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Grants to States to Support Oral Health Workforce Activities > FY 2007 Grantee Abstracts Arizona | Arkansas | Colorado | Delaware | District of Columbia | Florida | Georgia | Louisiana | Maine | Massachusetts | Michigan | Mississippi | North Carolina | Puerto Rico | Rhode Island | Vermont | Washington | Wisconsin T12HP07705 Currently there are weaknesses in the dental workforce infrastructure in meeting the dental needs of underserved, vulnerable, and/or special needs persons in Arizona. While private providers and safety-net dental programs provide dental treatment, the explosive population growth in Arizona, large rural areas, and the maldistribution of too few dental providers means that the dental needs of the population as a whole are not being adequately met. The expected outcomes of this project include an increase in the proportion of Medicaid and SCHIP beneficiaries who receive dental care each year, and an increase in the number of dental hygienist FTEs employed in rural Arizona. Both of these outcomes would be the result of full and successful implementation of the existing affiliated practice act, and expansion of capabilities in teledentistry as a diagnostic tool. This implementation will be documented in a “how to” manual to smooth the way for future growth in affiliated practice (and consequent increase in the number of people served in outlying areas). Another expected outcome is an increase in the number of general dentists trained in serving children with special health care needs. The project has four main components:
T12HP07715 Arkansas dentistry is often overwhelmed when addressing the needs of special populations – those with developmental disabilities, survivors of family violence, individuals with language barriers or the geographically isolated. Fewer than 10% of Arkansas dentists substantially participate in ARKIDS FIRST, the state Medicaid and SCHIP waiver programs, and few dentists practice in the Delta area of the state and other more remote locations. The major goals of the AR Oral Health Workforce Development project are to increase the number of dental professionals practicing in underserved areas, to promote dental careers especially in minority populations, to train dental professionals to address special populations and to address language barriers. Objectives to reach those goals are: (1) to work with the primary care association to recruit dental professionals to practice in underserved areas, (2) to work with secondary schools and colleges to promote dental careers, (3) to train dental professionals to better communicate with and treat special populations, and (4) to promote available interpretation services to minority populations. Populations to be served include dentally underserved patients of all ages, secondary school and college students (especially minority students), patients with developmental disabilities, survivors of family violence, and patients with language barriers. The Arkansas Office of Oral Health will coordinate grant-funded activities with the Arkansas Oral Health Coalition, Inc; Community Health Centers of Arkansas, Inc; Partners for Inclusive Communities; Philander Smith College; the University of Arkansas at Pine Bluff; Delta Dental Plan of Arkansas, Inc; the Arkansas Farm Bureau; and the Arkansas Department of Education. T12HP07716 The Colorado Rural Oral Workforce Project addresses the disparities in access to oral health services in the rural areas of Colorado. Colorado is primarily a rural state, with 47 of 64 counties designated as rural or frontier (less than six people per square mile). Currently, there are 8 counties without a dentist and an additional 18 without a dental Medicaid provider. Eighty-four percent of Colorado dentists practice along the Front Range in primarily urban areas. There are significant oral health disparities among the residents in Colorado. In the 2004 Impact of Oral Disease on the Health of Coloradans, it was reported that 27% of kindergarten and third grade children had untreated dental decay, yet only 35% had protective sealants. Nearly 10% of Head Start children had urgent dental needs, characterized by reports of pain or visible abcesses. This project will address the needs in three ways: 1) Increasing the number of participants in the State Dental Loan Repayment Program. Currently funded by state tobacco settlement funds, the program receives four applications for every loan repayment slot. This will allow 2-3 additional providers to participate, with emphasis on the recruitment and retention of rural providers. 2) Collaborating with the University Of Colorado School Of Dentistry to develop a “rural track” for new dental students. The School of Dentistry will work jointly with the Department of Family Medicine, who already has a rural track for medical students, to add dental students. Medical and dental students will take rural health seminars together and participate in a joint rural rotation during the summer months. A mobile van, Colorado Smile makers, will also ferry dental and dental hygiene students to rural areas to provide assessments, preventive, and restorative services. This project will support the faculty preceptor on the van. 3) The Colorado Health Institute will assist in assessing the oral health workforce through provider surveys and analysis to quantify and qualify the changes this project will have. Through all of these strategies, the primary population groups to be served will be the residents of Colorado living in rural areas. Also benefiting will be the dental providers who will receive assistance with their educational loans by participating in the State Dental Loan Repayment Program and serving underserved populations. Dental students will benefit as they will be exposed to rural practice and the need to collaborate with their physician colleagues if a reduction in health disparities, including oral health disparities, is to be realized. T12HP07718 Recent evidence indicates that there continues to be an insufficient supply of dentists to treat children who are traditionally underserved. This gap exists, despite the fact that the Medicaid program provides one of the highest reimbursement rates in the country. The purpose of this project is to improve the oral health infrastructure so as to support an increase in the availability and competency of the dental workforce, and to improve the oral health status of rural and other underserved families in Delaware. The project encompasses four major objectives:
