Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!

1. POLICY = ENGAGEMENT
LEGISLATION
APPROPRIATIONS
EXECUTIVE ACTIONS
NCCRT NOVEMBER 2019
Whitney F. Jones, M.D.
Founder, Colon Cancer Prevention Project
Upstream Health Strategies. LLC

2. GUIDING PRINCIPALS FOR STATE LEVEL SUCCESS
• What - Evidence based, operational, pragmatic with HIGH PROB success
• Why - at the state level - achievable and accessible. Build momentum.
• Who - independent 501c3 + hired governmental affairs expert ($) + team
• How – find a bill sponsor and get access to executive branch
• Write a bill and review with those it will effect (Insurers, Hospital or MD associations, Fiscal impact)
• Target decision makers
• Gather support from aligned entities, votes of legislature, recognize supporters + lobby with individuals
or societies
• Who can lobby? Who can inform and support?
• THERE IS A TIMELINE and HARD DEADLINES
• COMPETATIVE ………NOT A ROUNDTABLE
• Maintain of support and follow up – things change in politics.
• Be proactive not reactive. Build and maintain

3. 2012 Added CRC screening a top 8 quality metric to Medicaid
2015 closed polyp loophole/bait switch Screening code
for + FIT or sDNA colonoscopy FU
2014 Medicaid expansion
2012 KCCSP funding $500k/yr +
PPP with Ky Cancer Foundation
2010 coal
severance $$
2008 1. Insurance to cover CRC screening 2. KCCSP NO $$ 3. KCCSP advisory committee!!!
2018 KCCSP $$
Veto override
2019
AAGTA
2017 GC
licensing
2007 2020
2016 KCCSP $$
vetoed
Laws, appropriations and executive branch
actions in Kentucky from 2008 to 2019
KRS = Law
$$ = Appropriation
!! = Executive action
KRS
KRS
KRS
KRS
$$
!!
!!

4. KCCSP ADVISORY COMMITTEE: CRITICAL LEVER
Members
• KY Medicaid
• KY Public health (Staff)
• Department of Insurance
• Senators and Representatives
• University Ky and Louisville
• KMA, KHA, Multiple NGO/501C3
• KY cancer consortium ( CDC)
Advisory Committee Charge
• Third Thursday of every month since 2008
• Increasing CRC screening rates for ALL eligible
• Oversight of Kentucky Colon Cancer Screening
Program design and progress ( administered in
the Ky Dept of Public Health)
• Annual reporting to legislature and executive
branch
• Open to the public

5. CRC: STATE VARIATION IN INCIDENCE RATES BY AGE
50+ years20-49 years

6. 45Is your state an ACS or USPSTF?
http://www.ncsl.org/research/health/col
orectal-cancer-screening-laws-by-
state.aspx

7. AWARENESS AND
ACCESS TO
GENETIC TESTING
ACT OF 2019
• Jan 1 2020. If a person meets NCCN criteria for
genetic testing, it will be covered as a screening ( like
CRC/Breast ca screening) with no cost sharing.
• Only 5-10 % at risk are being tested to NCCN
guidelines
• Lynch 1 in 279, BRCA 1 in 400
• KY last 5 yr, 10000 in KY with cancer, only 10% tested
• Bill creates access – we must create awareness

8. SHAPE THE FUTURE…
• Invest in prevention beyond colonoscopy and FIT testing
• Family and hereditary risk
• Early age onset CRC focus
• Weight, diet, exercise, no smoking
• New technology, artificial intelligence
• Advance prevention with an early and on-time messaging
package

9. TIMELINE OF EAO-CRC AND SPORADIC CRC MESSAGING
Family history + test 
Early Message Package
Lifestyle modification 
ID + evaluate symptoms 
On time date
+
On time options
18yr 35-40yr 4575yr
+
Current
Message
Package
On Time Message
Package

10. HB 1080
THE GOVERNOR OF INDIANA HAS OFFICIALLY
SIGNED HB 1080 AND BEGINNING JULY 1ST,
THE STATE OF INDIANA WILL RECOGNIZE 45
AS THE NEW SCREENING AGE FOR
COLORECTAL CANCERS. 45 IS THE NEW 50
FOR KENTUCKY AND INDIANA! WE WANTO
TO GIVE A HUGE SHOTOUT TO BRUCE DEARK,
COLON CANCER WARRIOR, GRACE MILLER,
AND BRYAN HANNON
WITH THE ACS, WHO PUT IN AN INCREDIBLE
EFFORT ADVOCATING FOR THIS SCREENING
IN INDIANA.

11. BILL SPECIFICS
• Authored by Rep. Brad Barrett.
• Co-Authored by Rep. Chris May, Rep. Gregory Porter, Rep. Chris
Judy.
• Sponsored by Sen. John Ruckelshaus, Sen. Jack Sandlin, Sen.
Timothy Lanane, Sen. J.D. Ford, Sen. Lonnie Randolph.
• 3/4/20 bill passed in the Senate with 89 yeas and 3 nays
• 3/30/20 bill signed into law