A Chicago program that works to provide free mammograms to uninsured women may be at risk of being privatized or closed following the state's decision to terminate the city health department's grant funding for the effort over alleged mismanagement and quality of care concerns.
During a Thursday press conference at City Hall, a number of Chicago's African-American alderwomen, breast health advocates and unionized workers said it's crucial for the city to invest in the program in order to keep the program running and operated in-house.
Officials with the Public Health Organization, which has members who are patients and workers of the city’s Breast Health Program, said the city should continue funding the program while it invests in correcting the mismanagement and quality of care issues, which prompted the Illinois Department of Public Health (IDPH) to pull the $296,000 in Illinois Breast and Cervical Cancer Program funds back in April.
The city's Breast Health Program program serves thousands of women each year, and it is specifically focused on working to reduce the breast cancer mortality rate among African-American women in Chicago, a rate that is 62 percent higher than white women in the city. The health advocates at Thursday's gathering said they are particularly worried that if the Breast Health Program ends, four mammography sites located in low-income, minority communities would close.
But Ald. Carrie Austin (34th), who chairs the Chicago City Council's Budget Committee, said she has "been assured" through the city's budget director that services will continue at the clinics. She added, however, that city officials "do have to respond to what the state has done" in terminating the grant funds.
"I believe that it will be, what I consider, just a wrinkle in the system," she said. "I do believe we will work it out where the state will be able to fund (the program)."
Ald. Pat Dowell (3rd), a breast cancer survivor herself, said Chicago Public Health Commissioner Bechara Choucair and the city of Chicago are "very committed to maintain the current services that we have."
Austin noted that it is just a matter of negotiating with state officials in order for them to understand "our side of what it is that we are providing."
"I know that the state does not want to discontinue services," the alderman continued. "They want it better managed."
Among other reasons, IDPH says it terminated the funding due to concerns about the lack of hospital referral services available to women who had been screened after Mercy Hospital discontinued providing diagnostic services in December 2012 because the city did not pay for the services. IDPH also cited concerns that unauthorized personnel were performing services under the program. Additionally, the state maintains that clients were not given the opportunity to receive pelvic exams and Pap tests in conjunction with mammograms.
Austin pushed back on the claims saying, "I think we have one of the best public health services there is in Chicago."
Jo Patton, director of special projects with AFSCME, which represents a small number of workers in the city's mammography program, stressed that the issues cited by IDPH were management problems that "started out as relatively minor issues, and they grew because management failed to respond."
"It was a mismanagement issue, not a quality of care issue," she said.
Chicago Mayor Rahm Emanuel is reportedly looking into the option of privatizing the program and possibly turning it over to non-profit health care providers to manage. A Chicago Public Health Department spokesman recently told the Chicago Tribune that no decision on the program has been made yet, and the city is "exploring all options" regarding mammogram services.
Patton said small clinics are not in a position to handle the very expensive mammography equipment.
"Those mammogram machines are not cheap. They require regular maintenance, and it's the city's responsibility to continue to provide the resources," she said. "We need to continue to have this capacity, which is already in place, which we have a real clear track record for decades of providing quality service."
Austin said privatizing the program could create accessibility barriers to services. Although there are only a few centers, she said it would be "detrimental" if they were no longer in the communities where they have been operating.
Sandra Robinson, vice president of the Illinois Nurses Association, which represents five nurses providing services at the city centers, asked, "If privatization were to happen, who would be able to assure the quality of service that a young lady may receive?"
"Who would be responsible for tracking if there was an abnormal breast exam, an abnormal mammogram," she continued. "Who would provide the quality of service to make sure that that would happen at the present time? That’s our responsibility."
West Side Ald. Deborah Graham (29th) said the program's services are crucial for the Austin neighborhood, which is the largest African-American community in Chicago.
Eliminating the program would be "devastating," she said. She added that more awareness in general needs to be raised about breast cancer screening services to make sure "we lose no more lives to breast cancer."
"(African-American women) already have a low survival rate of breast cancer, so it's very important that we keep these services available for our community," Graham said.