1. Central Massachusetts Oral Health Initiative (CMOHI) PARTNERS Family Health Center of Worcester Great Brook Valley Health Center Quinsigamond Community College (QCC) Dental Hygiene School UMassMemorial Health Care UMass Medical School UMASS Dental Residency Massachusetts Society for Prevention of Cruelty to Children (MSPCC) Worcester Public Schools Webster Public Schools Webster/Dudley United Way Worcester Head Start FUNDERS Health Foundation of Central Massachusetts (HFCM) Oral Health Foundation (OHF) Kellogg Foundation Robert Wood Johnson (RWJ) Dental Service of Massachusetts (DSM) Massachusetts Access Program (MAP) Tenet Hugh Silk, MD 1 ; Ellen Sachs-Leisher, MHA 2 ; John Gusha, DMD 3, Mick Huppert, MPH 1 and Sheila Stille, DMD 4 1 [UMASS Medical School, Dept. of Family Medicine and Community Health], 2 [Independent Health Consultant], 3 [General Dentist, Holden, MA], 4 [UMASS Dental Residency Director] METHODS Five inter-related approaches:  Providing school-based dental services for underserved children  Increase the number of children who are screened, receive education, and have fluoride and sealant applications  Increase number of schools and add Head Start centers  Increasing the amount of oral health care for underserved  Recruit private dentists to increase the number and location of providers for uninsured and Mass Health patients  Utilize Community Health Centers and a Dental Hygiene School  Advocacy for oral health policy  Lead efforts to change local legislative, administrative, and regulatory policies and initiatives to increase the oral health services available to Mass Health members and the uninsured  Establishing a dental residency program  Establish a dental residency program using health centers as training sites to create interest in treating the underserved  Create a pool of potential future Central Massachusetts dentists  Educating health professionals on oral health  Increase the knowledge of oral health for medical students, residents and practitioners across specialties using Smiles for Life  Educate on oral examinations and build confidence in referrals RESULTS School-based Programs  Prevention programs in 28 schools through four different service providers serviced 11,174 children (40% of all students)  2007-08 Fluoride Varnish (FV) and Sealant (S) Programs  FV - 74.5% of students returned forms; 80.8% were positive  S - 81.2% students returned forms; 20.8% were positive Oral Health Accessibility  Office by office visits to private dentists increased private dentists accepting Mass Health to 55% up from 14%  Community Health Centers have increased dental care to include periodontics, endodontics, pedodontics, orthodontics, and surgery  Community Health Centers utilize various multi-lingual staff members to enhance the services that can be given to the community  QCC Dental Hygiene School increased care for underserved Medical Provider Oral Health Child Pocket Card From “Smiles for Life” (Side B) Figure #1. Family Health Center Dental Patient Visits, Per Month and Annual Average, January 1999- June 2008 Dental Residency  5 of 8 dental graduates now work in underserved areas  Residents take call for UMass Memorial Emergency Room improving acute care and connect patients to dental clinics  Residents participate in teaching medical students.  Residents do inpatient consults at UMass Memorial Medical Ctr  Residents are exposed to public health concepts, pediatrics, and special needs dentistry BACKGROUND  2003 survey of 3rd graders: 37.8% in Worcester County had no sealants (MA 46.7%); 28.9% had at least one untreated cavity (MA 26.6%); 8.9% needed emergency dental care (MA 7.5 %).  Worcester County has only 14 communities that are fully fluoridated (27.5% vs 59.3% of all MA residents)  Worcester adults were less likely to have had a dental visit in the past year in comparison to all Massachusetts adults.  Central Mass responded: in 1999 Dr. John Gusha and The Health Foundation of Central Massachusetts started CMOHI OBJECTIVES  To increase access to oral heath services and education for those on Mass Health or the uninsured in Central Massachusetts  To serve as a role model for expansion of oral health services and education that can be replicated across the state For additional information please contact: Hugh Silk Department of Family Medicine and Community Health UMASS Medical School silkh@ummhc.org Health Professionals  Oral health lectures/office experiences now part of the curriculum in Family Medicine, Pediatrics and Emergency Medicine Residencies.  Training sessions include oral health screening procedures, educational information for parents, and the importance of referrals to a dentist at an early stage of dental issues.  Half day inter-clerkship for third year medical students. SUSTAINABILITY  All school based programs will continue due to Mass Health reimbursements with support from UMASS/Memorial and the CHCs  Continue to increase number of Mass Health dental providers with support from Worcester District Dental Society efforts  QCC Dental Hygiene School “low fee’ program is self-sustainable  Educational curricula at medical school will continue to expand with HRSA funds and we will apply for RWJ grant  Oral health education will expand to private medical professional offices with new Mass Health initiative, OHF and HFCM  Federal Grants will continue to fund the dental residency program Advocacy  Passed legislation to “Cap” caseload, increased reimbursement rates, and created a “third party administrator” to resolve the arguments dentists held against taking Mass Health patients.  Representatives of our group are on the Massachusetts Oral Health Advocacy Taskforce addressing water fluoridation and legislation  Medical providers now reimbursed for fluoride varnish application