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Doreen Chamberlin, MPH, RD
 Bureau of Oral and Health Delivery Systems
      Iowa Department of Public Health
http://www.idph.state.ia.us/hpcdp/ohds.asp



                                              1
   Health Care and Public Health Facilities
     Hospitals
     Clinics/Private Practice
     Health Centers
     Free Clinics
     Local Public Health agencies and services
     State Health Department




                                                  2
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   Health Center Program Statute—Section 330 of
    the Public Health Service (PHS) Act (42 U.S.C.
    §254b)
   Health centers are non-profit private or public
    entities that serve designated medically
    underserved populations/areas or special
    medically underserved populations comprised
    of migrant and seasonal farmworkers, the
    homeless, or residents of public housing


                                                      4
   Health center provides all required primary,
    preventive, enabling health services and additional
    health services as appropriate and necessary, either
    directly or through established written arrangements
    and referrals.
   The health center has collaborative relationships with
    other appropriate providers and organizations in the
    area, including other Federally Qualified Health
    Centers (FQHCs).




                                                             5
6
   The Volunteer Health Care Provider Program (VHCPP)
    hopes to increase volunteerism by offering protection to
    eligible volunteer health care providers and eligible clinics
    providing free health care services.

   An individual health care provider establishes an
    agreement with the Volunteer Health Care Provider
    Program (VHCPP) and is provided the protection of an
    employee of the state under Iowa Code chapter 669.

   A clinic holding a current protection agreement with the
    VHCPP is protection as an agency of the state under Iowa
    Code chapter 669 and, in the event of a claim seeking
    damages, will be provided defense by the Iowa
    Department of Justice at no cost. Indemnification will be
    provided to the full extent of any judgment brought
    against the individual provider or protected clinic.
Once on site, click on the map
                                       To find free clinic locations.




http://www.idph.state.ia.us/webmap/default.asp?map=vhcpp
Over 900
                                                              Dental
                                                              Volunteers




                     Serving over
                     1,200 people
                     In 2 full days!



http://www.iowadental.org/events_calendar/iowa_mission_of_mercy.cfm
                                                                           9
   You can play a role in removing barriers for at-
    risk populations (lower income, elderly, very
    young) to go to a dental office for care
   Many Iowans experience barriers to access due
    to work schedules, inability to pay, and other
    difficulties. Public health programs must go to
    where the at-risk population is located to help
    them get care.
   As a provider you can impact access to care for
    these underserved populations.
                                                       10
   Consider agreeing to be a public health supervision dentist
    for hygienists who provide preventive services in public
    health settings (e.g. WIC, head start, schools, nursing
    homes)
   Consider contacting local nursing homes to become their
    dentist of record for residents – also offer to provide staff
    education on oral hygiene for residents, etc





                                                                    11
12
provide screenings, accept referrals
                                       13
   Meet with your local I-Smile Coordinator to learn how
    the I-Smile coordinator can be of assistance to you and
    your office
   I-Smile – building local systems (care coordination, referrals, providing
    preventive services in public health settings for moderate-high risk
    children from birth, health promotion) to ensure early and regular dental
    care and that all children have a dental home that includes prevention,
    screenings, diagnosis, and treatment
   http://www.ismiledentalhome.iowa.gov/




                                                                                14
   Work with I-Smile
    Coordinator / local
    elementary and high
    school – provide
    gap-filling
    screenings/exams
    for children unable
    to get theirs via
    traditional means for
    school screening
    requirement
                            15
   Oral Health Center

   Iowa Health Workforce Center

   Center for Rural Health and Primary Care




                                               16
   I-Smile™ Dental Home Initiative
   Maternal and Child Health Program
   School-Based Dental Sealant Program
   School Dental Screening Requirement




                                          17
The Iowa Health Workforce Center coordinates statewide efforts
to ensure a sustainable, competent, and diverse health workforce
and an appropriate health care delivery infrastructure. Activities
include:

• Development of biennial strategic plan to address access to health and
long-term care services in our state,
• implementation of a credentialing and training system for all direct care
professionals in Iowa,
• Coordination of a state-agency team to monitor and develop supply of
health professionals,
• Support of statewide efforts to recruit and retain health care
professionals through a website connecting health care professionals to
Iowa communities, workshops for communities to learn best practices,
and implementation of programs, grants, and directives related to
development and maintenance of health care professionals in Iowa.


