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Why are we here? From 5 CCC plans to 60+… we are well into implementation! Greatest need to support implementation: $$ We can learn from others: Successes in obtaining implementation funding through state funding, tobacco tax revenues, etc.
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Comprehensive Cancer Control Resources Workshop
October 21 – 22, 2009Atlanta, GA
Participant and Presenter Introductions
Why are we here?• From 5 CCC plans to 60+… we are well into implementation!• Greatest need to support implementation: $$• We can learn from others: Successes in obtaining
implementation funding through state funding, tobacco tax revenues, etc.
Northwest Portland Area Indian Health Board
Northwest Portland Area Indian Health Board
CA
ID
NM
TX
OK
NE
SD
ND
MN
WI
IL OH
KYVA
NC
GAALMS
LA
MI
PA
NYCTMA
VTNH
ME
TN
SC
OR
NV
MT
WY
COUT
IA
MO
AR
KS
IN
WV
FL
NJ
2008 National Comprehensive Cancer ControlStatus of Cancer Plans
Updating or Creating New PlanCurrent Plan
OR
Northwest Portland Area Indian Health Board
South Puget Intertribal Planning Agency
Cherokee Nation
Fond Du Lac Reservation
Aberdeen Area Tribal Chairmen’s Health Board
AK
Alaska Native Tribal Health Consortium
HI
National Comprehensive Cancer Control ProgramDivision of Cancer Prevention and ControlNational Center for Chronic Disease Prevention and Health Promot ionCoordinating Center for Health PromotionApril 2008
MDDE
RI
DC
WA
AMERICAN SAMOAFEDERATED STATES OF MICRONESIAGUAMCOMMONWEALTH OF THE NORTHERN MARIANA ISLANDSPUERTO RICOREPUBLIC OF THE MARSHALL ISLANDSREPUBLIC OF PALAUU.S. VIRGIN ISLANDS
AZTohono O’OdhamNation
10
2001 National Comprehensive Cancer ControlStatus of Cancer Plans
CA
ID
NM
TX
OK
NE
SD
ND
MN
WI
IL
KYVA
NC
GAALMS
LA
MI
PA
NYCTMA
VTNH
ME
TN
SCAZ
NV
MT
WY
COUT
IA
MO
AR
KS
IN
WV
FL
NJ
Updating or Creating New PlanCurrent Plan
OR
Northwest Portland Area Indian Health Board
AK
HI
National Comprehensive Cancer Control ProgramDivision of Cancer Prevention and ControlNational Center for Chronic Disease Prevention and Health PromotionCoordinating Center for Health PromotionDec 2001
MDDE
RI
DC
WA
OH
Why are we here?
• Implementing your CCC plan will take more resources than you have
• A CCC resource strategy helps identify what you can and cannot do with what resources you have
• A CCC resource strategy will prepare you for planned and unexpected opportunities to request and get resources
Throughout the day, we will…• Identify the benefits and uses of a CCC
resource strategy• Identify the steps in developing a
resource strategy• Determine the information needed to
estimate CCC implementation costs• Identify methods to communicate CCC
resource needs
Also throughout the day…
Today’s AgendaWorkshop Agenda / Topic Areas• Step 1: Determining Purpose and Scope of the
Resource Strategy• Step 2: Developing the Resource Strategy• Step 3: Using the Resource Strategy
Materials / Activities• Small & Large Group Discussions• Tools & Worksheets• Tips & Examples• Take Home Tools
Step 1: Determining the Purpose and Scope of the Resource Strategy
Overview of Step 1• Establish the rationale for developing
a resource strategy• Identify benefits and challenges• Select a process for developing the
resource strategy• Make initial decisions about the
scope of the resource strategy
≠CDC CCC Budget
CCC Resource Strategy
What is a resource strategy? CCC Resource Strategy• Identifies resources you
have to implement your CCC plan priorities
• Identifies resources you need to do a better or bigger job of implementing your CCC plan priorities
• Includes estimates of the cost to implement your CCC plan priorities
• Identifies who to communicate resource needs to and how
CDC CCC Budget• Identifies just the CDC CCC
resources you have• Does not include several
sources of funding or other types of resources
• Does not identify the resources you need to implement all the activities you would like
• Is used more as a day to day management tool
• Does not include a “game plan” for obtaining additional resources
Why develop a resource strategy? • Implementing your CCC plan probably
will take more resources than you have• A CCC resource strategy will help you
know what and where the resource gaps are
• A CCC resource strategy will prepare you for planned and unexpected opportunities to request and get resources
Pre-Work Review and Discussion• Questions:
– For our coalition, what would be the benefits of having a CCC resource strategy?
