Delaware Cancer Consortium
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MembersAttended – via phone / David Bentz – DE House of Representatives
Did Not Attend / Ruth Briggs-King – DE House of Representatives
Did Not Attend / Albert Shields, designee for John C. Carney, Jr. – Governor
Attended / Stephen Grubbs, MD – American Society of Clinical Oncologists
Attended – via phone / Bethany Hall-Long, RNC, PhD – University of Delaware/Delaware Lt. Governor
Attended / Patricia Hoge, PhD
Did Not Attend / Kara Odom-Walker – DE Department of Health and Social Services
Did Not Attend / Meg Maley, RN, BSN – Welldoc, Inc.
Did Not Attend / David McBride – Delaware Senate
Attended / Nicholas Petrelli, MD –Christiana Care - Helen F. Graham Cancer Center
Did Not Attend / Rishi Sawhney, MD – Bayhealth Medical Center
Did Not Attend / Shawn Garvin– DE Department of Natural Resources & Environmental Control
Attended / James Spellman, MD, FACS, FSSO – Beebe Medical Center - Tunnell Cancer Center
Staff
Attended / Lisa Henry – Delaware Division of Public Health
Attended / Heather Brown – Delaware Division of Public Health
Attended / Rich Killingsworth – Delaware Division of Public Health
Attended / Rosemary Doughten – Delaware Division of Public Health
Did Not Attend / Karyl Rattay – Delaware Division of Public Health
Public/Guests
Attended / Nora Katurakas – Christiana Care Health Services
Attended / Tricia Jefferson - YMCA
Attended / Jeanne Chiquoine – American Cancer Society
Attended / Tiffany Edwards – University of Alabama DNP Student/Nanticoke Health Services
Acting Chair Dr. Patricia Hoge began the meeting at 8:30 am. Dr. Stephen Grubbs moved to approve the October 18, 2016 minutes as written and Dr. James Spellman seconded the motion. A vote was taken and minutes were approved.
DCC Budget
Ms. Lisa Henry advised that The Delaware Cancer Treatment Program (DCTP) has excess funds in the budget due to steady enrollment into the insurance marketplace because of the Affordable Care Act (ACA). Currently the enrollment to DCTP hovers around 30. There is approximately 1.5 million in funds that needs to be used by June 30. Based on the fact that both physical activity and tobacco use are risk factors for cancer and a focus of the Delaware Cancer Consortium, Ms. Henry asked the Advisory Council members their thoughts on reallocating the funds to enhance activities that will educate Delawareans about these risk factors and their role in cancer prevention. Specifically, $750,000 could be utilized for projects related to physical activity to include work with schools and the Fitnessgram program. If decided, that would then leave about the same amount of funding to be utilized for tobacco. Dr. Petrelli expressed some concern if there are ways to measure how the money is spent and if schools would use the money for the purpose it is intended. He would like to see data or metrics on how the money is used. Ms. Henry advised that there would be information from the schools with regards to academics and behavior and that currently there is a contract with University of Delaware to gather the data so that improvements can be made next year. Dr. Grubbs mentioned that many places have good process measures but he also would like to see outcome measures. Dr. Spellman added that short term test scores could be checked and long term behavioral risks could be analyzed. To summarize, Dr. Hoge said that the proposal is for approximately $750,000 of money from the DCTP be used to analyze data already collected with Fitnessgram and also to keep the Fitnessgram program going. After the data is analyzed then the Advisory Council can review to determine some things to address based on the results of what is found. Ms. Henry added that funds could be used to link with other programs such as Motivate the First State (MTFS) campaign, MOU with the University of Delaware, and the Department of Education. Several members suggested that it might be better to have a focused project instead of looking at several projects. Ms. Henry responded the reason for suggesting to analyze the Fitnessgram data is that it is a program already in place. She emphasized that more could be done in July but the extra money needs to be used by the end of June. A couple of AC members that were calling in to the meeting via phone were asked if they support the proposal addressing fitness in schools. Representative David Bentz answered that he does support fitness data to be analyzed however he did question why it costs so much. Dr. Hoge advised that not all of the money would go towards analyzing the data that some would be used in other areas and programs like MTFS and also help physical education and health teachers obtain what they may need.
The discussion continued as to where the rest of the “extra” money should go. Suggestions included the following:
· Tobacco prevention and control with regards to youth and electronic cigarettes
· Education to public on link to diabetes and cancer
· Awareness campaigns
· Creating quality measures particularly on lung cancer screening
· Education with primary care physicians
· Stronger marketing for lung cancer screening program
· Readdress marketing of colorectal screening program in order to sustain
A question was posed regarding the score card for primary care physicians as to why tobacco is not included as a measure. Sometimes it is difficult when comparing the Federal and State law and what the FDA is doing.
Dr. Petrelli stated that the colorectal screening program was the most successful in the country but that disparity is coming back. He pointed out the need to focus some of the extra money towards the colorectal screening program so that it can get back to where it was. Ms. Henry advised that Screening For Life is still doing well but that we will need to reach out to partners during FY18 because based on data that was just reviewed we will be hitting the 76.4% mark for screening which puts us in the top five in the country, however we would like to be at 80%. This is an area that will be touched upon in the Early Detection & Prevention committee meeting. Dr. Grubbs advised that all practices in 2018 will have a score card that will determine how much they get paid from Medicare. Physician practices will install improvement practices and it will give them points so they will receive better Medicare payments. Dr. Spellman posed the question as to what would happen if we incentivized patients to get screened – see if it would result in lower premiums. A suggestion was made and supported by all the physicians present to send a copy of the article on the colorectal program to the U.S. Department of Health and Human Services illustrating the magnitude the impact of the treatment program had on cancer care in Delaware.