                                                                          18
• Primary Care Office - Coordinates Health Professional Shortage
   Area (HPSA) designations and the expansion of health care
   resources for vulnerable populations. Includes the J1-Visa waiver
   program, National Health Service Corps, and primary care
   initiatives.

• PRIMECARRE - Supports the recruitment and retention of primary
   care providers and manages the loan repayment program.

• State Office of Rural Health - Coordinates advocacy efforts,
   outreach services, and community health resources that target
   rural populations.




                                                                       19
   Shortage Designations includes:
       Health Professional Shortage Areas (HPSA) and
        Medically Underserved Areas (MUA), established
        under the US Public Health Service Act (Sections
        330 and 332), are federal designations of geographic
        areas (population groups or facilities) which meet
        the criteria as needing additional primary health
        care services.




                                                           20
   There are three different types of HPSA
    designations, each with its own designation
    requirements:
       Geographic Area
       Population Groups
       Facilities
   http://bhpr.hrsa.gov/shortage/hpsas/update
    s/09012011dentalhpsas.html



                                                  21
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   Must be rational areas for the delivery of dental
    services
   Meet one of the following conditions
       Have a population to full-time-equivalent dentist
        ratio of at least 5,000:1
       Have a population to full-time equivalent dentist
        ratio of less than 5,000:1 but greater than 4,000:1 and
        unusually high needs for dental services
   Dental professionals in contiguous areas are
    over utilized, excessively distant or inaccessible
    to the population
                                                                  24
   Must reside in a rational service area for the delivery of
    dental care services
   Have access barriers that prevent the population group
    from use of the area's dental providers
   Have a ratio of the number of persons in the
    population group to the number of dentists practicing
    in the area and serving the population group of at least
    4,000:
   Members of Federally recognized Native American
    tribes are automatically designated. Other groups may
    be designated if the meet the basic criteria described
    above.

                                                             25
   Must be either Federal and/or State correctional
    institutions or public and/or non-profit medical facilities
   Federal or State Correctional facilities must:
     Have at least 250 inmates and
     Have a ratio of the number of internees per year to the
      number of FTE dentists serving the institution of at
      least 1,500:1
   Public and/or non-profit private dental facilities must:
     provide general dental care services to an area or
      population group designated as having a dental HPSA
      and
     have insufficient capacity to meet the dental care needs
      of that area or population group
                                                              26
27
   Programs and opportunities that can:

     Assist in your job search
     Provide scholarships
     Provide loan repayment in three different
      programs



                                                  28
The National Rural Recruitment and
Retention Network (3RNet) members are
not-for-profit organizations helping health
professionals find jobs in rural and
underserved areas throughout the country.
Some of the health professions we serve
and the kinds of jobs posted include:

Physician jobs
Dentist jobs
Nurse Practitioner jobs
Physician Assistant jobs
Registered Nurse jobs
Mental Health Professionals
Other Health Care Professional jobs

https://www.3rnet.org/
                                              29
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   The NHSC Loan Repayment Program (LRP)
    offers primary care medical, dental, and mental
    and behavioral health providers the
    opportunity to have their student loans repaid
    for serving communities in need.
   http://www.nhsc.hrsa.gov/
   Primary care providers can pay off student
    loans while serving in communities with
    limited access to health care.


                                                  31
   The NHSC Scholarship Program (SP) awards
    scholarships each year to students pursuing careers in
    primary care. In return, students commit to serving for
    two to four years, upon graduation and completion of
    training.
   Last application cycle was November 2011 to May
    2012. Next application TBA, rumor has it at January
    2013.
   Currently serving 14 LRP Dentists, one scholar, and 5
    LRP Hygienists.
   Interested ? Link directly to the e-mail sign-up page:
   http://www.nhsc.hrsa.gov/emailsignup.html

                                                              32
   The Primary Care Recruitment and Retention
    Endeavor (PRIMECARRE) was authorized by
    the Iowa Legislature in 1994 to strengthen the
    primary health care infrastructure in Iowa.
    PRIMECARRE allocations currently support
    the Iowa Loan Repayment Program, with
    matching federal and state funds.

