Eliminate the Texas Cancer Council to Avoid Overlap with Other Programs

The Legislature should eliminate the Texas Cancer Council to avoid overlapping with programs dealing with cancer in the state.


Background
The Legislature created the Texas Cancer Council in 1985 to coordinate the state s efforts to fight cancer and to monitor and revise a strategy known as the Texas Cancer Plan.

This plan has four goals: to promulgate cancer-prevention programs, promote the early detection of cancer, improve the availability and quality of Texas cancer-tre atment programs and advance the development of new cancer treatment and prevention methods.

In addition, the council is intended to promote the development and coordination of effective and efficient statewide public and private policies, programs and services related to cancer and to encourage cooperative, comprehensive and complementary planning among the public, private and volunteer sectors involved in cancer research, prevention, detection and treatment. 1 The council employs ten people and will spend $4.1 million in fiscal 1993.

A number of private organizations, including the American Cancer Society, the Cancer Research Institute, the American Institute for Cancer Research, the American Cancer Association and the National Cancer Institute duplicate the council s efforts.

One of the council s missions is to provide cancer prevention and treatment information to Texans. This mission is furthered by a contract with the Texas Cancer Data Center, a clearinghouse for information concerning Texas can cer statistics, programs and services. Many of these data are not provided by any other organization.

However, the organizations cited above provide an enormous amount of information on cancer through a wide variety of publications, as well as the National Cancer Institute s CANCERFAX (a cancer information database that can be accessed with a fax machine). Several computer bulletin boards and databases can be accessed relatively inexpensively by hospitals, physicians, libraries and the general public. The se electronic services contain nutritional information, medical news and abstracts and articles from major medical journals. 2

The council provides a toll-free telephone number for information on tobacco abuse through its Office of Smoking and Health. The American Cancer Association and the American Institute for Cancer Research provide similar toll-free telephone services. The Am erican Cancer Society s 26 Texas offices provide telephone assistance, while the National Cancer Institute provides a toll-free cancer help line with on-line consultants who speak in both English and Spanish.

Another goal of the council is to further the education of health-care professionals through its Physician and Nurse Oncology Programs, which provides continuing medical education programs, and the School Health Project, which provides information through 16 regional school health specialists (with an emphasis on nutrition and smoking). However, this need appears to be adequately met by the state s medical schools, and again, other organizations provide similar programs and financial assistance. The Cancer Research Institute provides grants for health-care education; the American Institute for Cancer Research offers seminars and lectures for health-care professionals, and the American Cancer Society offers professional scholarships, teaching fellowships, meetings and films.


The council reports that it coordinates the work of various cancer organizations operating in Texas. However, the council has no statutory authority over the private organizations or the federally funded National Cancer Institute. Representatives of the American Cancer Association, Cancer Research Institute, American Institute for Cancer Research and the National Cancer Institute have all asserted their ind ependence on numerous occasions. Each organization works on its own projects, at its own discretion.

Finally, the council s budget of $4.1 million a year is insignificant compared to the funds spent by the five organizations mentioned above, which spend $3 billion a year nationwide. The council has little financial leverage in this arena.

The council has stated that its top priority is implementing the Texas Cancer Plan. The council spent nearly $3.8 million in fiscal 1992 on this plan, but representatives from the American Cancer Association, Cancer Research Institute and the American Inst itute for Cancer Research all told the Texas Performance Review (TPR) that they had never even heard of the Texas Cancer Plan and that it has no influence on their efforts. Only the American Cancer Society reported any contact with the council at all.


Recommendation
The Legislature should abolish duplicative functions of the Texas Cancer Council.

The council s services are duplicated by several major private organizations. The leadership the council is supposed to provide is not recognized by many active cancer organizations. Consequently, the council and the plan do not significantly affect the p olicies of cancer organizations. Numerous publications, public service announcements, teaching aids, seminars, research funding and several telephone cancer information lines provided by privately funded organizations and the federal government are available to the public.

However, since some information provided by the Texas Cancer Data Center (which is under contract with the Texas Cancer Council) is not available elsewhere, TPR recommends that the responsibility for this contract and its funding of $400,000 a year be tran sferred to the University of Texas M.D. Anderson Cancer Center.

In addition, TPR recommends that the position of Director of the Texas Cancer Council be transferred to the M.D. Anderson Cancer Center and renamed the Texas Cancer Liaison. This liaison would administer the contract for the Cancer Data Center and serve as a liaison with privately funded cancer organizations and the National Cancer Institute s Texas operations. The liaison also should work to secure research grants for Texas facilities.


Implications
TPR found that the services provided by the council are adequately provided by other organizations. The only function that does not appear to be duplicated elsewhere that provided by the Cancer Data Center could be made available directly through the University of Texas M.D. Anderson Cancer Center.


Fiscal Impact
The Texas Cancer Council is appropriated $4.1 million in fiscal 1993 for research and education funding and the administrative costs associated with the implementation of the Texas Cancer Plan. If this recommendation is enacted, $3.7 million of this funding would be eliminated.

Fiscal Savings to the General Change in
Year Revenue Fund 001 FTEs

1994 $3,695,000 -8
1995 3,695,000 -8
1996 3,695,000 -8
1997 3,695,000 -8
1998 3,695,000 -8



Endnotes
1 Tex. Health and Safety Code Ann. Sec. 102.009 (Vernon Pamphlet 1992).
2 Some of the bulletin boards and on-line databases are Black Bag, MEDLINE, SENIORNET, BRS After Dark, Compuserve and Dialog. See Marc Silver, Ten Terrific On-line Services, U.S. News and World Report (October 5, 1992), pp. 90-92.