Wisconsin s Roadmap to Improving Oral Health WORKGROUP SUMMARY REPORT

Transcription

1 Wisconsin s Roadmap to Improving Oral Health WORKGROUP SUMMARY REPORT This fall, Wisconsin s Roadmap to Improving Oral Health was released and made available to the community via the Wisconsin Oral Health Coalition (WOHC) website. The final document was approved by the WOHC steering committee; the Strategic Areas and Goals were developed by a group of key stakeholders convened by the WOHC, with additional input from members of the public health and dental communities. The overall goal of the roadmap is to reduce the prevalence of oral disease and reduce disparities in oral health status among populations. The roadmap has identified key issues and priorities across the state, and will now be used to as a starting point to drive the conversation around improving oral health. At the 2013 WOHC Annual Meeting, attendees were placed into workgroups for each of the four strategic areas laid out in the roadmap: infrastructure, prevention and health promotion, access and workforce. Participants then began brainstorming specific action steps for each of the goals under the four strategic areas; all ideas and suggestions are listed below. At the end of the session, participants voted on which of the goals they would like to prioritize. The notes provided are a summary of the notes submitted by the co-facilitators of each particular session. In the pages that follow, a summary paragraph on the identified top-three goals of each breakout group, as well as the proposed action steps for all goals within the group, are listed for each strategic area. It is important to remember that just because a goal was not voted as one of the topthree priorities, does not mean that it will be dismissed; rather, this will simply help the coalition see where to begin focusing the work from the roadmap. After reviewing this report, we ask that you let the coalition know which goals you or your organization would like to focus on. A partnership alignment chart will be created to show where overlap between organizations exists, so that groups and individuals can come together to work towards the completion of these action steps. We also will be creating workgroups for each of these strategic areas, and the coalition will help facilitate meetings and conference calls for these groups. The committees will be further defining and laying out concrete action steps, which will be approved by the WOHC steering committee. We encourage you to read through all of the goals and suggestions proposed for the four strategic areas; you are not limited to working within the group that you were assigned at the annual meeting. There was much enthusiasm at the annual meeting around beginning the work laid out in this roadmap, and we look forward to seeing collaboration across the state in order to begin working on the goals and action items in the roadmap. To identify which goal your organization would like to work on, or for any questions, contact Lexi Lozinak, WOHC coordinator, at or alozinak@chw.org.

2 STRATEGIC AREA 1: INFRASTRUCTURE Within the infrastructure group, participants prioritized Goal 1.5: Maintain and improve the oral health surveillance system to provide comprehensive and timely reporting of oral health needs, outcomes and disparities. Members suggested that a state-directed oral health surveillance system, as well as an expansion of the Wisconsin Immunization Registry program, could help in achieving this goal. Participants also would like to focus on Goal 1.2: Expanding the role of communities and local health department in education, prevention and treatment of disease; suggestions for this goal included continuation of the Head Start program, education on the Medicaid application process, creation of local dental societies and a focus on oral health care in local health departments. Finally, Goal 1.4: The maintenance, expansion and support of the Wisconsin Oral Health Coalition, was also prioritized, to include increasing membership, current member advocacy and visibility, as well as developing more local/regional coalitions and increasing the number of coalition meetings per year. 1.1: Increase funding to provide Wisconsin residents with needed preventative and restorative services. (4) Uninsured o Community foundations, clubs, fundraising Target population needy adult population Increase in state reimbursement Increase in legislative awareness Coordinated effort of supply purchasing (non-profit) Two-cents for tooth sense 1.2: Expand the role of communities and local health departments in education, prevention and treatment of disease. (9) The following are locations/programs where the expansion of role of communities and local health departments in education, prevention and treatment of disease could take place: o WIC o Head Start o Local dental societies Component/focus in local HD o Position (funded) Community dental literacy Education part of Medicaid app process 1.3: Expand the use of proven technology to facilitate oral health education and delivery of services. (0) Social media PSAs Consistent messaging Standardized messaging Dental module within WIR 1.4: Increase the number of providers and clinics providing oral healthcare to the underserved. (5) Increase Medicaid money to market rate

3 Increase safety net clinics Increase loan forgiveness available to Medicaid providers regardless of HPSA states 1.5: Maintain and improve the oral health surveillance system to provide comprehensive and timely reporting of oral health needs, outcomes and disparities. (13) Yes o Workgroup members agreed with the above statement that the oral health surveillance system should be maintained and improved to provide comprehensive and timely reporting of oral health needs, outcomes and disparities. State directed oral health information exchange system Expanding Wisconsin Immunization Registry program 1.6: Develop systems to support the evaluation of oral health programs and policies across the state. (1) Review HP 2020 outcomes and compare with state data Coalition developing standardized measurements 1.7: Promote and support oral health research. (1) WOHC engage research institutions to influence research agenda Research coordinator Healthy WI Partnership Marquette University School of Dentistry and other post-graduate dental education programs 1.8: Maintain, expand and support the Wisconsin Department of Health Services Oral Health Program. (3) State funding of positions Part of Medicaid program 1.9: Maintain, expand and support the Wisconsin Oral Health Coalition. (9) Increase membership Current member advocacy Increase visibility Development of more local/regional coalitions and alignment to WOHC Increase number of WOHC meetings per year

