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Breast & Cervical Cancer State Programs. A federal, state and local partnership for women in Texas ~ October 2007 ~ Evelyn Delgado Assistant Commissioner Division of Family & Community Health Services. Breast & Cervical Cancer Programs. Early Detection Early Treatment.
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Breast & Cervical Cancer State Programs • A federal, state and local partnership for women in Texas • ~ October 2007 ~ • Evelyn Delgado • Assistant Commissioner • Division of Family & Community Health Services
Breast & Cervical Cancer Programs • Early Detection • Early Treatment
Breast Cancer in Texas and Harris County Texas N=59,774 Harris Co. N=9,340 Source: Texas Cancer Registry
Cervical Cancer in Texas and Harris County Texas N=5,408 Harris Co. N=911 Source: Texas Cancer Registry
Mortality Rates in Texas Breast N=12,465 Cervical N=1,756 Source: Texas Cancer Registry
Early Detection: Breast & Cervical Cancer Services • Title XV Federal funding - $6.4 million/year for the screening of the target population (uninsured women most at risk) • State - DSHS responsibilities • Provide statewide coverage • Data Management & Surveillance • Professional Education • Quality Assurance
Early Detection: Breast & Cervical Cancer Services • BCCS focuses on high priority populations • Breast (50+) • Cervical (18-64) • Any woman with an abnormal screening
Early Detection: Breast & Cervical Cancer Services • Local Community Responsibilities • Screening & Education • Case Management of women with abnormal findings • Outreach • Partnerships
Treatment: EnactingLegislation U.S. Congress - 2000 Texas Legislature - 2001
Treatment: Medicaid for Breast & Cervical Cancer (2002 - 2007) • Medicaid coverage for women diagnosed by Texas BCCS with Title XV funds and who need treatment of breast or cervical cancer • DSHS confirms diagnoses and BCCS enrollment • HHSC processes Medicaid enrollment and re-certification
Medicaid for Breast & Cervical Cancer Texas (2002 – 2007)
Medicaid for Breast & Cervical Cancer Today • 80th Texas Legislature authorized the broadest expansion allowable under federal guidance • Additional state funds for treatment and diagnosis • $14.9 million - Medicaid • $5.2 million - BCCS • BCCS contractors are the primary contacts for assisting women and providers • BCCS contractors coordinate with local providers and HHSC/Medicaid
BCCS Expansion • Current BCCS contractors with capacity will offer services in new clinics • DSHS will release a new request for proposals targeting those counties that are not currently served or underserved. • Will be released by early November. • New contracts will begin January 1, 2008
Medicaid for Breast & Cervical CancerToday Eligibility: • Uninsured, no creditable insurance coverage • U.S. citizen or qualified immigrant • Income eligible (200% FPL) • A qualifying diagnosis • Under 65 • Texas Resident
Medicaid for Breast & Cervical CancerToday • Enrolled for full Medicaid coverage • 6 month recertification as long as there is a continued need for treatment
MBCC Breast Qualifying DiagnosesToday A qualifying pre-cancerous breast diagnosis* is biopsy confirmed: ◄Ductal carcinoma in situ (DCIS) Qualifying breast cancer diagnoses must be biopsy-confirmed. 1. Ductal Carcinomas: ◄Invasive ◄Comedo ◄Inflammatory ◄Medullary ◄Mucinous (colloid) ◄Papillary or Micropapillary ◄Scirrhous ◄Tubular ◄Cribiform 2. Lobular Carcinoma: ◄Invasive 3. Nipple Carcinoma: ◄Paget’s disease 4. Other Carcinomas (For the full list visit: ww.dshs.state.tx.us/chscontracts/pdf/MBCCQualifyingDx91807.pdf)
MBCC Cervical Qualifying DiagnosesToday Qualifying pre-cancerous cervical diagnoses are biopsy-confirmed: ◄CIN III ◄Severe dysplasia ◄Carcinoma or adenocarcinoma in situ Qualifying malignancies of the cervix are biopsy-confirmed: ◄Squamous cell carcinoma ◄Adenocarcinoma ◄Invasive endocervical adenocarcinoma ◄Small cell carcinoma ◄Invasive cervical cancer ◄Invasive neoplasm ◄Malignant neoplasia ◄Melanoma ◄Sarcoma ◄Glassy cell ◄Adenoid cystic ◄Adenosquamous carcinoma
Case Management for Treatment • BCCS conducts an assessment of medical, educational and essential support needs
Enrollment in Medicaid for Breast & Cervical Cancer • 2003 : 497 women • 2007: 678 women • 2008* Projected ~1,800 • 2009* Projected ~3,000
A Federal, State, and Local Partnership
Challenges • Some women will not qualify but need still need treatment: • Non-qualifying diagnosis • Immigration status • Education and Outreach on new policies • Covering both cervical cancer and breast cancer
How can you help? • Know your local BCCS provider • Talk to your provider • Identify ways to help those that need support • Let us know what works; what doesn’t • Call us if you have questions
For More Information • To find a BCCS clinic call 211 or visit the BCCS website: www.dshs.state.tx.us/bcccs • Email David Hagerla david.hagerla@dshs.state.tx.us • Call DSHS (512) 458-7796