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HRSA
awarded grants under its Special Projects of National
Significance program to the applicants listed
below. Each abstract provides both contact information
and a brief description of their project.
Lutheran
Medical Center
150 55th Street
Brooklyn, NY 11220
http://www.lmcmc.com/
This
four-part proposal seeks to create partnerships
between the Department of Health and community
health centers in the U.S. Virgin Islands and
Lutheran Medical Center, a Brooklyn, NY community
and teaching hospital, for the purpose of providing
preventive, restorative, and prosthetic oral health
services to underserved HIV+/AIDS patients. Grant
funds will be used to re-equip four dental treatment
rooms in Year 1(plus two more in Year 2) and to
reestablish services at three sites in St. Croix
and on in St. Thomas. A full-time dentist will
provide direct patient care and supervise Lutheran
Medical Center residents assigned to these clinics.
The grantee anticipates an eight-month lead time
before services are provided. Concurrent with
this effort, the grantee will create a 40-hour
distance learning curriculum which will be marketed
to dentists nationwide to create a cadre of oral
health providers trained to treat HIV+ persons.
Also, research effort will be mounted to evaluate
OraQuick, a too for diagnosing HIV during routine
dental examinations. An extensive evaluation protocol
will be implemented for all aspects of the program.
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Louisiana
State University
433 Bolivar Street
New
Orleans, LA 70112
The
HIV Outpatient Program of the Medical Center of
Louisiana at New Orleans (MCLNO) has ten years
of "hands on" experience in the provision
of oral health services to people living with
HIV/AIDS. Loss of healthcare facilities due to
hurricane Katrina offers a unique opportunity
to develop and implement new and innovative methods
of delivering dental care, using our extensive
experience. This project proposes the utilization
of a mobile dental unit traveling between six
community health center, in two distinct phases.
The first year dental care will be provided using
a 'best practices" model, during which time,
data concerning attitudes and beliefs about oral
health and wants and need for care will be collected
from HIV positive clients. The service delivery
systems will then be modified to accommodate the
input from consumers. A cost analysis will then
be performed between the original HOP dental clinic
and the two phases of the mobile dental unit.
In addition to providing oral health services
for HIV positive clients it is proposed that "at
risk" individuals be brought into dental
care, where HIV testing will be offered and linkage
into the local HIV continuum of care will occur.
The recent population shifts and influx of migrant
workers in New Orleans has increased the need
for HIV testing in these "at risk" populations.
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Montefiore
Medical Center
111 East 210th Street
Bronx, NY 10467
http://www.montefiore.org
Montefiore
Medical Center (MMC) proposes to be an urban demonstration
site for the Oral Health Initiative. The project
will design and implement an integrative model
of dental and medical primary care, integrate
a dental hygienist into an existing HIV specialty
team currently consisting of a treatment educator,
nutritionist, pharmacist, and mental health social
worker, and deliver dental services utilizing
a mobile dental unit.
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Special
Health Resources for Texas
2020 Bill Owens Parkway, Suite 230
Longview, TX 75604
http://www.shrt.net
The program proposes the establishment of a partnership
between the Texas A&M University Baylor College
of Dentistry, SHRT and Meyers, Villa & Associates.
SHRT will serve as the lead agent of the project
assuming responsibility for administrative and
programmatic oversight. SHRT will also provide
dental/oral health education to persons infected
with HIV. The education session will include information
on dental/oral health, service availability and
referral. To monitor and track service delivery,
SHRT will recruit and hire a case manager that
will assist the client retain dental/oral health
care services and collect appropriate data.
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St.
Luke's-Roosevelt Hospital Center, Center for Comprehensive
Care (CCC)
1111 Amsterdam Avenue at 114th Street
New York NY 10025
http://www.centerforcare.org
The Center for Comprehensive Care proposes to
develop and evaluate an innovative and replicable
model of care, "Keep Your Smile Sharp"
(KYSS), to provide oral health care to HIV-positive,
underserved populations. Project KYSS will be
delivered at community-based sites in four neighborhoods
of Manhattan in New York City that have high rates
of HIV seroprevalence and inadequate dental health
resources. The program will offer the full range
of oral health services currently provided by
the CCC at its two HIV outpatient clinics, complemented
by a program of community education conducted
in collaboration with community organizations.
The program will reach HIV-positive persons who
do not currently access oral health care or who
access care on an episodic basis only. The target
population may or may not be receiving consistent
HIV primary care. Project KYSS will link those
who do not with HIV outpatient care to insure
that program enrollees receive coordinated HIV
oral health and primary care.
