Dorothy: [00:00:00] If you’ve ever seen our mobile mammography health coach going down the highway, you know it’s a big, big machine, and if you’ve ever thought about having that coach come to your office or your church or community center, then this is the woman that you need to know. Candace Saxton is with us today to talk about all the ins and outs of having a mobile program and having a mobile coach come to take care of the women you care about.
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Let’s Talk About Your Breast, a different kind of podcast presented to you by The Rose. A breast center of excellence and a Texas treasure. You’re gonna hear frank discussions about tough [00:01:00] topics, and you’re gonna learn why knowing about your breast could save your life.
Candace, thank you so much for being with us today. We are excited to learn about the mobile program, but I want you to tell us a little something about your background. Now, you don’t live in Houston. You don’t work here at The Rose. I mean, you’re our employee, but you don’t office here. So give us some background on that.
Candice: Well, I was born and raised in Brazoria County. Um, I have very deep roots there. Uh, and, um, my family owned a small grocery store in, in that area. Um, I was something my grandparents started, um, it was there for 69 years.
Dorothy: Wow.
Candice: And they sold in 2015. But that’s just kind of where my home base has, has always been.
Dorothy: So you know that community well?
Candice: Yes ma’am.
Dorothy: And how did you find out about us?
Candice: It was kind of a series of events really. [00:02:00] Um, I was in a position, uh, I was working for a company called Help Incorporated in, uh, Brazoria County. And there, there was a lunch and learn. There was a community engagement navigator from the Groves that came into town to do a lunch and learn. And I had heard of The Rose and you know, I went to that to learn more. Um, just because of the position I was in at that time, it kind of made sense for, for me to be there. And that was really my first introduction, uh, to The Rose.
Dorothy: And so when we found a grant that was covering people outside of this county, then I, if I’m remembering right, I think you were our first one to actually have a grant wrapped around it for a salary. That was, we were so excited. We actually got salary coverage, you know, so.
Candice: Yes ma’am. It was, it was a pilot program and When I came on, it was, the initiative was just to focus on Brazoria County. And try to build the mobile [00:03:00] program and the EmpowerHer program in that area.
Dorothy: So I’m gonna have you go back and talk a little bit about EmpowerHer and what that means, but, uh. After you came on board, do you remember the success rate that we had? Because I had to report on it, so I’m just wondering if you remember it.
Candice: I, I don’t.
Dorothy: We had something like, let’s say 10 mobile sites before you came on board, and then within the first six months you had doubled it, almost tripled it, the number of sites. And we said, Hey, this works. I mean, we’d done everything we could to try and get folks to book a site, but it took someone from the community being in the community that knew some of these people to actually talk to ’em. So. You didn’t know that story?
Candice: I, I mean, I knew that I had a mission, you know, I, I was trying to, to definitely grow the program, but I didn’t really remember.
Dorothy: Yeah.
Candice: How, you know, what was already [00:04:00] there.
Dorothy: Right. It was great. It was, we were really so pleased. So let’s talk a little bit about, uh, the EmpowerHer Program. What does that mean exactly?
Candice: Well, um, EmpowerHer is the, the program that The Rose has, you know, to support sponsored patients in communities to, to make sure that their breast health services um that everyone has access to care.
Dorothy: And so when we call, when we talk about a sponsored woman, that’s our uninsured women.
Candice: Yes ma’am.
Dorothy: And we always say, you’re not charity care and you’re not indigent, you are sponsored by a grant, a person, a program. So, you know, I think, I think from that point on, we are talking to our uninsured in a way that’s a little different. I mean, we all know you could be uninsured at any time and down on your luck or whatever, but that shouldn’t stop you from getting a [00:05:00] mammogram.
Candice: Absolutely. Yeah. Making, just making sure everyone has access to care.
Dorothy: So tell me what you do in your day to day job.
