Title: An act relating to an early detection breast and cervical cancer screening program.

Brief Description: Establishing an early detection breast and cervical cancer screening program.

Sponsors: Representatives Cody, Bailey, Schual-Berke, Fromhold, Woods, Upthegrove, Williams, Darneille, Kenney, Hunt, Campbell, Simpson, Tom, Hasegawa, Haler and Santos.

Brief History:

Health Care: 2/24/05, 2/28/05 [DPS].

HOUSE COMMITTEE ON HEALTH CARE

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 15 members: Representatives Cody, Chair; Campbell, Vice Chair; Morrell, Vice Chair; Bailey, Ranking Minority Member; Curtis, Assistant Ranking Minority Member; Alexander, Appleton, Clibborn, Condotta, Green, Hinkle, Lantz, Moeller, Schual-Berke and Skinner.

Staff: Molly Belozer (786-7104).

Background:

In 1990, Congress passed the Breast and Cervical Cancer Mortality Prevention Act to provide grants to states for the purpose of screening women for breast and cervical cancer. The Centers for Disease Control and Prevention (CDC) developed the National Breast and Cervical Cancer Early Detection Program in 1991 to help low income, uninsured, and underserved women gain access to screening programs for early detection of breast and cervical cancer. Implemented in all 50 states, the program provides clinical breast examinations, mammograms, pap tests, surgical consultation, and diagnostic testing for women with abnormal screening results.

The Department of Health (Department), through a CDC grant, administers a breast and cervical cancer early detection program for low-income women. Federal funding from FY00 to FY04 was $15 million, and the state is required to contribute $1 for every $3 of federal funding. The Legislature has appropriated an annual $1 million for breast and cervical cancer screening, coordination, and outreach services.

Breast cancer is the second most commonly diagnosed cancer among American women; according to a report on cancer statistics from the CDC and the National Cancer Institute, Washington has the highest incidence of breast cancer in the nation. According to the Department, early detection screening could prevent approximately 15 to 30 percent of breast cancer deaths among women over the age of 40.

Cervical cancer has a low incidence in the United States. According to the CDC, human papillomavirus (HPV) infection is a strong risk factor for cervical cancer, but regular Pap tests can detect HPV infection and pre-cancers. The Department believes that early detection screening can prevent most cervical cancer deaths.

Summary of Substitute Bill:

The Department must administer a state-supported early detection breast and cervical cancer screening program to assist eligible women with preventive health services. The screening program must enroll eligible women and, as funds are available to expand the program, additional eligible women. Eligible women are defined as women aged 40-64, with income at or below 250 percent of the federal poverty level.

The funding from the state must not be used to replace federally-funded breast and cervical cancer early detection programs, but will be used to operate Department-approved programs or increase access to existing state-approved programs.

The Department must establish a Medical Advisory Committee (Committee) to provide expert medical advice and guidance in addressing concerns and program policy implementation of the early detection breast and cervical cancer screening program. The Committee must include interested medical professionals and consumer liaisons with expertise in areas relating to breast and cervical health.

Substitute Bill Compared to Original Bill:

The substitute bill clarifies that the program will enroll eligible women only as funding is available. The Department may continue to enroll additional eligible women using private funds and public funds in addition to those appropriated in the annual budget to support the cost of such enrollment.

Appropriation: None.

Fiscal Note: Available.

Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of session in which bill is passed.

Testimony For: The Department of Health has a federally-funded Breast and Cervical Cancer Early Detection Screening Program, however, there is no statutory framework for this program. Low income women need a comprehensive early detection breast and cervical cancer screening program. Washington has the highest incidence of breast cancer in the nation, and women need to have access to screening programs to help reduce mortality from breast cancer. Cervical cancer rarely becomes invasive if detected and treated in early stages, and it has an overall five year survival rate of 99 percent. This program reduces disparities by increasing access to care and saves lives by placing women into screening and treatment services.

Testimony Against: None.

Persons Testifying: Susie Tracy and Cherie Skager, Susan G. Komen Breast Cancer Foundation; Karla Rowe, Southwest Washington Medical Center and Vancouver Washington Comprehensive Cancer Control Partnership; Patty Hayes, Department of Health; Sandy Huskinson; Agnes T. Black and Barbara Davis-Stevens, Washington Breast and Cervical Health Program; Ellen Phillips-Angeles, Public Health-Seattle and King County; Melanie Stewart, American Cancer Society; and Lori Bielinski.

Persons Signed In To Testify But Not Testifying: None.