American Cancer Society Cancer Action Network
American Congress of Obstetricians and Gynecologists, District II
Central New York Affiliate of Susan G. Komen
Density Education National Survivors' Effort
Family Planning Advocates of New York State
Greater New York City Affiliate of Susan G. Komen
League of Women Voters of New York State
Medical Society of the State of New York
New York Chapter of the American College of Surgeons
New York Public Interest Research Group
New York State Academy of Family Physicians
New York State Public Health Association
Northeastern New York Affiliate of Susan G. Komen
Roswell Park Cancer Institute
Twin Tiers Affiliate of Susan G. Komen
Western New York Affiliate of Susan G. Komen
December 19, 2013
Governor Andrew M. Cuomo
Executive Chamber
Capitol Building
Albany, NY 12224
Re: Recommend funding support for the New York State Cancer Services Program
Dear Governor Cuomo:
On behalf of New Yorkers concerned about cancer, our organizations urge you to ensure that the state’s
Cancer Services Program (CSP) is adequately funded at its current level in your upcoming executive
budget.
In recent fiscal years, the CSP received as much as $29 million to conduct outreach and screenings for
cancer. Combined cuts to the CSP have reduced overall spending for this lifesaving screening to $25.3
million in FY 2013-14, of which about $19 million directly supports the screening services. Although we
understand that these are difficult economic times, the need for CSP is critically important to the nearly
2.5 million uninsured New Yorkers.1
The CSP has worked diligently in every community across the state to provide screening and early
detection of breast, cervical and colorectal cancer to women and men who are under- and uninsured for
more than twenty years. Operating through 36 Partnerships—a network of thousands of hospitals,
clinics and doctors' offices – they provide crucial cancer screening, diagnostic services and case
management for New Yorkers with little or no insurance in every county of New York State. And
while the program has screened tens of thousands of people, at current funding levels for example, the
1
United State Census Bureau, see:
http://www.census.gov/hhes/www/hlthins/data/historical/HIB_tables.html, accessed 11/12/12, Table HIB-4, “Health
Insurance coverage Status & Type of Coverage by State All People: 1999 to 2011.
1
New York State Cancer Services Program is able to help fewer than 20% of the women who don't have
insurance and can't afford a mammogram.2
Cancer screening saves lives. Detecting cancer early increases the chances of successful treatment,
improves survival rates, and saves New York in overall medical costs. For example, research shows that
the earlier breast cancer is detected and treated, the better the survival rate. When breast cancer is
diagnosed when the tumor is localized and has not metastaticized, the 5-year survival rate is 99%.3 Yet,
uninsured patients are less likely to get recommended cancer screenings and are more likely to be
diagnosed with cancer at later stages.4 For example, uninsured women diagnosed with breast cancer are
2.5 times more likely to have a late stage diagnosis than women enrolled in private health insurance.5
Published research on the success of the National Breast and Cervical Cancer Early Detection Program,
which partially funds and guides the state screening program, demonstrates a substantial impact on
reducing mortality from breast cancer in medically uninsured, low income women.6
These evidence-based findings justify the state’s investment in the early detection of breast cancer. In
2009, the State Department of Health estimated that the cost of the Cancer Services Program was offset
by $46 million in savings due to early detection.
We applaud the state’s successful roll-out of the NY State of Health, the Official Health Plan
Marketplace, which showed robust enrollment numbers early on. But even with the implementation of
the Affordable Care Act, we will not reach everyone. An estimated 10% of men and women ages 50-64
will continue to remain uninsured in New York State. Twenty years of CSP experience has developed a
robust infrastructure, capacity and expertise that is essential because insurance is not the only barrier to
receiving cancer screening especially, for low income families. It is therefore critical that this program is
adequately funded as the demand for these services remains high.
In addition, there are many program aspects that continue to be necessary in order for New Yorkers to
benefit from critical, potentially life-saving cancer screening services:



Recruitment, public and provider education, quality assurance, and data collection.
Patient navigation and coordination of care.
Language and cultural barriers, transportation barriers, knowledge and attitude barriers to
preventive medicine will continue to exist and, even with insurance, men and women will need
assistance to fully access these services.
Lastly, the CSP provides a direct entry to Medicaid for those diagnosed thanks to the Medicaid Cancer
Treatment Program. This federal law allows New Yorkers diagnosed through the program to receive
immediate Medicaid coverage. It behooves the Medicaid program to simultaneously consider the
important role this program plays in optimizing federal dollars to care for New Yorkers diagnosed with
New York State Department of Health, “Breast and Cervical Cancer Early Detection Program Report,” Program
Year 2008-2009, see: http://www.health.ny.gov/diseases/cancer/cervical/resources/docs/20082009_early_detection_report.pdf.
3
American Cancer Society, “Cancer Treatment and Survivorship: Fact and Figures, 2012-2013,” p. 4.
4
Halpern MT, Bian J, Ward EM, Schrag NM, Chen AY. “Insurance status and stage of cancer at
diagnosis among women with breast cancer.” Cancer 2007; 110: 403-11.
5
Kaiser Commission on Medicaid and the Uninsured. “The Uninsured: A Primer. Key Facts About
Americans Without Health Insurance,” January 2006.
6
Hoerger, Thomas J., PhD, et al. Estimated Effects of the National Breast and Cervical Cancer Early Detection
Program on Breast Cancer Mortality. Am J Prev Med 2011;40(4):397– 404.
2
2
cancer. Those who continue to fall through the cracks are not only diagnosed with later-stage cancers,
they often come into the Medicaid Program through a more traditional door, relying on state funding to
finance their care.
We respectfully request that the CSP funding be returned to $29 million so that local programs can
adequately serve their existing clients and outreach to the eligible population to the extent possible. Your
support, through the budgetary process, can mean the difference between life and death for New Yorkers
impacted by cancer.
If we can be of further assistance, please contact Michael Burgess at the American Cancer Society Cancer
Action Network at michael.burgess@cancer.org.
Sincerely,
Michael Burgess
NYS Advocacy Director
American Cancer Society Cancer Action Network
Donna Montalto, MPP
Executive Director
American Congress of Obstetricians and Gynecologists, District II
Kate Flannery
Executive Director
Central New York Affiliate of Susan G. Komen
Joann Pushkin
Founder
Density Education National Survivors' Effort
M. Tracey Brooks
President and CEO
Family Planning Advocates of New York State
Anita McFarlane
Director of Grants and Public Policy
Greater New York City Affiliate of Susan G. Komen
Sally Robinson
President
League of Women Voters of New York State
Sam L. Unterricht, MD
President
Medical Society of the State of New York
David W. Wormuth, MD, FACS
President
New York Chapter of the American College of Surgeons
3
Raymond Ebarb, MD
President
New York State Academy of Family Physicians
Blair Horner
Legislative Director
New York Public Interest Research Group
Michael Seserman, MPH, RD
President and Policy Chair
New York State Public Health Association
Lynette Stark
Executive Director
Northeastern New York Affiliate of Susan G. Komen
Dr. Donald Trump, FACO, MD
President and CEO
Roswell Park Cancer Institute
Patricia Nozell
Executive Director
Twin Tiers Affiliate of Susan G. Komen
Juliana Janson
Executive Director
Western New York Affiliate of Susan G. Komen
CC:
Robert Megna, Director of the Division of the Budget
Nirav Shah, Commissioner of the State Department of Health
Courtney Burke, Deputy Secretary for Health
Hon. Kemp Hannon
Hon. Richard N. Gottfried
4