Background

The California Breast and Gynecological Cancer Treatment Task Force (the Task Force) was formed in January 1999 in response to a request from state Senator Jackie Speier to provide technical advice to the state legislature regarding breast and gynecological cancer treatment for low-income, uninsured women. The State of California had been providing breast and gynecological cancer screening but, up until the 2000/01 fiscal year, had not taken responsibility for funding the treatment of those diseases. Funded by The California Endowment, the work was completed over the past year in response to Sen. Speier’s request. Full reports for each section are available upon request.

Legislation Update

In May 2000 Governor Gray Davis included $20 million for the treatment of breast cancer for low-income uninsured and underinsured individuals. This funding is for the fiscal year July 2000 to June 2001. (Review page 29 of the Governor’s Budget May Revision found at http://www.dof.ca.gov/html/bud_docs/bud_link.htm.

Legislation has recently passed both the Senate and the Assembly that will administer the funding included in the budget by the governor. This legislation institutionalizes a breast cancer treatment program as administered by the Department of Health Services through contracts to already existing private or public nonprofit organizations (Review AB 2878 at www.leginfo.ca.gov). Authored by Representative Howard Wayne and signed by the Governor, this program will be put into state statute, a status that requires the Department of Health Services to submit annual budget requests to fund the program. This legislation essentially replaces AB 40.

The single greatest priority that was raised during the various meetings the Task Force held around the state with breast cancer advocates was the need for the breast cancer treatment program to provide full comprehensive care, not just treatment for breast cancer. While AB 2878 does not do that, we are continuing to communicate to the appropriate individuals the importance of this issue.

Senator Jackie Speier has amended SB 1154 to institutionalize a breast and gynecological cancer treatment program, with comprehensive care, within the Department of Health Services (Review SB 1154 at www.leginfo.ca.gov). This legislation would take advantage of federal funding if federal legislation S. 662 passes the U.S. Senate this summer. S. 662 would allow states to fund breast and cervical cancer treatment through their Medicaid programs (in California it’s called MediCal) with a federal match. If S. 662 passes the U.S. Senate, we understand that Senator Speier will reintroduce SB 1154 in the beginning of the 2001 California Legislative term.

We will keep our web page up-to-date as AB 2878 is implemented and other treatment and funding opportunities (i.e., SB 1154 and S. 662) become available. Please check www.treatmentnow.org to ensure you have the latest information. Feel free to contact any of the Task Force organizations for more information on this important issue.

Statewide Survey Findings

The Task Force commissioned a statewide survey of 1,000 registered voters and four focus groups conducted by Lake Snell Perry & Associates and Market Strategies (full report available on request.)

Their findings:

• 52% of voters believe that Breast Cancer is the biggest health problem facing women today.

• 44% of voters have either been personally diagnosed with breast cancer or have had a family member or friend diagnosed.

• 86% of voters say it is personally important to them to guarantee all uninsured women, including low-income uninsured women, access to breast cancer screening.

• 86% of voters favor guaranteeing low-income uninsured women with breast cancer access to high quality treatment.

• 82% of voters are bothered that uninsured Californians receive screening for breast cancer, but they do not receive treatment.

Program Needs

The Task Force, in analyzing strengths and weaknesses of the current Breast Cancer Treatment Program, believes that a long-term, sustainable treatment program (institutionalized within the government), that includes the following components, will provide the most cost-effective and efficient services for low-income, uninsured women:

• Full access to comprehensive health care (not just cancer care) for individuals diagnosed with breast or gynecological cancers.

• Extensive coverage of cancer treatment without arbitrary cut off dates.

• Patient care coordination to ensure quality of care.

• Point-of-Service eligibility.

• Minimal co-payments/out-of-pocket expenses.

• Eligibility for the working poor (up to 300% of the federal poverty level).

• Eligibility for the underinsured (those with high co-pays or deductibles) as well as the uninsured.

• Open to all California residents.

Fifty-State Survey

The Task Force commissioned the National Conference of State Legislators to conduct a survey of all fifty U.S. states to determine the level of government-based treatment programs (full report available on request.) Until California passed AB 2878 this year, there were only six other states funding treatment programs.

• Six states currently provide funding for breast cancer screening and treatment for low-income, uninsured people. These are Arkansas, Georgia, Maryland, North Carolina, South Carolina and West Virginia. And now California (the seventh!)

Cost Estimates

The Task Force reviewed Department of Finance Current Population Survey information, as well as cost data developed by the actuarial firm of Milliman & Robertson to determine program cost estimates. For the first full year of the program:

• 1724 women, up to 300% of poverty, would be eligible for the program (these calculations are an overestimation as some of these women would be eligible for MediCal and the current screening program is only reaching 10-15% of the eligible population.)

• The cost for providing comprehensive care for one year, based on MediCal rates, for one woman with breast cancer would be $13,800.

• The total annual cost if all eligible women utilized this program would be $23 million.

Budget Impact

In May 2000 Governor Gray Davis included $20 million in the State Budget for the treatment of breast cancer for low-income uninsured and underinsured individuals. This funding is for the fiscal year July 2000 to June 2001 and was approved by the State Legislature. (Review page 29 of the Governor’s Budget May Revision - http://www.dof.ca.gov/html/bud_docs/bud_link.htm).

Task Force Members

• WIN Against Breast Cancer

• American Cancer Society, California Division

• Breast Cancer Action

• Breast Cancer Alliance of California

• The Breast Cancer Fund

• California Breast Cancer Early Detection Program (BCEDP) Partnerships

• BCEDP Advisory Council

• California Breast Cancer Organizations

• California Breast Cancer Treatment Fund

• California Health Officers Association

For more information, please contact:

Marj Plumb

Marj Plumb and Associates
1040 Camelia Street
Berkeley, CA 94710
Telephone: (510) 524-0246
Fax: (510) 524-0247
E-mail: marjplumb@aol.com

Additional information on the California Breast Cancer Treatment Fund can be found on the California HealthCare Foundation's web site at: http://www.chcf.org/press/view.cfm?itemID=423

10/01/00

(Source: Marj Plumb and Associates)

Last Updated: 06/01/2004

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