1. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
February 2015
Bureau of Medicaid Services
Presented by: Bob Reifinger

2. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
Presentation Objectives
At the end of the presentation participants will be able to answer:
What progress is FL making in regards to Medicaid or CHIP eligible children, age 1 through age 20 years, who receive a preventive dental service?
Where is FL ranked nationally regarding Medicaid or CHIP eligible
children, age 6 through age 9 years, who receive a dental sealant on a
permanent molar tooth?
What is the Florida ‘State Oral Health Action Plan’ and how will it impact the Florida Medicaid oral health program?
FLORIDA’S STATE ORAL HEALTH ACTION PLAN

3. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
Where does Florida rank nationally?

4. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
FL’s baseline was 18% in 2012 and looking to be at 28% in We have a good start.

5. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
FL is at the bottom of the list when it comes to getting sealants on Medicaid eligible children, ages 6-9.

6. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
Oral Health Initiative
The Centers for Medicare & Medicaid Services (CMS) selected a total of five states in the fall of 2014 to participate in a learning collaborative to provide state Medicaid agencies with technical assistance to design, develop and implement a State Oral Health Action Plan (SOHAP)
District of Columbia, Kansas, Michigan, Utah and Florida
Initial collaborative period October 27, May 15, 2015
FLORIDA’S STATE ORAL HEALTH ACTION PLAN

7. SOHAP Goals
Aimed at meeting CMS’ children’s oral health care improvement goals:
- Increasing the proportion of children ages 1-20
enrolled in Medicaid or CHIP for at least 90
continuous days who receive a preventive dental
service by 10 percentage points between FFY 2011
and FFY 2015
- Increasing the proportion of children ages 6-9
enrolled in Medicaid or CHIP for at least 90
continuous days who receive a dental sealant on a
permanent molar tooth by 10 percentage points

8. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
What’s included in the SOHAP?
Describes and assesses the FL Medicaid dental delivery system
Structure, current workforce participation, dental reimbursement rates, opportunities, and resources (which will improve dental service utilization and identify key barriers to preventive service utilization)
Identifies key drivers of change and interventions needed to meet the CMS goals (using a driver diagram)
FLORIDA’S STATE ORAL HEALTH ACTION PLAN
How is the SOHAP going to help achieve these goals. By….

9. Sample Driver Diagram
The interventions assist in achieving the secondary driver which drives the primary driver in achieving the ultimate goal, the AIM goal.

10. FLORIDA’S STATE ORAL HEALTH ACTION PLAN
What’s included in the SOHAP?
Describes and assesses FL’s Medicaid dental delivery system.
Structure, current workforce participation, dental reimbursement rates, opportunities, and resources (which will improve dental service utilization and identify key barriers to preventive service utilization)
Identifies key drivers of change and interventions needed to meet the CMS goals (using a driver diagram)
Determines the resources needed to implement the interventions
What barriers will we encounter? Potential solutions?
What technical assistance will be needed from CMS to overcome these barriers?
FLORIDA’S STATE ORAL HEALTH ACTION PLAN
How is the SOHAP going to help achieve these goals. By….
Ultimately, a plan will be created to assess the success of each intervention and their drivers, including the data needed to do so.
Examples of barriers:
Limited number of providers in rural communities
Administrative enrollment and managed care credentialing requirements
Reimbursement
Limited oral health literacy
Examples of needed TA would be:
Identify critical barriers to appropriate utilization or oral health care
Identify proven and effective strategies/ best practices used by other Medicaid/CHIP programs for increasing participation rates with a focus on strategies that could be employed in a managed care delivery system.
Identify strategies for increasing provider enrollment in meeting our goals, including financial and non-financial incentives.
Aligning data collection methodologies from the managed care plans, health access settings, and other community patrners in order to produce more accurate federal reporting results.

11. Participants Florida Agency for Health Care Administration (Medicaid)
Florida Dental Association
Florida Dental Hygiene Association
Florida Department of Health
Florida Institute for Health Innovation
Liberty Dental Plan
Sunshine State Health Plan

12. Questions? Thank you for your time!
Contact Information:
Bob Reifinger
Florida Agency for Health Care Administration
Primary & Preventive Care Policy