institutions and organizations. Myriad health agencies and organizations sponsor free or reduced-cost screening programs for a diseases other than breast or cervical cancer withour offering coverage for definitive diagnostic and treatment services. The strategies and approaches of the 35 state BCCEDPs described here may be useful and relevant to those implementing other types of disease screening programs ACKNOWLEDGMENTS Lisa C. Richardson, MD, MPH, is now with the CDC. This project was funded by the CDC Division of Cancer Prevention and Control. and was approved by the University of Michigan Health Sciences Human Subjects Review Commit- tee. Rosemarie Henson, MSSW. MPH, Stephen Wyan. DDM, MPH, Nancy C Lee, MD. Diane Duner, MPA. Jane Schulman, PhD, Martha Hare, PhD, Carlyn Orians, MA, and Madelaine Pfahler contributed to the design and implemen- tation of the project. In addition, the authors thank the CDC Program Consultants for their ccoperation with and effort on this project 48 WOMEN'S HEALTH ISSUES VCL 9, NO JANUARY FEBRUARY 1999 May-05-99 11:49am From-CANCER SURVEILLANCE BRANCH +7704884759 T-425 P.13/13 F-585 REFERENCES 1. The Breast and Cervical Cancer Mortality Prevention Act of 1990, 42 USC 201 et seq 1501-1509 (1990). 2. Henson RM. Wyart SW, Lee NC. The National Breast and Cervical Cancer Early Detection Program: a comprehensive public health response to two major health issues for women J Public Health Management Prace 1996,2:36-47. 3. U.S. Department of Health and Human Services. The National Breast and Cervical Cancer Early Detection Program: At-A-Clance 1998. + Reynolds T. States begin CDC-sponsored breast and cervical cancer screening J Nad Cancer Inst 1992;84:7-9. 5. Lantz PM, Sever LE. et al. Strategies for providing follow-up and treament services in the national breast and cervical cancer early detection program-United States, 1997. MMRW 1998;47 215-8. 6. Caplan LS, Helzlsouer KJ Delay in breast cancer. a review of the literature. Public Health Rev 1993;20.187-214. 7. US. Department of Health and Human Services. The national strategic plan for the early derection and control of breast and cervical cancers. Arlanta: Centers for Disease Control and Prevennon, 1994. 8 Maralir M. Orlaff TM. Desonia R Transforming state health agencies to meet current and future challenges Washington (DC): National Covernor's Association, 1997 9. Studnick I. Steverson B. Blais HN. Goley E, Richards TB, Thorton JN. Analyzing organizational practices in local health organizations. Public Health Rep 1994;109: 485-90. LANTZ ET AL. STRATEGIES IN CANCER SCREENING PROCRAMS 49 During the House Commerce Subcommittee on Health and Environment Hearing on H.R. 1070 in July, the tremendous need to enact this bill was illustrated through compelling testimony. Following are a few highlights: Mr. Biliraks: "..I am an early cosponsor of this legislation, and I do feel that something like this is needed. You heard during the prior testimony and the questioning, that we have only been able to reach approximately 15 percent of the eligible population as far as the screening is concerned. So, something has to be done, I think we would all agree, for improvement there, which would take additional funds. Dr. Stanley Klausner: "Yes, the issue is really the fact that it is very difficult to do charity work, pro bono work, work at the markedly reduced rates, when you have to pay your staff, your rent and so on. I think that making an effort, even if it is at the Medicaid level, the government is making that effort. It is putting the signal out to the physicians, if the government is moving funds in that direction, we have to meet them halfway Ms. Carolyn Tapp (President, Women of Color Breast Cancer Survivors Support Project: "Many of the women who are in our group were screened through the CDC program, and they must have been the ones that fell through the cracks, because it wasn't as easy as I have heard, you know, to get treatment. Some of the women I know took about 6 months to actually get treatment I have known women who have had t borrow medication from other women in the group, because they couldn't afford to buy the medication. I know that I loaned many women some of my medication Tamoxifen especially, because they were left out to get this kind of medication, and it costs hundreds of dollars. So they couldn't afford to buy it. So we share Mr. Lazio: " What would the impact be in terms of the breadth of service is you had a Medicaid option, if there was a Medicaid reimbursement in our backyard?" Dr. Klausner: " The bill would be effective, because after I do my portion, which is surgery for a diagnosis and definitive care, sometimes they require - the lymph nodes are positive. They require chemotherapy. That is when we start running into problems. I have an oncologist who does a lot of work for me in the private sector, $6 he is more apt to be favorable for this, but he has to fill out reams of paper to get medication under indigent - there is an indigent drug plan. So here is fellow I am asking to do something for free, and he is filling out reams of paper just to get medication to give to the patient. There are a lot of oncologists around they won't do it for me and I don't blame them. They are not bad people." Ms. Fran Visco (President, National Breast Cancer Coalition: "I think Josefina's testimony summarizes it for all of us, and there are many like her. These women initiated treatment, but they are sitting with second mortgages and third mortgages. They are sitting with $40,000 in bills, with creditors knocking on their door. They are sitting with - begging the health care community to help them; and the health care community wants to. but the evolving health care system is harming them and is stopping them from doing this." Mr. Lazio: " So we don't really know in any real sense about the continuity of care. When you say, for example, that a treatment was "initiated," we don't know whether that was an appointment, or whether it was surgery or radiation, chemotherapy, reconstruction, Tamoxifen. We have no idea what that means and whether it was spotty and sporadic or whether it was initiated." Ms. Nancy Lee: (Director, Division of Cancer Prevention and Control, CDC): "As stated in my testimony, we are not able to collect data on the type of treatment, or even more difficult on the quality of treatment either from the perception of the providers or the perception of women. That is not something we are able to do." Dr. Klausner: " Even more disturbing is my gradual awareness that the working poor are afraid to elect breast conserving surgery. They are so terrified of their medical bills that their medical judgment is biased. Take for example a working mother supporting two children and not qualified for Mediciad. Even if her breast cancer is amendable to breast conserving surgery, she often elects a mastectomy