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University
of Miami School of Medicine
1801 NW 9th Avenue, Suite 300
Miami, Florida 33136
http://www.med.miami.edu
The
overall goal of the Miami Dental Access Program
(MDAP) is to increase access to oral health care
services for HIV-infected patients and to decrease
identified barriers. Within this context, MDAP
proposes to develop, implement and evaluate a
new and innovative mobile dental program for medically
underserved persons living with HIV in the urban
area of Miami-Dade County. The program will emphasize
prevention, early intervention, and linkage to
comprehensive oral health care for low income
persons living with HIV. MDAP will visit HIV primary
care clinics that do not have on-site dental care
in Miami-Dade County and offer dental services
to patients who are being seen on that day for
HIV primary care initial screenings. An innovative
aspect of this program is that patients can receive
oral health services on the same day that they
receive HIV primary care.
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AIDS
Care Group
2304 Edgmont Avenue
Chester, PA 19013
The
AIDS Care Group of Chester City, Delaware County,
Pennsylvania will establish a new satellite dental
office and target HIV positive patients living
in Chester, Lancaster, and York Counties of Pennsylvania.
Access to dental care in these counties is limited
by insurance status, poverty, disease stigma,
and lack of transportation. In addressing these
barriers, the AIDS Care Group will initiate a
Demonstration Model of Oral Health Care and collaborate
with current HIV/AIDS medical and services providers
to link their patients into the project. Start-up
activities will include equipping a new one-chair
dental office in Coatesville, Chester County;
hiring a dentist to work with the AIDS Care Group's
dentists; training auxiliary staff; establishing
transportation systems; and developing evaluation
measures. Within four months, patients from surrounding
communities in Chester, Lancaster, and York Counties
will have access to comprehensive oral health
care. The interventions will include the use of
evaluation measures to help determine the replicability
of the project to other high-need groups.
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AIDS
Resource Center of Wisconsin
445 South Adams Street
Green Bay, Wisconsin 54301
http://www.arcw.org
Summary
of Intervention: The AIDS Resource Center of Wisconsin
(ARCW) is requesting a five-year, $1,757,467 Part
V SPNS grant to extend dental services into a
51-county rural service area in greater Wisconsin,
an area in which no HIV dental services are currently
available. ARCW's innovative hybrid model of providing
care includes the establishment of an HIV Dental
Clinic in Green Bay the part of the proposed service
delivery area that has the highest concentration
of HIV cases and the development of an HIV Dental
Reimbursement Program for parts of the service
delivery area with lower concentrations of HIV
cases. ARCW projects that the HIV Dental Reimbursement
Program will begin by October 2006 and the HIV
Dental Clinic in Green Bay will open in February
2007.
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HIV
Alliance of Lane County
1966 Garden Avenue
Eugene, OR 97403
http://www.hivalliance.org
The
Community Health Centers of Lane County, Lane
Community College, and the HIV Alliance have partnered
to provide reduced cost, comprehensive oral health
care to HIV patients by conventional oral health
care providers in the region. Lane Community College
has a modern, 18 chair dental clinic that currently
is not fully used by the dental programs. The
Community Health Center is an association of many
groups including the Lane HIV Alliance. The Community
Health Center currently has an active, school
based prevention program, but does not otherwise
provide comprehensive dental care. Dental care
for southern Oregon will be provided in the Lane
Community College dental clinic in Eugene, Oregon,
which is readily accessible from Interstate 5
and by frequent Lane Transit District busses from
both Eugene and Springfield.
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Community
Health Center, Inc.
635 Main St.
Middletown, CT 06457
http://www.chc1.com
The Community Health Center, Inc. proposes to
bring new oral health care services to the 400
low-income HIV+ residents of Norwalk and an approximate
200 HIV+ residents from areas surrounding the
city. We will be providing 1 day of dentistry
and 1 day of hygiene services at our new dental
clinic in Norwalk which will open in December
of 2006, and will render an additional day of
hygiene at either the MidFairfield Project AIDS
Care or at our current site at the Ben Franklin
Head Start (165 Flax Hill Rd). Until the new clinic
opens in December of 2006, 2 days of mobile dentistry
will be offered at our 165 Flax Hill site. Key
features of the intervention include: referral
coordination services, a comprehensive continuum
of oral health services which include: restorative,
diagnostic, preventive, periodontal, prosthodontic,
endodontic, oral medications, oral surgery, emergency
care and oral health education/health promotion,
24-hour emergency care, and health education/
promotion onsite at our full-service clinic. CHC
will also employ a driver one day per week to
bring patients who lack reliable transportation
(the majority of our target population) directly
to our clinic.
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University
of North Carolina at Chapel Hill
104 Airport Drive
Chapel Hill, NC 27599-1350
This
project seeks to establish a collaborative group
of investigators to conduct a multidisciplinary
oral health program to address the dental needs
of newly diagnosed HIV positive individuals from
the Research Triangle/Piedmont regions of North
Carolina. The oral health of these newly diagnosed
patients will be compared to that of HIV positive
individuals who already receive their routine
dental care at the UNC Hospitals dental clinic
A comparison will be made between these two groups
at all levels to assess the impact of initiation
of oral health care in the HIV population early
rather than in the midst of medical treatment
or emergently.
