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Breast, Cervical and Colon Health Program Megan Celedonia, Manager WCOMO, February 15, 2013

Breast, Cervical and Colon Health Program Megan Celedonia, Manager WCOMO, February 15, 2013. Program Description. Established by: National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Colorectal Cancer Control Program (CCRP). Goals.

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Breast, Cervical and Colon Health Program Megan Celedonia, Manager WCOMO, February 15, 2013

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  1. Breast, Cervical and Colon Health Program Megan Celedonia, Manager WCOMO, February 15, 2013

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

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

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

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

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

  7. 2012-2013 Funding Sources

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

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

  10. Breast Health Services for Women

  11. Cervical Health Services for Women

  12. Colon Health Services for Men and Women

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

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

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

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

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

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

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

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

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

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

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