because she knows the cost of the additional treatments needed in breast conservation, such as radiation and chemotherapy. are too expensive. What a difficult decision this woman must make when she opts to sacrifice her breast rather than incur medical bills she can't pay. As for plastic surgical reconstruction of her mastectomy site. this has simply never been an option." After the House Hearing on H.R. 1070, a hearing was held in the Senate Finance Subcommittee on Health (on the companion legislation - S. 662). Following are a few highlights: Ms. Barbara Matula: (Director, Health Care Programs, North Carolina Medical Society Foundation Former Chairperson, National Association State Medicaid Directors Raleigh, North Carolina): "Imagine now that you come home tonight and you learn that someone in your family has a potential diagnosis of breast or cervical cancer. Your only concern is getting the best care. You have a sense of relief that she has regular care, regular exams. So you are hoping that it was caught early. And all you look for is full recovery But if you are that same woman and your income is below 200 percent of poverty, which is so very little - if you are a single person that is $16,480 a year, if you are married and it is $22,000 for the couple. That is very low, but twice what Medicaid eligibility is. You have run out of funds and you are left to your own devices " This is unconscionable. For all the little administrative wrinkles in Medicaid eligibility, I hope this bill will pass." Senator Chafee: Ms. Matula and the others Some have suggested that CDC provide the treatment as well as the screening, in other words forgo Medicaid. What would you say to that? Ms. Matula: "If it was the last resort, I would say do it, of course." Senator Chafee: "Do not put it in the last resort category. Move it up. Let us say you were queen Would you have a CDC treatment program?" Ms. Matula: " The only reason I would not do it is that, and this was after talking to a fellow with many years experience with CDC programs. they have no experience as third party administrators. Their job is to do public education and outreach which they do very very well. To duplicate what an existing program is already doing Senator Chafee: "Meaning Medicaid?" Ms. Matula: "Meaning Medicaid. Learning how to reimburse physicians and hospitals and pharmacies and clinics and doing it in a quick turnaround time so that they will continue to participate would be a waste of our time and resources to duplicate this in another agency." Ms. Barbara Flett: Director Women's Health Partnership of Suffolk County "Lack of guaranteed treatment means there is no way to tell how long a woman will have to wait to get the care following a diagnosis of breast or cervical cancer. Moreover, once a woman receives treatment, she often must spend her time arguing with doctors and hospitals and sometimes creditors over her bills rather than focusing on recovering from her devastating illness." Senator Chafee: " Would Medicaid have problems interfacing with another program's eligibility standards? Will Medicaid be able to easily enroll and cover those who are found eligible in screening done under the CDC program?" Ms. Matula: "If you would have asked me this 15 years ago, I would say we do not even speak to our public health agencies, but in that interim, we have learned how to do it with the pregnant women coverage to reduce infant mortality where the determination of pregnancy services as the presumptive eligibility, where the income tests at that time were easily twice as high as we had for the women on welfare who were the only other women. I do not that this would be a problem. The State Medicaid agency and the public health agency could have a cooperative agreement that would spell out those 200 percent of eligibility as a trigger. And it could be as smooth as silk" NBCC NATIONAL BREAST CANCER COALITION grassroots advocacy in action Testimony of Fran Visco, President National Breast Cancer Coalition before the House Commerce Committee Subcommittee on Health and Environment July 21, 1999 Thank you Mr. Chairman, and members of the Committee for inviting me to testify today. I am Fran Visco, President of the National Breast Cancer Coalition, and a breast cancer survivor. I am one of the 2.6 million women living with breast cancer in the U.S. today. The National Breast Cancer Coalition (NBCC) is a grassroots advocacy organization dedicated to eradicating breast cancer. We are made up of 500 member organizations and more than 60,000 individual women, their families and friends. NBCC seeks to increase the influence of breast cancer survivors and other activists over public policy in cancer research, clinical trials, and access to quality health care for all women. BACKGROUND The National Breast Cancer Coalition has made passage of H.R. 1070, the Breast and Cervical Cancer Treatment Act, a top priority. As you know, this legislation would establish a federal treatment component for the Centers for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) that Congress enacted as part of the Breast and Cervical Cancer Mortality Prevention Act in 1990. That program - which has screened more than one-half a million women for breast cancer - does not provide any federal resources to pay for the treatment when women are diagnosed with breast or cervical cancer. Instead, Congress asks participating states to assure that the women who are screened get the treatment they need. The fact that the CDC Early Detection Program does not cover any costs of treatment for breast and cervical cancer has created a very serious public policy gap. State and local providers and women themselves have been left to scramble for resources to pay for treatment. Women are relying on charity and donated care when it is available and sometimes going into debt when no public or private dollars can be found. The NBCCEDP is a program dedicated to serving low-income women, but at times fails to come through. 