City of Portland, Maine Oral Health Program

Overview of Presentation

Purpose Demographics Community collaboration Oral Health program overview Integrated Homeless Health Clinic Innovations

– Open access– Case management

Outcomes

Purpose

To offer an overview of the program to suggest ways to help other clinics operate more effectively, including reducing lost provider time, accommodating emergencies, decreasing the time between appointments, and increasing collaboration with other providers.

Demographics

Rural New England state Metropolitan population: 230,000 Homeless population: 5,000 Special populations served:

– Refugee– HIV positive– Teenagers

Community Collaboration

Social service agencies– Mental Health– Halfway houses– Teen Center

Oral surgeons Community dental clinics Hospitals Public Health Division of the City of Portland State of Maine

– Public Health nurses– Intensive case managers

Portland Oral Health Program

Homeless– Hygiene– Dental clinic– Denture laboratory contract

Low-income– Hygiene– Volunteer Dentists, Oral Surgeons, and Endodontists– Community clinic

Nursing home Case Management

Homeless Health Clinic Overview

Integrated clinic– Dental– Primary care – Mental health– Substance abuse

Close to day shelter, soup kitchen, overnight shelter, social services agencies

Open Access

No-shows vs. lost time Client working list Sit and wait Emergencies

– 1 slot per day Customer satisfaction

– Control over pace of care– Always an option to engage services

Case Management

Follow-up on no-shows Outside providers

– Oral surgeons– Denture program

Outreach– Contact hard-to-reach patients– Teens– Street

Education– Health fairs– Progress in treatment

Resources– Volunteer dentists– Local philanthropic societies

Outcomes

No-show rate/lost time– Case management

Same-day/next-day service Booking out maximum 2 weeks

– Only with people who follow-up