UCSF Public Health Seminar Series


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  • CDA Foundation is the fiscal agent and program administrator. Receive the support of CSPD for curriculum review, faculty selection and programmatic revisions. LAOHF was an original partner and is still actively involved when the program is offered in Los Angeles County. The First POHAP was conducted in Los Angeles County in 2003 and was funded by L.A. Care Heatlh Plan. They were very pleased with the success of the program, and granted continuation funding for a second program in 2004. Most recently, L.A. Care partnered with First 5 L.A. for their community health initiative and awarded POHAP funding for a third program. Planning is underway and is expected to occur this fall. In order to move POHAP beyond Los Angeles County, CDA Foundation worked closely with The California Endowment to craft a proposal for expansion to six programs in various areas of the state. These trainings began in early 2007 and will continue through 2008.
  • To address the shortage of pediatric dentists in the state of California, Delta Dental’s Denti-Cal Outreach program provided funding to create a comprehensive curriculum for general dentists in pediatric dentistry topics. The original topics were presented to a group of pediatric dentists and general dentists for review and feedback. The original presenters were also videotaped with the intent of creating online modules for continuing education. However, after the presentations occurred, funding to complete the project was unavailable and the materials were shelved. The CDA Foundation was created in 2002 as the charitable arm of the CDA. One of the first tasks the Foundation set upon was to seek funding to continue the work and provide the full training to a group of general dentists.
  • This is my first morning to "sleep in" in about 3 weeks!  I wanted the opportunity to thank you all for the opportunity to attend the POHAP training.  In Plumas County we have a "dental crisis" and my years of training at U.C.S.F. just didn't prepare me for the overwhelming problems I see here regarding access to healthcare, particularly children.  The obstacles here are unique, and I am learning everyday.  But back to what I wanted to say...this course has empowered myself and my staff.  Yesterday we had an office meeting and decided that we are going to become proactive.  My assistants will be setting up seminar/assessment dates in the preschools, headstart centers, and WIC programs.  We will be offering dental screenings (caries risk assessments) on site at no charge to children 0-5 years.  We will also be offering the same in our office on set days.  In addition the word has spread in our little town ( huge county!) that our office treats children and special needs patients.  We are also getting calls from nearby counties: Lassen and Sierra. I will be sending you my quarterly forms.  I wanted to also update you to the fact that I was elected to be the Northern Vice Chair of the Children's Caucus for the California Democratic Party over the weekend at the state democratic convention.  I am a 3rd Assembly District delegate representing 9 counties here.  This position as Vice Chair will allow me to be a strong advocate for access to healthcare for children, particularly in the rural counties.    We are seeing an increase number of children in our practice, and we are screening young infants as well, thanks again to POHAP.
  • UCSF Public Health Seminar Series

    1. 1. UCSF Public Health Seminar Series Rolande Tellier Loftus Program Director May 15, 2007
    2. 2. Overview <ul><li>What is POHAP? </li></ul><ul><li>POHAP: Past, Present and Future </li></ul><ul><li>Applicant Profile </li></ul><ul><li>Program Challenges and Successes </li></ul>
