Wyoming Cancer Control Act.

WORKING DRAFT

ORIGINAL SENATE

FILE

NO.
0131

ENROLLED ACT NO. 92, SENATE

FIFTY-NINTH LEGISLATURE OF THE STATE OF
WYOMING
2007 GENERAL SESSION

AN ACT relating to public health; providing for a comprehensive cancer control program; providing for screening and preventive treatment for colorectal cancer as a necessary support of the poor; providing for additional education, outreach and screening for breast and cervical cancer;
creating a pain management advisory committee;
providing definitions; authorizing positions; providing appropriations; and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.

W.S. 35
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25
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201 through 35
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25
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206 are created to read:

CHAPTER 25
PUBLIC PROGRAMS

ARTICLE 2
WYOMING
CANCER CONTROL ACT

35
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25
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201.

Short title.

This act shall be known and may be cited as the "Wyoming Cancer Control Act."

35
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25
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202.

Definitions.

(a)

As used in this act:

(i)

"CDC" means the federal center for disease prevention and control;

(ii)

"County cancer resource coordinator program" means a program undertaken through a private organization, county hospital, hospital district hospital or city or county health department which provides local level education, outreach, patient navigation services, community planning and data collection in order to lessen the impact of cancer on Wyoming people;

(iii)

"Department" means the department of health;

(iv)

"Evidence based" means relying on scientifically valid evidence.
Scientifically valid evidence relies on studies and experiments including systematic reviews of multiple randomized controlled trials or epidemiological studies, one (1) or more randomized controlled trials, one (1) or more epidemiological studies and the recommendations of nationally and internationally recognized groups of experts in the field.

(v)

"Medicaid" means the joint federal and state program of health care financing for the poor authorized by Title XIX of the federal Social Security Act and title 42 of the Wyoming statutes;

(vi)

"Statewide comprehensive cancer control steering committee" means a committee whose mission is defined by the 2006-2010 Wyoming cancer control plan and which provides advice and guidance to the Wyoming comprehensive cancer control program. The committee is a private entity whose members include government employees;

(vii)

"This act" means W.S. 35
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25
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201 through 35
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25
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206.

35
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25
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203.

Cancer control plan and program.

(a)

T
he department shall develop a comprehensive cancer control plan. The department shall begin with the plan and recommendations in the
Wyoming
cancer control plan published in October 2005 by the
Wyoming
comprehensive cancer control consortium.
The goals shall be to reduce the numbers of people affected by cancer with improved prevention and education and, for those individuals who are diagnosed with cancer, the goal shall be to provide diagnostic, therapeutic and palliative interventions that are evidence based, scientifically proven best of care.
The comprehensive cancer control plan
may include
:

(i)

Cancer prevention and education for both the public, health care professionals and institutions;

(ii)

Evidence based early detection, screening, diagnosis and treatment;

(iii)

Research
and data collection
;

(iv)

Palliative care including pain management and other steps to improve the quality of life of probably terminal cancer patients;

(v)

Rehabilitation of cancer victims; and

(vi)

Programs to assist cancer survivors in returning to normal life.

(b)

In financing and implementing the program established pursuant to subsection (a) of this section the department shall consider the use of the Medicaid program. This section does not constitute authorization to expand the services and eligibilities of the Medicaid program which requires specific legislative authorization. The department may recommend such authorization where appropriate.

(c)

The department may contract with one (1) or more third parties to develop and implement the plans authorized by this section. Any contract awarded under this section shall be awarded on the basis of competitive bids and shall include specific requirements relating to outcome based evaluation.

(d)

Subject to the restriction of subsection (b) of this section, the department may accept state, federal, local and nongovernmental funds for developing and implementing the plans established pursuant to this section.

(e)

The department may solicit proposals for grants under this section by publication of a request for proposals. Grant recipients under this section may include local governments, private nonprofit organizations, schools and other organizations as appropriate. Any grants to organizations not political subdivisions of the state of
Wyoming
or under the absolute control of the state shall be subject to any restriction necessary to comply with Article 16, Section 6 of the Wyoming Constitution. Any request for proposals used during the competitive grant process shall include specific requirements relating to outcome based evaluation of the grant recipient's performance.

(f)

The department shall collaborate and coordinate with public and private entities including state and local governments and the CDC to assure maximum effective use of resources
,
people and money. The department shall take advice, as appropriate, from the statewide comprehensive cancer control steering committee.

(g)

Considering funds available and the purposes for which those funds are made available, the department shall give
emphasis
to the following cancer control and prevention programs:

(i)

The county cancer resource coordinator program.
T
his program shall be a pilot program in two (2) sites, one (1) urban and one (1) rural. Each program shall cover at least one (1) county and may cover several counties. The program may be expanded to additional sites if sufficient funds become available;

(ii)

Public education relating to cancer prevention and awareness for all cancers;

(iii)

Early detection of cancer including those cancers identified in the state cancer control plan and specifically including the
Wyoming
colorectal cancer early detection and prevention program;

(iv)

Programs
and public education
which promote the reduction of risk factors to reduce cancer and other chronic diseases within the state; and

(v)

Programs
and public education
which enhance treatment and quality of care of those impacted by cancer within the state.

(h)

The department may propose cancer control as a specific line item in its biennial budget.

(j)

The department shall, in accordance with the Wyoming Administrative Procedure Act, promulgate rules and regulations as appropriate to implement this act.