Candice: Well, my day-to-day job is serving as one of the main points of contacts between our mobile partners who are, we go all the places that we go to take the coach and try to reach people in different communities, and The Rose, you know, we are kind of the face, the, my, my team and I were the face, the people that are out. I. Trying to maintain our partners, but also trying to find new partners. And, and grow the program in our service area.
Dorothy: What qualifies as a partner?
Candice: It really can be anyone.
Dorothy: Okay.
Candice: There’s a, some requirements, of course, to host a mobile day. You know, we have to make sure that there’s adequate space. For parking the coach, that’s usually the first thing that we’re gonna look at. Um.
Dorothy: Is that something you do or does someone [00:06:00] from the mobile team go check it out? Or is it a mutual thing?
Candice: It’s a mutual thing. You know, we typically look at it first.
Dorothy: Okay.
Candice: And then if there’s something that’s questionable, like we can’t say a hundred percent that um, the site would work for the coach, then we might ask a driver, you know, their opinion on it. And then occasionally, you know, they’ll go out in person and, um, you know, just to make sure that there’s not a barrier. I mean, we have to look at the level of the area. Um, we have to look, make sure that we have 14 foot height clearance. Um, you know, some parking lots are pretty small and our coaches are large.
Dorothy: Yes.
Candice: They’re, they’re big. They can’t make sharp turns and So that’s always the first step is just making sure before we get way into it, that the coach can fit.
Dorothy: And this could be at a clinic or it could be at an FQHC, a fairly qualified health center, or even a physician’s office.
Candice: Correct. Right.
Dorothy: Or a business.
Candice: Yes, ma’am. Yeah. Yeah. We work with, [00:07:00] with, with clinics, we work with FQHCs. Um, we work with different corporations, school districts, nonprofit organizations, community centers. You know, just, just about anywhere that can have the adequate space, but also meet our minimum requirement of, uh, patients.
Dorothy: What is that?
Candice: Uh, it’s 20. We look to have at least 20 women pre-registered for a mobile day.
Dorothy: Before we continue this episode, I have to let you know about something that is happening throughout this month of July. Our Anonymous Donor is at it again, and she wants to match your donation up to a hundred thousand dollars. So think about it, $20 is now $40, a hundred dollars is now $200, and if you’re feeling really generous, a thousand dollars is now $2000. Just think about all the women that we could help with your donation and our Anonymous Donors match. Please go to therose.org. [00:08:00] It’s easy to make your donation there. And as our do said, every dollar counts. Now, back to the podcast.
Why is the pre-registration so important?
Candice: Well, um, you know, of course we do serve both insured and uninsured. Um, if they have insurance, we’ve got to get their insurance verified, you know? But prior to their appointment, but then if they’re asking for sponsorship, we have to get ’em qualified for the sponsorship program.
Dorothy: And what are they gonna need to do that?
Candice: There’s a financial assistance application that has to be filled out. They, um, have to provide household proof of income. And they also have to have a doctor’s order, um, for the screening.
Dorothy: Talk a little bit about what it means to be screened, because you can’t go to a mobile unit if you’ve already found a lump.
Candice: Correct. So on the coach, it is just 3D mammogram screenings. We do not have diagnostic services yet, yet, [00:09:00] so a screening is looking for an abnormality.
Dorothy: Okay.
Candice: You don’t know something’s going on. It is to purely look to see if there’s something that’s that’s out of place that you may not know about yet.
Dorothy: Normally done annually?
Candice: Yes, ma’am. Every 12 months.
Dorothy: And how old do they have to be?
Candice: For annual screenings? You typically start at 40. Well, we hope that you start at 40, but we also highly recommend a baseline mammogram starting at 35.
Dorothy: That is just really important.
Candice: Yes, ma’am. Yeah.
Dorothy: Especially so many young women being diagnosed these days.
Candice: So on the coach, you know, we see females 30, 35 and older. Um. To, you know, to be seen, seen on the coach. The Rose, of course, offers young women services and, and services to men at our diagnostic centers, but in those cases, they would need to have a, a diagnostic screen.
