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Colorectal Cancer
Screening Pilot Program
(1/1/05-6/30/06)A Collaboration between
the Rockland County Cancer Institute
of the Rockland County Department of Health,
Good Samaritan Hospital and
Rockland County Gastroenterologists
October 27, 2006
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Ronda Rosman, RN, MS
Coordinator, Rockland County Cancer Institute
Rockland County Department of Health
Pomona, New York
C. Scott Vanderhoef - County Executive
Joan Facelle, MD, MPH - Commissioner of Health
(image: seal of Rockland County, NY)
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The Rockland County Cancer Institute (RCCI)
An outreach, education, screening and referral program targeting the four most prevalent cancers in Rockland County: breast, colorectal, prostate and lung.
(image: Rockland Cancer Institute logo)
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Background of the RCCI
- In 1984, County Legislature created Rockland County Special Commission on Women's Issues.
- Breast Cancer Task Force was created to raise awareness about breast cancer and promote early detection.
- Several legislators, themselves prostate cancer survivors, also wanted to address the issue of prostate cancer in Rockland County.
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- Legislature designated funds to address the issue of cancer in Rockland County.
- In 2001, County Executive C. Scott Vanderhoef asked the Health Department to develop an initiative to educate county residents and promote early detection of cancer through screening.
- A Medical Advisory Committee was convened and came up with recommendations which led to the formation of the Rockland County Cancer Institute.
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- Health Department worked together with the Medical Advisory Committee, Good Samaritan and Nyack Hospitals, ACS and other local community agencies to develop programs to expand cancer services in the county.
- In 2005, new programs were initiated through RCCI funding and became operational.
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Colorectal Cancer Screening Pilot Program
Developed based on the:
- Medical Advisory Committee Recommendations
- NYSDOH Colorectal Cancer Screening Program and Breast Health Partnership Program
- Rockland County Community Health Assessment 2005-2010
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Rockland County Community Health Assessment 2005-2010
- Diverse population
- Pockets of uninsured, underserved residents
- Pockets of poverty despite low overall poverty rates
- Substantial growth in the newly-immigrated, foreign-born population, and in the number of non-English speakers
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Rockland County Community Health Assessment 2005-2010
- Cancer is the leading cause of death for Rockland residents aged 45-64, second leading cause for ages 65 and older.
- County has a higher incidence rates for colorectal cancer than New York State.
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Colorectal Cancer Screening Pilot Program
Provide 100 free screening colonoscopies, follow-up and treatment to eligible uninsured and underinsured county residents.
(image: colorful GOAL image)
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Key players identified:
- Health Commissioner
- Local American Cancer Society Director
- Gastroenterologist
- Surgeon
- Pathologist
- Anesthesiologist
- Hospital Administrator
- RCCI Staff
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Our lead gastroenterologist encouraged his colleagues to participate in the program.
13 out of 14 local gastroenterologists agreed to participate.
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The gastroenterologists agreed to:
- provide office consultation visits in-kind.
- accept greatly reduced fees for performing the colonoscopies.
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Good Samaritan Hospital and participating doctors (representing the following specialties) also agreed to accept greatly reduced fees:
- Anesthesiology
- Pathology
- Surgery
- Oncology
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Funds for treatment were included in the grant
for patients diagnosed with colorectal cancer.
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Program Steps
- Program flyer was developed and translated by RCCI staff.
- Flyer was mailed by ACS to Breast Health Partnership participants and families.
- RCCI staff promoted the program in the community.
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(image: Mass mailing of flyer titled "Are you 50 or older? It's time to get tested for colon cancer!" to the ACS database)
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RCCI staff:
- scheduled appointments for the patient's office consultation with the gastroenterologist.
- provided frequent reminders (phone and mail).
- assisted with translation and transportation.
- referred patients to facilitated enrollers for health insurance.
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RCCI staff also:
- translated the colonoscopy prep and
- post-colonoscopy instructions into Creole, Spanish and Russian.
- purchased Fleet Phospho-Soda prep.
- put together "prep kits" to include prep instructions, two 1.5 ounce bottles of
Fleet Phospho-Soda, and county HIPPA form, and distributed to each office.
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Office Consultation
The gastroenterologists:
- examined patients
- obtained more extensive medical history
- educated patients about the colonoscopy procedure and prep instructions
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After office consultation, medically eligible individuals were scheduled for colonoscopy at Good Samaritan Hospital on an outpatient basis.
(image: photos of adults)
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Due to our efforts, clients kept their colonoscopy appointments 97% of the time.
(image: image of thumbs up, "Nice Job!")
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Keys to Success
(image: drawing of several men holding a large key)
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RCCI staff developed and maintained strong working relationships with the health care providers and office staff.
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(image: copy of "Thank You for Participating" advertisement which appeared in local paper)
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RCCI staff developed and maintained an effective system of communication.
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RCCI developed and maintained a successful system for vouchering and reimbursement.
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Colonoscopy Results 100 People Screened
- No colorectal cancer was detected.
- 18 patients had precancerous polyps identified
and removed during their colonoscopies.
- 12 patients had hyperplastic polyps (not
generally considered precancerous) identified
and removed during their colonoscopies.
- Other diagnoses included internal hemorrhoids,
diverticulosis, and other common findings.
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Using This Model In Your Community
- Look at your community needs assessment to demonstrate need
- Encourage buy in from key players
- Form partnerships with the medical community
- Advocate for funding - early detection saves lives ... and money!
- Start small, show success, then expand
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Thank you…
Ronda Rosman, RN, MS
Coordinator, Rockland County Cancer Institute
Rockland County Department of Health
50 Sanatorium Road – Building J
Pomona, New York 10970
845-364-3857
rosmanr@co.rockland.ny.us
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