    3. 3. What is POHAP? <ul><li>Program Partners: </li></ul><ul><ul><li>CDA Foundation </li></ul></ul><ul><ul><li>CA Society of Pediatric Dentistry </li></ul></ul><ul><ul><li>L. A. Oral Health Foundation (L.A. County) </li></ul></ul><ul><li>Program Funders: </li></ul><ul><ul><li>L.A. Care Health Plan </li></ul></ul><ul><ul><li>First 5 L.A. </li></ul></ul><ul><ul><li>The California Endowment </li></ul></ul>
    4. 4. POHAP: The Past <ul><li>2000: CSPD, CDA and Delta Dental Denti Cal Outreach </li></ul><ul><ul><li>21 hours didactic </li></ul></ul><ul><ul><li>Simulation lab “bench” training </li></ul></ul><ul><ul><li>2-3 days on-site in a pediatric dentist’s office </li></ul></ul><ul><ul><li>25-hour oral conscious sedation course </li></ul></ul><ul><li>Didactic training tested in 2001 </li></ul><ul><li>Funding not available to complete the project </li></ul>
    5. 5. POHAP: The Past <ul><li>2003: L.A. Care Health Plan’s Community Health Initiative </li></ul><ul><li>Funding available to provide training to 50 general dentists in Los Angeles County </li></ul><ul><li>Ability to add a module on children with special health care needs and videotape Dr. Paul Casamassimo </li></ul>
    6. 6. POHAP: The Past <ul><li>Continuation funding received from L.A. Care in 2004 </li></ul><ul><li>Created online modules for didactic materials; built Mediapod </li></ul><ul><li>Program fulfillment for continuing education credit </li></ul><ul><li>Additional correspondence with participants for reporting </li></ul>
    7. 7. Los Angeles Results 3,291 2,331 960 Extractions 3,824 2,765 1,059 Pulpotomies 3,050 2,142 908 Stainless Steel Crowns 11,075 7,600 3,475 Fillings 6,712 4,804 1,908 Prophies 647 428 219 OCS *utilized oral conscious sedation 390 292 98 Referred Out *due to complexity of case 692 576 116 New Special Needs Patients 6,649 5,346 1,303 New Patients 0-5 Years Old Total LAPOHAP II LAPOHAP I Quarterly Report Data 2,765 2,618 147 Current number of special needs patients? 12,734 6,356 6,378 Current number of patients ages 0 - 5? Total LAPOHAP II 2004 (45 DDS) LAPOHAP I 2003 (50 DDS) Baseline Data
    8. 8. 40% 28% 52% Oral Conscious Sedation Permit 70% 80% 66% Mentoring Completed 71% 86% 56% Pro Bono Fulfillment *completed less than 18 pro bono children 40% 62% 18% Pro Bono Fulfillment *completed at least 18 pro bono children 61% 77% 45% Quarterly Reporting Fulfillment *reporting forms submitted Combined Average LAPOHAP II LAPOHAP I Participant Compliance 744 454 290 Extractions 1,355 890 465 Pulpotomies 1,190 732 458 Stainless Steel Crowns 3,511 2,182 1,329 Fillings 908 591 317 Prophies 993 647 346 Total Pro Bono Patients Total LAPOHAP II LAPOHAP I Pro Bono Reporting Form Data 1,095,893 691,097 404,796 Pro Bono *children without insurance or financial means 4,323,075 3,200,359 1,122,716 Fee For Service *children with insurance Total LAPOHAP II LAPOHAP I Treatment Values (based on 70% of LA UCR's)
    9. 9. POHAP: The Present <ul><li>Funded by The California Endowment </li></ul><ul><li>Revisions include: </li></ul><ul><ul><li>Expand age range to 0 – 12 years of age </li></ul></ul><ul><ul><li>Replace OCS training with nitrous oxide and local anesthesia </li></ul></ul><ul><ul><li>Addition of Regional Care Coordinators </li></ul></ul><ul><ul><li>Live lectures vs. online </li></ul></ul>
    10. 10. POHAP: The Present <ul><li>32-hour continuing education course for general dentists </li></ul><ul><li>Pediatric dentistry topics include: </li></ul><ul><ul><li>Prevention </li></ul></ul><ul><ul><li>Diagnosis and Treatment Planning </li></ul></ul><ul><ul><li>Children with Special Health Care Needs </li></ul></ul><ul><ul><li>Behavior Management </li></ul></ul><ul><ul><li>Restorative Materials </li></ul></ul><ul><ul><li>Nitrous Oxide and Local Anesthesia </li></ul></ul><ul><ul><li>Case Presentations and Hands-on Bench Training </li></ul></ul>