1707 L Street, NW, Suite 1060, Washington, DC 20036 phone: (202) 296-7477 fax: (202) 265-6854 http://www.natlbcc.org Let me be perfectly clear. The individuals who run this program and the thousands of volunteers who help find women treatment do all that they can everyday to ensure that patients diagnosed through the program get the treatment they need. It is the people who do the screening and spend countless hours trying to find treatment who have identified the problems with a system that lacks a treatment component. It is the system that is broken, and we need to fix this problem so that they can screen more women, and not have to spend the majority of their time finding treatment services. What H.R. 1070 Would Do NBCC-Personal Stories Not long after the CDC screening program was enacted into law, Jan Eick-Swigart, an NBCC advocate from California, launched an effort to guarantee treatment for women screened and diagnosed with breast cancer through the federal program. Prior to losing her battle with breast cancer, Jan wrote a compelling memorandum on the need for a federal treatment component to CDC's Early Detection Program. Her memorandum states: "One of the heartbreaking ironies about the BCCEDP and other programs that offer underserved women free or low cost mammography is the lack of resources to treat the women who are diagnosed with breast cancer as a result of these programs." In the years following Jan Eick-Swigart's efforts to ensure that women screened and diagnosed with breast cancer through CDC's federal program are guaranteed treatment through Medicaid coverage, many NBCC advocates have reaffirmed the need for a federal treatment component to this program. Our members have witnessed the delay that can result from having to scramble to find treatment - and the physical and emotional result that delay has on women screened and diagnosed through the program. A woman in Florida had to wait 5 months before a volunteer found her treatment dollars. This woman had five agonizing months of knowing she was sick and having no way to get the treatment she so desperately needed. Moreover, we have heard from women who ultimately got treatment, but were then saddled with medical bills that they couldn't pay. Instead of focusing on getting well, these uninsured women have had to focus on how they are going pay for their care. A woman in Massachusetts, for instance, has already spent her children's college fund for her treatment and is paying off more than $20,000 in medical bills. Her story is incorporated in a statement from Mary Ann Waygan, coordinator for the CDC Breast and Cervical Cancer Initiative for Cape Cod, Massachusetts. (Mr. Speaker, may I introduce this statement into the record?) A woman in New York said that during her treatment, it seemed that her conversations with her doctors were more about the bills than how to save her life. There are other women who after having a mammogram find out they need follow-up diagnostic services but refuse to get them. They do not want to know they have cancer without knowing exactly where the treatment dollars come from. A woman from Virginia explained she "feels that if she is not diagnosed it is better because she will not have to worry about treatment." A woman from Maine had an initial mammogram through the NBCCEDP program and the results were "highly suggestive of malignancy." Due to the cost, rather than pursue a biopsy and the treatment, which may have been needed, the client decided to wait and have a repeat mammogram in six months. Surely, these scenarios are not what Congress intended when it enacted the National Breast and Cervical Cancer Early Detection Program into law. Yet, these scenarios are the reality of what happens when women are screened and diagnosed with breast and cervical cancer through a federal program that does not guarantee federal treatment coverage. CDC-Case Study NBCC is not alone in our belief that the CDC Early Detection Program needs a system that provides sufficient funding for treating women. In response to concerns about treatment raised across the country (and raised by advocates like us), CDC conducted a case study which illustrated a similar conclusion. The study focused on participating states (California, Michigan, Minnesota, New Mexico, New York, North Carolina and Texas) and looked at the treatment following a diagnosis of breast or cervical cancer through the program. The results of that study, released in January 1998, found that although treatment had been initiated for most of the women in whom cancer was diagnosed, the system of treatment is "tenuous and fragile at best." (Mr. Chairman, may I introduce the report which summarizes the results of the study into the record?) The Numbers Don't Tell Us the Whole Story I want to make very clear that the issue is not just that some women don't get treated. We have had to look beyond the numbers to find the real story. It is behind these numbers that the story exists - the story that women from all over the country come and talk to me about. It's the story that CDC's own study underscores. The story of women - diagnosed with breast and cervical cancer - wondering how and whether and when they'll find treatment for their disease, and then often left with a lifetime of bills to pay for that treatment. Lack of Treatment Funding Is Diverting Resources Away From the Screening Program There are several findings that are very telling in the conclusions of CDC's study. First, the study highlights the considerable time and effort involved in developing and maintaining systems for diagnostic follow-up and treatment. It illustrates the labor- intensive process required to identify resources within states to provide diagnostic and treatment services. NBCC has heard about the serious problems people who run the screening programs across the country have in finding treatment for women diagnosed through the program. The hours spent searching for treatment are diverting resources away from the screening program. As a result, fewer women are being screened. This is very serious - the program currently serves only 12% to 15% of age eligible, uninsured women nationally. The threat that the lack of treatment funding poses - not only to the woman who have been diagnosed through the program - but also to the women who may rely on the screening services in the future - is lethal. This is the story behind the numbers. It is our hope that in enacting a Medicaid option for these women, they will be presumed eligible for Medicaid on the first day that they are diagnosed. This way - they know they'll get the immediate care they need instead of facing delays and wondering how and whether they'll get treated. This way - program coordinators can focus their efforts on increasing the number of women they are able to screen for breast and cervical cancer. In the Context of an Evolving Health Care System Second, the CDC study puts this issue in the context of an evolving health care system. The study highlights what we too are hearing from our advocates around the country, and what Dr. Stanley Klausner has testified about today - an increasing number of physicians who do not have the autonomy, because of the changes in the health care system, to offer free or reduced-fee services to NBCCEDP clients. Mr. Chairman, I point you to a letter from Robert Brooks, MD, Secretary of the Department of Health for the Florida Department of Health and Human Services. (Mr. Chairman, may I submit this letter for the record?) In his letter, Dr. Brooks writes, "We are starting to see the strain our providers are experiencing through their support of the program One county program had had three women diagnosed with breast cancer during their first two years in operation; each one