– What might be the downsides to having a CCC resource strategy?
– What have we already done about estimating the additional funds needed to implement our CCC plan priority strategies?
• Review your current CCC priorities and resources
• Review priority strategies you brought with you to work on during the workshop
Benefits and Challenges of CCC Resource Planning• Benefits:
– Planning ahead, long-term focus
– Realistic expectations
– Quick response to opportunities
– Greater credibility and visibility
• Challenges:– Takes time to
develop– Not everyone will
agree on scope or how to present
– Cancer plan may not be specific enough
– Often “best guess” estimates of costs
Other CCC Coalitions’ Resource Strategies and Estimated Costs
• HANDOUT - Matrix of resource strategies and estimated costs
• SECTION in BINDER - Existing strategies, estimated costs and other documents
More details about…
• Wyoming resource strategy and costs
• Texas resource strategy and costs
Wyoming’s Story
• Plan unveiled – October 2005
• Resource Strategy development begins– January 2006 (C-Change)
• Steering Committee Meeting– June 2006
• Letter to Editor – September 2006
Wyoming’s Story (Cont.)• Legislative Conference Call
– October 2006• Cancer Control Act drafted
– November-December 2006• Cancer Control Act passed
– March 2007
Wyoming Resource Strategy Considerations
–Rationale–Benefits–Uses–Challenges–Lessons Learned
How did a resource strategy help in our process?• Credibility;• Cancer Control Plan tied to
legislation;• Initial Cancer Act funding amount:
– $2.175 million
What does the Act fund?• Breast & Cervical Cancer Program
Enhancements;– 60/40 federal grant requirements– Wind River Reservation Project– Big Horn Basin outreach/ Migrant Workers
• Colorectal Cancer Screening;• Wyoming Cancer Resource Services
(Regional Patient Navigation & Outreach Model)
Team Activity
Tool 1A: Case Study of a CCC Coalition that Needs More Resources
Key Questions about the Scope of the Resource Strategy• Breadth:
– Full CCC plan?– Select CCC plan priorities?
• Include existing resources?• Time period strategy covers?
Team Activity
Tool 1B: The Breadth of Our Resource Strategy
How to Develop the Resource Strategy
• Options:– Use existing workgroups– Create a small resource planning
workgroup– Select one person to develop the plan– Hire external assistance– A combination of the options above
How did other CCC coalitions develop their resource plan?• Existing committees
– Delaware• Formed small resource planning workgroup
– Iowa– Kansas
• External assistance– New Hampshire
• Combination– Texas– Wyoming
WCCCC Resource Strategy Development• Workgroups reconvened to assist in
identifying a “budget” for their cancer plan activities;
• New partners were brought forth to fill information gaps;
• Wyoming EAD assisted in ratifying the budget and gave it the “seal of approval” (no cost)
Resource Strategy Planning
WY TOOL # 1:
Budget Planning Document
WCCCC Resource Strategy Development• All plan activities encompassed;• Existing resources identified;• Funds dissemination plan identified;• Resource strategy covers one year time
period;– Tobacco tax / tobacco funds as alternative– $21,000,000 annually– Menu of “options”
Yet Again…
–Rationale–Benefits–Uses–Challenges–Lessons Learned
Team Activity
Tool 1C: How will We Develop Our CCC Resource Strategy?
Wrap Up: Step 1
Additional questions about this step?
Step 2: Developing the Resource Strategy
Overview of Step 2
• Ask: Do we have enough detail to develop cost estimates?
• Decide what to include in your resource strategy (e.g. current resources)
• Identify budget categories for cost estimates• Develop a list of assumptions needed• Identify sources of information for assumptions• Develop your resource strategy and cost
estimates
Team Activity
Tool 2A: Do you Have Enough Detail to Estimate Costs?
What to Include in Your Cost Estimates• Possible budget categories or types of resources:
– Service delivery– Contracts/consultants– Personnel costs– Materials development/printing– Equipment– Data collection– Training– Coalition development costs– Travel and meeting costs – Etc.
Team Activity
Tool 2B: What Types of Resources Do We Need?
