Mission Statement: Cancer Resource Center of the Desert (CRCD) is a community organization dedicated to providing a guiding hand and compassionate heart to cancer patients and their families through services that educate, guide, support, and empower the patient through the cancer journey.
Advancing Health and Wellness: The Cancer Resource Center of the Desert advances health and wellness for Imperial County (IC) cancer patients through its Patient Navigation Program (PNP) by responding to specific needs and cultural barriers to cancer care with an emphasis on financial/insurance navigation. Cancer is the leading cause of death in IC.
IC is 76 percent Hispanic, mostly Spanish-speaking, 21.3 percent live in poverty, 38 percent are non-H.S. graduates, and 27.7 percent are uninsured (IC 2008 Health Status Report). These cultural barriers and the inequities and disparities in access to healthcare increase the cancer burden for IC. CRCD PNP mitigates these barriers. In IC, cancer treatment is denied to the uninsured. Cancer treatment is cost-prohibitive to the under-insured. CRCD mitigates insurance barriers to cancer treatment by providing timely conversion of the uninsured to Insured status (MediCal, cancer-specific MediCal programs, and the Pre-existing Condition Insurance Program), and Under-insured to Adequate insurance.
Description: The Cancer Resource Center of the Desert (CRCD) was established in 2006 for the purpose of responding to specific needs and barriers to timely cancer care in Imperial County. Utilizing cancer patient navigation, CRCD’s Patient Navigation Program (PNP) is modeled after the Harold P. Freeman, M.D., program started in Harlem, New York, in 1990.
In Imperial County, CRCD has been the bridge that closes the gaps to the fragmentation of care that occurs when cancer patients are in emotional distress, do not understand their diagnosis or treatment plan, are unfamiliar with the cancer healthcare system, and are not fully informed regarding their insurance coverage. CRCD’s innovative service ensures a positive effect on quality, cost, and satisfaction of the consumer and clinical team.
The CRCD PNP addresses multiple barriers to cancer care, including insurance, transportation issues, language/cultural barriers, limited health literacy regarding cancer diagnosis and treatment, and psychosocial barriers.
Recognizing that insurance/financial issues are the first and most impactful barriers to healthcare access for the uninsured and under-insured, CRCD first mitigates that barrier for its constituents. In January 2013, the article, “Cancer resource center of the desert patient navigation program: removing financial barriers to access to cancer care for rural Latinos,” was published in the peer-reviewed academic journal, SpringerPlus, where CRCD insurance navigation was highlighted. In 2013-2014, CRCD converted 57 uninsured persons under the age of 65 to full insurance status. The value of those conversions was $3.5 million dollars for the first year of chemotherapy treatment.
One of the insurance barriers for the under-insured is bi-national health insurance, whereby U.S. employers offer health insurance in Mexicali, Mexico. In Imperial County, this is a common practice, and many U.S. residents opt for this coverage. Unfortunately, that coverage is often inadequate for cancer care. CRCD works with its clients to ensure that their cancer treatment can continue in the U.S. with as smooth a transition as possible.
In Imperial County, transportation to medical treatment can be a challenge. The vastness of the county (4,177 square miles), extreme summer temperatures (consistently over 100° in summer months), 23.3 percent of the population living below the poverty level, and sub-optimal vehicles create a situation in which patients may not have the transportation needed to get to and from their appointments. CRCD mitigates transportation issues on their behalf. In 2014, CRCD provided over $21,000 in direct transportation assistance to its clients.
Approximately 80 percent of CRCD clients are non-English speaking Hispanics. CRCD PNP addresses communication barriers with their medical providers to cancer care including a lack of understanding of the disease, treatment options, treatment plan, as well as side effects of treatment by reviewing pertinent information in their primary language. CRCD Navigators are bi-lingual and bi-cultural in English and Spanish. Mitigating this barrier assists both physician and patient in moving forward with the treatment plan, avoiding unnecessary delay.
Cancer patients are also faced with numerous doctor’s appointments with new and multiple physicians, various diagnostic work-ups, and labs. Often, they do not understand the implication of the doctor’s appointments and tests and can be non-compliant when they are not informed. CRCD educates the patients to ensure attendance at medical appointments and participates in the communication portal between physician and patient.
In Imperial County, Hispanic women living in the regions of the North and South County have a significantly higher late-stage diagnosis rate for breast cancer and a higher mortality rate. These statistics were the foundational reason CRCD began its Outreach Navigation program. Outreach Navigation (ON), a term used to inclusively describe recruitment of women for screening mammograms, assisting with making appointments, ensuring the woman attends the screening, and following her until the results are known, is the work of the Outreach Navigator at CRCD. Utilizing relationships built through the Farmworkers Coalition, the Mexican Consul, health agencies in the region, school districts, and many others, CRCD goes to where the women are to recruit them for screening mammograms. In 2014, CRCD facilitated 165 screening mammograms and reached over 6,600 persons with the message about the importance of early detection.
During the 2014 calendar year, CRCD introduced a new intervention for cancer patients in Imperial County, SURVIVORWEAR. SURVIVORWEAR are post-surgical garments designed to ease the physical and emotional transitions occurring post cancer diagnosis and treatment. These garments are provided at no charge to cancer patients in Imperial County.