program description established by: national breast and cervical cancer early detection program...
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Program Description• Established by:• National Breast and Cervical Cancer Early
Detection Program (NBCCEDP)• Colorectal Cancer Control Program (CCRP)
Goals• Promote breast, cervical and colorectal cancer
screening and early detection• Provide access to quality breast, cervical and
colorectal cancer screening services
Federal LawsBreast and Cervical Cancer Mortality Prevention
Act of 1990 • Established the NBCCEDP
Breast and Cervical Cancer Prevention and Treatment Act of 2000 • Established State treatment programs through
Medicaid
State Laws • Early Detection of Breast and Cervical Cancer
Screening Program – Medical Advisory Committee – RCW 43.70.655
• Related RCWs• 74,04.050, 74.04,055, 74.04.057, 74.08.090, 74.08.090,
74.04.050, 74.04.057, 74.09.530, 74.09.510
State Rules• Washington Administrative Codes (WAC)• Breast and Cervical Cancer Treatment
Program (BCCTP) - WAC 182-505-0020• Alien Emergency Medical (AEM) Program
(WAC 388-424-0001 & 388-424-0006)
2012-2013 Funding Sources
Funding Breast/Cervical
Amount
Federal BCHP 4.3 millionState 2.8 millionSusan G Komen for the Cure Affiliates
1.4 million
Total B/C 8.5 millionFunding ColorectalFederal CRC- screening 607,489Combined Total 9,107,489
Prime Contractors• Citrine Health, Inc.• PeaceHealth Southwest Medical Center• Public Health Seattle & King County Health Department• Spokane Regional Health District• Wenatchee Valley Medical Center• Yakima Health District
Public Health Seattle-King
County
Yakima Health District
Wenatchee Valley
Medical Center NW
Spokane Regional Health District
Breast, Cervical and Colon Health Program Service Delivery Network Map 2012-2013
PeaceHealth Southwest Medical Center
Whatcom Okanogan Ferry Stevens Pend Oreille
Spokane
LincolnDouglas
Grant
Kittitas
Chelan
Snohomish
King
Pierce
Lewis
Pacific
Grays Harbor
Jefferson
Clallam
Adams Whitman
Garfield
AsotinColumbia
Walla Walla
Franklin
BentonYakima
KlickitatSkamania
Cowlitz
Clark
Wahkiakum
Thurston
Mason
Skagit
San Juan
Island
Kitsap
Citrine Health
Breast Health Services for Women
Age Presentation Income Services Covered40-64 Well woman
Breast cancer symptomsBreast cancer findings
< 250% FPL251% - 300% FPL – available in most counties
Breast cancer screening & diagnostics
18-34 Breast cancer findings(i.e. suspicious CBE)
< 300% FPLavailable in most counties
Follow-up CBEBreast cancer diagnostics
35-39 Breast cancer symptoms < 250% FPL251% - 300% FPL – available in most counties
CBEBreast cancer diagnostics
65+ Well woman Breast cancer symptomsBreast cancer findings
<250% FPLNot eligible for Medicare
Breast cancer screening & diagnostics
Cervical Health Services for Women
Age Presentation Income Services Covered40-64 Well woman
Cervical cancer symptomsCervical cancer findings
< 250% FPL Cervical cancer screening & diagnostics
35-39 Breast cancer symptoms
<250% FPL Cervical cancer screening & diagnostics
65+ History cervical cancer findings(CIN2, CIN3)
<250% FPLNot eligible for Medicare
Cervical cancer screening & diagnostics for 20 years after pre cancer diagnosis
Colon Health Services for Men and Women
Age Presentation Income Services Covered50-64 Asymptomatic &
Average RiskIncreased Risk
<250% FPL Colon cancer screening or surveillance & diagnostics
18-49 Asymptomatic & Increased Risk due to personal or family history
<250% FPL Colon cancer screening & diagnostics
65-75 Asymptomatic &Average RiskIncreased Risk
<250% FPLNot eligible for Medicare
Colon cancer screening & diagnostics
Priority Populations• Native Americans/Alaska
Natives• Asian and Pacific
Islanders• Hispanics• Lesbian and Bisexual• People with disabilities
• Women who have never been screened for breast or cervical cancer
• Men 50+ for CRC
Breast & Cervical Cancer Treatment• Breast & Cervical Cancer Treatment Program
(Medicaid – comprehensive)• Alien Emergency Medical (AEM) Program
(Medicaid) - limited care only
Colorectal Cancer Treatment
• No specific program for colorectal cancer treatment
• Referred to charity care and other organizations that may assist in paying for treatment
Reimbursement• Prime Contractors sub-contract with many providers in
their region• Reimbursement is paid at the highest Medicare allowable
rate regardless of location• Reimbursement is specific to breast, cervical and colon
cancer screening and diagnosis• CDC limits some reimbursement rates• CDC and BCCHP/MAC determine what procedures we can
reimburse
Program Screens FY12• 14,916 screened for breast and cervical cancer• 1439 screened for colorectal cancer, 30 suspicious
polyps removed
2013 Legislative session• Assumption with HCR that all clients will be eligible for
the exchange or expansion• Governor’s budget eliminates state funding for our
program by 2016• Phased out reduction plan for state funds:• 28% FY 14• 70% FY 15
• Federal budget unknown
Health Reform Impact• Technically:• 70% of current clients will be eligible for
Medicaid expansion (at 138% FPL or less)• 30% of current clients will be eligible for
the exchange (above 139% FPL)
Health Reform Impact• What we know:• 10% of eligible state population may not
get insurance due to financial hardship
Health Reform -- Planning • Community Health Worker Training System• Partnership with HCA• Connecting clients to services• Playing the waiting game
Megan Celedonia, MES
Manager, BCCHP
360 236-3785
Megan Celedonia, MES
Manager, BCCHP
360 236-3785