Dorothy: So how, how do you know if that lady has a, a lump or not?
Candice: They’re gonna do a medical history.
Dorothy: Okay.
Candice: You know it, when we do the online registration or the [00:10:00] paper registration, that should be a question that, that’s asked.
Dorothy: And we need them to answer it correctly.
Candice: And we need to answer ’em correct, correctly. And, you know, sometimes we don’t find out until they’re already on the coach. There, you know, there are times.
Dorothy: But that happens in the, in the centers too. You’ll have the patient go back. You, we all think she’s there for screening and.
Candice: And then as soon as she kind of gets with the tech and they start asking them some of their questions, then they might open up a little bit more and, you know, mention something that could possibly be a symptom.
Dorothy: Right. It’s just really important that when you have a symptom that becomes a diagnostic, uh, exam because there’s different things we do when we think something’s going on.
Candice: Correct.
Dorothy: So, yeah, it, it gets a little tricky, but, it is important.
Candice: It’s important. And you know, usually at that point, the, the, you know, we’re not gonna be able to do their screening mammogram. But our team will usually take the steps to go ahead and make sure, and, [00:11:00] you know, help them get their appointment registered, I mean, scheduled for.
Dorothy: Yeah.
Candice: For the diagnostic screening at one of the centers.
Dorothy: And explains to him what, what’s going on.
Candice: Yes ma’am.
Dorothy: So I’m a facility and I’m all gung ho about having you come out, but I want it in October. What happens then?
Candice: Well, unfortunately October feels really fast. It is breast cancer awareness month. And every, you know, everybody wants October and wants us to come out in October. Um, we just, we don’t have enough coaches or days in the month.
Dorothy: Wait, wait, wait. How many coaches do we have?
Candice: We have five.
Dorothy: That’s not enough.
Candice: It’s not enough for October? No, ma’am. No, it. Um, ev, you know, it’s, it’s an important month. It’s when everybody’s really thinking about it. But no, we, we were not able to do all the requests that we get for, for the month of October.
Dorothy: Aren’t we booked out what months or almost a year or what?
Candice: We book out [00:12:00] about a year in advance.
Dorothy: So it’s real important if a company or a clinic wants to do this, that they get on our list.
Candice: Correct. Yes, ma’am. Right.
Dorothy: Yeah. And, and we have a strong list of past clinics that come back every year and we keep doing it. Yeah.
Candice: Yeah. We have a lot of long, long term partners, you know, that we’ve gone to for years. And, you know, it it, and that’s part of the job is just maintaining those partnerships. But also growing the program at the same time. Making sure we’re bringing in new partners and trying to reach as many as we can and figure out where we can fit ’em all in at.
Dorothy: Right. And funding’s real important in all of this.
Candice: Yes, ma’am.
Dorothy: Because it, it really can dictate just how many new people we can go to or how much we can expand. And.
Candice: Definitely makes a difference, of course, on, you know, how many we can serve and each community.
Dorothy: Right.
Candice: You know, we kinda, as Jessica always says, we have little [00:13:00] buckets, you know? Like this bucket will cover this area. And this bucket will cover this one.
Dorothy: And how many areas do we have?
Candice: Uh, we’re currently in 45 counties in southeast Texas.
Dorothy: Wow. You’re helping to coordinate an awful lot of that area and not just.
Candice: Yes, ma’am. It’s not how it started.
Dorothy: No, that’s not how it started. Yes.
Candice: But now yes ma’am.
Dorothy: Yeah. You.
Candice: Doing what I can to help build the program in, in the entire service area.
Dorothy: When a woman has a mammogram on, on the mobile, it is the same equipment we have here at the centers.
Candice: Yes, ma’am.
Dorothy: Right. And it’s our same text. There’s no difference really when she has her mammogram on the mobile except for the con, the convenience of it coming to her.