cared for by a different provider. Since October, 1998, five additional women have been diagnosed and approximately 10 to 15 more have abnormal clinical breast exam or mammogram results and could be diagnosed with cancer. Needless to say, the providers are concerned with these increasing numbers. Some of the providers have asked the local program coordinator not to refer additional patients to them for the remainder of this program year " " Another county program has seen a total of 10 women with cancer and they have two to three physician providers and one hospital provider who agrees to see program clients. Three providers have also expressed alarm at the number of women with abnormal exams who are referred to them for care. We have been told that these current providers may not be willing to support the Program when this county renews their program agreement this October " And the stories go on. Dr. Brooks concludes with the fear that Florida's providers continue to show signs of abandoning this program unless they are provided with some assistance that is not available through the CDC grant. Florida, a state with the highest degree of managed care penetration in the country, is perhaps one of the best (but certainly not the only) example of a situation where the lack of availability of treatment can only get worse, and where any attempts to expand the screening program are hindered. It is important to note that as managed care continues to expand across the country, more and more doctors may have less autonomy to provide the charity care relied on by NBCCEDP coordinators. To illustrate this point, a recent survey based on 12,000 U.S. physicians was published in the April 1999 issue of the Journal of the American Medical Association. The study finds that doctors whose income depends most heavily on health maintenance organizations and other managed-care health plans, on average, devote only half as much time to charity care as do their colleagues who don't participate in managed care. What will this mean for the people who run the NBCCEDP programs who are already spending countless hours searching for treatment for women diagnosed with breast and cervical cancer? What will this mean for women who are already suffering a delay in treatment? Or who are saddled with treatment bills they can't pay? Or who are reluctant to get screened because they "prefer not to know" if there is no treatment available? What will this mean for the ability of the National Breast and Cervical Cancer Early Detection Program to sustain itself? Precedent in the Medicaid Program Respondents in CDC's study suggest a similar solution to the lack of funding for treatment that we bring before you today - a solution that passage of H.R. 1070 would guarantee. That solution is a provision of treatment services assured through a federal "Medicaid option" which would give state Medicaid programs permission to allow eligibility to BCCEDP clients who are diagnosed with cancer through the program. This would include those women who are eligible for BCCEDP services but whose incomes and/or assets exceed Medicaid limits. There is a precedent for covering participants in the Breast and Cervical Cancer Early Detection Program under Medicaid. In 1993, Congress created the Tuberculosis Optional Benefit Program, making individuals who are infected with tuberculosis eligible for Medicaid. Mr. Chairman, and Members of the Committee, as the stories of NBCC's advocates and as the results of CDC's own study show - what we have today is an ad-hoc system that is incapable of serving the future needs of the program and the women it serves. Solutions in the vast majority of states are short-term, tenuous and fragile. The fact that so many women eventually get treated reflects the dedication of providers and volunteers who spend enormous effort and time to find treatment services. Yet, while the majority of women get care, there is no system of care. As a result, some women experience unnecessary delays or are lost to follow-up care, and a few don't get treated at all. Our message is not to put an end to the screening program. It is to finish the work Congress initiated in 1990 by adopting a treatment component that will serve all the women screened and diagnosed with breast and cervical cancer through this program. How This New Treatment Program Would Work Enactment of H.R. 1070 would allow the women who are eligible for the CDC Early Detection program -- that is women who are between 200% and 250% of poverty depending on their state and who are not already insured -- to receive their treatment through the state Medicaid program. States would not be required to participate, but those that do will receive an enhanced match - 75 percent federal dollars and 25 percent state dollars. NBCC is heartened by the incredible support for this legislation from you, Mr. Chairman, and from the Committee. All but three Subcommittee members have signed on as cosponsors, and three quarters of the Full Commerce Committee has cosponsored H.R. 1070. We are pleased that in a bipartisan way - this Committee has come together in recognition that breast and cervical cancer screening alone does not prevent cancer deaths; it must be coupled with treatment if we are to achieve a reduction in mortality. We now ask the Committee to ensure that happens as the screening program grows by enacting H.R. 1070, the Breast and Cervical Cancer Treatment Act this Congress. Mr. Chairman, and members of the Committee, thank you again for the opportunity to testify. We look forward to working with you on this critically important issue. I'd be happy to answer any questions you may have. Statement of Mary Ann Waygan March 18, 1999 Hello, my name is Mary Ann Waygan and I am the coordinator for the CDC Breast and Cervical Cancer Initiative for Cape Cod, Massachusetts. Before I begin, I would like to thank Senators Chafee, Mikulski, Snowe and Moynihan for sponsoring this legislation. I would also like to thank Senator Smith for his support of this bill. Clearly, the single largest problem facing the Breast and Cervical Cancer Screening Program today is finding resources and caregivers to provide treatment to the women who are diagnosed with breast or cervical cancer. The lack of treatment dollars is one of the biggest policy gaps in the program - and the problem is only getting worse. The barriers to recruiting providers for charity care are growing, and funding for the treatment is an ad-hoc system that relies on volunteers, state workers and others to find treatment services. In the community, we go to tremendous ends to find treatment - and raise money to help pay for it. I've organized luncheons, bake sales, raffles - you name it. Anything to raise money for women who could not afford to pay out of pocket for treatment. Despite these efforts, all too often, we come up short. Funding for