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Libby, Montana's Public Health Emergency: Asbestos Health Screening

Award Number: NU61TS000295
ORGANIZATION: AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY
OPDIV: CDC
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: HEALTH SERVICES
PERIOD OF PERFORMANCE START DATE: 09/01/2019
PERIOD OF PERFORMANCE END DATE: 02/28/2025

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Libby, Montana's Public Health Emergency: Asbestos Health Screening - Background: Exposure to Libby Amphibole asbestos (LA) resulted from mining contaminated vermiculite ore in the Libby, Montana area from 1923-1990. Awareness was raised in 1999. ATSDR conducted health screenings in 2000 and 2001 that identified high incidences (18%) of asbestos related lung abnormalities in local residents based on chest x-ray interpretation. The Center for Asbestos Related Disease (CARD) was established in 2000 as a department of the community hospital in order to treat asbestos related health conditions. CARD became an independent community based non-profit in 2003. Through multiple funding mechanisms, screening conducted at CARD over the past sixteen years has continued to identify high incidences of asbestos related disease (ARD). Screening in Libby remains a priority because of the 10 to 40 year latency period prior to disease development, and the high rate of environmental exposures resulting in ARD health outcomes. In 2009, the U.S. EPA declared a Public Health Emergency. In 2010 Medicare benefits were made available to individuals diagnosed with ARD resulting from the LA exposure in Lincoln County, Montana. CARD is currently conducting a screening program under CDC/ ATSDR grant #5 NU61TS000251-04 with successful implementation and outcomes. Purpose: CARD will (1) conduct nationwide outreach to raise awareness of screening programs and certain Medicare benefits for eligible individuals; (2) provide ARD, lung cancer, and FOBT screening to eligible persons with possible exposure to LA that occurred in Libby and Troy, Montana; and (3) provide health education to multiple audiences to detect, prevent, and treat environmental health conditions related to LA exposure. Outcomes: Outreach outcomes will include increasing: 1) awareness of screening services and certain Medicare benefits and 2) the number of people enrolled in the screening programs (initial and repeat). Activities to achieve these outcomes will include extensive media campaigns, targeted mailings and local, regional and national event participation. Screening outcomes will include increasing: 1) the number of individuals with qualifying diagnosis who become enrolled in Medicare, 2) disease management programs, and 3) early treatment programs for lung and other asbestos related cancers as appropriate. Activities to achieve these outcomes will include implementation of ARD screening and lung cancer screening. ARD screening includes a CXR, spirometry, ANA blood test, health/exposure questionnaires, a medical provider evaluation and if appropriate a FOBT, high resolution CT and second medical provider visit. Lung cancer screening includes questionnaires and a low does CT and medical provider visit if warranted. Benefits education and referrals for diagnostic and treatment needs outside of the scope of CARD are also integral to screening implementation. Education outcomes will include increasing knowledge among 1) community members, 2) program participants and 3) medical providers about ARD, exposure prevention, smoking risks/cessation and disease management. Activities to achieve these outcomes will include annual CARD rally and engagement with community organizations and events. Program participants will receive individual patient education verbal and written, smoking risk/cessation education, and biannual newsletters. Medical community activities include conference presentations and attendance, web based resources, and provider video/written education packets. Accomplishment of these outcomes will lead to increased early detection and treatment of ARD, improved quality of life, increased survival from lung and other asbestos related cancers.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$1,069,737 )
2025	2023	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	06	5	9/27/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$1,069,737
2025	2022	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	06	5	9/27/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2021	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	06	5	9/27/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2020	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	06	5	9/27/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2019	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	06	5	9/27/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = -$1,069,737

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	03	5	1/25/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	05	5	9/8/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	The Center for Asbestos Related Disease, Inc.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	04	5	5/3/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	01	5	12/7/2023	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	02	5	1/18/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	05	5	9/8/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	01	5	12/7/2023	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	02	5	1/18/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	The Center for Asbestos Related Disease, Inc.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	04	5	5/3/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	03	5	1/25/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	02	5	1/18/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	03	5	1/25/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	01	5	12/7/2023	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	THE CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	05	5	9/8/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	The Center for Asbestos Related Disease, Inc.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	04	5	5/3/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $2,999,999 )
2023	2023	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	5	6/27/2023	NON-COMPETING CONTINUATION	$2,999,999
2023	2022	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	5	6/27/2023	NON-COMPETING CONTINUATION	$0
2023	2021	CENTER FOR ASBESTOS RELATED DISEASE, INC.	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	5	6/27/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,999,999

Issue Date FY: 2022 ( Subtotal = $2,999,994 )
2022	2022	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	4	6/10/2022	NON-COMPETING CONTINUATION	$2,999,994
2022	2021	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	02	3	10/26/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2022	2021	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	4	6/10/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,999,994

Issue Date FY: 2021 ( Subtotal = $3,499,995 )
2021	2021	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	3	6/1/2021	NON-COMPETING CONTINUATION	$2,499,997
2021	2021	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	01	3	7/27/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$999,998
														Subtotal = $3,499,995

Issue Date FY: 2020 ( Subtotal = $2,499,974 )
2020	2020	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	2	6/4/2020	NON-COMPETING CONTINUATION	$2,499,974
2020	2019	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	2	6/4/2020	NON-COMPETING CONTINUATION	$0
2020	2019	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	01	1	10/31/2019	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $2,499,974

Issue Date FY: 2019 ( Subtotal = $2,499,969 )
2019	2019	CENTER FOR ASBESTOS RELATED DISEASES	214 E 3RD ST	LIBBY	MT	59923	LINCOLN	USA	Affordable Care Act Program for Early Detection of Certain Medical Conditions Related to Environmental Health Hazards	00	1	7/19/2019	NEW	$2,499,969
														Subtotal = $2,499,969

Grand Total All Awards = $13,430,194

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Libby, Montana's Public Health Emergency: Asbestos Health Screening

Award Number: NU61TS000295

ORGANIZATION: AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY

OPDIV: CDC

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: HEALTH SERVICES

PERIOD OF PERFORMANCE START DATE: 09/01/2019

PERIOD OF PERFORMANCE END DATE: 02/28/2025

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