Outreach workers will be stationed at public places such as malls starting today to recruit low-income women for breast and cervical cancer screening, District officials said last night.
The move came three days after cancer doctors publicized their complaints that a federally funded screening program, Project WISH (Women Into Staying Healthy), came to a halt for six months because the D.C. Health Department failed to spend its $1 million grant.
More than 400 needy women could not get low-cost mammograms and about 450 could not get Pap smears because of the funding problems, doctors said. Health Department officials told doctors that Project WISH screening had been halted, said Donald Henson, co-director of George Washington University's office of cancer prevention and control. He said funding problems have continued this year.
Health Department Director Herbert R. Tillery and City Administrator Robert C. Bobb said in an interview at Bobb's office that miscommunication and job vacancies within the department were the issues, not funding. The money has been available since October, they said.
Tillery pointed out that the program has not been dormant. Through yesterday, 596 women were screened for breast cancer and 312 for cervical cancer, Tillery said.
In previous years, Project WISH has provided up to 1,900 mammograms and up to 2,100 Pap smears, according to Jeanne Mandelblatt of Georgetown University's Lombardi Comprehensive Cancer Center.
Tillery said the outreach workers, who are being brought in on contract, include some who speak Spanish and would be sent to "find folks who might have fallen through the cracks."
Many doctors consider the tests essential in the early detection of cancer in the District, which has the nation's highest breast and cervical cancer death rates and worst overall cancer mortality when compared with the 50 states.
Bobb also promised major changes at the Health Department, a massive agency that employs 1,400 and has a $1.5 billion annual budget.
Bobb and Tillery said they were blindsided by the doctors' complaints. "I was totally and completely outraged, and the mayor was equally outraged," Bobb said. "It's not something we're very proud of. Public health initiatives for the poor demand persistence and aggressiveness in bringing services to the community rather than waiting for people to come to providers.
"You have to take it to the street," he said.
Tillery, who took the reins at the Health Department in March after Bobb removed James A. Buford as director, said the department was adrift. "Morale was very low," he said. "There was a lack of faith in leadership."
Today's outreach campaign comes less than two weeks before the expiration of the $1 million grant and is designed to link eligible women with the program as quickly as possible, Tillery said.
"That's good news," Henson said last night. "It wasn't our intention to humiliate anyone, but we felt our efforts were being stymied either by the lack of interest or the stonewalling at the Department of Health."
He said he now wants to see exactly how the grant money has been used since it was given to the city by the federal Centers for Disease Control and Prevention last summer. "We would like to have some kind of public accounting of the funds," Henson said. "Our concern was they were using this money for their friends."
Tillery is to meet today with CDC officials to try to get authority to spend this year's remaining grant money after July 1, when the second of five years of funds arrives for Project WISH.
The Health Department has often been criticized for mismanaging grant funds. Tillery pledged last night to conduct an unprecedented inventory of the department's grants -- it has more than 100 -- and begin tracking exactly how much money has been spent and whether it is used appropriately. A grants management council will be created to monitor the department's performance, he said.
"It's a new day," Bobb said. "You don't just sit on your butt and watch a problem anymore."