Maryland Cigarette Restitution Fund Public Health Grant at Johns Hopkins

1. Maryland Cigarette Restitution Fund Public Health Grant at Johns Hopkins New Pathways for Care: A Model for Delivering Prostate Cancer Screening to Men in Need Charlotte Neuhaus, MHS Program Manager Community-based Research Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins November 12, 2003

2. Age-adjusted Prostate Cancer Rates in Baltimore City, 1999 Per 100,000 population 237 169 77 37 Source: Maryland Cancer Registry, 2002

3. Prostate Cancer Screening Practices, Baltimore City, Males over Age 40 Have you ever had a PSA test? When did you have your last PSA test? Source: Maryland BRFSS, 2001

4. Baltimore City: Significant Facts • 25% of residents have no health insurance. • African-Americans twice as likely uninsured. • 57% of uninsured men age >40 report having no health coverage in over 5 years. Source: City of Baltimore, 2000 Source: City of Baltimore, 2000 Source: Maryland BRFSS, 2001

5. Mission Statement The Community-based Research team is dedicated to cancer prevention and control through innovative community-based programs and research.

6. Public Health Grant:Goals • Implement new model for community-based cancer education, screening diagnosis and treatment. • Reduce prostate cancer disparities in Baltimore City. • Improve access to prostate cancer screening. • Leverage existing resources through partnerships to increase men’s access to other health services.

7. Public Health Grant:Who We Are • Johns Hopkins partnership with 7 organizations: 5 community-based organizations, a community-based health provider, and a historically black university. • Recruited and trained staff from communities to: • Increase community awareness about prostate cancer • Outreach and provide education • Ensure informed decision-making prior to screening, • Provide prostate cancer screening, diagnosis, and treatment services to eligible men.

8. Plan OverviewPrevention, Education, Screening • Develop and expand community infrastructure for cancer awareness and screening • Sites • Credible presence in the communities and a commitment to cancer prevention and control • Assess individual community needs through a qualitative and quantitative methods • Screening methods • Prostate: PSA & DRE

9. Delivery of Services Region A Urban Medical Institute Region B St. Clare Medical Outreach Van

10. Plan OverviewDiagnosis and Treatment • Individuals with suspicious and/or positive cancer screening results: • For those with health insurance, covered via their existing health insurance plan • For those without health insurance or who are underinsured and meet eligibility requirements, covered via Federal/State medical assistance programs

11. Plan OverviewDiagnosis and Treatment (cont’d) • For those without health insurance or who are underinsured and do not meet eligibility requirements for Federal/State medical assistance programs, covered via the CRF/JH Diagnosis and Treatment Program

12. A New Roadmap: Pebbles in the Road • New pathway for providing care • Budget cuts • Interface with • 7 partners • Baltimore City Department of Health • Baltimore City Cancer Coalition • Department of Health and Mental Hygiene • Clinical providers • Serving as health insurer, health educators, case managers, outreach workers, patient navigators

13. Necessary Components for a New Pathway • Community capacity building • CLAM • A shared vision for health promotion • Sustainable service programs in the community • Clear and honest communication

14. Public Health Grant Progress

15. On the Road: Maintaining Success

16. On the Road: Maintaining Success

17. On the Road: Maintaining Success

18. On the Road: Maintaining Success