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Harbor
Health Services, Inc.
398 Neponset Avenue
Dorchester Massachusetts 02122
Harbor
Health Services, Inc. (HHSI) has designed an HIV
Oral Health Collaborative model to increase accessibility
and affordability of dental services for people
living with HIV/AIDS (PLWHA) on Cape Cod. HHSI
will create a new dental site in the Outer Cape
in collaboration with Outer Cape Health Services
and will expand existing services at its two community
dental sites located in the Mid and Lower Cape.
The dental clinics will use a collaborative model
of care where patients are referred by partner
agencies to the dental clinics and dental case
managers will coordinate dental services, follow
up with referring agency on visit outcomes and
ensure that patients are linked to primary care
and social services. HHSI currently partners with
Cape Cod Healthcare-Infectious Disease Clinical
Services, a Title III grantee around dental and
primary care services. The delivery of services
at HHSI current dental sites, the Ellen Jones
Community Dental Center (EJCDC) in Harwich and
the Mid/Upper Cape Community Health Center (MUCCHC)
in Hyannis, will begin in project year I. Planning
and development of the new dental site in the
Outer Cape will begin in project year I, with
services anticipated to start in project year
II.
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The
Native American Health Center, San Francisco
160 Capp Street
San Francisco, CA 941
http://www.nativehealth.org
The Native American Health Center's HIV+ Oral
health Program and Evaluation (HOPE) Project will
revolve around establishing NAHC as the "dental
home" for the HIV+ San Franciscans of color
with pipelines back into the community for specialty
dental care. The "dental home" will
stress 3 core components: dental case management,
dental services on-site (including prevention
of oral disease and maintenance of oral health),
and specialty dental services off-site in Partner
Specialty Dentists' (PSD) offices. The HOPE Project's
innovative interventions include dental case management
and broadening the dental safety net via partnerships
with private-practice specialists.
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Sandhills
Medical Foundation, Inc.
P. O. Box 366
McBee, SC 29101
http://www.sandhillsmedicalfoundation.com
Sandhills
Medical Foundation (SMF) proposes to implement
Project Save Our Smiles (SOS), an innovative service
delivery model to provide oral health care to
persons living with HIV/AIDS (PLWH/A) in a rural,
six-county region. In response to these needs,
SMF will lease/purchase a mobile oral health unit
with two operatories, and staff this with a specially-trained
team including a dentist, dental hygienist, and
dental assistant. The mobile unit will visit seven
rural community health center sites on a scheduled
basis. Staff at these sites will schedule their
patients with HIV/AIDS for oral health care visits.
The program will provide oral health care services
including restorative, diagnostic, preventive,
periodontic, prosthodontic, endodontic, oral medications,
oral surgery, emergency care and oral health education/health
promotion. Oral health services will be provided
in accordance with professional practice guidelines.
Individualized treatment plans will be developed
for each patient receiving service. Further, the
dental program will serve as an entry point into
HIV medical care as it will refer to the Ryan
White Title III Programs participating in Project
SOS when it identifies patients who may need HIV
testing or services. As many of those identified
with HIV are not in medical care, dental care
may be a reasonable access route.
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Tenderloin
Health
183-191 Golden Gate Ave.
San Francisco, CA 94102
http://www.tlhealth.org
The
project is a collaboration of the Tenderloin Health,
San Francisco Department of Public Health Tom
Waddell Health Center (TWHC) & Dental Services,
Asian & Pacific Islander Wellness Center,
and Positive Resource Center. These partners will
provide comprehensive oral health services incorporating
the following key elements: a) Co-Location of
Services: Dental clinics will be located at TARC
and TWHC, existing providers of HIV services.
b) Integration of Oral Health Care into Existing
Multidisciplinary Program will result in seamless
access to care. c) Case Management and Peer Advocacy
will increase access and patient adherence to
treatment. d) Referral & Coordination for
Specialty Services: While most dental services
will be provided at TARC and TWHC, a formal referral
process and patient accompaniment will ensure
access to specialty services off-site. e) Cultural
Competency & HIV Care Training for Oral Health
Staff will ensure that oral health staff can work
skillfully, sensitively and in a culturally competent
manner with the target population. f) Training
of Non-Oral Health Staff will ensure all team
members understand the critical importance of
oral health in the provision of HIV care. g) Outreach,
Patient Education & Early Intervention will
ensure patient engagement, increased receptivity
to care, and participation in their oral care.
h) Benefits Eligibility Screening will mean patients
can document a disability that is a result of
an oral health problem. i) Developing Systems
of Reimbursement to Ensure Program Sustainability:
The project will implement multiple approaches
to ensure program sustainability, including maximizing
third-party reimbursement, primarily Medi-Cal.
j) Continuous Quality Improvement: Oral health
services will be integrated into an existing system
designed to monitor the quality of services.
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