1. EaSY Does It: E xpansion of S ervices to your Dental Program’s Y oungest Patients Scott Wolpin, DMD Chief of Dental Services Choptank Community Health System, Inc. Eastern Shore of Maryland

2. Choptank Community Health System (CCHS) Rural, community health center Rural, community health center 7 primary care sites and 14 health care providers offering offer a full range of primary health care services for all area residents 7 primary care sites and 14 health care providers offering offer a full range of primary health care services for all area residents Community based services provided in five school based wellness centers, and the migrant health project Community based services provided in five school based wellness centers, and the migrant health project In 2001 CCHS was awarded funding from the BPHC to develop comprehensive oral health care services at one of its primary care sites - Federalsburg Dental Center. In 2001 CCHS was awarded funding from the BPHC to develop comprehensive oral health care services at one of its primary care sites - Federalsburg Dental Center.

3. “The Funnel Effect” – D. Rosenstein CCHS’s In-house referrals CCHS’s In-house referrals CCHS’s school-based dental program referrals CCHS’s school-based dental program referrals Children with acute care needs are seen the same day for definitive care (open access). Children with acute care needs are seen the same day for definitive care (open access).

4. Why do it??

5. “EaSY Does It” A n innovative partnership between a rural, community health center [CCHS] and a dental school [UMDS] where a native Spanish speaking pediatric dentist provides clinical services four days a week at our health center’s dental clinic. A n innovative partnership between a rural, community health center [CCHS] and a dental school [UMDS] where a native Spanish speaking pediatric dentist provides clinical services four days a week at our health center’s dental clinic.

6. Community Responsiveness The Maryland Department of Health and Mental Hygiene and UMDS collect oral health data on children every five years in an effort to describe the oral health status of school-aged children in Maryland The Maryland Department of Health and Mental Hygiene and UMDS collect oral health data on children every five years in an effort to describe the oral health status of school-aged children in Maryland

7. UMDS Pediatric Dentistry Fellowship

8. Guess what?? The 2000 statewide study revealed that Eastern Shore children have: the highest mean number of decayed teeth the highest mean number of decayed teeth highest proportion of dental decay history made up by untreated decay highest proportion of dental decay history made up by untreated decay And are: the least likely to have benefited from dental sealants statewide the least likely to have benefited from dental sealants statewide least likely to have visited a dentist least likely to have visited a dentist and most likely to have their parents report unmet oral health care needs and most likely to have their parents report unmet oral health care needs

10. Innovation

11. Collaboration/Integration “EaSY Does It” is a jointly developed shared vision to improve the oral health status of Maryland’s most needy children where: Both individual and organizational agendas are valued in reaching this common goal. Both individual and organizational agendas are valued in reaching this common goal. Clear expectations are drafted in a Memorandum of Agreement (MOA) Clear expectations are drafted in a Memorandum of Agreement (MOA)

12. Outcomes In 2004, the CCHS dental center saw 3248 patients for 6,687 visits. Sixty percent of the patients were under 19 years of age and 12 percent were five years of age or younger.

13. Replication/Sustainability The “EaSY Does It” partnership is a revenue neutral program for both the UMDS and community health center. The “EaSY Does It” partnership is a revenue neutral program for both the UMDS and community health center. Donations from the Maryland State Office of Oral Health and Managed Care Organizations [MCO’s] that administer the State Medicaid program have afforded a local hospital O.R. to be equipped for dental services provided by the pediatric fellow. Donations from the Maryland State Office of Oral Health and Managed Care Organizations [MCO’s] that administer the State Medicaid program have afforded a local hospital O.R. to be equipped for dental services provided by the pediatric fellow.

15. Challenges legislation legislation writing a good business plan writing a good business plan facility capacity facility capacity recruiting adequate support staff recruiting adequate support staff the fellow’s satisfaction of the workplace. the fellow’s satisfaction of the workplace.

16. Administrative Effectiveness Chart audits, peer review surveys and patient questionnaires are evaluated to assure quality. Chart audits, peer review surveys and patient questionnaires are evaluated to assure quality. The only resources needed to operate the program are: availability of nitrous oxide sedation, adequately trained support staff and facility capacity (a quiet room outfitted with dental equipment for restorative care). The only resources needed to operate the program are: availability of nitrous oxide sedation, adequately trained support staff and facility capacity (a quiet room outfitted with dental equipment for restorative care).

17. In an effort to continuously improve a program you must always look to what opportunities might be obtainable. Funding is often the most difficult piece of any public health initiative but there are several alternative opportunities. In an effort to continuously improve a program you must always look to what opportunities might be obtainable. Funding is often the most difficult piece of any public health initiative but there are several alternative opportunities.

18. Contact Information for Pediatric Fellowship Program Harold S. Goodman, DMD,MPH Director Pediatric Fellowship Program Department of Health Promotion and Policy Dental School University of Maryland at Baltimore 666 West Baltimore Street Room 3 E 10 Baltimore, MD 21201 410-706-7970 410-706-3028 (FAX) hgoodman@umaryland.edu Harold S. Goodman, DMD,MPH Director Pediatric Fellowship Program Department of Health Promotion and Policy Dental School University of Maryland at Baltimore 666 West Baltimore Street Room 3 E 10 Baltimore, MD 21201 410-706-7970 410-706-3028 (FAX) hgoodman@umaryland.edu hgoodman@umaryland.edu Scott Wolpin, DMD Scott Wolpin, DMD Dental Director Choptank Community Health System, Inc swolpin@choptankhealth.com

19. Questions?