The Delaware Division of Public Health (DPH) manages a school sealant program. A significant limitation is the difficulty in scheduling schools because of limited school space for portable equipment. Urgent care needs are referred to private dentists, but routine referrals are provided only upon request because of limited dentist availability and uncertainty of ability to pay for services. A case management system does not exist to link these services to children. The proposed objectives and activities of this grant will complete a circuit for the identification of children with untreated dental needs, assessment of financial need, and either immediate treatment or referral to a dental provider for comprehensive treatment. The acquisition of a mobile dental van with funding from this grant will replace the use of portable equipment, thus allowing for an expanded and increased array of dental services. The case management system will enable children to be referred as appropriate to dentists who are not currently seeing a significant number of children. Dental residents will have rotations on the dental van in rural Delaware, thus increasing their experience in treating high-risk children and exposing them to practicing in the underserved rural area of Delaware. The dental hygiene students will be able to gain additional experience both in public health dental programs, and the treatment of children. The project will increase the number of children receiving dental care by overcoming the structural barriers of availability of dentists, costs, and incomplete information. T12HP07712 In support of developing a State Oral Health Plan in the District of Columbia, the Department of Mental Health and the Department of Health are collaborating in an effort to address the oral health workforce needs in the District of Columbia. The Department of Mental Health (DMH), the only government agency addressing the oral health needs of adults in the District of Columbia with acquired disabilities, will take the lead on the collaborative effort. Despite numerous findings indicating the importance of good oral health and the need for timely unhindered access to dental services, many vulnerable, low-income residents in the District of Columbia (DC) are still adversely affected by needless dental complications. This may oftentimes be attributed to the fact that: there are insufficient dental professionals in areas where they are most needed; oftentimes, quality of care and cultural competency from dental professionals are low; health care workforce does not represent the population it serves (nationwide, less than 7% of dentists are African American, Hispanic or American Indian); and increased promotion of oral health and dental public health is needed. The District of Columbia (DC) realizes that the best way to address these issues is to work collaboratively to develop initiatives to support oral health workforce activities that: Increase recruitment and retention efforts; Increase the number of general dentistry residents program completers; Increase dental services in areas that have been identified as dental health professional shortage areas; Enhance continued dental education; Encourage children within DC Public Schools to enter professions related to oral health or science; Enhance faculty recruitment programs; and Augment the DC Department of Health (DOH) Oral Health Division. The General Practice Residency Training Program in General Dentistry sponsored by the District of Columbia Department of Mental Health (DMH) Saint Elizabeth Hospital (SEH) provides advanced general practice residency training in dental specialties to five (5) recent dental graduates, with emphasis on management and treatment of the adults with acquired (mental health) disabilities who are wards of the District of Columbia. These patient populations receive very little attention and have difficulty locating community resources to provide appropriate, necessary and affordable dental care. In support of this collaboration to improve workforce activities and address the global oral health needs of adults and children within the District of Columbia, we are requesting HRSA support for program expansion. T12HP07706 Early Childhood Caries (ECC) is a significant national and local problem. ECC disproportionately affects children in low-income households, i.e. Medicaid recipients. Current Florida data suggest that less than 12% of Medicaid children under age 6 years receive preventive dental care and less than 10% of Florida dentists see Medicaid children. One strategy suggested by Florida’s State Oral Health Improvement Plan (SOHIP) and consistent with the HRSA Program Guidance to expand the oral health workforce to reach underserved populations, is to utilize non-dental health providers, for example, physicians. This proposal addresses this strategy