Candice: Yes, ma’am. And our coaches are specially designed so that they can carry the same equipment.
Dorothy: Yeah.
Candice: You know, equipment is heavy and they weigh a ton. We actually have to have CDL drivers because of It’s not necessarily the length of the coach, it’s because of the weight.
Dorothy: Of the weight. Yeah.
Candice: Of the coaches.
Dorothy: Do you know [00:14:00] more about coaches now than you ever thought you would?
Candice: Absolutely. Oh, yes ma’am.
Dorothy: But what other things do you look for when you’re considering a site visit.
Candice: Other than parking, being able to meet that minimum requirement, we have to have someone that we call our site facilitator.
Dorothy: Okay.
Candice: So if that’s somebody that’s going to be our direct point of contact for the, the location for the mobile day, they’re the person that’s responsible for either doing the registration, the pre-registration, um, getting the paperwork and everything together, or responsible for doing the promotion for an online registration. So those are the people that we work directly with and kind of pinpointing who it is. We, you know, we get all kinds of inquiries, you know, to go to health fairs. And to be honest, we don’t do a tremendous amount of health fairs. Something that we say, no, never. You know, we would do some. But once people realize that there’s a pre-registration and that [00:15:00] we have to get it done in advance. It’s not just pull the coach and anybody can have a screening that wants one that day. Yeah.
Dorothy: We, we learned a long time ago that the community screenings where you just go and set up and hope the community will come in. It’s just not a good system.
Candice: No, it, it, it’s, it’s not. And, um, you know, to do something like that, everybody would have to show up with everything that they need and that’s just not gonna gonna happen. We have to get it all done in advance. There’s a lot of behind the scenes work within The Rose, but also that our sites do to make a mobile day happen.
Dorothy: And, most of the facilitators are working with these women already, right? I mean, they’re either their clients or their patients, or.
Candice: Correct. Yes ma’am.
Dorothy: Yeah. But they’re so valuable.
Candice: And that’s one of the things, you know, who are you trying to target when we talk to ’em initially, you know, are you trying to reach the community? Is this for your employees? Is it for your patients? [00:16:00] Who were, who were you wanting to reach?
Dorothy: Right? And how do you make sure they know about the number of that’s required and, and I know there’s times people know show, but we still try to keep that 20. Uh.
Candice: 20 plus. Yes ma’am.
Dorothy: Plus, yeah.
Candice: When somebody’s interested, we, we give them the basic information. Um, and there’s kind of an inquiry form that we’ll send them just to help them realize what is needed. Once they fill that out and then come back to us, then we typically will set up a teams meeting so that we can sit down, face-to-face or virtual meeting or an in-person meeting. If we can, um, phone call. Something just to talk more in detail about everything, but, um.
Dorothy: Well, you’re still, you’re kind of the manager of all this, right?
Candice: Yes, ma’am. Yeah.
Dorothy: I knew you. I knew you weren’t gonna talk about that, but we need you to because almost every part of this mobile program you’re touching in [00:17:00] some way or another.
Candice: Yes, ma’am.
Dorothy: And I’m wondering if when you’re, when you’re setting up someone and you know they’re not gonna make, do we have any options?
Candice: Um, yeah. Uh, we, uh, try to step in if we see something’s not going quiet and you know Give them ideas on how we can help. Maybe increase numbers or maybe suggest if it’s like a corporation that we’re going to and they’re only focusing on their employees, you know, can we open it up to their spouse, you know, employee spouses, and, you know, we will try to help guide them if, if, if they’re struggling, um, occasionally we’ll have to reschedule, you know? Move something back just so they have a little bit more, more time. And then there are times where it just, you know, ends up not panning out.
Dorothy: Right.
Candice: But, um, we, you know, do everything we can to help get where it needs to be.
Dorothy: But my gosh, some 10,000 women are screened through this program every year.
