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Iowa Access to Baby and Child Dentistry (ABCD)
 

Iowa Access to Baby and Child Dentistry (ABCD)

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    Iowa Access to Baby and Child Dentistry (ABCD) Iowa Access to Baby and Child Dentistry (ABCD) Document Transcript

    • ABCD Model 8-02 Iowa Access to Baby and Child Dentistry (ABCD) Program Model The Iowa Access to Baby and Child Dentistry (ABCD) Program is an initiative of the Bureau of Oral Health at the Iowa Department of Public Health. Iowa ABCD is designed to improve access to dental services for low-income children age one to twenty-one. Emphasis of the program is on children from low-income families, children enrolled in Medicaid, and those without dental insurance. It is an approach that requires commitment from the child, family, community and local dentists. Modeled after the Washington State ABCD program, this initiative identifies and eases the barriers to preventive dental treatment, and promotes life long practices of good oral health. The program has two major components: 1) The community component increases the capacity of the local community to provide services. 2) The direct services component includes education, care coordination, screenings, fluoride varnish applications, and referrals to dentists. Map 1: Iowa ABCD Community Component Iowa ABCD Community Stakeholders Community Planning Infrastructure Building Building Partnerships Outcomes Dental Healthy Homes Mouths Access to Care
    • ABCD Model 8-02 IOWA ABCD COMMUNITY COMPONENT The community component of Iowa ABCD has three primary areas of focus: community planning, building partnerships, and infrastructure building. Community stakeholders such as consumers, Title V child health contractors, community leaders, health care providers, dentists, dental hygienists and others interested in improving dental services in the community are involved in the several aspects of Iowa ABCD. Community planning is crucial in the implementation of Iowa ABCD. It is through this planning that a community assessment of dental access needs and assets is completed, strategies are developed to overcome local barriers to service, and resources are organized to build a system of care that provides access to dental services for all children in the community. Careful implementation of those strategies with continuous monitoring and evaluation of the success of the strategies is crucial to the success of the program. Also important to ABCD is building partnerships with area dentists and dental hygienists, schools, local DHS offices, medical providers and area Head Start programs to foster community-wide support for the program and allow sharing of resources. A major focus of the ABCD program is to build the infrastructure of the dental service delivery system to fit the unique assets and needs of the community. It is this infrastructure that defines the direct service component of the model. The expected outcomes of these activities are improved access to dental services, identification of dental homes, and healthy mouths for all children ages 1 to 21 in the community. 2
    • ABCD Model 8-02 Map 2 Iowa ABCD Direct Services Component Outreach Education Dental Care from Dental Homes Dentists Enrollment Care Coordination Access Outcomes to Care Healthy Mouths Screenings and Fluoride Varnish Application Applications IOWA ABCD DIRECT SERVICES COMPONENT Iowa ABCD direct services are provided as illustrated with variations based on specific community needs and assets. Outreach efforts inform families and the community about the Iowa ABCD program, identify children in need of dental care, and lead families to community educational activities and/or enrollment in the ABCD program. Outreach activities include media campaigns, brochures, informational signs in local establishments, and notification to providers of family services about the purpose of ABCD, referral mechanisms, and eligibility guidelines. Children may enter the ABCD program in a variety of ways. They may enter by referral from individuals or agencies in the community. They may receive services from the ABCD dental hygienist at school dental screenings, WIC clinics, Head Start or the local 3
    • ABCD Model 8-02 Title V Child Health Center. Families may also contact Iowa ABCD directly or attend community educational programs that guide them to dental care. Community education programs and brochures provide information on practices that promote healthy mouths and information on services available within the community to help children receive regular dental care. Equipped with this information, families can make changes in the way they care for their children’s teeth. Some families may be able to access regular dental care without additional help, but for those that cannot, enrollment in the ABCD program will provide assistance. For those families needing additional help, enrollment into the ABCD program is the next step. Once enrolled in the program, children are screened for eligibility for Title XIX, hawk-i, or Title V dental payment plans, and are assisted to enroll in those programs as appropriate. Children not eligible for the programs receive care coordination regarding other resources for care. Care coordination is the primary emphasis of this program. Care coordinators link children to dental care by assisting families in finding transportation to dental appointments, determining appropriate payment sources for dental care, educating families about the importance of keeping appointments, and reminding families of upcoming appointments. In addition, the care coordinator acts as gatekeeper to refer children without a dental home equitably among dentists, and assures the child receives timely and appropriate follow-up dental care. Dental screenings are provided by a dental hygienist who identifies oral health needs and educates caregivers and children on the importance of oral health. Dental hygienists also apply fluoride varnish for children at high risk of developing tooth decay. Referrals are made to dentists and other community services as needed. The dental hygienist continues to provide regular and periodic screening and fluoride varnish applications until a dental home is established for the child. All these activities improve a child's access to the local dentist for regular dental care. The goal of the ABCD program is for this dentist to become the "dental home" for this child, meaning that this is the place where a child receives continuous, comprehensive, coordinated, family-centered dental care. The dental home works with the family to help children achieve optimal dental health. The three major outcomes to measure the effectiveness of direct care services are improved access to dental services, identification of dental homes, and healthy mouths for all children ages 1 to 21 in the community. 4