	U.S. Department of Health & Human Services Health Resources and Services Administration HRSA Press Office: (301) 443-3376 http://newsroom.hrsa.gov

Remarks to the Public-Private Partnership on Children and Oral Health Networking Conference

Prepared Remarks of Claude Earl Fox, M.D., M.P.H.
Administrator, Health Resources and Services Administration

Public-Private Partnership on Children and Oral Health Networking Conference
Washington, D.C.

March 14, 2001

Introduction

Thank you, Dr. Satcher, for those remarks and for taking time out of your busy schedule to be here to support our efforts today. I’d like to publicly thank you for your landmark report on Americans’ oral health and the folks on your staff that helped you. Many of them are with us today.

I would also like to thank all of you in the audience who have come to today’s meeting. You are committed to increasing access to dental care and eliminating oral health disparities. You share our belief that the best way to do this is by creating partnerships that include local communities, state and Federal government, professional entities, business and academic organizations, and charitable foundations.

You know the problem is serious.

· 80 percent of dental disease is found among just 25 percent of America’s children, primarily low-income, minority and immigrant youngsters;

· Poor children are four times more likely to have dental decay in early childhood;

· Less than one in five Medicaid children get even one preventive dental service per year; and

· Some 108 million people – including 28 million children -- have no dental insurance.

Increasing access to dental care and eliminating oral health disparities is a top priority for me as HRSA administrator, for our bureaus and office staff in Rockville, and for our 10 field offices throughout the country.

We have raised the profile of oral health inside HRSA by emphasizing its vital importance in all of our bureaus and their many programs. We have developed partnerships with public and private agencies involved in oral health, and we are promoting science and technology that can minimize the occurrence of oral disease in targeted underserved populations.

The HRSA-HCFA Partnership

Oral health is such a priority at HRSA that we have partnered with the Health Care Financing Administration in an initiative that is committed to reducing profound disparities in oral health. It has three goals: to engage the private sector, to engage science and to coordinate federal efforts.

We created the HRSA-HCFA partnership in response to a 1996 Inspector General report that cited Medicaid’s failure in providing dental care to child beneficiaries. The problem of too little access to dental care and our own inability to resolve it led to a kind of “spontaneous combustion” that sparked the partnership. Our collaboration wasn’t caused by a directive from HHS, it resulted from health professionals realizing we had a situation that needed our immediate attention. And it is a fine example of how federal agencies are expanding joint efforts on oral health issues.

Together, we are addressing access issues for children eligible for health care under Medicaid and the State Children’s Health Insurance Program. And the initiative is stimulating innovative state and community-level oral health programs that improve access to care and health status by relying on both public and private resources.

The partnership is having specific impacts in regions and communities across America:

HRSA and HCFA have put together oral health teams in each of our 10 regions and identified part-time dental consultants and part-time regional dental Medicaid consultants to help. In addition, the American Academy of Pediatric Dentistry has identified a pediatric dentist in each of the regions to provide technical assistance to the regional teams. Other organizations and professions – including hygienists, children’s hospitals and primary care associations -- may join the partnership, too.
In North Carolina and California, our Maternal and Child Health Bureau and HCFA are funding two demonstration projects on “Innovative Management of Dental Decay for Young Children Enrolled in Medicaid/SCHIP.” Funds will allow the two states to provide and assess a variety of very promising services -- including preventive and therapeutic regimens – that have not been widely implemented in dental practice or publicly funded dental services delivery programs.

Other Federal Partnerships

HCFA is not our only partner in the campaign to improve access to dental care:

· We also have joined forced with the National Institute of Dental and Craniofacial Research on their new grant program to support Centers to Reduce Oral Health Disparities. The grants will fund five to 10 centers through partnerships with academic institutions, safety net programs and professional organizations. Grantees will look at basic and health services research issues associated with oral health disparities in target populations.

· In Fiscal Year 2000, HRSA’s Office of the Administrator and the National Governors Association convened an oral health policy academy with officials from eight states. The academy brought teams of high-level policymakers from the states to Washington, D.C., to meet with experts to address the problems low-income children have in accessing oral health services. The policy academy concept will be expanded to reach more states in FY 2001.

My office and MCHB have funded state oral health summits in about 15 states. These meetings bring together key players to discuss oral health for vulnerable populations in their states and develop strategies that will lead to solutions at the community and state levels. Additional summits will take place this fiscal year. We also provide technical assistance through state-level workshops conducted with the National Governors Association, the National Conference of State Legislatures, the Association of Maternal and Child Health Programs, the National Association of State Medicaid Directors and other state policymaker groups.

· With Head Start and WIC, HRSA sponsored a forum on oral health to talk about access to care, nutrition and fighting cavities for children served by these programs. This type of forum has been replicated in one region and has the potential to bring together partners capable of addressing the oral health needs of these vulnerable children and their families.

These are but a few examples of exciting new partnerships at the federal and state level. As a former State Health Officer in Mississippi and Alabama, I know that the real action is local and that you all have stories of success through your own partnerships. All of the efforts I’ve just discussed are intended to bolster and supplement your own initiatives, not supplant them.

Now, let me turn the podium over to Dr. Burton Edelstein, who serves as a consultant to HRSA on the Oral Health Initiative and directs the Children’s Dental Health Project here in Washington.