1. Muskegon Family Care: New Advances in the Treatment of Adult Patients
Monday, August 8, 2005
Dr. Amy Renee Lalick
Dental Director
Muskegon Family Care
Muskegon, MI

2. Where Is Muskegon? Population 40,510 Area in Square Miles: 18.99 miles
Founded in 1861
North of Holland, MI,
West of Grand Rapids and Lansing, MI
On the Shores of Lake Michigan

3. *Dental Clinic at our Oak Street campus
One of 2 FQHC’s in Muskegon County
Serving Muskegon, Newago, and Ottawa Counties
We also have patients from Kent county
The only Dental clinic accepting limited new adult patients
2 sites- Getty and Oak
*Dental Clinic at our Oak Street campus
*6 dental chairs
*6 Dentists- 2FTE, 4 part-time
*5 FTE Hygienists
*4 FTE Dental Assistants
*3 front desk staff
*1 Dental Financial Specialist

4. State of Michigan Medicaid
October 1, 2003, Medicaid coverage for Adult Dental was cut for those 21 and over
Full services still available for children
Scheduled for October 1, 2005, Adults 19 and over will have their dental benefits cut

5. What Now? We are left with a large problem
Where do adults go for dental care?
After extracting teeth, what do we do?
What happens if Adult benefits are ever reinstated?

6. Adult Needs Comprehensive Care including: Preventative Care
Restorative Care
Prosthodontics
Oral Surgery
Alternatives to extractions
Emergency Care

7. The MFC Solution
Continue to see our existing adult patients as Sliding Fee patients
Add only 20 new adult patients per month
Separate Sliding fee scales created for dentures, and Endodontic procedures
Additional Operatory in new Getty Street Medical Building
Continue to see as many children as possible

8. Adult Restorative and Preventative Programs
Since October 1, 2003 we have seen 1098 patients for restorative visits, and 1726 patients for preventative visits
This is not the actual number as many patients have had multiple visits

9. Restorative & Preventative, Cont.
Adult patients get one 45min appointment with the Dentist a month
Patients are also eligible for 1 visit with the hygienist
At last meeting, we had only seen 149 restorative and 114 preventative patients

10. Big Increases! Additional hours of operation
Increased the number of providers
More people are trying to become new patients
Young adult patients are losing their benefits, by turning 21
Sneaking in a few of our children’s parents
The codes for these adult patients have been checked for past errors, and the figures from the last presentation were lower than they should have been
Some existing patients have lost their insurance

11. Dentures
Since October 1, 2003, We have fabricated CD’s or RPD’s for 107 Patients
As of December 2004 only 72 prosthetics had been fabricated

12. Dentures, Cont. Patients are on a sliding fee scale for Dentures
Patients are given an estimate for their dentures when the need is diagnosed
Patients have had charity organizations such as Love Inc., Mental Health foundation, and Michigan Rehab help with the patient’s fees
Local churches have also helped out patients with fees
Local labs have also donated cases for our patients

13. SFS: Dentures SFS 0% patients pay out of pocket $500 per CD or RPD
Patients at 100%SFS pay the base fee of $800 per CD or RPD
Patients also pay the regular SFS co-pay for extractions, restorations, and any periodontal care
Patients are required to pay for Dentures before anything is sent to the lab
Fee Percentage
500 0

14. Endodontics Program modeled after our Denture program
Patients are on the SFS, they pay the fee associated with their percentage
Payment must be received before treatment is started

15. Endo, Cont.
The SFS is different for Anterior teeth, Premolars, and Molars
Patients are given the estimate for their SFS percentage
Patients are also asked to sign an Endo Consent form
Post-operative instructions, and any complications are on the Endo Consent form

16. SFS: Endo Anterior Teeth, Premolars
Percentage Fee
0 $196
$216
$236
$256
$276
$296
$316
$336
$356
$376
$391
Percentage Fee
0 $227
$250
$273
$296
$319
$342
$365
$388
$411
$434
$453

17. SFS: Endo Molar Percentage Fee 0 $309 10 $340 20 $371 30 $402 40 $433
$309
$340
$371
$402
$433
$464
$495
$526
$557
$588
$618

18. Outcomes: Endo
Since October 1, 2003, 61 Root Canals have been completed
10 One(1) hour blocks are reserved a month for Endo
These are distributed between 2 dentists
They are used for starting or completing RCT
Additional spots are made in the other dentists schedules case by case

19. New Building Opened on June 27, 2005 1 new operatory for dental
Dental treatment started in July 2005
Hygienists rotating through the clinic
Plan to have Dentists rotate though starting in 2006

20. New Building, Cont.
Dental room furnished with donated equipment including Patient Chair, Cabinet, Assistant Chair, Provider Chair, and some trays
Other equipment purchased for future use outside the clinic… Portable!

21. New Building Used mainly to capture MFC Medical patients
Preference is being placed on our children
Will also see Pregnant women
Planning on using this chair for future referrals from MFC Medical and for the Diabetes Collaborative

22. New Building, Cont. MFC was approved for the PA58 on July 18, 2005
This gives our hygienists the ability to work without a Dentist on location
They can see new patients without an exam or assignment from a dentist

23. New Building, Procedure
New patients (children) are seen at the new clinic for a Hygiene screening, and a prophy
They are referred to the main dental clinic for an exam and x-rays
Patients are then seen for all restorative care at the main dental clinic
Any existing patients are allowed to schedule their cleaning appointments at the New building, or at the Main clinic

24. Big Successes Increased our number of Adult patients seen
We have shifted to 50% Medicaid and 30-40% SFS
Much of the equipment at the new clinic was donated due to people believing in our cause
More teeth are being saved
More Smiles restored
More happy patients-rated 95-99% good or excellent by our patient in the yearly survey