ORAL HEALTH AMERICA

Share and Learn

September 24, 2014

/Oral Health America @Smile4Health

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Oral Health America changes lives by connecting communities with

resources to increase access to care, education, and advocacy for

all Americans,

especially those most vulnerable.

OUR MISSION

OHA PRIORITIESOur Programs and Campaigns must have the capacity –short term or longer term – to influence health literacy, improve access to services and to advocate for systemic changes that will impact the oral and overall health of all Americans – particularly those most vulnerable.

ACCESS EDUCATION

ADVOCACY

Grant Funding

Sealant Initiative

Product Donation

Technical Assistance

Supportive Research

Innovation, Integration, Inspiration

Presented by Krista Postai, Chief Executive OfficerCommunity Health Center of Southeast Kansas

kpostai@chcsek.org

Describe Key Aspects of a Multi-FacetedRural-Based Oral Health Program

and Its Contribution to Eliminating Dental Disparities

Demonstrate How a Mission Focus Can Translate Into a Sustainable Model

Explain How “Cats and Dogs” Can Work Together to Createan Integrated Health Home

Reveal the “Secret” to Garnering Programmatic Supportfrom Community Dentists to Congressmen

Today’s Objectives….

One-Third of our Population; All of our Future

•50% of the children born are low-income

*1 in 3 elementary children have visible signs of tooth decay; in some districts, it’s 1 out of 2.

*SEK has highest rate of reported child abuse, neglect,

out-of-home placement in Kansas.

*Almost 30% live below FPL

Our Children

*50% of our children don’t have their immunizations by age 2 as recommended.

Our beginnings…

CHC/SEK …Designated FQHC 2003.4,000 patients to 35,000 patients

11,000 visits to 130,000 patient visits

Dan Minnis DDS, Chief Dental Advisor

Dental Hubs

• Distributive model for providing dental services using…

– Existing safety net clinics

– Hub-and-spoke delivery sites

– Increases in resources dedicated to oral health

– Integration of oral health with other aspects of care

Hub(Safety Net

Clinic)

Schools/Day Care

Facilities

Public Health

Department

Group or Nursing Home

Fixed

Satellite

Hub and Spokes

• Hubs – Dentists and hygienists– Safety net clinics

– Provide preventive, emergency, restorative services

• Spokes – ECP hygienists– Fixed satellites

• Outreach to unserved or underserved rural populations in permanent clinic locations

– Public health and community settings• Outreach to targeted underserved

rural populations using portable equipment

Model Specifications

Staffing

Up to 3 full-time dentists

Up to 1 FTE in-house hygienist

Up to 2 FTE extended-care practice registered dental hygienists

Up to 2 dental assistants per dentist

Model Specifications

Equipment 2.5 operatories/dentist, one operatory/on-site hygienist

Level of Service Preventive, emergency and restorative dental services to the underserved.

Integration of medical and dental services

Outreach workers to support case management

Productivity standards of 2400 encounters per year for dentists; 1400 encounters per year for hygienists

OUTCOMES

$1 million Dental Hub Investment

5,590 to 11,422 patients

2.5 to 8 dentists

2 to 8 ECP Hygienists

22,000+

children

from 15

counties

screened

annually

Outreach to Children

Area Schools, Head Starts, WIC, Child Care Facilities

3,000 Cleanings

6,172 fluoride applications

9,193 teeth sealed

Forms, forms, forms….Instructions, consents, parent

education…

http://tinyurl.com/SchoolOralHealth

Percentage of Third Grade Children in Southeast Kansas with Untreated Dental Decay

2004 Smiles Across Kansas Data 28%

Healthy People 2020 Target:

Reduce the Proportion of Children Aged 6 to 9 years with Untreated Dental Decay in their Primary and Permanent Teeth

Under 25.9%

2012 Smiles Across Kansas Data 12%

Innovation Integration

*Blood Pressures

*Blood Glucose, INR, HIV/AIDs

*Special Populations

*Case Collaboration

*Trainings

Making A Difference – Bridge to Work

Making a Difference…

One Smile At A Time….

Ronald McDonald House Charities in Omaha

Care Mobile Program

Omaha’s Care Mobile

The Challenge

Tension between two areas of town create an inability to serve all children in need.

Segregation in Omaha

The History

The Problem Today

Children below poverty level: Omaha: 18.7%State: 14.6%

Second highest percentage of uninsured patients in the US.

A total of 5.3% of parents with children under 18 at home report having no insurance coverage for their child’s healthcare expenses.

Addressing the Need

Federally Qualified Health Centers

FQHCs qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits. FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors.

Benefits of Partnering with FQHC’s

FQHC’s receive Section 330 of the Public Health Service (PHS) Act Funding providing:

New Access Points Grants Expanded Medical Capacity Grants Service Expansion Grants

Boundaries with FQHC’s

In order to maximize limited resources and access to care for their patients, health centers are expected to collaborate in service areas serving underserved populations to create a community-wide service delivery system.

Who FQHC’s Should Serve

FQHC’s are designed to focus on areas with high populations of unmet need who may need special approaches to ensure access (e.g., non-English speaking groups, people who are homeless, or newly arrived immigrants/refugees).

North vs. South

RMHC Stance

The Solution

Questions?