by implementing demonstration projects of physician-implemented oral health services in Duval County, an urban area with 18,000 Medicaid eligible 0-3 year old children, and in Collier, Lee and Charlotte counties, a rural area with 16,500 similar children. The percentage of licensed dentists in four counties that have submitted preventive Medicaid claims ranged from 1.8% to 8.1% in 2003. Both locations contain numerous Dental Health Professional Shortage Areas with a projected shortfall of 61 dentists. The project will involve primarily educational interventions with pediatricians (and residents in years 2 and 3) to increase their competence in detecting and preventing ECC and making appropriate referrals of high risk children to private dentists and safety net providers for treatment. We will form a statewide Advisory Committee composed of key stakeholders from the Florida Department of Health, Florida’s Agency for Health Care Administration, Florida Pediatric Society (FPS), Florida Academy of Pediatric Dentistry, Florida Dental Association, and others including appropriate safety net providers. In addition, three consultants from states where such programs have been successfully implemented will assist in program development, implementation and evaluation. The overall plan would be to form the Advisory Committee, develop the educational materials, conduct a pre-education evaluation survey of physicians in the two sites, implement the educational program, wait an appropriate length of time, and then implement post-educational evaluation procedures. Following potential modifications of the educational and implementation plan as recommended by the Advisory Committee after review of evaluation outcomes, and the availability of additional years of funding by HRSA, the program would be implemented statewide in the second and third year; the FPS has achieve several HRSA and SOHIP goals, i.e., enlarge the oral heath workforce, better integrate oral health into general health, and provide a long term, significant oral health intervention to underserved children, hopefully reducing ECC in this population, both improving their overall oral health and reducing long term costs to the state Medicaid system. T12HP07717 The purpose of this project is to improve access to oral health care for underserved citizens in the state of Georgia by improving the current and future dental workforce treating these patients. Georgia is generally a rural state with a few major population centers. Census Bureau figures indicate nearly 1.8 million people lived in rural counties in 2002. There are 108 counties with fewer than 35,000 people. Georgia has a poverty rate of 12%, which is the 18th highest poverty rate in the nation. In Georgia, poor children are 80% more likely to have dental disease and 30% of tooth decay remains untreated. There are 36 single county and low income DHPSAs in Georgia. There are approximately 38 dentists/100,000 population in Georgia, ranking the state 45th out of 50. In summary, Georgia has a large rural population that does not have ready access to the dental treatment needed for this population The Medical College of Georgia School of Dentistry will collaborate with the Division of Dental Public Health, private charitable dental clinics and Area Health Education Centers, to place students in dental clinics to care for underserved patients. All sites were chosen to serve designated Dental Health Profession Shortage Areas (DHPSAs). Identified locations in Georgia include 7 clinics in 5 urban and rural areas: Atlanta, Columbus, Dalton, Dublin and Rome. Each student will provide oral health education and dental services on a rotating basis for two weeks. Loan forgiveness funds totaling $50,000 annually will be provided for two dentists who agree to serve in a DHPSA. This one year commitment will be renewable for 2 additional years with a ceiling of $75,000 loan repayment per dentist. The third aspect of this application involves rotating Pediatric Dentistry residents from MCG to the Children’s Hospital at Scottish Rite Dental Clinic in Atlanta. This rotation would improve the residents’ educational experience by treating the very vulnerable and medically compromised patients seen in that facility and would benefit the patients. To maintain the quality of didactic education for students and residents on rotations, computer technology will be used to allow offsite students to view live or recorded presentations. This grant will help fulfill the mission of the Medical College of Georgia School of Dentistry by educating our students to be excellent, compassionate clinicians who are prepared to provide oral health care to the citizens of the state, regardless of their socioeconomic status, or medical condition. The short term benefit for the selected communities is increased availability of oral health care. If the program is successful the long term benefits will include sensitizing students to the oral health needs in rural Georgia and the development of local and state mechanisms to encourage development of loan forgiveness programs and community efforts to address care for underserved citizens. T12HP07700 Access to oral health care and improving the dental health of Louisiana residents is greatly needed, particularly following the devastating hurricanes. Dental health clinics are overwhelmed by the oral health needs of residents living in the affected areas. As a result of vast reduction in the number of dentists in the areas that were most devastated by the storm, the HRSA Bureau of Health Professionals has designated 34 of the 64 parishes in Louisiana as health professional shortage areas. The insufficient dental health workforce creates more of