(k)

The department shall report on its activities
, program outcomes, conclusions and goals for the next two (2) years
under this act to the joint labor, health and social services interim committee and the joint appropriations interim committee. The report shall be due on October 1 of every odd numbered year.

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204.

Wyoming
colorectal cancer early detection and prevention program.

(a)

Subject to the availability of appropriations, the department shall undertake a colorectal cancer screening and prevention program for those who
qualify as specified in subsection (c) of this section.

(b)

Initially the screening and prevention program funded under this program shall consist of colonoscopies which shall consist of both the examination of the colon and rectum and the removal and pathological examination of polyps in accordance with the normal standards of care for colonoscopies.

After July 1, 2008, the department may, by rule and regulation, authorize other forms of screening to participate in the program provided these other forms of screening are evidence based and are shown by the evidence to be as effective or as cost effective as traditional colonoscopies.

(c)

Starting July 1, 2007 Wyoming residents with incomes at or below two hundred and fifty percent (250%) of the federal poverty level shall be eligible to participate in this program and this shall remain the standard if the biennial budget bill does not establish a different standard and unless a different standard is established pursuant to subsection (d) of this section.

(d)

Eligibility for the program set forth in this section shall be limited to individuals who are
Wyoming
residents and have been so for at least one (1) year. The eligibility shall be for one (1) colonoscopy every ten (10) years, counting any done before the effective date of this act or before the individual became a
Wyoming
resident.
E
ligibility shall be restricted to individuals who are at least fifty (50) years old and who have not become eligible for the federal Medicare program. In the event that analysis shows spending in the program will exceed the budget available, the department shall
institute a waiting list.

(e)

The department shall provide vouchers to eligible persons for reimbursement for a colonoscopy at the rate paid under the Wyoming Medical Assistance and Services Act for colonoscopies, including polyp removal. The person receiving a voucher under this subsection shall pay all other costs of the colonoscopy. When the funds appropriated for this program are expended, the department shall cease issuing vouchers under this section.

(
f
)

The department shall develop an internet based application process for determining individual eligibility. The result of a successful application may be a voucher that the individual may present to a provider the department has contracted with or may be an online statement of eligibility that the providers can access or both. The department may use city or county health departments, other public health offices, providers, advocacy groups and any other appropriate governmental or private entities to assist individuals in completing the application process.

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205.

Breast and cervical cancer programs.

(a)

The breast and cervical cancer program within the department is authorized to obtain private and federal grant funds and to seek appropriations for:

(i)

Education, outreach and breast and cervical cancer screenings for those unable to afford them;

(ii)

Continuation of the existing pilot outreach program for the medically underserved population in the Big Horn Basin and expansion of that program to other areas of the state; and

(iii)

Implementation of the program known as the native sisters program for outreach to members of the Shoshone and Arapaho Tribes, provided that any grants or contracts entered into pursuant to this paragraph shall contain any restrictions necessary to comply with Article 16, Section 6 of the Wyoming Constitution.

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25
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206.

Pain
m
anagement
.

(a)

The department may establish an acute and chronic pain management advisory committee consisting of the following members:

(i)

One (1) employee of the department appointed by the director who will serve as the chairman of the committee;

(ii)

One (1) member appointed by the board of medicine;

(iii)

One (1) member appointed by the board of nursing;

(iv)

One (1) member appointed by the board of pharmacy; and

(v)

One (1) member of the public who has experience in pain management appointed by the director.

(b)

The members of the pain management advisory committee shall serve at the pleasure of the director of the department and shall meet at least two (2) times each year. The travel expenses of the members of the pain management committee as described in subsection (a) of this section shall be paid by their respective departments or boards. The department shall pay the per diem and travel expenses of the member of the public appointed pursuant to paragraph (v) of subsection (a) of this section and shall provide administrative support for the operation of the committee.

(c)

The committee shall perform the following functions:

(i)

Research issues associated with acute and chronic pain management including those issues assigned to the committee by the director of the department;

(ii)

Offer recommendations to the director of the department, other state agencies and licensing boards of health care professionals regarding policies and programs that would manage acute and chronic pain more effectively or efficiently; and

(iii)

Make recommendations regarding legislation to the director of the department.

Section 2.

(a)

For the fiscal biennium ending June 30, 2008,
one
million
two
hundred thousand dollars ($
1
,2
00
,000.00) is appropriated from the general fund to the department of health for the colorectal cancer screening program authorized by this act.

(
b
)

One hundred twenty thousand dollars ($120,000.00) is appropriated from the general fund to the department of health for breast and cervical cancer education, outreach, screening and program management.

(
c
)

Thirty thousand dollars ($30,000.00) is appropriated from the general fund to the department of health for the outreach pilot program for medically underserved populations.

(
d
)

One hundred thousand dollars ($100,000.00) is appropriated from the general fund to the department of health to implement the native sisters program.

(
e
)

Two
hundred
thirty
thousand
sixteen
dollars ($
23
0,0
16
.00) is appropriated from the general fund to the department of health for the expenses of administering the programs
, including administrative and supporting costs,
provided by this act and two (2) additional FTE's for the department of health are authorized.
This appropriation shall not be included in the agency's 2009-2010 biennial standard budget request.

Section 3.

This act is effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the Senate.

Chief Clerk

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