   Sara Schlievert, BS, CPH
    PRIMECARRE Program Coordinator
    Sara.schlievert@idph.iowa.gov 515/281-7630
                                                     33
   Offers two-year grants to primary care medical,
    dental, and mental health practitioners for use
    in repayment of educational loans.
   Requires a two-year practice commitment in a
    public or non-profit site located in a health
    professional shortage area (HPSA).
       To find out whether a particular area or facility is
        located in a HPSA, go to: http://hpsafind.hrsa.gov/.




                                                           34
   Provides up to $50,000 per year for full-time and
    $25,000 per year for part-time primary care physicians,
    psychiatrists, clinical psychologists, dentists, dental
    hygienists, physician assistants, registered nurse
    practitioners, certified nurse midwives, clinical social
    workers (LISW), and psychiatric nurse specialists.
   PRIMECARRE applications are accepted annually
    through a Request for Proposal (RFP) process. The RFP
    packet is posted each fall on the Iowa Department of
    Public Health website. Contracts begin each January
    with approximately 5-8 successful applicants.
   Currently the program has 3 LRP Dentists
                                                               35
   This program annually offers a $50,000 award for the repayment
    of dental education debt to be used over a three-year grant
    period.
   The FIND program is an extension of the Delta Dental of Iowa
    Loan Repayment Program, which collaborates with communities
    on the recruitment and establishment of a private practicing
    dental office that is located in rural, underserved areas in Iowa
    for up to $100,000 loan repayment award.
   In return, the selected dentist agrees to practice in one of Iowa's
    designated dental shortage areas and to allocate 35% of patient
    services to underserved populations.
   For more information on the two loan repayment programs visit
    http://www.deltadentalia.com/publicbenefitprogram/find

                                                                    36
37
38
   The ACCESS Update is a bi-monthly electronic newspaper
    published by the Iowa Department of Public Health's Bureau of
    Oral and Health Delivery Systems. It is distributed via email on
    the last Tuesday of the month.
   The ACCESS Update provides news, calendar of events, and useful
    grant related information for health care professionals, hospitals,
    clinics and other health care related organizations and groups.
    There are numerous resources and tools to assist with program
    development, and community engagement. The newsletter
    captures the issues and challenges related to ACCESS to
    healthcare.
   To subscribe to the ACCESS Update, send a blank e-mail message
    to join-HCA@lists.ia.gov. You may receive an email response to
    your subscription. To confirm, you will need to "reply" to the
    confirmation email.


                                                                      39
40
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NHSC Display at the Iowa Dental Practice Opportunity Fair.
Hosted by the University of Iowa, College of Dentistry and Iowa American
Student Dental Association

Date: October 11, 2012               Time: 5:00pm to 8:00pm
Iowa dental students are invited to attend this exhibit that's being held in
conjunction with the Iowa American Student Dental Association's (IASDA)
annual conference. This is an ideal time for dental students to network with
Iowa dental practices, many of which are NHSC-approved sites. There will
also be someone on hand to discuss National Health Service Corps
scholarship and loan repayment opportunities at the event.

Location: Holiday Inn Conference Center
1220 1st Ave.
Coralville, IA 52241

Contact: Deb Hoyle, Iowa Practice Coordinator, College of Dentistry
debra-hoyle@uiowa.edu
(319) 335-9865
                                                                               42
Community Day Open House and Celebration Reception.
Hosted by River Hills Community Health Center, (a current NHSC site).

Date: October 12, 2012              Time: 1:00pm to 2:00pm

Description: Open House/Reception to honor NHSC participants and
inform the community about the NHSC. Tori Squires, Senior Program
Director for the Iowa State Primary Care Association will speak regarding
the NHSC loan repayment and scholarship Programs. Community
members, members of the Iowa primary care community, and local
students are invited. Refreshments will be served.