an access problem for individuals seeking oral health care. Although fluoridation is the safest, most cost-effective way to reduce caries prevalence, fluoridation is underutilized in Louisiana. In Louisiana, less than 46% of the population is served by public water systems containing optimal fluoride. A study of Louisiana Medicaid data by the CDC showed that the average dental treatment costs for Medicaid eligible children living in non-fluoridated areas were twice as high as the average treatment costs for Medicaid-eligible children living in fluoridated areas. Dental sealants seem to be an underutilized treatment option for many of the children as well. Louisiana’s sealant rate is 18% of 3rd grade children. A school-based dental sealant program would improve our rate of sealants utilization for 3rd graders. This effort would help meet the goals set in this performance measure and the Healthy People 2010 sealant goal. Educating communities on the importance of water fluoridation, and providing preventive services and access to oral health care are critical to reduce and eliminate oral health disparities existing in disadvantaged populations. The goals of the grant are to: 1) augment the Oral Health Program to coordinate oral health and access issues in the State 2) and develop or enhance community-based prevention services including water fluoridation and dental sealant programs. These steps are needed toexpand the existing Oral Health Program office to enhance our ability to coordinate oral health services and address access to care issues caused by our diminished dental workforce. T12HP07719 The Maine Oral Health Workforce Initiatives Project consists of three coordinated but distinct strategies that complement work currently occurring within the state while increasing the breadth and depth of that work. The purpose of the Project is to develop initiatives that will address oral health workforce issues in our state, with a focus on strategies to improve access to dental services and accessibility of the oral health workforce for underserved geographic areas and populations. In Maine, a largely rural state, a significant proportion of the population has difficulty in accessing needed dental services, and the distribution of dental professionals, particularly dentists, is a matter of increasing concern. The first strategy aims to coordinate current and develop new recruitment and retention activities; the second aim is to increase the capacity of current providers; and the third will ensure that young people across the state are exposed to dental careers and offered a path into higher education and training in a dental profession. These are envisioned as follows.
T12HP07701 Massachusetts has overwhelming unmet oral health and workforce needs. Fifty percent of 3rd graders have experienced dental decay and 50% of low income 3rd graders have untreated decay and only 8% of the state’s school nurses report having a school dental prevention program. About 1 million of the state’s residents are considered disabled. Over 100 communities do not have a dentist, and another 100 communities do not have a dentist that accepts Medicaid. The state’s only dental program for the developmentally disabled recently lost 7 of 8 its’ AEGD residents and the 4 state public health hospitals dental programs are overwhelmed. To respond to these issues MA OH WINS was developed. The primary purpose of the grant is to improve the oral health of underserved residents by increasing the dental workforce and expanding community based prevention programs. The project is comprised of three different, but complementary initiatives: (1) Address the oral health needs of underserved populations and communities by identifying and assessing oral health needs, and workforce and prevention resources with the expansion of the Office of Oral Health’s (OOH) infrastructure; (2) Promote, develop and implement school prevention dental (sealant) programs in federally qualified dental health professional shortage areas and other underserved and rural areas of the state, and support other effective community prevention programs; and(3) Recruit culturally and linguistically competent practitioners to care for the oral health of underserved populations, including the 4 state public health hospitals and 7 dental clinics for the developmentally disabled and other underserved and rural areas. The populations served include rural, underserved and/or DHPSA communities; the 4 state public health hospitals that care for the chronically ill and the 7 dental clinics for the developmentally disabled. The OOH will create a Dental Workforce/Data Consultant position to develop, implement and monitor a data collection system for oral health and workforce assessments, prevention programs and community water fluoridation; as well as, apply for new DHPSA designations. It also will hire a Community Prevention Oral Health Consultant to develop, implement and promote statewide school preventive dental (sealant) programs (grades 2 and 7), in DHPSA, rural and underserved areas, replicating a successful model in Boston; and support fluoridation and school fluoride mouth rinse programs. An assessment of the oral health needs of the 4 state public health hospitals will be done in partnership with the Tufts Dental School; and the development of a faculty recruitment campaign to increase the dental workforce in the 4 state hospitals and 7 facilities for the developmentally disabled, as well as loan repayment and limited licensed dentists program for underserved populations. An Advisory Committee made up of key stakeholders such as the state dental society, primary care association, dental and dental hygiene schools, several