Collaborative Practice: Bridging the Gap n Preventive Dental Services

Julie Ann Janssen, RDH, MAIFLOSS Coalition

Sherri M Lukes, RDH, MS, FAADHPresident, Illinois Dental Hygienists Association

Access, a multifaceted health problem, encompassing a broad set of concerns that center on the degree to which individuals and groups are able to obtain needed oral health care.

MedicaidSystem

PreventionPrograms

Public HealthClinics

Workforce Value ofOral Health

Access to oral health care is limited by such factors as the:

WorkforceState dental practice actPublic facilitiesReimbursementValue of oral healthPreventionLocation

Oral Health of Illinois’ Third Graders22% have untreated decay (26%

FRMP)48% are cavity free (41% FRMP)2% need urgent care (2% FRMP)50% have dental sealants (51%

FRMP)

The statute does not require the presence or supervision of a dentist in a public or private school, a dental or dental hygiene school or a facility owned by a local health department. Special Requirements: None Services: Hygienist can provide prophylaxis, root planing, screening, treatment planning, sealants and delegable duties. Notes: - Direct Medicaid reimbursement allowed.

Differences exist between populations seeking oral health care. All have unique problems that act to further exacerbate the difficulties in accessing oral health care. Special needs populations Incarcerated Poor ChildrenElderlyRural

The DilemmaOral Health Needs Assessment and

Planning (1995-2003) All grantee communities have identified access

to oral health care as a priority problemProject Smile Data (1993)

55% of 6-8 year-olds have had cavities 38% of 6-8 year-olds have untreated cavities 19 % of 8 year olds have dental sealants

Access to Oral Health Care in Illinois

Dental SealantGrant Program 1986

1993Project Smile OH Survey

OH ConferenceDental Directors 1998

1998Beyond Dental Clinic Directors

1996 O H Needs Assessment & Planning

IPLAN 1995

IFLOSS 1998

The IFLOSS Coalition is a private-public group addressing access to oral health care in Illinois.

IFLOSS Coalition November 1998

Partners: Local Health Departments Illinois State Dental Society Illinois Dental Hygienists Association State Agencies Advocacy Groups

Goal:Develop Strategic Plan to Increase AccessFramework

community based focus on prevention integrate with primary health care Medicaid system partner with private sector

Workgroups Reimbursement Clinic Development Marketing and Data

FY9714 Grantees17 Communities1,437,876 Pop

FY9815 Grantees21 Communities4,199,951 Pop

FY998 Grantees9 Communities651,575 Pop

FY0011 Grantees12 Communities1,256,314 Pop

FY873 Grantees7,121,Sealants

FY9326 Grantees60,812 Sealants

FY9956 Grantees48,146 Sealants

Total (FY87 - FY00)502,446 Sealants

Safety Net Dental Clinics

•What is the role of safety net What is the role of safety net dental providers…dental providers…

Dental Services Use by Medicaid Children

IDPA, 2000. For the period of March 1, 1999-February 29, 2000.

0%10%20%30%40%50%60%

% u

tiliz

ing

dent

al se

rvic

es

HP 2010 goal of 57%

Type of Dental Services Provided

Preventive30%

EPSDT19%FQHC Encounter

Fee1%

Diagnostic29%

Restorative15%

Oral Surgery4%

Other2%

Counties With At Least One Pediatric Dentist

Illinois Dental Graduates 1980-2002

460399

315

178 181110

050

100150200250300350400450500

Total IL DentalGraduates

Source: 1996/97 Survey of Predoctoral Dental Educational Institutions: Academic Programs, Enrollment, and Graduates, Vol. 1, ADA, Chicago, IL.

Percentage of Active Dentists Who Participate in Medicaid

0%10%20%30%40%50%60%70%80%90%

100%

Illinois CookCounty

Urban Rural

Part

icip

atin

g

IDPA, 2000. For the period of March 1, 1999-February 29, 2000.

24

The future of oral health in Illinois depends on committed communities.