Location: River Hills Community Health Center
201 South Market Street
P.O. Box 458
Ottumwa, IA 52501
Contact: Rick Johnson, CEO River Hills Community Health Center
(641) 683-5773 or Bonnie Grant, HRSA Regional Office
bgrant@hrsa.gov (816)-426-2918
                                                                            43
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2012 dental student presentation2

  • 1. Doreen Chamberlin, MPH, RD Bureau of Oral and Health Delivery Systems Iowa Department of Public Health http://www.idph.state.ia.us/hpcdp/ohds.asp 1
  • 2. Health Care and Public Health Facilities  Hospitals  Clinics/Private Practice  Health Centers  Free Clinics  Local Public Health agencies and services  State Health Department 2
  • 3. 3
  • 4. Health Center Program Statute—Section 330 of the Public Health Service (PHS) Act (42 U.S.C. §254b)  Health centers are non-profit private or public entities that serve designated medically underserved populations/areas or special medically underserved populations comprised of migrant and seasonal farmworkers, the homeless, or residents of public housing 4
  • 5. Health center provides all required primary, preventive, enabling health services and additional health services as appropriate and necessary, either directly or through established written arrangements and referrals.  The health center has collaborative relationships with other appropriate providers and organizations in the area, including other Federally Qualified Health Centers (FQHCs). 5
  • 6. 6
  • 7. The Volunteer Health Care Provider Program (VHCPP) hopes to increase volunteerism by offering protection to eligible volunteer health care providers and eligible clinics providing free health care services.  An individual health care provider establishes an agreement with the Volunteer Health Care Provider Program (VHCPP) and is provided the protection of an employee of the state under Iowa Code chapter 669.  A clinic holding a current protection agreement with the VHCPP is protection as an agency of the state under Iowa Code chapter 669 and, in the event of a claim seeking damages, will be provided defense by the Iowa Department of Justice at no cost. Indemnification will be provided to the full extent of any judgment brought against the individual provider or protected clinic.
  • 8. Once on site, click on the map To find free clinic locations. http://www.idph.state.ia.us/webmap/default.asp?map=vhcpp
  • 9. Over 900 Dental Volunteers Serving over 1,200 people In 2 full days! http://www.iowadental.org/events_calendar/iowa_mission_of_mercy.cfm 9
  • 10. You can play a role in removing barriers for at- risk populations (lower income, elderly, very young) to go to a dental office for care  Many Iowans experience barriers to access due to work schedules, inability to pay, and other difficulties. Public health programs must go to where the at-risk population is located to help them get care.  As a provider you can impact access to care for these underserved populations. 10
  • 11. Consider agreeing to be a public health supervision dentist for hygienists who provide preventive services in public health settings (e.g. WIC, head start, schools, nursing homes)  Consider contacting local nursing homes to become their dentist of record for residents – also offer to provide staff education on oral hygiene for residents, etc  11
  • 12. 12
  • 14. Meet with your local I-Smile Coordinator to learn how the I-Smile coordinator can be of assistance to you and your office  I-Smile – building local systems (care coordination, referrals, providing preventive services in public health settings for moderate-high risk children from birth, health promotion) to ensure early and regular dental care and that all children have a dental home that includes prevention, screenings, diagnosis, and treatment  http://www.ismiledentalhome.iowa.gov/ 14
  • 15. Work with I-Smile Coordinator / local elementary and high school – provide gap-filling screenings/exams for children unable to get theirs via traditional means for school screening requirement 15
  • 16. Oral Health Center  Iowa Health Workforce Center  Center for Rural Health and Primary Care 16
  • 17. I-Smile™ Dental Home Initiative  Maternal and Child Health Program  School-Based Dental Sealant Program  School Dental Screening Requirement 17
