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.