Section 1: Filling Gaps in HIV Dental Care

HRSA's Oral Health Initiative

HRSA is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. The following are some of the key oral health care services provided under HRSA’s auspices:

• Health Centers. In 2006, 2.6 million patients received basic dental services from Health Centers, which is an increase of over 80 percent from 2001 and reflects HRSA efforts to have current clinics expand their dental services.
• Oral Health Disparities Collaborative. Pilot to increase the quality of dental care in community clinics.
• Maternal and Child Health Initiatives. In 2007, HRSA administered $3.2 million to support State efforts to increase early access to services to prevent oral disease for vulnerable children and their families.
• Provider Training of Oral Health Professionals. Residencies in General and Pediatric Dentistry and Residency Training in Dental Public Health.

Oral Health Under HRSA's Ryan White HIV/AIDS Program

Ryan White is funded at over $2 billion annually to deliver a multitude of core medical and support services for PLWH. Dental care is but one of the core medical services that are a priority for funding under Ryan White program funding streams, called Parts. Among these are Parts A through D, which fund HIV/AIDS services to hard hit urban areas, each of the States, and population- and service-specific activities. In fiscal year 2006, Parts A-D devoted nearly $43 million to HIV oral health care for 78,000 people, resulting in over 220,000 visits, according to Ryan White program data.

Ryan White also funds the following dental-specific activities:

• Part F Dental Programs. Two dental-specific programs operate under Ryan White Part F. They include the Community Based Dental Partnership Program—the focus of this report—and the Dental Reimbursement Program. The Dental Reimbursement Program, the older of the two, was established with the first wave of Ryan White funding in 1991 and helps cover unreimbursed dental care costs for PLWH being incurred in dental schools across the Nation. In 2005-2006, over 32,000 HIV-positive patients received reimbursement-funded care in such service settings as hospitals and dental schools. The most common procedures covered are diagnostic, preventive and restorative care, although a wide range of services are provided.
• Special Projects of National Significance (SPNS) Oral Health Initiative. SPNS supports demonstration and evaluation of innovative models of HIV/AIDS care in many areas. The Oral Health Initiative was started in 2006 and is funding 15 projects in both urban and rural settings to undertake development of innovative models of oral health services.
• Training of Dental Professionals. HIV care training of dental professionals occurs under the Dental Partnership program as well as Ryan White’s AIDS Education and Training Centers (AETC) Program, which trains health care providers from multiple disciplines. Ten percent of AETC trainees in 2006-2007 were dental professionals.

See the HRSA HIV/AIDS Bureau Web site to learn more about Ryan White’s varied community and State programs that deliver HIV/AIDS care to underserved populations. To learn more about technical assistance and training services for Ryan White HIV/AIDS Programs, see the TARGET Center.