United Cancer Introduction
Mission: “United Cancer provides assistance to our cancer patients and their families in a way that enhances their quality of life. We strive to educate Elkhart County residents in the prevention, detection and treatment of cancer.”
Although United Cancer is frequently confused with large, national agencies, UC is not a branch office of a national organization but was founded here in Elkhart County in 1958. While most other cancer agencies fund research, as a completely local organization, United Cancer’s focus is to help Elkhart County area cancer patients pay for their treatment, supplies & medicine. Since the year 2000, United Cancer has had a $2 million impact on Elkhart County helping your neighbors back to good health, with the vast majority those funds coming from the support of local organizations, events and donations.
In 2009, United Cancer directed benefit to Elkhart County was an estimated $200,025!
In 2009, United Cancer’s Total Community Impact is estimated to be $200,025.00. As the graph above shows, the largest portion of United Cancer's benefit (30%) was in Direct Financial Aid going to 1) people in cancer treatment ($53,363), and 2) women needing help paying for mammograms ($5,233) totaling $58,595.57. In 2009, United Cancer registered 150 cancer patients and helped approximately 42 underserved women pay for mammograms.
Dollars directed toward direct staff time with cancer patients ($59, 246) account for 29% of our total benefit and are used in our Journey Through Treatment program. Journey Through Treatment is designed to provide emotional support and help cancer patients form a plan for their time in treatment. The plan focuses on seven areas including: 1) understanding the patient's diagnosis and treatment, 2) family issues related to cancer treatment, 3) information about the healthcare industry, 4) researches specifics about the patient’s insurance coverage, 5) budgeting and estimating treatment costs, 6) income replacement while in treatment, and 7) helping patients emotionally, such as providing tools that help patients regain some of the control over their lives that they feel they have lost.
One key result of the Journey Through Treatment planning process refers clients to a myriad of governmental and other nonprofit programs for which they may qualify. Referrals that make the largest financial impact would be to governmental insurances such as Medicare or Medicaid. This kind of coverage could represent tens of thousands to hundreds of thousands of dollars in benefit for the client. However healthcare organizations are most likely to connect patients with the best benefits available from governmental insurance before they come to United Cancer. The group of people United Cancer is most likely to refer to government insurance are senior citizens with Medicare who do not realize that they may also qualify for Medicaid. This referral to Medicaid may cover a portion to all of the 20% that Medicare leaves to seniors. In the context of cancer treatment, this referral could represent tens of thousands of dollars in benefit for the client. United Cancer estimates that these benefits totaled approximately $43,280 and account for 22% of the agency’s total benefit in 2009.
Another key result of the planning process addresses the issue of insurance coverage. On average United Cancer helps 150 to 160 cancer patients per year, and occasionally finds people who are seeking cancer treatment out of their insurance network. Depending on the kind of treatment and the number of times the patient received treatment, moving from out of network coverage to a network coverage could benefit the patient by thousands or tens of thousands of dollars. United Cancer estimates that we saved cancer patients approximately $38,904 in unnecessary out-of-pocket costs in 2009 and accounts for an additional 19 % of our total benefit.
Finally, half of the proceeds from United Cancer's signature breast cancer awareness month event, the Middlebury Breast Cancer Walk, ($5,233) goes to a fund at Goshen Health System to help underserved women pay for mammograms.
The chart above breaks down the Direct Financial Aid portion of UC’s programming
budget ($53,363). 2009 was an extraordinary year for United Cancer's direct financial aid program, in that for the first time the category of General Patient Aid constituted the largest portion of our direct payments.
Due to the economic turmoil and the passage of the Federal Government's Stimulus Package, Elkhart County's FEMA program received an additional $100,000 in funding in the spring of 2009. Traditionally, United Cancer receives a small grant from the Elkhart County FEMA Emergency Food Fund each year to purchase ensure for cancer patients. Because United Cancer was online with FEMA, our agency was eligible for the additional funding. United Cancer received $22,000 in additional funding which could be used for rent and mortgage aid. As a result United Cancer provided $24,601 in this category which usually covers mortgage, rent, utilities and other such normal costs of life. Providing aid to cancer patients in this category is important, because the most common reason that patients seek help from United Cancer is loss of income due to their inability to work during treatment.
The categories of Treatment Costs & Medication traditionally constitute our largest financial aid. In 2009, United Cancer provided $12,307 or 23% of our direct financial aid toward the cost of purchasing Medication, and help with Treatment Costs came in third at $8,815 or 17%. Supplies ($5,470 or 10%) are generally nutritional supplements and post surgical needs, and Transportation ($2,169 or 4%) generally provides help with the costs of out-of-town travel.
In 2009, United Cancer helped 150 cancer patients and their families with finances through the Journey Through Treatment Program. This represented a reduction of 22 people from the number helped in 2008. These results were a surprise to the staff and board especially considering the severity of the economic downturn. However, United Cancer soon began to understand that the reason for the reduction in patient need was a direct result of the recession.
When such a large number of people lost their jobs in Elkhart County, they also lost their health insurance coverage. It follows then that when people don't have health insurance they tend not to go to the doctor. So, we suspect that for a period of time in 2009 when people saw symptoms that they would have investigated if they had health insurance, they simply did not go to the doctor when they did not have insurance. As uninsured people began to get online with state health insurance such as HIP and Medicaid, the numbers of people asking for help began to rise to more traditional levels.