treatment through the CDC program is the biggest problem I face as a coordinator and frankly a barrier to screening and detection. Funding for treatment is tenuous at best. Without passage of the Breast and Cervical Cancer Treatment Act, future funding for treatment for these women will remain uncertain. I want to tell you one story in particular that clearly illustrates the problem some of these women face. A woman who lives in Buzzard's Bay, Massachusetts who was diagnosed with breast cancer through the CDC program. Arlene McMann is a married woman in her early forties with two teenage sons and no health insurance. When Ariene was diagnosed with breast cancer through the CDC screening program, she was devastated - not just with the diagnosis, but with the fact that she had no way to pay for the treatment she needed. Faced with that situation, she and her husband were forced to use the $20,000 they had been saving for years to pay for their children's college tuition. In less than a year, that money was gone. After that, she and her husband were forced to go into debt to pay for her ongoing chemotherapy/radiation treatment and other procedures including a craniotomy and gall bladder surgery. They are now more than $40,000 in debt, were forced to move into a much smaller house and lost their dream of sending their sons to college without going into further debt. The additional stress and pressure placed on Ariene and her husband by this situation has turned a difficult situation into an almost unbearable one. To make it even worse, Ariene recently found out that the cancer has spread to her hip, pelvis, lungs and liver. Through all of this. Arlene has showed tremendous resolve. Despite being in pain and discomfort and forced to use a wheelchair, Arlene desperately wanted to be here today to share her story with you directly. She thought it was important for everyone to understand not just what the cancer had done to her. but what the affect of having to take on this incredible financial burden had done to her physical health. mental strength and family resources. Due to her condition. Ariene's treatment finally is being paid because she qualified for disability. But to this day, Ariene is convinced that her cancer would not have spread had she been able to afford regular visits to an oncologist. Arlene's energy and determination to fight this disease and remain positive are amazing. I feel lucky to know her and to have worked with her. I only wish that as the program coordinator, I could have done more - that I could have assured her that any treatment she needed would be paid for and that she wouldn't have to spend time dealing with bank statements, mortgages or packing boxes on top of everything else. In summary, we hear over and over again that early detection saves lives. In actuality, early detection alone does nothing but find the disease; detection must be coupled with guaranteed, quality treatment to actually save lives. We must pass the Breast and Cervical Cancer Treatment Act to make sure that screening and treatment always go together. I would like to thank the National Breast Cancer Coalition for its leadership role in working to get this legislation passed and thank the members of Congress here today for sponsoring and supporting this legislation. Thank you. Received: 7/12/99 10:41AM; 301 657 9341 .> NBCC; Page 2 Jul 12 99 11:06à Robyn Lipner 301-657-9341 p.2 1 HEALTH Jeb Bush Robert G Brooks, MD Governor Secretary June 22 1999 The Honorable Connie Mack United States Senate 517 Hart Senate Office Building Watchington DC 20510 Dear Senstor Mack This letter in response to the May 4th telephone inquiry from Mark Smith 10 Margo Blake regarding cancer treatment for woman enrolled in Florida's Breast and Carvical Cancer Early Detection Program (the Program) Thank you for allowing us the opportunity to furnish some details about the Program. Fior da received 113 award from the Centers for Disease Control and Prevention (CDC) in late surr mer 1994 We started operations in nine counties in September 1895 and grew to 20 cou in 1996. The 20 counties are comprised of large urban areas, mid-sized counties and smal rural counties (A map depicting all 20 participating countres IS enclosed.) Population data show that there are approximately 275.000 women. ages 50-64 in Florida who are under or uninsured Slightly over 175.000 of these women reside in the 20 participating counties Since late 1995, CDC grant funds have allowed the Program to provide screening services to sightly over 10000 eligible woman Annually, the participating counties screen approximately 3,500 women or about 2 percent of the eligible population. One hundred thirty women have been diagnosed with breast or invasive cervical cancer through this Program in Florida. As you know CDC funds cover reimbursement at the Medicare rate. for breast and cervical screening services such 88 Pap smears and mammograms. There are also limited funds for specified nostic procedure such as colposcopies. biopsies, and breast ultrasounds The CDC funds can not be used for reimbursement for treatment or other associated costs This IS the Program's most vulnerable area as we are now entering a competitive application process for add tional CDC grant funds to begin year SIX in October 1999 We are starting to see the strain our providers are experiencing through their support of the program Before providing case scenanos that demonstrate this strain, I would like to expand on the definition of provider as used throughout this letter Normally. we refer 10 the general or oncologic surgeon as the principal provider or treatment Many others also donate services to the breast and cervical program. These include oncologists radiologists radiation oneologists, pathologists and nospitals. The scenarios mentioned include the following One county program worked with a client diagnosed with cervical cancer in November 1998 The woman saw a gynecological encologist in January 1999 and underwent a hysterectomy in March after filing for Medicaid Her family had to pay $6825 'up front to cover hospital costs. which may be covered retroactively by Medicaid 2020 Capital Circle SE . Tallahasse FL 32399-1700 Received: 7/12/99 10:41AM; 301 657 9341 -> NBCC; Page 3 Jul 12 99 11:07a Robyn Lipner 301-657-9341 p.3 Senator Mack Page two June 22, 1999 One county program had three women diagnosed with breast cancer during their first two years in operation: each one cared for by a different provider. Since October 1998, five additional women have been diagnosed and approximately 10 to 15 more have abnormal clinical breast exam or mammogram results and could be disgnosed with cancer Needless to say the providers are concerned with these Increasing numbers Some of the providers have asked the local program coordinator not 10 refer additional patients is them for the remainder of this