A New Decade of Advancing Oral Health in Kansas Work Plan June 10, 2013

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1 A New Decade of Advancing Oral Health in Kansas Work Plan June 10, 2013 GOAL 1: PROJECT STEERING COMMITTEE Set up a project steering committee to oversee the project objectives related to improving the dental care delivery and financing systems. Objective 1Aa: Contact all stakeholders who took part in the grant planning process to determine their continued interest. Deadline: May 2013 All stakeholders involved in the grant development have been contacted and have indicated they are interested in taking part in the planning project. Objective 1Ab: Ask committed stakeholders to recruit colleagues who would enrich the steering committee with their expertise. Deadline: Ongoing Stakeholders who took part in the May 29 project kick-off meeting were asked to identify additional stakeholders who should be involved in the planning project. Continue to identify and invite stakeholders to join the project. Set up a larger stakeholder group, which will supplement the work of the steering committee and meet less frequently. Objective 1Ac: Convene monthly steering committee meetings to oversee the community conversations and explore models to improve the dental care delivery system and reimbursement. Deadline: June 2013 April 2014 The initial meeting was held on May 29, and another is scheduled for June 10. Set a meeting schedule for June through November 2013.

2 Objective 1Ad: Seek technical assistance from Oral Health 2014 grantees also working on financing models and strengthening the dental care delivery system: California, Colorado, Hawaii, New Hampshire, New Jersey, Oregon, and Pennsylvania. Deadline: June 2013-April 2014 Identify the goals the target states have set and determine which mirror the Kansas goals most closely.

3 GOAL 2: LOCAL PILOT PROJECTS Develop community conversations and local pilot programs to strengthen the local dental care system and models of reimbursement for care. Objective 2A: Select three communities in which to set up pilot programs to increased community-based dental care delivery: 2Aa: Contact rural communities that have expressed interest in increasing access to dental care for their residents, such as Wakeeney, Ness City, Ashland, Greensburg, St. Francis, and Scott City. 2Ab: Determine which communities already have developed the necessary foundation to be able to begin the community conversations. 2Ac: Engage a facilitator to work with the community leaders as they identify barriers and set up pilot programs. Deadline: September 2013 Six western Kansas communities were originally listed in the grant application. Set the criteria to use in selecting the three communities to develop pilot programs. Such criteria can include: o Demonstrated success in establishing a community resource in recent years new hospital wing, family practice, OB/GYN services, new employer o Energetic, open, hardworking city and county elected officials and staff o Demonstrated community resources for ongoing funding o Demonstrated ability to produce a new entity through stakeholder collaboration o Critical mass of population to sustain the dental model of care o Intelligent, creative, collaborative individuals who have the time and energy to commit to the task... start up and sustaining o Community Needs Assessment on Kansas Health Matters Objective 2B: Convene community conversations in the selected communities. 2Ba: Based on input from the steering committee and local leaders, invite stakeholders in each community to join a series of community conversations. 2Bb: Set the first community conversations in each selected community. Deadline: September October Bc: Set a schedule of community conversations for each selected community. Deadline: April 2013 Objective 2A must be met before activity can begin on Objective 2B.

4 Objective 2C: Using local resources, develop and launch pilot programs in each of the three communities to increase access to dental services in community-based settings. 2Ca: Through the community conversations identify the key local barriers and resources to providing dental services in community-based settings. Deadline: September November Cb: Identify a pilot program area of focus for each community, e.g., hospital-based services, nursing home-based services, etc. Deadline: October December Cc: Design the pilot program for each community and secure commitment from each stakeholder who must be involved in the pilot. 2Cd: Develop an evaluation mechanism in each community to determine the effectiveness of each pilot program. Deadline: January April Ce: Launch the pilot program in each community. 2Cf: Use the evaluation tools developed in each community to assess the effectiveness of the pilot programs and make recommendations about course corrections for the future. Begin: April 2014 Objective 2A must be met before activity can begin on Objective 2C.

5 GOAL 3: POLICY AND FINANCE MODELS Identify current barriers to full implementation of the current dental practice act and explore potential new models of reimbursement. Objective 3A: Articulate the barriers to full implementation of the current dental practice act: 3Aa: Review the dental practice act's provisions related to the Extended Care Permit, hospital-based dental services, satellite dental offices, etc. 3Ab: Review the laws and policies governing hospital and nursing facility services and their relation to the provision of dental services. Deadline: June September 2013 Identify the barriers in current law that stand in the way of dental services being provided as planned. Identify the barriers in current law that stand in the way of dental services being provided specifically in hospital and nursing facility settings. Objective 3B: Identify policy changes and new models of reimbursement to enable full implementation of the dental practice act: 3Ba: Explore the feasibility of new dental insurance policy models that would meet the needs of seniors living in nursing facilities. 3Bb: Explore the feasibility of new dental insurance policy models that would meet the needs of older Kansans living in the community. Deadline: October 2013 April 2014 Identify and evaluate the opportunities to provide new dental insurance models for underserved seniors in nursing facilities. Identify and evaluate the opportunities to provide new dental insurance models for retired Kansans who lack dental insurance.

6 3Bc: Explore ways to reduce the effect on hospital and nursing facility cost reports of adding dental services. 3Bd: Set up policies for hospitals and nursing facilities to be able to bill Medicaid for dental services provided in their facilities. 3Be: Determine how to streamline the Extended Care Permit (ECP) system to make it less cumbersome for dental hygienists to want to provide ECP services. 3Bf: Conduct new outreach to find more dental hygienists who can become ECP hygienists. 3Bg: Identify any additional opportunities to improve financing models to provide dental services to dentally underserved Kansans. Deadline: October 2013 April 2014 Develop a best practice model to enable hospitals to provide dental services. Develop a best practice model to enable nursing facilities to provide dental services. Advocate with the Kansas Medicaid program to allow hospitals and nursing facilities to bill for dental services. Building on the experience of ECP providers, develop best practice recommendations to encourage more hygienists to become ECP hygienist. Set up an outreach program to encourage hygienists to become ECP hygienists. Delineate other possible opportunities to reduce barriers to oral health care caused by a lack of access to a dental service payment source. 3Bh: Develop a final report that includes recommended policy and financing model options, as well as the pilot program focus areas for each of the local communities. Deadline: October December 2013 Share the information learned from the planning processes. Develop a plan for addressing the policy and financing barriers. Identify the communities and focus areas for the pilot programs.

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