    11. 11. POHAP: The Present <ul><li>Trainings completed: </li></ul><ul><ul><li>Greater Sacramento Region </li></ul></ul><ul><ul><ul><li>25 participants </li></ul></ul></ul><ul><ul><ul><li>Cover the Kids </li></ul></ul></ul><ul><ul><li>San Francisco Bay Area Region </li></ul></ul><ul><ul><ul><li>45 participants </li></ul></ul></ul><ul><ul><ul><li>RCC not identified </li></ul></ul></ul><ul><ul><li>Orange County / San Diego Region </li></ul></ul><ul><ul><ul><li>35 participants </li></ul></ul></ul><ul><ul><ul><li>Healthy Smiles for Kids of OC and Share the Care </li></ul></ul></ul>
    12. 12. POHAP: The Future <ul><li>Trainings to be held: </li></ul><ul><ul><li>Late Fall 2007: </li></ul></ul><ul><ul><ul><li>Los Angeles County (funded by L.A. Care Health Plan and First 5 L.A.) </li></ul></ul></ul><ul><ul><li>Early 2008: </li></ul></ul><ul><ul><ul><li>Northern California </li></ul></ul></ul><ul><ul><ul><li>Central Valley </li></ul></ul></ul><ul><ul><ul><li>Orange County / San Diego/ Imperial </li></ul></ul></ul><ul><li>cdafoundation.org/programs_pohap </li></ul>
    13. 13. Applicant Profile (current project) <ul><li>Years in practice: </li></ul><ul><ul><li>69: less than 5 years </li></ul></ul><ul><ul><li>32: 6 – 10 years </li></ul></ul><ul><ul><li>22: 11 – 20 years </li></ul></ul><ul><ul><li>20: 20+ years </li></ul></ul><ul><li>Dental School </li></ul><ul><ul><li>74: California dental school </li></ul></ul><ul><ul><li>40: Other U.S. dental school </li></ul></ul><ul><ul><li>30: Foreign trained </li></ul></ul>
    14. 14. Applicant Profile <ul><li>Ethnicity </li></ul><ul><ul><li>67: Asian </li></ul></ul><ul><ul><li>38: White </li></ul></ul><ul><ul><li>16: Hispanic </li></ul></ul><ul><ul><li>10: Other </li></ul></ul><ul><ul><li>6: Black </li></ul></ul><ul><ul><li>5: Pacific Islander </li></ul></ul><ul><ul><li>2: American Indian </li></ul></ul><ul><li>Gender </li></ul><ul><ul><li>74: Female </li></ul></ul><ul><ul><li>37: Male </li></ul></ul><ul><ul><li>30: no response </li></ul></ul>
    15. 15. Applicant Profile <ul><li>Role in Practice: </li></ul><ul><ul><li>62: Owner </li></ul></ul><ul><ul><li>57: Employee </li></ul></ul><ul><ul><li>21: Associate </li></ul></ul><ul><ul><li>1: Volunteer </li></ul></ul><ul><li>Sedation: </li></ul><ul><ul><li>6 have oral conscious sedation certificate for minors </li></ul></ul><ul><ul><li>74 have offices equipped with nitrous oxide </li></ul></ul>
    16. 16. Applicant Profile <ul><li>Percent of patients with Denti-Cal: </li></ul><ul><ul><li>57: less than 10% </li></ul></ul><ul><ul><li>39: 11% - 49% </li></ul></ul><ul><ul><li>44: over 50% </li></ul></ul><ul><li>Percent of patients with other public insurance: </li></ul><ul><ul><li>72: less than 10% </li></ul></ul><ul><ul><li>61: 11% - 49% </li></ul></ul><ul><ul><li>8: over 50% </li></ul></ul>
    17. 17. Applicant Profile Languages Spoken in Practice <ul><li>Spanish: 141 </li></ul><ul><li>Farsi: 31 </li></ul><ul><li>Chinese: 25 </li></ul><ul><li>Vietnamese: 26 </li></ul><ul><li>Hindi: 14 </li></ul><ul><li>Tagalog: 9 </li></ul><ul><li>Punjabi: 8 </li></ul><ul><li>Others: </li></ul><ul><ul><li>Arabic </li></ul></ul><ul><ul><li>Fillipino </li></ul></ul><ul><ul><li>French </li></ul></ul><ul><ul><li>German </li></ul></ul><ul><ul><li>Korean </li></ul></ul><ul><ul><li>Armenian </li></ul></ul><ul><ul><li>Japanese </li></ul></ul><ul><ul><li>Hmong </li></ul></ul><ul><ul><li>Russian </li></ul></ul>
    18. 18. Program Challenges <ul><li>Recruitment beyond Los Angeles County </li></ul><ul><li>Oral Conscious Sedation certificate for minors </li></ul><ul><li>Low response to RCC request for proposals </li></ul><ul><li>“ Pro-bono” care </li></ul><ul><li>Mentoring component </li></ul><ul><li>Implementation in rural areas </li></ul>
    19. 19. Program Successes <ul><li>Outreach in Plumas County </li></ul><ul><li>Practice changes in Sacramento office </li></ul><ul><li>Collaboration among participants </li></ul><ul><li>Involvement beyond POHAP </li></ul><ul><ul><li>Obtaining pediatric specialty </li></ul></ul><ul><ul><li>CSPD and Special Care Dentistry </li></ul></ul>
    20. 20. Thank You! Questions?