4 STRATEGIC AREA 2: PREVENTION AND HEALTH PROMOTION The prevention and health promotion group focused their efforts on specific action steps to promote the impact of personal behavior and self-care on the prevention of oral disease. This could be done a variety of ways, such as through communication mediums. Advertisements and PSAs on rethinking your drink, the cost that preventative measures will save, the why of good oral health, and how good oral hygiene will improve appearance, could all have a positive effect on the value of education and the big picture impact. These action ideas closely align with the other two top goals: increase awareness of the connection between oral health and overall health and improve oral health literacy. By specifically targeting at-risk populations with a uniform, relatable message on why oral health care is important, we can stop preventable oral health emergencies. 2.1: Maintain and expand fluoridation in community water systems. (4) Support the work of the Wisconsin Alliance for Fluoridation Page 36 of roadmap o Apply for project funding to support Wisconsin Oral Health Coalition s fluoridation education campaign o Increase collaboration between stakeholders, including Wisconsin Waterworks Association, Department of Natural Resources, Department of Health Services, Wisconsin Oral Health Coalition Continued collaboration health education (create consistency) Nurse training (healthcare workers) advocacy o Systemic vs. topical Point person at health department Toolkit (is community is thinking about stopping fluoridation) Legislative action Statewide communication Public education (benefits/risks) Ad campaign public support/recognition for having fluoride Support work of current programs, increasing collaboration Continued collaborated health education (consistency) FEASIBILITY: o Focus on educating anti-fluoride groups o Build upon what we are already doing o Notify where info is (one website) o o Get all associations on same page, same message Message visual; impactful; strong I grew up with fluoride story 2.2: Increase the number of children receiving sealants. (1) Forms home in registration packets (distribution) Seal-A-Smile program Public education on benefits Increase partnerships/collaboration Seal-A-Smile program expansion (ex: private schools) Formally Department of Public Instruction level Coordinating delivery of consents with other school items

5 Adopt a smile sponsor to get oral health supplies FEASIBILITY: o Supporting ongoing funding o Sponsoring kids to get sealants adopt a smile o Expanding to private schools o Consents 2.3: Increase the use of evidence-based preventative measures, such as oral cancer screenings, sealants, tobacco cessation education and fluoride. (7) Increase collaboration Public education/healthcare work force training and performing EB resources CDC communication guide Identify evidence-based research CDC community guide Senior center (partner) Surveillance FEASIBILITY: o Workforce education (partnerships) 2.4: Educate the public on evidence-based oral health prevention measures. (4) Use of social media o Text messaging o o Twitter o Facebook Health fairs Materials that speak to health literacy level (oral health) Target soda/sports drinks positive role models o Partner with sports groups Consistent messaging/materials Targeting in home care Target parents *key Birth 3 years/women, Infants and Children program (WIC) Earlier is Better Motivational interviewing for healthcare professionals Give them a why Prevention is more affordable Education mobile units FEASIBILITY: o Social media/texts/health fairs o General and common education tools 2.5: Develop culturally-sensitive/competent patient education materials. (6) Translations of materials Pictures (culturally sensitive) Work with specific community groups

6 Use national resources that are available Videos/use technology smart phone Social media Literacy (level) tool FEASIBILITY: o Translation o Pictures o Build on national 2.6: Increase engagement of the general public in oral health-related initiatives. (1) Promotion/contests/prizes Be visible at community events o Town hall meetings o Schools o Focus groups Billboard/advertising FUNDING Recognize current efforts/public awareness campaign o Schools, community organizations o Thank for willingness to be involved Oral/system link make connection between oral health and overall health Invite public members to organization meetings/legislators/other groups 2.7: Develop and share evidence-based and consistent oral health messages with community-based organizations, policymakers, health professionals and educators. (6) (See 2.6) Continuing Education (CE) credits for health professionals E-learning Share with local project with Board of Health members PSA to raise awareness Local magazines School newsletters Displays Online forum (don t reinvent the wheel) Oral health calendar Continuing Medical Education (CME s) Training for professionals (professional education) More collateral materials 2.8: Increase awareness of the connection between oral health and overall health. (12) Educate/motivate healthcare workers Collaborate (medical/schools) School curriculums PSAs