offices within MDPH, and 2 dentists board certified in dental public health will oversee this proposal by planning, monitoring and evaluating the progress of the objectives and activities of each initiative. T12HO07702 Michigan continues to rank among the lowest in the country for dental care access. Despite recent steps to alleviate oral health disparity such as reinstating adult dental Medicaid in October 2005, the positive step of mandating dental care through Community Health Centers and developing an oral health infrastructure, the demand for services far exceeds the resources available. The ailing economy, aging workforce and increasing areas of oral health disparity exacerbate the existing problem. Over 65 of Michigan’s 83 counties are designated as full or partial health provider shortage areas for services. This grant will address two critical workforce issues that can significantly improve access to care to some of Michigan’s most vulnerable populations. First, establishing a community-based dental facility in an area of high poverty with an underserved population will significantly improve access to care for a broad population base. When State funding has allowed, developing dental clinics within the safety-net network has been very successful in increasing access to oral health services, especially for the Medicaid population. The collaborative support of Michigan Primary Care Association, Community Health Centers, the Michigan Association of Local Public Health, the Oral Health Coalition, the Michigan Department of Community Health, the Michigan Dental Association, local public health clinics and other stakeholders is in place to ensure success of this endeavor. The second workforce issue will address access to preventive services. Establishing a pilot project for a community dental hygiene coordinator in an area or areas of high decay incidence, low sealant placement, lack of community water fluoridation and limited access should result in a model that can be utilized state-wide to greatly improve oral health and health care systems by eliminating barriers to oral health access. Both projects have components that address the four goals listed in the grant:
T12HP07709 Mississippi is a predominately rural state with approximately three-quarters of the 2.9 million state residents living in non-metropolitan areas. The states three largest populated areas have sufficient supplies of dentists; however a majority of Mississippians live in rural areas, and face tremendous shortages, particularly in dentists who specialize in pediatric dentistry and periodontics. In 2005, the Mississippi State Board of Dental Examiners reported 1,197 active and 208 inactive dentists in the state, with 42 new dentists licensed during 2004. Based on Mississippi’s 2010 projected population of 3.1 million people, the state will have one active dentist for every 2,605 people. In FY 2005, only 472 dental providers participated in the Medicaid dental program. This proposal seeks to improve the distribution of dentists in rural Mississippi by increasing the agency’s capacity to identify dental workforce supply and demand, and facilitate partnerships to provide a rich dental public health education experience that encourages dentists to practice in rural areas. The key objectives of this proposal are:
T12HP07711 The prevalence of early childhood caries is increasing in low-income children in North Carolina. A stable number of dentists combined with the rapid growth of the child population, particularly poor Latino immigrants, contribute to much of this dental disease going untreated. A demonstration project, referred to throughout the application as the Carolina Dental Home initiative, is proposed in which we address disparities in oral health for preschool-aged children by targeting Medicaid enrolled children from birth to 5 years of age. The overall goal of the proposed demonstration is to develop and pilot test a collaborative, coordinated and comprehensive community-based system that provides access to dental homes for preschool-age Medicaid children. It will build on successful efforts that already have engaged more than 400 medical offices in the delivery of preventive oral health services for young children and those children who are enrolled in all 18 Early Head Start (EHS) programs in the state. The objectives of this project are to: (1) enhance the ability of medical providers participating in the ongoing dental initiative to provide risk-based dental referrals; (2) improve the availability and adequacy of the dental workforce to meet the dental needs of preschool-age children enrolled in Medicaid; and (3) increase the value that primary caregivers of preschool-age Medicaid children place on early and regular dental visits. Physicians, dentists and other community providers for pre-school children and their families located in a pilot site will be enrolled in a learning collaborative to develop risk-based guidelines for coordinated care for children 0-5 years of age. We anticipate that guidelines will recommend that children who are at high risk for dental disease or develop obvious disease before 3 years of age will be referred by physicians to a pediatric dentist, while low risk patients will remain under the care of physicians and subsequently referred to a general dentist at 3 years of age, the age at which the dental benefit in medical offices ends. This risk-based approach leaves most 0-2-year-old children under the care of physicians. General dentists will be trained to provide dental services according to the level of care agreed upon by collaborative participants through enhanced continuing education and in-office collaboration among