CCC Budget Assumptions• Definition: calculations and justifications
used to arrive at your budget figures• Key questions to ask about
assumptions:– What are the types of assumptions we’ll
need to make?– What existing cost information can we use?– What are potential sources of cost
information?
Information Needed to Develop Estimated Costs• Types of information• Clinical data, costs and usage• Reimbursement rates for clinical
services through government programs and insurers
• Assumptions and examples of how others have estimated costs
• Costs from other programs in your state or district
Budget Assumption ExampleDissemination of Survivorship Tools • Costs associated with this strategy
relate to promotion of previously developed evidenced-based materials
• $75,000 - printing of 40,000 materials and
• $25,000 for shipping / dissemination to hospitals, cancer treatment centers and healthcare professionals
Budget Assumption Tips
• Utilizing budget numbers that have been used previously in other efforts will make both your budgeting efforts easier as well as provide more credibility to your budget numbers.
• Keeping the budget simple = putting detailed assumptions in a separate document
• Don’t reinvent the wheel! See examples from other coalitions to get ideas for your assumptions.
Budget Assumption Examples and Lessons Learned• Wyoming• Texas
Wyoming Budget AssumptionsTOOL # 2:
WCCSP screening budget
Wyoming Budget AssumptionsTOOL # 3:
Cost Avoidance Document/ Uncompensated Healthcare Issue
And Again…
– Rationale– Benefits– Uses– Challenges– Lessons Learned
Team Activity
Tool 2C: Creating Assumptions to Accurately Estimate our Costs
Key Question: How do we want to show costs in our resource strategy?• One budget for all our priorities or
mini-budgets for each priority? • How do we handle including
overall operating costs, overhead, or indirect costs?
• How much detail is appropriate for our audience?
Team Activity
Tool 2D: Sample Worksheet for Estimating Costs
Wrap Up: Step 2
Additional questions about this step?
Good morning!Welcome back!
Step 3:Using the Resource Strategy
Overview of Step 3
• Determine how you will present and communicate about your CCC resource needs, including:– Audience– Major interests/concerns– Talking points– Forums/presentation setting– Materials needed
Now that you have a resource strategy, use it! • Key Questions:
– How will we package our resource needs for different audiences?
– How will our “materials” be disseminated?– How will we present our needs and to
whom? – What are our follow up strategies once our
needs are presented?
Communicating Your Resource NeedsMaterials you might want to use:• A presentation with slides and handouts• An appendix to go with your CCC plan• A ‘one-pager’ with main messages that
lists your resource needs • An update of your CCC plan that
includes estimated costs for implementation
How they did it…
• Resource strategy packaging and how it was used:– Wyoming– Texas
Wyoming Resource Strategy Document• Audience• Dissemination• Concerns
– Who should deliver the message?• Who can share your story?• Who will tell the story correctly?
Example: Wyoming
3%1%
3%
5%2%
25%
16%
2%2%
6%
11%
24%
Administrative Costs PreventionMarketing Tobacco ControlCSHP Worksite WellnessBreast & Cervical Cancer Colorectal CancerProvider Education TelehealthQOL/Survivorship Data & Evaluation
Wyoming Comprehensive Cancer Control
Consortium
Estimated Yearly Budget Proposal
2006-2010Budget Costs by
Percentage (Adjusted)
Working with Policymakers• TOOL # 4
Education vs. Lobbying
Tips for Talking with Policymakers
• TOOL # 5:Tips for Talkingwith Policymakers
And one more time…
– Rationale– Benefits– Uses– Challenges– Lessons Learned
Example: Texas
• Prepared by the Texas Comprehensive Cancer Coalition and represents their best available estimates of additional costs currently needed to implement the Texas Cancer Plan given existing program funding and capacity for services
• Geared toward single audience
Team Activity
Tool 3A: Communicating our Resource Needs
Wrap Up: Step 3
Additional questions about this step?
Checklist of Other Important Considerations
Lessons Learned • Each CCC coalition has different resource
planning needs… plans and budgets will differ• Be flexible – the resource plan and budget will
change• Documenting assumptions is important when a
potential funder asks for the details• Use coalition members/policy leaders to
promote your resource plan• Put some win-wins in your budget (strategies
with immediate outcomes)• Document your process so new members (and
other CCC coalitions) will know how you made decisions
Team Activity
Tool 3B: To Do List When Back Home
Kim RogersPhil HuangTodd Tyler
Team Report Outs
Regarding your resource strategy:
• In one year what do you hope to accomplish?• In two years what do you hope to accomplish?