  • 18. The Iowa Health Workforce Center coordinates statewide efforts to ensure a sustainable, competent, and diverse health workforce and an appropriate health care delivery infrastructure. Activities include: • Development of biennial strategic plan to address access to health and long-term care services in our state, • implementation of a credentialing and training system for all direct care professionals in Iowa, • Coordination of a state-agency team to monitor and develop supply of health professionals, • Support of statewide efforts to recruit and retain health care professionals through a website connecting health care professionals to Iowa communities, workshops for communities to learn best practices, and implementation of programs, grants, and directives related to development and maintenance of health care professionals in Iowa. 18
  • 19. • Primary Care Office - Coordinates Health Professional Shortage Area (HPSA) designations and the expansion of health care resources for vulnerable populations. Includes the J1-Visa waiver program, National Health Service Corps, and primary care initiatives. • PRIMECARRE - Supports the recruitment and retention of primary care providers and manages the loan repayment program. • State Office of Rural Health - Coordinates advocacy efforts, outreach services, and community health resources that target rural populations. 19
  • 20. Shortage Designations includes:  Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA), established under the US Public Health Service Act (Sections 330 and 332), are federal designations of geographic areas (population groups or facilities) which meet the criteria as needing additional primary health care services. 20
  • 21. There are three different types of HPSA designations, each with its own designation requirements:  Geographic Area  Population Groups  Facilities  http://bhpr.hrsa.gov/shortage/hpsas/update s/09012011dentalhpsas.html 21
  • 22. 22
  • 23. 23
  • 24. Must be rational areas for the delivery of dental services  Meet one of the following conditions  Have a population to full-time-equivalent dentist ratio of at least 5,000:1  Have a population to full-time equivalent dentist ratio of less than 5,000:1 but greater than 4,000:1 and unusually high needs for dental services  Dental professionals in contiguous areas are over utilized, excessively distant or inaccessible to the population 24
  • 25. Must reside in a rational service area for the delivery of dental care services  Have access barriers that prevent the population group from use of the area's dental providers  Have a ratio of the number of persons in the population group to the number of dentists practicing in the area and serving the population group of at least 4,000:  Members of Federally recognized Native American tribes are automatically designated. Other groups may be designated if the meet the basic criteria described above. 25
  • 26. Must be either Federal and/or State correctional institutions or public and/or non-profit medical facilities  Federal or State Correctional facilities must:  Have at least 250 inmates and  Have a ratio of the number of internees per year to the number of FTE dentists serving the institution of at least 1,500:1  Public and/or non-profit private dental facilities must:  provide general dental care services to an area or population group designated as having a dental HPSA and  have insufficient capacity to meet the dental care needs of that area or population group 26
  • 27. 27
  • 28. Programs and opportunities that can:  Assist in your job search  Provide scholarships  Provide loan repayment in three different programs 28
  • 29. The National Rural Recruitment and Retention Network (3RNet) members are not-for-profit organizations helping health professionals find jobs in rural and underserved areas throughout the country. Some of the health professions we serve and the kinds of jobs posted include: Physician jobs Dentist jobs Nurse Practitioner jobs Physician Assistant jobs Registered Nurse jobs Mental Health Professionals Other Health Care Professional jobs https://www.3rnet.org/ 29
  • 30. 30
  • 31. The NHSC Loan Repayment Program (LRP) offers primary care medical, dental, and mental and behavioral health providers the opportunity to have their student loans repaid for serving communities in need.  http://www.nhsc.hrsa.gov/  Primary care providers can pay off student loans while serving in communities with limited access to health care. 31
  • 32. The NHSC Scholarship Program (SP) awards scholarships each year to students pursuing careers in primary care. In return, students commit to serving for two to four years, upon graduation and completion of training.  Last application cycle was November 2011 to May 2012. Next application TBA, rumor has it at January 2013.  Currently serving 14 LRP Dentists, one scholar, and 5 LRP Hygienists.  Interested ? Link directly to the e-mail sign-up page:  http://www.nhsc.hrsa.gov/emailsignup.html 32
