Healthy Teeth,

Healthy Communities Project

Medi-Cal 2020 1115 Waiver Local Dental Pilot Program (LDPP)

Baharak Amanzadeh DDS, MPHAlameda County Dental Director

Healthy Teeth Healthy Communities Project

Update on the grant submission:

• Budget: Requesting approximately $4 million per year for 4 years for a total of $16 million of the course of the

grant program

• Time line: Application submitted Sep 30, Notification of Final decision of approval: Dec 6th, Program

Commences: Feb 15nd

State Dental Transformation Initiative

LDPP Goals

PreventionIncrease the utilization of children ages 1-20 enrolled in Medi-Cal who receive any preventive dental service, by at least ten (10) percentage points over a 4-year period.

Access to Care Increase the number of actively participating providers in each county who provide preventive services.

Continuity of Care Increase utilization of children continuously enrolled in the Medi-Cal Dental Program who receive services performed by the same provider in 2-, 3-, 4-, 5-, and 6-year consecutive year periods.

Alameda County Denti-Cal Utilization

Of 156,342 children (0-20) eligible for Denti-Cal Services: Only 43,932 (28%) were seen by a dentist in 2014.

Of these, only 21,634 (49%) saw a dentist in the following year.

Barriers To Dental Care In Alameda County

Families lack knowledge of age-appropriate oral health guidelines, including

the need for early and consistent preventive care.

Families have difficulty finding appropriate dentists who

• Accept Denti-Cal;

• Are accepting new patients;

• Have appointments available within reasonable timeframe;

• Are linguistically and culturally responsive;

• Are close to home or work.

Families may not understand how to access Denti-Cal benefits.

Dentist shortage: simply not enough dentists on Denti-Cal and not enough capacity to treat all patients.

• up to 2,713 patients per Medi-Cal dental provider in some areas.

• many do not accept new patients or do not treat children

Many dentists are reluctant to enroll as Denti-Cal providers because of:

• low reimbursement rates;

• excessive paperwork;

• high no-show rates; and

• administrative complexities.

Some dentists lack adequate training to treat children, especially the youngest children.

Barriers To Dental Care In Alameda County

Create

Connected

Care

Rethink

Places

Train

Dental Care

Coordinators

Create a cross-agency workforce of Community Dental Health Care

Coordinators who are linguistically and culturally responsive to

community.

Leverage existing infrastructures for outreach and care

coordination: First 5, School Districts, WIC sites, FQHCs and

Community Clinics.

Develop a web-based Care Coordination Management System to

link families to dental appointments and support continuity of care.

HTHC Strategy 1: Increase Care Coordination

Expand provider network through recruiting private dentists into Denti-Cal and

enhancing FQHC participation.

Offer additional local incentives to participating dentists, in addition to State DTI

incentives:

• Family Oral Health Education incentive;

• Data Reporting incentive; and

• Continuing Education Units for dentists.

Develop a Dental Community of Practice to connect dental providers to additional

training and technical assistance.

HTHC Strategy 2:

Increase Safety Net Dental Network and Capacity

Budget and Positions

• $16 M for 4 years

• Approximately 25% ($1million annually) of these funds for PHD and HCSA/Center for Healthy Schools and

Communities staffing and operating expenses.

• Approximately 65% ($2.6 million annually) for community partners.

• Another 10% ($400,000 annually) for provider incentives and technology support.

• In addition, the grant will support 15 FTE new county positions across PHD and HCSA/Center for Healthy

Schools and Communities staffing and operating expenses.

• And, another 25-27FTE CBO positions will be funded.

Sustainability Planning

• Ongoing sustainability analysis through the project Steering Committee and Sustainability Workgroup to

build on the infrastructure and to leverage other funding.

• Partnerships with UCSF School of Dentistry and DentaQuest Foundation to identify and document lessons

learned and best practices in order to support potential scaling or replication in other jurisdictions.

• Results to inform policy changes through DHCS on increasing reimbursement rates and incentives.

Together we can!