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CHICAGO - In most states, Jane Chenier-Williams would be up a creek without a paddle if the free breast cancer screening she got from a well-intentioned charity found a spot that turned out to be malignant.
Luckily Chenier-Williams lives in Illinois, which recently plugged a common loophole big enough for an unsuspecting woman to fall clear through.
Until recently, the Illinois Breast and Cervical Cancer Program for low-income, uninsured women guaranteed treatment at government expense only if the disease had been found through one of the program's state-funded mammograms or Pap tests.
Women who received free mammograms from private groups - as Chenier-Williams did - could be denied care, leaving them in a Catch 22 situation.
But as of Sept. 1, the state screening program was expanded to make thousands more women eligible. Under a little-noticed budget provision pushed through by Gov. Rod Blagojevich, low-income women with breast or cervical cancer can qualify for treatment whether or not their cancer was detected through the program.
That makes Illinois "a leader in providing breast cancer treatment to low-income and uninsured women. The majority of states are more restrictive than Illinois" in this area, said Sean Tenner of the Susan G. Komen Breast Cancer Foundation.
Donna Thompson, CEO of Access Community Health Network, whose clinics are part of the screening program, said the change removed a significant barrier to care for underserved women.
"Before," said Thompson, "a woman who was referred to us and came in with a mammogram under her arm, we'd have to say, `Sorry, we can't enroll you in the program.'"
A woman in that situation would have had to seek treatment at a public institution like Stroger Hospital or find some other charity care.
Chenier-Williams, of Oak Park, who lost her job and her health insurance earlier this year, received one of the 200 or so mammograms provided so far this year by the Chicago-based charity A Silver Lining Foundation.
"What a difference a single phone call made!" said Chenier-Williams, who saw a listing for the foundation on a local television station. The founder and chairman of the foundation is Sandra Goldberg, the station's "Dr. Sandy."
Chenier-Williams, a widow and a former legal assistant, said she had not had a mammogram for several years. "I was between jobs and with no health benefits," she said, "and that's not a good place to be."
Being able to get a mammogram and find out the results were normal "meant I had one less thing to be concerned about," she said.
Chenier-Williams admitted she did not stop to think about what would have happened had the mammogram found an abnormality that required follow-up care, but added: "I'm really glad to know my care would now be covered if I had a problem."
Other organizations that offer free mammograms include the National Breast Cancer Foundation, which funded more than 20,000 mammograms nationwide in the past year. Y-Me Illinois is also planning to offer more free screening tests.
Jan Costello, deputy director of the state's Office of Women's Health, said the screening program began in 1995 and was rolled out gradually. At first, screening was available only to women at or below 200 percent of the federal poverty level, and there were no funds for treatment until 2001. At that time, she said, treatment had to be limited to women who were screened and diagnosed through the program because of budgetary constraints.
That is still the situation in many other states, including Indiana. A spokeswoman for the Indiana Breast and Cervical Cancer Program confirmed that women in her state "can't come into the treatment program if they've already been diagnosed with cancer."
Costello said the expansion of the Illinois program means "the state will be screening 3,000 more women each year and treating nearly twice as many." She said Illinois now screens about 17,000 women a year for breast and cervical cancer and treats more than 400.
A separate but similar program aimed at black and Hispanic women, Stand Against Cancer, does not restrict treatment to women who were screened in the program and has no age limits. The number to call is 888-SAC-HOPE.
Goldberg, who was diagnosed with breast cancer six years ago, said she was appalled to discover that "what was readily available to me was not available to most other people." That's why she started A Silver Lining Foundation, she said.
This year the foundation raised enough money to provide 700 free mammograms through the University of Illinois at Chicago Medical Center. In addition, she said, it established a grant to pay for transportation, food and drug co-pays for women undergoing breast cancer treatment at the medical center.
Chenier-Williams, who now helps out as a volunteer at A Silver Lining, said she believes "the face of the underserved is changing" to include people like her, who once had a steady income and excellent benefits.
"You can suddenly find yourself without a job," she said, "and then where are you?"
(c) 2006, Chicago Tribune. Distributed by Mclatchy-Tribune News Service.