In 2009, United Cancer gave referral information to approximately 800 people asking for information on cancer and alternative health insurance options. This is a higher number than in 2008 and corresponds with our belief that lack of insurance reduced the number of people asking for financial aid as they search for alternative funding. United Cancer also gives health and prevention information, and reached approximately 1000 community members.
Our experience clearly shows that a cancer patient’s greatest need comes in the first year of their treatment. The first year creates this great need because cancer patients face high initial test & treatment expenses combined with the loss and/or reduction of their income. Expense issues include a battery of initial tests; expensive treatments (surgery, chemo & radiation), and high out-of-pocket insurance deductibles. Most patients are not able to work during treatment and many employers no longer offer disability income benefits. Those employees that do have disability income often face delays of weeks or months before income begins and the cancer patient must continue to pay their portion of health insurance costs.
United Cancer does not limit the kinds of cancer required for help from the agency, as many cancer organizations do. As the graph above shows, into 2009 United Cancer helped people with 29 different kinds of cancer. Interestingly, year after year breast cancer is the most common diagnosis and consistently represents over 20% of the number of people asking for help. Lung cancer is consistently the second most common diagnosis leading people to ask for help. Skin cancer, which is possibly the most common cancer, is rarely represented in United Cancer clients, because it tends to be very treatable at a very low cost. Prostate cancer seems to be consistently underrepresented in United Cancer figures, and we do not have a definitive explanation for that outcome.
The common perception that United Cancer is funding very low income people afflicted with cancer is not the case at all, even with the remarkable changes that have happened in the economy. In the graph below, approximately 68% of UC’s clients in 2009 had health insurance in place that was not based on financial need (private, Medicare, VA) when they were diagnosed. This represents only a 5% reduction from 2008’s total of 73%. The balance of our clients, those with economically based health needs, were only 32 % of new clients, and are comprised of clients with No Insurance, Medicaid, HIP, or Medicaid Pending.
Cancer patients of all types and ages ask United Cancer for help. 2009 was slightly different than previous years, in that our largest age group tended to be between 50 and 70. 2009 saw more people in their 40s asking for help, and the graph above clearly shows the largest group of the people asking United Cancer for help were between the ages of 40 and 70 (71%). However, cancer knows no age boundaries. UC has helped babies as young as two weeks old and seniors in their nineties. In 2009, our youngest client was one year old and our oldest was 89 years old.
United Cancer clients are eligible for funding if they live, work, or have worked in Elkhart
County, and a doctor verifies that they are in cancer treatment. Clients living outside Elkhart
County made up 5% of our clients. The number of Elkhart County towns that clients live in decreased from eight to seven. The chart above is typical United Cancer's geographic service area and shows a good cross section of Elkhart County hometowns for 2009.
United Cancer’s goal is to help cancer patients reduce the financial and emotional stress during treatment, so they can concentrate on healing. UC works to keep in regular contact with our clients and according to their reports, we were very successful in our goal. We achieved our goal through the combination of helping our clients devise a plan for their time in treatment, educating them about key issues related to the medical and insurance industries, connecting them to the network of government and non-profit resources available, and, of course, distributing $53,363 in financial aid. Clients report that our information and referrals are extremely helpful. Not to be minimized in the United Cancer experience is the emotional support and caring that our staff provides to our clients. United Cancer works to stay in touch with our clients as they progress through treatment and move into remission. Clients often report that the information they gain from the Journey Through Treatment program is just as valuable as the Direct Financial Aid that we provide.
Maintaining Financial Viability
The question of economic viability is obviously an important one going into 2010. Although United Cancer’s staff and board were prepared for 30% to 40% losses in revenue in 2009 following the catastrophic results of the 2008 United Way campaign, 2009 had a dramatically better result with United Cancer showing only a 2.8% loss in total revenue.
However, beneath the total revenue figure United Cancer was definitely affected by the economic downturn. In the first half of 2009, several of our stalwart revenue lines showed an average reduction of 39%. However our new event, The Stephenson's Fashion Show, did dramatically better than expected. Receiving the FEMA grant of $22,000, and a donation of a mutual fund from the Culver Duck Farm family greatly bolstered our numbers. And, defying current wisdom, our year-end appeal raised 250% more than expected.
All these comparisons speak volumes to the strength of United Cancer's financial viability when we realize that we are comparing to 2008 which was the strongest financial year in the agency's 50 year history. In a year where both businesses and nonprofit agencies in Elkhart County were retrenching and laying off staff, United Cancer’s donors and supporters showed dramatic loyalty and generosity.
Going into 2010 United Cancer still faces challenges in fundraising as does any nonprofit in Elkhart County. The staff and board believe that nonprofits will lag behind an economic recovery, so we must be conservative in our estimates and our budgeting. However, United Cancer believes that 2010 will still be a strong year and that the agency will provide resources for Elkhart County area cancer patients at about the same level as 2009. United Cancer has a 50 year tradition in Elkhart County, and we will continue to help our neighbors in cancer treatment get back on the road to good health… no matter what the economy says or does.
As an independent, grass roots organization, United Cancer’s success is based on the support of the people of the Elkhart County area. If you are a supporter, I hope that you will continue to help. If you have not given in the past, I hope that you will consider a gift now. Each year, the number of cancer patients coming to ask for help continues to rise, and our ability to help relies on you.
Thank you for your interest and support!
Peter T. Norton
Executive Director