program year. Another county program has seen a total of 10 women with cancer and they have two to three physician providers and one hospital provider who agrees to see program clients These providers have also expressed alarm at the number of women with abnormal exams who are referred to them for care. We have been told that these current providers may not be willing to support the Program when this county renews their program agreement this Cictober Tine fourth county program diagnosed 10 women with breast cancer during their first two y ears and since January 1999 diagnosed four more women with breast cancer. Ten providers who originally agreed to each see one to two cliente per year have formeo three separated groups who have agreed to see one to two clients per group. for a total of three to SX clients per year. This would not be sufficient coverage if the rate of diagnosing cancer continues. CDC nas informally conveyed to us that they may award the Florida Program more funds for breast and cervical screening services in our next five-year grant cycle that begins this October While this 10 positive news for the many thousands of women at need for these services, we also believe this will have a domino effect on the providers who provide in-kind treatment. With increased numbers of women screened comes an increase in the numbers of cancers diagr osed. placing an ever-increasing burden on our already overwhelmed providers of cancer treatment! Please note these same providers more than likely also donate in-kind services to other clients disgnosed with cancer or other chronic diseases So walle our information shows that a provider may furnish pro bono treatment for two or three women with breast or cervical cancer per year. in all likellhood that same provider IS asked to donate treatment services for other clients as well. We are deeply indebted to all of these individuals and institutions for their support of the Program and would like to see them receive some measure of acknowledgement for their efforts In aummary the Florida Breast and Cervical Cancer Program nes provided cancer services to over 10.000 women at or below the 200 percent poverty level. and found treatment services for over 130 women through the generosity of local providers in 20 counties AS screening numbers increase. so will the number of women diagnosed with breast or cervical cancer Received: 7/12/99 10:42AM; 301 657 9341 .> > NBCC; Page 4 Jul 12 99 11:07a Robyn Lipner 301-657-9341 p.4 Seriator Mack Page three June 22. 1999 Our providers are showing signs of abandoning this program unless we are able to provide their some assistance that is not available through the CDC grant. Thank you for your personal interest in Florida's Program. If you have further questions. please feel free to contact me at (850) 487-2945, or Ms. Mergo C Blake, Program Manager for the Breast and Cervical Cancer Early Detection Program at (850) 488-2901. We look forward to a successful conclusion to this year's session and wish you our best Sincerely Roluty brook Robert G Brooks MD Secretary. Department of Health RGB/jg Enclosure Cc Mark Smith CDC March 27, 1998 / Vol. 47 / No. 11 - FOR - CONTROL AND PREVENTE 209 Imported Dracunculiasis - United States, 1995 and 1997 MMWR 211 Update: HIV Counseling and Testing Using Rapid Tests - United States, 1995 215 Strategies for Providing Follow-Up and Treatment Services in the National Breast and Cervical Cancer Early Detection Program - United States, 1997 MORBIDITY AND MORTALITY WEEKLY REPORT 218 World Health Day - April 7, 1998 219 Notices to Readers Imported Dracunculiasis - United States, 1995 and 1997 Dracunculiasis is a parasitic infection caused by a filarial worm (Dracunculus medi- nensis [i.e., Guinea worm]) that is transmitted through contaminated drinking water. Approximately 1 year after a person is infected, one or more meter-long adult female worms begin to emerge through the skin, often incapacitating the patient for ≥2 months. Despite a dramatic decrease in cases worldwide, dracunculiasis is still occa- sionally imported into the United States. Since 1995, two cases of dracunculiasis have been reported in the United States, both imported from Sudan. This report summa- rizes the investigation of these cases. Patient 1. A 9-year-old girl residing in Tennessee had emigrated from Sudan in Sep- tember 1995 (1). Before the girl left Sudan, a Guinea worm had emerged and had been extracted from her right lower leg. The lesion had healed when she arrived in the United States. After she had been in the United States for 3 weeks, another Guinea worm began to emerge from her left leg. Medical examination at a local health clinic revealed a string-like worm dangling from a lesion on her left leg, and she was re- ferred to an infectious disease specialist. The leg was secondarily infected and swol- len, and the girl was unable to walk. Despite antibiotic treatment, her cellulitis did not improve, and the lesion was surgically opened, drained, and debrided of pus, necrotic debris, and fragments of the Guinea worm. The patient was hospitalized for 2 weeks, requiring surgery to stretch a contracture of her ankle and to apply a skin graft to the wound. After outpatient physical therapy, she was able to walk without crutches. Patient 2. A 31-year-old woman residing in Connecticut had emigrated from Sudan in January 1997. In April 1997, she was evaluated at a university clinic for possible tuberculosis (TB). A radiograph revealed lung lesions consistent with TB and a worm- like calcification in her left chest. Physical examination revealed multiple, indurated, oval lesions 4-8 cm in diameter on both lower legs. The patient reported the lesions had been present for 1 year and were intermittently painful. She recalled that a long string-like worm had emerged from her leg during the previous year. Biopsy of the leg lesions revealed erythema induratum, consistent with Bazin disease, a cutaneous manifestation of TB. The patient had evidence of a dead and calcified Guinea worm in her chest and a history suggesting a live Guinea worm had emerged from her leg before she arrived in the United States. She also had pulmonary TB with a cutaneous tuberculid skin manifestation. Treatment with isoniazid, rifampin, and pyrazinomide U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Vol. 47 / No. 11 MMWR 215 HIV Counseling and Testing - Continued ing that persons who receive preliminary results understand the meaning of the result and prefer rapid testing (4). When additional rapid tests become available for use in the United States, the PHS will re-evaluate algorithms using specific combinations of two or more rapid tests for screening and confirming HIV infection. References 1. Kamb ML, Bolan G, Zenilman J, et al. Does HIV/STD prevention counseling work? Results from a multi-center randomized trial (Project Respect) [Abstract 0134] In: Program and abstracts of the International Congress of Sexually Transmitted Diseases. Seville, Spain: Association for Research in Clinical Microbiology, 1997:83. 