  • 33. The Primary Care Recruitment and Retention Endeavor (PRIMECARRE) was authorized by the Iowa Legislature in 1994 to strengthen the primary health care infrastructure in Iowa. PRIMECARRE allocations currently support the Iowa Loan Repayment Program, with matching federal and state funds.  Sara Schlievert, BS, CPH PRIMECARRE Program Coordinator Sara.schlievert@idph.iowa.gov 515/281-7630 33
  • 34. Offers two-year grants to primary care medical, dental, and mental health practitioners for use in repayment of educational loans.  Requires a two-year practice commitment in a public or non-profit site located in a health professional shortage area (HPSA).  To find out whether a particular area or facility is located in a HPSA, go to: http://hpsafind.hrsa.gov/. 34
  • 35. Provides up to $50,000 per year for full-time and $25,000 per year for part-time primary care physicians, psychiatrists, clinical psychologists, dentists, dental hygienists, physician assistants, registered nurse practitioners, certified nurse midwives, clinical social workers (LISW), and psychiatric nurse specialists.  PRIMECARRE applications are accepted annually through a Request for Proposal (RFP) process. The RFP packet is posted each fall on the Iowa Department of Public Health website. Contracts begin each January with approximately 5-8 successful applicants.  Currently the program has 3 LRP Dentists 35
  • 36. This program annually offers a $50,000 award for the repayment of dental education debt to be used over a three-year grant period.  The FIND program is an extension of the Delta Dental of Iowa Loan Repayment Program, which collaborates with communities on the recruitment and establishment of a private practicing dental office that is located in rural, underserved areas in Iowa for up to $100,000 loan repayment award.  In return, the selected dentist agrees to practice in one of Iowa's designated dental shortage areas and to allocate 35% of patient services to underserved populations.  For more information on the two loan repayment programs visit http://www.deltadentalia.com/publicbenefitprogram/find 36
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  • 39. The ACCESS Update is a bi-monthly electronic newspaper published by the Iowa Department of Public Health's Bureau of Oral and Health Delivery Systems. It is distributed via email on the last Tuesday of the month.  The ACCESS Update provides news, calendar of events, and useful grant related information for health care professionals, hospitals, clinics and other health care related organizations and groups. There are numerous resources and tools to assist with program development, and community engagement. The newsletter captures the issues and challenges related to ACCESS to healthcare.  To subscribe to the ACCESS Update, send a blank e-mail message to join-HCA@lists.ia.gov. You may receive an email response to your subscription. To confirm, you will need to "reply" to the confirmation email. 39
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  • 42. NHSC Display at the Iowa Dental Practice Opportunity Fair. Hosted by the University of Iowa, College of Dentistry and Iowa American Student Dental Association Date: October 11, 2012 Time: 5:00pm to 8:00pm Iowa dental students are invited to attend this exhibit that's being held in conjunction with the Iowa American Student Dental Association's (IASDA) annual conference. This is an ideal time for dental students to network with Iowa dental practices, many of which are NHSC-approved sites. There will also be someone on hand to discuss National Health Service Corps scholarship and loan repayment opportunities at the event. Location: Holiday Inn Conference Center 1220 1st Ave. Coralville, IA 52241 Contact: Deb Hoyle, Iowa Practice Coordinator, College of Dentistry debra-hoyle@uiowa.edu (319) 335-9865 42
  • 43. Community Day Open House and Celebration Reception. Hosted by River Hills Community Health Center, (a current NHSC site). Date: October 12, 2012 Time: 1:00pm to 2:00pm Description: Open House/Reception to honor NHSC participants and inform the community about the NHSC. Tori Squires, Senior Program Director for the Iowa State Primary Care Association will speak regarding the NHSC loan repayment and scholarship Programs. Community members, members of the Iowa primary care community, and local students are invited. Refreshments will be served. Location: River Hills Community Health Center 201 South Market Street P.O. Box 458 Ottumwa, IA 52501 Contact: Rick Johnson, CEO River Hills Community Health Center (641) 683-5773 or Bonnie Grant, HRSA Regional Office bgrant@hrsa.gov (816)-426-2918 43
  • 44. 44