Best Practices: Ongoing Challenges. Dr. Mary Lashley Towson University October 2011

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1 Best Practices: Ongoing Challenges Dr. Mary Lashley Towson University October 2011

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3 Impaired nutrition and physical development Pain Absenteeism (work, school) Diabetes, CVD, Stroke Pre-term birth Self esteem Employment

4 Medicare Covers Hospital Based Procedures Only (i.e. oral cancer surgery) Medical Assistance -Maryland Healthy Smiles

5 Children to age 20 Pregnant women until delivery Adults in the Rare and Expensive Case Management (REM) Program.

6 Fluoride treatments Cleanings X-rays Crowns (some caps) Fillings Extractions Root canals Anesthesia Some sealants Space maintainers Orthodontics (if medically necessary) Dentures

7 Provides health care coverage for low-income adults in Maryland Dental benefits are optional and can be changed or discontinued at any time. Dental services include exams, cleanings, and x-rays. Fillings and extractions offered by some participating MCOs.

8 50-state report card on children s dental health awarded Maryland an A grade for children s dental health and identified MD as its topperformer in the nation. Only state to meet or exceed seven of eight key benchmarks set by the Pew Center on the States.

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10 Maryland Medicaid Program reimburses EPSDT medical providers (physicians, NPs) who apply fluoride varnish to children, ages 9 months to 3 years old. Must complete online training program. Outcomes: Number of procedures, number of practitioners trained, number of trained practitioners billing Medicaid.

11 Targets 2nd and 3rd grade students in Baltimore County Title I elementary schools (schools with a high percentage of students on the Federal Free and reduced lunch program). Students with signed consent forms receive dental screening and dental sealant placement. Screening results sent to parents. School nurse provides case management for students that needs additional dental treatment. Outcomes: Number of children who are screened and receive sealants.

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13 One of Baltimore s oldest and largest faith based non-profit organizations serving the poor, homeless, and chemically addicted.

14 Improve access to oral health care. Inspire emerging health professionals to work with homeless and underserved populations.

15 Pankey Institute for Advanced Continuing Dental Education University of Maryland Dental School Towson University Department of Nursing Helping Up Mission

16 DHMH Office of Oral Health Private Foundations Helping Up Mission

17 Oral health education On-site screening,referral, case management Treatment

18 Entering sixth year of operation 700 HUM residents served to date 600 students in nursing, dental hygiene, and dentistry participate

19 Satisfaction with care 100% Smile more 91% Improved ability to eat 85% Help me in the job market 84% Improved appearance 99% Improved self confidence 97% Improved knowledge 95.5%

20 Employment 69% Avg. Length of Stay 660 vs. 155 days (general population) Graduation from one year program 86.5% vs. 17% (general population)

21 Change in perception of homeless - 83% Change in perception of addicts 86% Care more 91% Greater sensitivity 93% More likely to volunteer 99% More likely to advocate 94% Would consider working with underserved populations 94%

22 Pankey Institute Best Practice Model 2 day event that mobilizes volunteer manpower to promote high volume delivery of dental care to large underserved populations Patterned after the free mobile clinic model

23 Conducted 2 two day DAD events over last two years Outreached to five organizations serving the poor and homeless throughout MD Over 1700 treatment procedures Over 200 individuals served Over $300,000 in free dental care delivered Cost - less than $16,000.

24 Where is the control group? Cost of tracking outcomes Funding for treatment vs. administrative costs

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26 Donor Cultivation Professional Dental Community Relentless pursuit of grant opportunities Securing organizational buy-in Political Advocacy Partner, partner, partner Pray!

27 Promote awareness of the need for access to oral health care and the impact of oral health on QOL. Advocate for funding for oral health for underserved adults. Advocate for dental benefits for children in the Patient Protection and Affordable Care Act that cover current professional and government evidence based guidelines.

28 Support legislative efforts to expand access to oral health care. Partner with oral health champions in the legislative arena. Balance need with sustainability.

29 American Academy of Pediatric Dentistry - American Academy of Pediatrics - American Dental Association - Maryland Dental Action Coalition - Maryland Office Oral Health - National Maternal and Child Oral Health Resource Center - National Institute of Dental and Craniofacial Research -

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