2. CDC. HIV counseling and testing in publicly funded sites: 1995 summary report. Atlanta: US Department of Health and Human Services, CDC, September 1997. 3. George JR, Schochetman G. Detection of HIV infection using serologic techniques in AIDS testing: a comprehensive guide to technical, medical, social, legal, and management issues. 2nd ed. Schochetman G, George JR, eds. New York: Springer-Verlag, 1994. 4. Kassler WJ, Dillon BA, Haley C, Jones WK, Goldman A. On-site, rapid HIV testing with same-day results and counseling. AIDS 1997;11:1045-51. 5. CDC. Interpretation and use of the Western blot assay for serodiagnosis of human immunode- ficiency virus type 1 infections. MMWR 1989;38(suppl 7):S4-S6. 6. Stetler HC, Granade TC, Nuñez CA, et al. Field evaluation of rapid HIV serologic tests for screen- ing and confirming HIV-1 infection in Honduras. AIDS 1997;11:369-75. 7. Kassler WJ, Haley C, Jones WK, Gerber AR, Kennedy EJ, George JR. Performance of a rapid, on-site human immunodeficiency virus antibody assay in a public health setting. J Clin Mi- crobiol 1995;33:2899-902. Strategies for Providing Follow-Up and Treatment Services in the National Breast and Cervical Cancer Early Detection Program - United States, 1997 The Breast and Cervical Cancer Mortality Prevention Act of 1990* authorized CDC to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to increase screening services for women at low income levels who are uninsured or underinsured (1). Although the NBCCEDP covers most diagnostic serv- ices that women need after receiving an abnormal mammography or Papanicolaou (Pap) test result, the program does not reimburse for breast biopsies. In addition, the Act prohibits the use of NBCCEDP funds for cancer treatment. Participating health agencies must ensure that NBCCEDP clients receive timely, appropriate diagnostic and treatment services. In 1996, CDC began a case study to determine how early de- tection programs in seven participating states (California, Michigan, Minnesota, New Mexico; New York, North Carolina, and Texas) identified resources and obtained diag- nostic and treatment services. This report summarizes the results of the study (2), which indicate that respondents in these states reported that treatment had been initi- ated for almost all NBCCEDP clients in whom cancer was diagnosed. However, re- spondents also considered the strategies used to obtain these services as short-term solutions that were labor-intensive and diverted resources away from screening ac- tivities. In the seven states, NBCCEDP-sponsored screening services had been provided for ≥3 years, and breast cancer had been diagnosed in ≥60 women. The states were se- Public Law 101-354. 216 MMWR March 27, 1998 National Breast and Cervical Cancer Early Detection Program - Continued lected to provide a range of geographic locations, a combination of urban and rural populations, and racial/ethnic diversity among program clients. Researchers con- ducted semi-structured interviews with 192 persons affiliated with the seven state programs. Of these interviewees, 120 (63%) were providers of screening, diagnostic, and/or treatment services; 58 (30%) were state program staff; and 14 (7%) were coali- tion members. Interviews included topics such as guidelines related to diagnostic and treatment services, strategies used to obtain and pay for services, level of effort re- quired to secure these services, and changes in strategies over time. Each interview was tape recorded and transcribed. Using a systematic scheme derived from the re- search questions, three researchers coded the same transcripts until an inter-rater agreement of 80% was reached. Thereafter, all transcripts were coded independently. Coding results were entered into text analysis software that sorts text from transcripts into sets of information, themes, and evidence relevant to the specific research ques- tions (3). The results reflect a synthesis of the interviewees' responses. Respondents described several strategies used to ensure necessary diagnostic and treatment services for women screened through the NBCCEDP. State-level strategies in all states included 1) computerized tracking and follow-up systems that used pro- gram surveillance data to identify and manage clients in need of diagnostic and treat- ment services; 2) provisions in contracts requiring screening providers to arrange for diagnostic follow-up and treatment before screening women; and 3) arrangements with provider groups and state professional associations for free or reduced-cost serv- ices for NBCCEDP clients. All states also had access to public or private funds to help support services not covered by the program; such revenue sources included state appropriations from general or tobacco tax revenues or funds from private founda- tions. These funds were available primarily for breast diagnostic services. Local strategies tailored to the needs of individual clients were used to obtain diag- nostic and treatment services. Common strategies reported by respondents included the following: providers billed public or private insurance plans; providers or local health departments helped clients apply for public assistance programs; providers re- ferred clients to public hospitals; county indigent-care funds and hospital community- benefit programs financed services; clients received services through individually negotiated payment plans; and clients paid reduced or full fees for services. Respondents strongly supported the continued growth of NBCCEDP and its goals but expressed several concerns. First, considerable time and effort were involved in AST developing and maintaining systems for diagnostic follow-up and treatment. Second, the process of identifying available resources within states for diagnostic and treat- ment services was considered labor-intensive. Third, the lack of coverage for diagnos- tic and treatment services negatively affected recruitment of providers and restricted the number of women screened. Fourth, respondents believed that an increasing number of physicians will not have the autonomy, because of changes in the health- care system, to offer free or reduced-fee services to NBCCEDP clients. Respondents reported that arrangements for treatment were made for almost all NBCCEDP clients who received a diagnosis of breast cancer or invasive cervical can- cer. Respondents stated that some women experienced time delays between screen- ing, definitive diagnosis, and initiation of treatment. State program officials reported that, according to 1992-1996 surveillance data, small numbers of clients in whom can- cer was diagnosed (i.e., from three to 13 women in each state) subsequently refused Vol. 47 / No. 11 