Candice: Yes, ma’am.
Dorothy: So, yeah. What other things do we need to [00:18:00] know when it comes to that referring physician?
Candice: It’s a barrier. It’s a, It is a challenge. Um, you know, some patients that are, would be sponsored are uninsured and they don’t have a current, current doctor. And, um, that’s, a lot of times when, if we find that out, we’ll try to figure out a way to help them. Um, navigate them either to a clinic or there’s times where we pull in our mammography to medical home program to um, help patients obtain an order.
Dorothy: And that’s our, uh, nurse practitioner who sometimes has gone on the mobile just to do the clinical, so the exam, the breast exam.
Candice: Yeah. I had, I did a mobile day. I mean, sometimes we don’t know we need it until we, until we need it.
Dorothy: Right.
Candice: Um, there was an event we did with the school district one time and they had been a long time partner and then all of a sudden they were like, you know, we really wanna do a mobile day for our maintenance and operations department. I was like, okay, great. You know, it was growth, we’re, let’s get it set up. But [00:19:00] it was an online registration. And when the lady started registering, we started to notice that a lot of them were asking for sponsorship and they didn’t have a doctor.
Dorothy: Right.
Candice: And so we, um, started reaching out to them to confirm, you know, that they didn’t just not enter the information, that they didn’t have a doctor. And, um, there was just surprising, there was just more than we expected. And we were able to, you know, call in mammography to medical home, get the nurse practitioner out, and still move forward with the, the mobile day. And what was really kind of neat about that is not only did they get their screening, but then they’re also getting navigated, help navigated into a medical home.
Dorothy: Right.
Candice: Right.
Dorothy: And so many of the maintenance folks are on contract, I mean, you know, they’re not employed so. It does make it difficult.
Candice: Yeah. It, you know, those are the ones that are special. Kind of the ones that you, um, you think it’s gonna go one way, and then [00:20:00] as you start working with it, you realize that there’s just a different need and trying to help break that barrier.
Dorothy: Right. So do you often go to community events, just you to talk about the mobile program?
Candice: That is a big portion of the job. Is, you know, just outreach and education. Um, sometimes the outreach is more geared toward, we’re gonna go to this event ’cause we could possibly find some new partners at this event. And then a lot of it is going out and, um, doing education and letting people know that The Rose is here, these are the services that we offer. And you know, just making sure that everybody knows there’s somewhere they, that they can go.
Dorothy: Right. So do you have another favorite story?
Candice: One of my favorites, I, and I believe that she was on the, on the podcast is we had a site that we were working with. It was a, a corporation and uh, they were struggling to meet the [00:21:00] minimum requirement of, of numbers and, um, and talking to them, you know, and just trying to encourage the site facilitator herself had not registered for the screening. Um, she wasn’t quite at the 40, she was more in that baseline mammogram age, and so she just didn’t think she needed to do it yet, but to help, I put one more on the schedule, so we didn’t have, you know, we could get to the number. She went ahead and signed up herself and we ended up diagnosing her with breast cancer.
Dorothy: Yeah. She was on the show.
Candice: And it’s just, you know, had we not been there, you know?
Dorothy: Right.
Candice: It’s, she wouldn’t have known, she just wouldn’t have known that was there and it was all by mistake that she, you know.
Dorothy: Ooh, that gives me chills.
Candice: That she found out that she had, you know. It was just to kind of meet that minimum.
Dorothy: Oh my goodness. That’s a great story.
Candice: Yeah, that’s, that’s a special one.
Dorothy: So by the way, the survivor and, and the woman who signed up and didn’t expect her to do [00:22:00] anything except make the numbers work, was Morgan Muraca. And we had her on, and we’re gonna have in the show notes her episode so that you can go and hear her story. It’s not all that simple, but there are steps and we can certainly take ’em to ’em. There is probably nothing we haven’t heard or seen.
Candice: Yes ma’am.