Dr. Grubbs made a motion to use the excess funds of approximately $1.5 million for what was discussed regarding physical fitness to include work with schools, Fitneessgram analysis, including linkages with MTFS, UD, and DOE, as well as on the increased awareness needed in lung and colorectal cancer screening programs, and for primary prevention around tobacco. Dr. Petrelli seconded the motion. A vote was taken and all in attendance and on the phone agreed to the motion.
DCC Five Year Plan Update
Ms. Heather Brown provided several draft copies of the new “orange” book that will be the next five year state cancer plan 2017-2021 based on the agreement of goals and objectives of all DCC committees and the Advisory Council. The book should be complete and bound before the July meeting. Once it is complete it will also be posted on the website and a link will be sent to all members. Dr. Hoge inquired if all members of legislature receive a copy. In the past, legislators were sent a letter along with a flash drive containing the current book. Representative Bentz suggested sending physical copies along with an executive summary and Lt. Governor Hall-Long agreed and added it would be good to get copies to the Legislative Aides.
DCC Retreat Update
Current registration for the DCC Retreat that is scheduled for April 25, 2017 is at 96. This number includes 23 teachers that represent all three counties in the state. The theme is Creating a Culture of Prevention Through Physical Activity: The Role of Physical Activity in Cancer Prevention and Health Promotion in Youth.
Partnership Update
The Comprehensive Cancer Control Program (CCCP) is partnering with YMCA of Delaware to offer LIVESTRONG at the YMCA evidence-based intervention program in four Delaware YMCA branches. LIVESTRONG at the YMCA is small groups of cancer survivors meeting in a supportive environment held at YMCA branches. It is a 12-week intervention that started April 1 with two 90-minute sessions per week. The sessions include cardiovascular conditioning, strength training, balance, and flexibility exercises. The evaluation includes process, functional and quality of life assessments before and after participation. The sessions are facilitated by LIVESTRONG at the YMCA certified instructors. With funding received by CCCP from the Centers for Disease Control and Prevention (CDC) to support this initiative, enrollment into this program will be offered at no cost and will include an in-kind family membership to the YMCA for all participants
The CCCP will partner with YMCA of Delaware to execute the evidence based “Pool Cool” program in all seven Delaware YMCA branches between June and August statewide. More than 1,200 YMCA youth between the ages of three and nineteen will be provided eight five-minute “Pool Cool” information sessions. The 40 minutes of instruction will be infused into their swim lessons or competitive swim team practice, one time per week. YMCA Instructors & Coaches will share curriculum specific information from “Pool Cool” accordingly and it is anticipated that the YMCA of Delaware has the capacity to serve over 1,200 people through the “Pool Cool” initiative over the summer months in all three of Delaware’s counties.
The Screening for Life Program is involved with Federally Qualified Health Centers (FQHC) with grant money to have very specific materials on screenings available and is also working with patient navigators. Through this federally funded program, navigators can break down barriers and lead patients through the process. Ms. Henry advised that SFL has been selected by the CDC to evaluate Delaware’s model of cancer screening. It is very specific and the program is looking at individual demographics and tailoring messaging and activity to each specific FQHC branch. There will be a request for proposal (RFP) asking for a sustainable program. Dr. Petrelli commented that the Ebright Group (Accountable Care Organization) has a program with the goal being to get Delaware to be in the top five healthy states in the country. He suggested possibly contacting this group and partnering on cancer screening efforts.
Sharing Time
Some discussion took place regarding the next two scheduled DCC meetings. Chairs are needed for July and October. It was decided to move the remaining meetings for 2017 to the second Monday of July and October. The meetings will be held on July 10 from 8:30-10:00 am with Dr. Grubbs chairing and October 9 from 8:30-10:00 with Dr. Petrelli chairing.
Public Comment
Jeanne Chiquoine from the American Cancer Society suggested that someone from the Advisory Council should meet with the Delaware Health Innovation Center Board and see where they are with the SIMS grant. She also provided a print out of the “shared cost of cancer” report. This report will be sent out electronically with the DCC Retreat Agenda upon meeting conclusion. It was suggested that the DCC staff invite Chairs from the SIMS working groups to the July DCC Advisory Council meeting to learn more about the work they are doing that impacts cancer early detection and care in Delaware
Dr. Grubbs advised that he is doing work at American Society of Clinical Oncologists (ASCO) that involves certifying cancer homes as an alternative payment model. He suggested that Delaware might want to incorporate in the innovation group.
Adjournment
The meeting was adjourned at 9:45 am.
Meeting documentation is available on the DCC website (www.healthydelaware.org) or by contacting Rosemary Doughten ( or 302-744-1000).
Next Meetings:
Location: The Outlook at the Duncan Center, 500 West Loockerman Street, Dover, DE 19901
Monday, July 10, 2017, 8:30 a.m. - 10:00 a.m.
Monday, October 9, 2017, 8:30 a.m. - 10:00 a.m.