MMWR 217 National Breast and Cervical Cancer Early Detection Program - Continued treatment. Because these clients were not interviewed, it could not be determined whether financial barriers contributed to their decisions to refuse treatment or their loss to follow-up. Respondents were concerned that the NBCCEDP did not provide funding for all diagnostic procedures and treatment for the diseases for which clients were being screened; approaches for delivering services were fragmented; and the process of ob- taining resources required substantial effort at the state, local, and provider levels. Respondents reported that the continuation of every strategy for diagnostic and treat- ment services beyond the next few years is uncertain. Reported by: PM Lantz, PhD, Univ of Michigan School of Public Health, Ann Arbor. LE Sever, PhD, Battelle, Centers for Public Health Research and Evaluation, Seattle, Washington. Program Svcs Br, Office of the Director, Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC. Editorial Note: During July 1991-March 1997, the NBCCEDP provided 576,408 mam- mograms to women aged ≥40 years, and 3409 cases of breast cancer were diagnosed. During this same period, the program provided 732,754 Pap tests; 23,782 cases of cer- vical intraepithelial neoplasia and 303 cases of invasive cervical cancer were diag- nosed. These totals included women referred to the program for diagnostic evaluation of an abnormal screening result. The NBCCEDP internal estimates suggested that dur- ing this period only 12%-15% of uninsured women aged 40-64 years in the United States had been screened by the program (CDC, unpublished data, 1997). Screening alone does not prevent cancer deaths; it must be coupled with timely and appropriate diagnostic and treatment services. The Congressional mandate for NBCCEDP requires grantees to take all appropriate measures to ensure provision of services required by women who have abnormal screening results. CDC provides funds for case management to help these women access health-care services. To in- crease the comprehensive nature of the program, CDC recently approved the use of NBCCEDP funds for breast biopsies. The results of this study indicate that state health departments and their partners in the seven states had developed a wide range of strategies for diagnostic and treat- ment services in the absence of program resources. However,the time and effort-re- ** quired to arrange and maintain these services diverted resources away from screening activities. This study was subject to at least two limitations. First, the results were based solely on the experience and opinions of informed professionals affiliated with the program and did not include the perspectives of NBCCEDP clients. Second, the results may not reflect the program experiences in other states. Case-study methods, how- ever, are an appropriate and well-accepted approach to gaining in-depth under- standing of complex programs in real-life situations (4). The validity of the findings was enhanced by developing standard instruments to guide the semi-structured inter- views, protecting the confidentiality of respondents' remarks, using interview tran- scripts for data analysis rather than relying on interviewer notes, and obtaining feedback concerning state summary reports from respondents. As more women are screened by the NBCCEDP, a greater burden will be placed on participating health agencies, providers, and other partners to obtain resources for breast and cervical cancer treatment. Case-management services will continue to be essential in helping underserved women overcome financial, logistical, and other bar- 218 MMWR March 27, 1998 National Breast and Cervical Cancer Early Detection Program - Continued riers to receiving these services. Other long-term solutions to ensure that women in the program receive necessary treatment services are being pursued. References 1. Henson RM, Wyatt SW, Lee NC. The National Breast and Cervical Cancer Early Detection Pro- gram: a comprehensive public health response to major health issues for women. J Public Health Management and Practice 1996;2:36-47. 2. Lantz PM, Macklem DJ, Hare M, Richardson LC, Sever LE, Orians CE. Follow-up and treatment issues in the National Breast and Cervical Cancer Early Detection Program: results from a multiple-site case study-final report. Baltimore: Battelle, Centers for Public Health Research and Evaluation, 1997. 3. Miles MB, Huberman MA. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thou- sand Oaks, California: Sage, 1994. 4. Yin RK. Case study research: design and methods. Sage: Newbury Park, 1989. Notice to Readers World Health Day - April 7, 1998 "Invest in the Future: Support Safe Motherhood" is the theme in the United States for World Health Day, April 7, 1998. In the United States, this day will focus on the continued importance of maternal health and opportunities to improve this aspect of women's health. Although the risk for women dying from pregnancy has decreased substantially during the past 50 years, the maternal mortality ratio for the nation has not decreased since 1982 (1). Approximately 50% of pregnancy-related deaths remain preventable (2), and the extent of morbidity associated with pregnancy is often unrec- ognized. Safe motherhood begins before pregnancy with healthy lifestyles that include good nutrition, physical activity, preconception care, and avoidance of harmful sub- stances. Safe motherhood continues with planned pregnancies; early, quality prenatal care; knowledge of warning signs of problems; and the delivery of a healthy, full-term baby with the minimum of necessary interventions. Postpartum support for women and their families in a positive, nurturing environment also is important. In 1998, in the United States, women can plan, carry, and deliver a pregnancy more safely than in the past. However, additional efforts need to be taken to make safe motherhood a reality for all women. Improved public health surveillance, prevention research, and prevention programs are needed to continue improving the health of women before, during, and after pregnancy and delivery. Examples include new sur- veillance methods to monitor and understand pregnancy complications; prevention research on the essential content of prenatal care; and prevention programs to ensure the adequate intake of folic acid by women of reproductive age to prevent neural tube defects (3). The World Health Day Advisory Committee of the American Association for World Health coordinates World Health Day activities in the United States. Additional infor- mation about special events and resource materials about World Health Day 1998 are available from the American Association for World Health, 1825 K Street, N.W., Suite 1208, Washington, DC 20006; e-mail: [email protected]; or from the World-Wide Web site: http://www.aawhworldhealth.org.