7 Ad campaigns Target populations o Pregnant women o Diabetes o Children and Youth with Special Health Care Needs (CYSHCN) 2.9: Improve oral health literacy. (8) Translations available Website (centralized) Educate healthcare workers to be aware of problem with health literacy levels (not only message but how to deliver) o Jargon does not translate Teach-back method Webinar trainings/online/on-demand Identify educators within the community Uniform messages FEASIBILITY: o Website 2.10: Promote the impact of personal behavior and self-care on the prevention of oral disease. (19) Visuals (ex: rethink your drink) Education on value (cost you will save) Appearance (good OH) o Hireability (good appearance) Wisconsin Dental Association ads/psas big impact YouTube Workforce aware of need for financial incentive o Educate employers on importance of oral healthcare Tobacco the why in schools why not to use tobacco products Ownership of own health/conditions/value itself o Build on positives/empower Materials available to healthcare workers to do education in schools free of charge (Mr. Grossmouth) Value education/big picture impact Emergency room staff education YouTube videos DISCUSSION COMMON THEMES: ALL POINTS o Create a consistent message o Develop or find and put together (ownership) someone to take on creation o Lifestyle choices Education/training of healthcare workers o Low money = webinars Oral healthcare workers Nursing schools college level/degree education Community members and leadership

8 o Face-to-face webinar Depending on population MDs count as Continuing Education Partner with healthcare facility to meet requirements for Continuing Education credits Evaluation key o State-level support for staff o Affordable Care Act (ACA) required to look into community health assessments o Work with local health department or hospital o Partnerships o In-kind funding o Identify like-minded with members or groups o Collaboration o Reach out to universities/degree programs (ie: nursing student projects) o Tap into mini grants (local) o Identify grants/grant writers Wisconsin Dental Association having more available? o Dental suppliers (usually through dentists) o Corporations o Private foundations o Partner for marketing and public relations o Donation matching o Grant writers available identify/volunteers who work with other organizations/webinars o Identify what grants are available BIG PICTURE IDEAS o Coalition grant writer o Innovative 2 cent soda tax o Affordable Care Act (ACA) required to look into community health assessments o Having dental offices contact their suppliers or private donors or other businesses o Marketing/public relations students o Businesses donate to charities; match program o Sharing of current oral health grants Tap into other community agencies Dental screening for all kids school, daycare, etc. Expand practice settings for dental hygienists Consistent messaging and materials (ownership?) trying to find Lifestyle choices

9 STRATEGIC AREA 3: ACCESS In the access strategic area group, emphasis was placed on the goal to support and expand school and community-based oral health programs. Suggestions for action on this goal included creating dental suites in public settings and training dentists with portable equipment for restorations. In addition, advocating for continued state funding and grants, or creating a fund by the state that private dentists can use to see Medicaid patients, were also proposed. Participants also focused on the goal to increase the availability of dental service for underserved populations, which could be achieved by creating safety-net clinics, school-based clinics, mobile dentistry vans and dental residency programs, or by addressing childcare and transportation issues for those adults seeking appointments. Finally, the goal to promote adequate and sustainable funding for publicly-financed dental coverage was also prioritized; action steps proposed for this goal included grants with supporting data, partnerships with non-profits, and increased Medicaid reimbursement. 3.1: Expand access to early oral health interventions. (7) Apply for grants Prenatal/post-education for moms Education for OBGYNs Collaboration with medical providers Education for dental school students regarding public health o Ex: fluoride varnish, amalgam restorations Education for MDs, nurses, medical professionals Create more dental homes Continue supporting programs that work well Education for working with the disabled Strong messaging regarding dental disease Head Start sealant program (for all ages) 3.2: Improve the accessibility to oral healthcare services for individuals from vulnerable populations. (8) WOHC listserv for info/sharing of ideas/questions Increase local access for int. disabled patients o Ex: building/equipment/staff/resources to identify where to go oral health advocate coordinator Transportation services Strategies for tribal populations that are working Wheelchair lift Medicare should cover oral healthcare Expand scope for RDH ipad translation programs Local Missions of Mercy on a regular basis Special Smiles type of outreach Promote give a kid a smile day regularly, not just in February In-home o Mobile units/service for homebound care Increase education for cultural diversity have translators available at all times Share Point networking state-wide

