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Diane Balma
Legal Counsel, The Susan G. Komen Foundation (National),
Director of Komen Champions for the Cure (Public Policy
Program) and Survivor
Diane speaks to a host of national issues including federal
funding for research and outreach programs. She states that
finding a cure for breast cancer is going to take a collaborative
effort between the public and private sectors. Diane feels
that Congress and the Federal government face enormous funding
pressures, but now is not the time to scale back funding
for breast cancer. Ms. Balma advises that another issue
of paramount importance is access to care and the underserved/uninsured.
She states:
"While we invest for the future, we must not forget
about the needs of those facing breast cancer today - particularly
the needs of low-income and medically underserved individuals,
who are disproportionately impacted by breast cancer. The
National Breast and Cervical Cancer Early Detection Program
(NBCCEDP) operated by the CDC, in conjunction with state
health departments (in NJ through NJCEED), helps meet these
needs by providing free mammography screening to women with
little or no health insurance. A recent study reports that
low-income women have lower screening rates and are 41%
more likely to be diagnosed with late-stage breast cancer
and are three times more likely to die from breast cancer.
The NBCCEDP is making a difference, but it currently only
serves 15% of eligible women because of a lack of federal
funding. We must do better."
Diane believes personal advocacy makes a public impact.
She advises that every American can make a difference in
the fight against breast cancer - whether it's by volunteering,
making a contribution or making their voices heard. "All
of us will be touched by breast cancer in some way."
More than 200,000 women and men will be diagnosed with breast
cancer this year, and more than 40,000 will die from this
disease. "We hope that viewers will feel empowered
to write a letter or place a call to their Members of Congress
and let their voices be heard." Another issue is the
lack of adequate Medicare reimbursement for cancer treatments,
including cancer drugs and technology, such as mammography.
"We are concerned that patient access to quality care
has been and will continue to be threatened. The decline
in mammography facilities and radiologists entering the
field of breast cancer are of particular concern, as are
the recent cuts to oncology drugs mandated by the Medicare
Modernization Act of 2003."
Eddy A. Bresnitz, MD, M.S.
New Jersey State Epidemiologist/Dept. of Health and
Senior Services
Eddy believes strongly that early detection and screening
are of great importance. He advocates that insurance programs
should be required to provide medical coverage for mammograms
to women under the age of 40. Additionally, he states that
fighting breast cancer also involves promoting education,
and insuring adequate funding for outreach programs that
promote access to services for underserved populations.
Eddy speaks to the Governor's Comprehensive Cancer Control
Plan and the three topic areas identified in the report.
Those areas are: Awareness and Education, Research and Surveillance,
and Treatment. Within these areas the Plan has sought to
develop a consistent educational message that promotes early
detection and prevention. Eddy states that the Department
of Health and Senior Services is a public advocate in the
fight against breast cancer. He advises that the Department
must constantly lobby on the local, state, and Federal levels
to work towards coordination of services and appropriate
and fair resource allocation. In addition, he believes that
the Department has a responsibility to education on an individual
basis, plus promoting personal advocacy as well.
Doreleena Sammons-Posey
Program Manager, Cancer and Reproductive Health Services,
NJ Dept. of Health
Doreleena is familiar with the New Jersey Cancer Education
and Early Detection Program (NJCEED). The NJCEED Program,
with funding from the CDC and the state, provides funding
to all 21 counties in the state for cancer screening and
early detection. CDC funds are exclusively targeted to women
50 - 64 years of age who are uninsured or underinsured,
underserved populations, and racial/minority populations
for breast and cervical cancers. State funds are used for
comprehensive breast, cervical, prostate and colorectal
cancer education, outreach and screening. The goal is to
increase awareness and encourage individuals to use screening
services. She can also address NJCEED funding increase proposed
in the Governor’s budget.
Additionally, Doreleena emphasizes the racial disparity
in respect to higher morbidity rates for African American
women and younger women with the disease. She advises that
the healthcare delivery system has not met the needs of
the undereserved. She states that hours of operation, location
of clinics, hospitals, and physician's offices often make
treatment impossible. Furthermore, women who work save their
sick leave for times when they must stay home to care for
their ill children. Attitudes towards obtaining health care
are also cultural issues. Sammons-Posey advises that Hispanic/Latina
women traditionally care for their families first and themselves
last. She advises that women of color and those of different
ethnic origins are the best outreach workers. According
to Sammons-Posey, this type of public advocacy , of "putting
a face to the disease" is most effective in educating
women about the disease. Doreleena is vocal about what she
considers to be gaps in funding and programmatic inconsistencies
on both a state and federal level. While funding may be
available for screening, once a diagnosis of breast cancer
has been determined, there may not be any monies available
for treatment.
Larry McReynolds
Executive Director, Jersey City Family Health Center,
Patient Navigator Program
This Patient Navigator Program received its funds through
legislation introduced by Congressman Robert Menendez, of
the 13th District, New Jersey (Jersey City, Bayonne, Perth
Amboy), which is called "The Patient Navigator, Outreach
and Chronic Disease Prevention Act of 2003." This program
at the Jersey City Family Health Center focuses on case
management of populations that have been identified as unlikely
to follow-up in treatment. Those populations have been identified
as women in the greater Jersey City area who are undocumented
aliens, the non-insured, and non-English speaking. Individuals
are treated regardless of their ability to pay. This one-year
funding of $100,000 from a federal grant expires in August,
2004.
McReynolds advises that one of the key issues in New Jersey
is access to care for vulnerable populations. He advises
that this issue of access is closely entwined with cultural
attitudes towards healthcare and prevention. The Patient
Navigator program hired part-time (20 hours a week) outreach
workers that are from a variety of backgrounds mirroring
those in the community: Indian, Pakistani, African American,
Hispanic, etc. He advises that each population has its own
unique communication style. In Far-Eastern cultures, for
example, many times the wife cannot speak for herself, so
workers must address the husband about the need for early
detection and prevention. There are many challenges, but
McReynolds advises that this program is increasing the awareness
of services that are available in the community. He feels
that it is helping to overcome a "why bother"
attitude in the community, especially for those who don't
have insurance and assume that not having insurance means
they cannot receive treatment. Additionally, he advises
organizations to look to a variety of funding sources rather
than to rely on one source. Those sources include foundations,
as well as federal and state programs.
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