pediatric and general dentists. Dental practices agreeing to provide a dental home for children will receive an access improvement grant tied to the number of children enrolled in their practices. Case managers employed by Health Choice (NC’s EPSDT program) or other social service programs will coordinate and integrate the delivery of dental services. Physician counseling of parents of young children will be enhanced to include the importance of dental homes for young children. Medicaid claims for reimbursement filed by physicians and dentists in the demonstration site compared to the remainder of the state will be used to monitor changes in access to dental care and the quality of that care. We anticipate that the project will increase access to dental care for low-income children through a comprehensive system of evidence-based care. T12HP07703 Cantera Peninsula children suffer from oral health disparities as a result of many factors such as the dietary and hygiene habits, the attitudes of parents towards oral health, lack of knowledge of the right time to take their children to their first dental visit, not having a health insurance, limitations in health coverage, health professional discriminating attitudes toward low-income families and lack of confidence in the health system, among others. On the other hand, studies in Puerto Rico indicate that HIV patients also suffer from oral health disparities as a consequence of lack of knowledge and willingness to treat from dental providers. To reduce these inequalities not only proper oral health care is necessary but also adequate training of medical/dental provider, patients and families regarding oral health. The propose project intend to reduce these disparities. The proposed project has the following goals:
To accomplish these goals the University of Puerto Rico will initiate three new components to increase and improve the oral health services provided to underserved communities:
T12HP07708 In recent years, RI has received federal and foundation funds to support a variety of oral health initiatives. As a result, the Oral Health Program, RI Department of Health has been revitalized, the dental Medicaid program through the RI Department of Human Services has undergone significant reform, community health centers have started new or expanded dental clinics, and extensive oral health partnerships have been developed. Despite these accomplishments, RI is facing significant oral health workforce challenges. Nearly half of actively practicing dentists are approaching retirement and the state has a less than optimal supply of dental hygienists, dental assistants, dental laboratory technicians and/or the expert faculty to train students seeking entry to these professions. These shortages will likely impact the state’s most vulnerable populations – children from families with low-income, children with special health care needs, disabled adults, elders in nursing facilities, and those of minority race/ethnicity. RI does not have a dental school and currently only eight Rhode Islanders are enrolled in out-of-state dental schools. In addition, the baccalaureate degree program for dental hygienists at the University of RI has been eliminated and the Community College of RI remains the only accredited program for dental hygiene [associate degree] and certified dental assistant training. Only 14% of currently licensed dentists are women and people of minority race/ethnicity are underrepresented in the state’s oral health professions and existing training programs. The proposed project seeks to further advance and implement strategies identified by key RI coalitions including the RI Senate Commission on Oral Health, Early Childhood Oral Health Coalition, Oral Health Access Project Advisory Committee, Oral Health Professional Advisory Council, and Dental Care in Nursing Homes Workgroup and by stakeholders participating in the 1st Annual RI Oral Health Summit. The proposed activities will help to enhance the clinical/ cultural competency of currently practicing oral health professionals and promote recruitment of diverse, qualified students to oral health professions. Project Objectives/Actions include: 1) Establishing an interdisciplinary Steering Committee to guide implementation/evaluation; 2) Conducting mini-residency programs for general practice dentists, dental hygienists, and dental assistants in 3 focal areas [Pediatric, Special Care, and Geriatric Dentistry]; 3) Increasing the cultural/linguistic competency of the oral health workforce serving disadvantaged populations through training in CLAS standards; 4) Increasing recruitment/ retention of oral health professionals to RI and science/community-minded students, particularly those of minority race/ethnicity to careers in dentistry; and 5) Developing legislation and leveraging funds to assure a highly trained/culturally sensitive oral health workforce able to meet the needs of underserved populations. T12HP07710 Success and commitment in developing programs for oral health access, clearly reflects Vermont’s ability to effectively collaborate with key constituents to improve access to oral health services for its citizens. However, given the improvements in policy and insurance coverage which have increased access to oral health services, Vermont continues to be challenged to retain and develop an oral health workforce adequate in size and distribution to provide the types of services and care promoted and supported by these system and policy initiatives. Over the past several months a group of stakeholders has met regularly to develop a plan for improving the coordination and breadth of activities related to training and recruiting dentists. This stakeholder group has included the Vermont State Dental Society (both the Executive Director as well as individual members), University of Vermont Area Health Education Centers Program, Vermont Department of Health, Bi-State Primary Care Association, Vermont Dental Residency Program and staff from the office of U. S. Senator James Jeffords. This group has identified a number of consensus key activities and initiatives which will advance the state and its training and recruitment activities. These key activities have a high level of support across the oral health, university and public health sectors. Vermont is proposing to expand its existing workforce development infrastructure to generate and support an oral health workforce adequate to meet the expanding needs of the state. In order to do this, Vermont will concentrate on the following goals:
These goals will be accomplished through a collaborative process monitored by an Oversight Committee of stakeholders which will act as a subcommittee to the existing oral health recruitment and retention working group. Subcommittee participants will include the Department of Health, Vermont Dental Society, Vermont Residency Training Program and UVM Area Health Education Center Program. T12HP077 The 2005 Washington State Smile Survey, conducted by the Washington State Department of Health, indicated that, “There are significant oral health disparities in Washington with minority, low-income, and non-English speaking children having the highest levels of dental decay, rampant decay, untreated decay, and urgent need for dental care and the lowest level of dental sealants.” The proposed project will target low-income and minority populations in Yakima County, Walla Walla, and Seattle. The Yakima County and Walla Walla target communities are in rural areas of the state, and the Seattle target community is an underserved urban area of the state. These communities experience substantial oral health disparities and lack of access to adequate oral health care and dentist workforce s hortages. The purpose of the project is to plan and implement innovative programming to improve access to oral healthcare through a needs-based program that increases the number of trained and culturally competent dentists and other dental health professionals practicing in rural and urban underserved areas of Washington State. This will be accomplished through a partnership among the Washington State Department of Health Office of Community & Rural Health, the Maternal and Child Health Oral Health Program, the Washington State Healthcare Authority, the Yakima Valley Farm Workers Clinic, Puget Sound Neighborhood Health Centers, University of Washington School of Dentistry, the Washington Dental Service Foundation and the Washington State Dental Association that will accomplish an expansion of the newly-established Northwest Dental Residency Program and support pipeline programs to assist young people of color and those from dental shortage areas of the state to enter dental health professions. These partners have a strong history of partnership activities specific to oral health workforce development and access to dental services. The project will expand the Northwest Dental Residency by 4 additional resident slots, 1 in Yakima County, 1 in Walla Walla and 2 in Seattle. The project will provide for dental profession pipeline activities to occur in Yakima County and Seattle. In addition, the project will establish a unique interagency Evaluation/Technical Assistance team, made up of staff from each of the partner organizations. Formalization of this partnership will be important to future expansion efforts for the community-based dental residency program. T12HP07707 In many areas across Wisconsin, families and individuals have a difficult time obtaining adequate access to dental care services. A variety of obstacles may deter individuals from obtaining the care they need. These barriers may be financial, geographic, perceptual, educational, linguistic, cultural, or provider-related. Substantial oral health disparities between populations of different income levels, ages, and cultures also exist. Increased resources targeted to high risk populations for the prevention of oral disease could improve the oral health of Wisconsin children. The purpose of the project is to improve access to oral health care by increasing the number of oral health providers providing evidence-based preventive services to targeted populations. Specifically, the project will expand Wisconsin’s Seal a Smile initiative. Based on a systemic review of the evidence on the effectiveness of population-based interventions to prevent and control tooth decay, the Task Force on Community Preventive Services strongly recommended school-based or school-linked pit-and-fissure sealant delivery programs. The Wisconsin Department of Health and Family Services (DHFS) will contract with the Children’s Health Alliance of Wisconsin to administer mini-grants for school-based and school-linked dental sealant programs. The Seal a Smile program will assure that children receive a highly effective but underutilized dental prevention service through a proven community-based approach. The program will support infrastructure workforce capacity by increasing funding support to local public health departments for the increased utilization of dental hygienists for community-based activities. Seal a Smile will maximize effectiveness by targeting high risk children. High risk children include vulnerable populations less likely to receive private dental care, such as children eligible for free or reduced-cost lunch programs. The primary grades to be targeted are the second and sixth grades. |