10 3.3: Promote available and affordable options for dental care for all Wisconsin residents. (6) State public service media campaign Statewide coordinator Van with dental students traveling the state Investigate more effective ways in affordable options Scope of practice for mid-level providers Progressive income-based dental care coverage (universal healthcare) Private/public collaborative partnerships Social work/case management for oral health patients Medicaid Mondays o How to integrate best practice o MA in private practice 3.4: Increase the availability of dental services for underserved populations. (13) Safety net clinics Another dental school? School-based clinics Mobil vans Increasing incentives for providers Loan forgiveness/meaningful L.F. programs Developing a dental residency program Have mid-level providers Increasing settings for RDH Tele dentistry Research Iowa program Address childcare issues/transportation/time-off to get to appointments 3.5: Promote adequate and sustainable funding for publicly-financed dental coverage. (9) Continue to write grants o Collect information to show supporting data Develop partnerships with non-profits Grant writers within DHS Best practices to keep costs down Increased MA reimbursement 3.6: Support and expand school and community-based oral health programs. (15) Oral health coordinator/resource for more info Increase settings for RDH without DDS Advocate for continued state funding/grants Dental suites in public settings Create a special fund by state that private DDS s can get for seeing patients that does not require them to be MA certified o Don t charge for the service charge for the DDS s time Pro-bono off the DDS s taxes Volunteer service time counts as continuing education

11 School districts employ RDH s working with school nurses Training DDS s with portable equipment for restorations 3.7: Reduce oral health-related emergency department visits. (5) Collaborative efforts with local DDS s Grants to help ER oral health costs Hospitals staffing DDS s/add a GPR Marquette University School of Dentistry pilot program Train DDSs to work with portable equipment for restorations Develop funding with hospital foundations

12 STRATEGIC AREA 4: WORKFORCE The final strategic area of the roadmap addresses the oral health care workforce; an overwhelming majority of this group placed emphasis on the first goal to identify gaps in the oral health workforce and develop strategies to address them. Some of these strategies included implementing community dental health coordinators, surveying technical schools with dental assistant programs, creating additional opportunity for working in long-term care, ensuring hygienists can work within the full scope of practice, piloting an advanced dental hygiene practitioner or dental therapist program, and maximizing the use of the current workforce. Participants also offered ideas on how to promote the education and utilization of public health principles within the oral health community; suggestions included increasing integration of public health principles in educational curriculums, integrating quality measures in dental practices, defining population-based goals for oral health, and expanding the coalition to address contributing factors to poor oral hygiene. The third prioritized goal was to promote lifelong learning related to oral health disciplines, which could potentially be achieved via a bachelor s degree program for hygiene, dental residency programs, required service learning for students, and state oral health consultants. 4.1: Identify gaps in the oral health workforce and develop strategies to address them. (33) Implement community dental health coordinators (4.3) Survey technical schools with dental assistant programs: o Where do students come from? o How do graduates align with areas of need? o Identify the gaps/needs in dental assistant training program/curriculum More opportunity for working in long-term care nursing home population Ensure hygienists can work within full scope of practice by facilitating systems that utilize the full existing legal scope of practice Pilot Advanced Dental Hygiene Practitioner or Dental Therapist (4.3) Maximize use of current workforce 4.2: Increase interdisciplinary clinical and professional collaboration. (6) Integrate oral health education/training in medical education/training Identify and train champions within the medical community to promote oral health (MDs, nurses, others) Get dental industry to be more involved in integrating with medical information systems o Electronic health records o Health information systems Expand hygiene practice settings within medical health settings Educate the practicing community on link between dental and medical: o Should start at dental educational institutions o Continuing education o Distance learning opportunities o Service learning opportunities o Continue learning by the dental profession on latest connections between oral and physical health o Education of medical and other allies health 4.3: Promote lifelong learning related to oral health disciplines. (7) Establish bachelor s degree program for hygiene

13 Expand dental residency programs Require service learning and provide credits o Ex: Special Olympics requires one hour training Bring back state oral health consultants Create expanded function dental assistants (EFDA) (goals 1 & 5) 4.4: Improve and increase recruitment and educational support for students interested in oral health professions. (5) Targeted recruitment o Work with area health education centers (AHECs) o Grow your own Pipeline program o Must engage parents, community in addition to students and schools Ensure loan forgiveness programs o Students must know early enough about what is available, when and how much o Look at dental shortage area scoring criteria Create dental mentors/program Explore/promote packages offered by Chamber of Commerce to recruit (or like organizations) Recruitment for diversity must come from diverse leaders 4.5: Promote the education and utilization of public health principles within the oral health community. (15) Ensure/increase integration of public health principles in educational curriculums o Dental education o Continuing education o Residency programs o Community service programs Integrate quality measures in dental practices and safety net clinics o Dental quality alliance measures o Oral health quality of life measures Define population-based goals for oral health o Take oral health goals outside of dentistry Schools Medical community Community health Establish base-line data for who currently utilizes public health principles Engage educators in schools who have relationship with parents, kids, community Partner with Department of Public Instruction on incorporating dental health curriculum Expand coalition to address contributing factors (soda/obesity) o Two-cent tax for tooth/tummy sense