Dorothy: Yes. And we can make it work. I think that’s the one message I keep hearing.
Candice: Yes ma’am.
Dorothy: You know, you’ll make it work one way or another.
Candice: That’s. Th that’s it. It’s just, and, and there’s sites, you know, sometimes it’ll go to that the parking doesn’t work out. So we start looking, where could we go nearby? You know?
Dorothy: Ah, yeah.
Candice: Where could we, um, where can we fit?
Dorothy: I, I know where ago you said something about, uh, the different types of people that can book different types of companies, uh, you know, clinics, community centers, but you also mentioned businesses or iSDs, give us an example of A ISD that we go to.
Candice: So, one of the school [00:23:00] districts that we work with is Alief ISD. Um, they’ve been a, a long time partner, I, I believe, for over a decade. And, um, we go multiple times a year throughout the school year, sometimes three times a month, you know, to the school we always set up in the same spot. Um, but it’s a way for the teachers, they have their screening during their off period throughout the day. Most teachers, they’ll have their class and then they’ll be like one classroom period where they’re off.
Dorothy: Oh, okay.
Candice: To do that. So a lot of at Alief, I know that’s how a lot of the teachers will book during their, like, off hour.
Dorothy: So we, we might be there three times a week?
Candice: Uh, a month.
Dorothy: A month. And we’ll go at different times, but we keep going back.
Candice: Yes ma’am. Yeah.
Dorothy: Yeah. So it’s not like just one time of year that you could book.
Candice: Absolutely. I mean, we do have partners that, you know, are, one time we go once a year, we. Screen their employees or patients. And then we have partners that we have on a regular schedule, um, that we go to [00:24:00] monthly, um, in some cases three, three times a month.
Dorothy: Interesting. But our school districts are really a group that we very much love serving.
Candice: Absolutely.
Dorothy: Yeah. Because they, teachers just don’t have enough time for anything.
Candice: And that’s one of the goals of the mobile program is, you know, just to make it convenient for ladies to have their screening done so that they’re, they don’t put it off. It’s hard to get off work to take a half day or a whole day.
Dorothy: That’s a good point. ’cause it’s only what. 15, 20 minutes go down to the coach?
Candice: Yep. They can have it done in a 15 minute break. Um, and they’re done for the year.
Dorothy: They and the business or the school district, I mean, they’re, they’re doing a great benefit for their teachers. How many have we diagnosed through those programs? I mean, it’s, their teachers don’t have to take off and, you know, they’re, give it a great employee service.
Candice: Absolutely, man. That’s what the program’s all about.
Dorothy: [00:25:00] Candice, thank you again for driving all this way. And you know, like we said earlier, you don’t work in this center or the other center. You, you are home-based and you’re out in the community and you are leading the community engagement navigators. Tell us one more thing, in your mind, what is probably the most I important thing that you’ve learned about women and having there are mammograms on the mobile.
Candice: It has to be that 77% of the ladies that we serve through the mobile program say they would not have had their screening mammogram or delayed their screening mammogram had we not been there.
Dorothy: Oh my gosh. 77%. And that’s insured or uninsured?
Candice: Yes.
Dorothy: It’s both?
Candice: Both.
Dorothy: Both. Oh my gosh. Well, I think that says it all. We go when we can get to them, they’ll have it done.
Candice: Yes, ma’am.
Dorothy: It’s all about convenience. Thank you again so much for being with us today.
Candice: Thanks for [00:26:00] having me.
Post-Credits: Thank you for joining us today on Let’s Talk About Your Breasts. This podcast is produced by Speke Podcasting and brought to you by The Rose. Visit therose.org g to learn more about our organization. Subscribe to our podcast. Share episodes with friends and join the conversation on social media using #LetsTalkAboutYourBreasts. We welcome your feedback and suggestions. Consider supporting The Rose. Your gift can make the difference to a person in need. And remember, self-care is not selfish. It’s essential.
