California Colorectal Cancer Coalition (C4)

Sandra Robinson, MBAVice President Board of Directors, C4

Director, California Colorectal Cancer Control Program

“Our mission is to save lives and reduce suffering from colorectal cancer in all Californians.” reduce suffering from colorectal cancer in all Californians.

C4 Mission Statement:

To save lives and reduce suffering from colorectal cancer in all Californians

C4 plans to fulfill this mission by:

• Implementing strategies to reduce disparities in CRC screening, diagnosis, and treatment among underserved populations in California

• Increasing capacity for colorectal cancer screening

• Advocating for CRC screening programs to serve uninsured and underinsured populations

The Beginning - The Dialogue Summit

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

Steps Taken

• Identifying the Board of Directors• Drafting the By Laws and Articles

of Incorporation• Filing Articles of Incorporation for

501c3 Non-Profit status and incorporation

• Developing the Mission Statement and Objectives

• Identifying the first activity as a Board to increase CRC screening

The Ingredients •  Our mix of participants:

– Originally: legal and public relations. (now a gap) – Currently: clinicians, academics, survivors, public

health administrators, legislative staff, advocates.  (smart, dedicated volunteers)

• Regular meetings held with action items reviewed and ongoing projects discussed.

• A strong shared mission and goals among the Board Members – “Get Californians screened for CRC”.  

• A forum for sharing ideas and best practices to increase CRC screening.

• The key role of ACS involvement and integration with the state organizations (government and stakeholders).  

• The remaining problem - a reliable, steady revenue stream/source.

California’s Challenge – What Drives Us• 38.8 million population 2014*• Almost 12 million currently enrolled

in Medicaid• 6.6 million Californians in 2013

were uninsured, with 4.1 million lacking coverage for at least a full year.

• California's uninsured rate fell by as much as 40% in 2014**, (to roughly just under 4 million) in large part because of expanded coverage under the Affordable Care Act.

• At least 1 million is undocumented.*http://quickfacts.census.gov/qfd/states/06000.html**California Healthline Report: California Uninsured Rate Fell by as Much as

40% Under ACA, Thursday, February 26, 2015

CRC Screening Rates in California• In 2012, Behavioral Risk Factor

Surveillance Survey (BRFSS) - 64% of Californians over age 50 reported being up to date with CRC screening according to U.S. Preventive Services Task Force (USPSTF) guidelines.

• Persons with income at or below 250% of the Federal Poverty Guidelines (FPG) – 52%

• Hispanics – 46%• Uninsured – 26%• 2014 FQHC CRC screening rate -

34.8%**http://bphc.hrsa.gov/uds/datacenter.aspx?year=2014&state=CA

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

California Pilot Project: Colorectal Cancer Community Screening - Improving access to colorectal cancer screening and treatment for the uninsured and underserved

A Joint Venture Championed by

13

Pilot sites applying these models:• Alameda County

– Pilot FIT screening program at ACMC’s Internal Medicine clinic– Expand pilot to consortium clinics and develop OA’s network of

volunteer GI teams at non-profit hospitals to provide added capacity

• Sacramento County– Identify and develop resources before piloting a CRC screening

program– Potential pilot program with Kaiser Permanente and student-run

clinics

• Los Angeles County– Pilot screening program with FIT at Venice Family Clinic’s eight sites– Expand FIT screening program at East Valley Community Health

Center– Broaden network of volunteer GI teams at private hospitals and

endoscopy centers

• Stanford University Community (Santa Clara County)– Implement FIT screening at Stanford’s two affiliated free clinics– Establish OA-type model at Stanford Medical Center with volunteer GI

teams

• Orange County– Expand GI network and services at AccessOC (two GI days held in

2011, expanding in 2012)

Stakeholder meetings with Partners 

April 26, 2012 Colorectal Cancer Roundtable Meeting:

Objectives:•Establish strategic ways that organizations throughout the state can work together to reduce the burden of colorectal cancer.•Establish regional plans to implement the colorectal cancer objectives of California’s Comprehensive Cancer Control Plan, 2011-2015 – Sponsored by California Dialogue on Cancer (CDOC State Cancer Plan).

March 2015 ACS 80% by 2018 Stakeholder MeetingsColon Cancer Screening Initiative 80% by 2018: What it will take to get there Los Angeles and Oakland

March 2015 Roundtable in San DiegoRequirement of 2014 C4 grant – conduct County wide meeting for Council of Community Clinics attended by Clinic Medical Directors.

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

Grants Program 2013• LA Care Health Plan $5000

Patient Navigator to increase FIT screening

• San Diego NHC $5000Comprehensive approach to

increase FIT CRC screening (in-reach) • UC Davis $7500

Train Peer Navigators for patients with newly diagnosed colon cancer

• UC San Francisco $4500Develop FIT use videos in 10 languages

• Celilia De La Hoya Cancer Center $5000FIT testing paired with breast cancer screening

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

Grants Program 2015• Clinica Sierra Vista – Fresno, CA - $8,000Increase CRC screenning rates through FIT tests

and Education.• White Memorial Medical Center, Los

Angeles, CA-$5,910Educational material and FIT tests distributed

through EWC (BCCEDP) program. Focus on Hispanic and Korean population.

• Vista Community Clinic – Vista, CA - $7,300Patient education materials• San Diego County Medical Society

Foundation – San Diego, - $10,000Increase CRC screening for high risk populations

with focus on Latino and African American Males

Grants Program 2015

• Community Health Systems – Moreno Valley Family Health Center – Moreno Valley, CA - $6,000

Provide iFOBT tests for high risk population• Neighborhood Healthcare – Escondido,

CA - $10,000Increase CRC screening rates to 65% in 3

clinics• Methodist Hospital of Southern

California – Arcadia, CA - $5,250Community education and screening events

distributing FIT tests• Linda Vista Health Center – San Diego,

CA - $5,000Education and clinic in-reach to increase out-

reach and follow up for FIT test return

FIT Test purchase strategy

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

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

Advocacy Efforts to Date • Six annual C4 Sacramento Lobby

days have occurred in March to pass a resolution to make March Colorectal Cancer Awareness Month.

• Lobby days educated the legislators on the burden of colon cancer in their districts.

• 2016 Lobby Day will focus on colonoscopy co-pay bill and March CRC Awareness Resolution.

Advocacy Need• Bill requiring health

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

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

Putt for Your Butt

• Undy Run/Walk • On line donations• Personal donations• Truck Show

C4 Projects • Partnerships • Grants Program• Advocacy• Fundraising• Education

Educational opportunities

• Grand Rounds• Webinars• Community stakeholder

meetings• Meetings with the Legislators• Our website

Thank You

Please visit our website:http://www.cacoloncancer.org/