ORAL HEALTH AMERICA
Share and Learn
September 24, 2014
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/Oral Health America
@Smile4Health
HOUSEKEEPING INFORMATION • •
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Webinar is being recorded; for rebroadcast on OHA’s website – OralHealthAmerica.org Your feedback is important to us. Please take our brief webinar evaluation after this session; link will be sent via email.
OUR MISSION 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.
OHA PRIORITIES Our 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
Product Donation
Sealant Initiative
Technical Assistance
Supportive Research
Innovation, Integration, Inspiration
Presented by Krista Postai, Chief Executive Officer Community Health Center of Southeast Kansas kpostai@chcsek.org
Today’s Objectives…. Describe Key Aspects of a Multi-Faceted Rural-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 Create an Integrated Health Home Reveal the “Secret” to Garnering Programmatic Support from Community Dentists to Congressmen
Our Children
•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.
*50% of our children don’t
*Almost 30% live below FPL
have their immunizations by age 2 as recommended. One-Third of our Population; All of our Future
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 and Spokes • Hubs – Dentists and hygienists – Safety net clinics – Provide preventive, emergency, restorative services
Schools/Day Care Facilities
• 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
Fixed
Hub
Satellite
(Safety Net Clinic)
Group or Nursing Home
Public Health Department
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
Outreach to Children 22,000+ children from 15 counties screened annually
Area Schools, Head Starts, WIC, Child Care Facilities
3,000 Cleanings
9,193 teeth sealed
6,172 fluoride applications
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:
Under 25.9%
Reduce the Proportion of Children Aged 6 to 9 years with Untreated Dental Decay in their Primary and Permanent Teeth 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?