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Proposals to
Achieve Kentucky
Health Now Oral
Health Goals
Submitted by the Kentucky Oral Health
Coalition
6/19/14
Goal: Reduce the percentage of children with
untreated dental decay by 25% and increase
adult dental visits by 10%.
Data and Planning
• Ongoing and sustained oral health surveillance (early
childhood, school age, adults, seniors) by State Dental
Epidemiologist
• Develop a regularly scheduled state oral health plan
with data and stakeholders
Strengthen and maintain current
programs
• Incentivize and enforce completion and data gathering from
the required kindergarten dental screening
• Provide guidance and support to schools to effectively meet
screening requirements and follow up for parents
• Continue to expand Kentucky’s fluoride varnish program in
health departments by building awareness of the need
Medical / Dental Integration
• Encourage and incentivize (reimburse) non-dental
health professionals such as pediatricians and nurses to
apply fluoride varnish and incorporate the national
Smiles for Life Curriculum in their practice.
• Develop and disseminate to fluoride varnish tool kit to
dental and health professionals.
Access to Dental Services
• Increase transparency on MCO funding, RFP process,
utilization, access, and quality for dental services
• Allow an enhanced reimbursement for dentists to see
children under age 3 (i.e. 15%)
• Encourage dental professionals to become Medicaid
providers and to locate to rural areas.

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Achieve #Kentucky Health Now Oral Health Goals

  • 1. Proposals to Achieve Kentucky Health Now Oral Health Goals Submitted by the Kentucky Oral Health Coalition 6/19/14
  • 2. Goal: Reduce the percentage of children with untreated dental decay by 25% and increase adult dental visits by 10%.
  • 3. Data and Planning • Ongoing and sustained oral health surveillance (early childhood, school age, adults, seniors) by State Dental Epidemiologist • Develop a regularly scheduled state oral health plan with data and stakeholders
  • 4. Strengthen and maintain current programs • Incentivize and enforce completion and data gathering from the required kindergarten dental screening • Provide guidance and support to schools to effectively meet screening requirements and follow up for parents • Continue to expand Kentucky’s fluoride varnish program in health departments by building awareness of the need
  • 5. Medical / Dental Integration • Encourage and incentivize (reimburse) non-dental health professionals such as pediatricians and nurses to apply fluoride varnish and incorporate the national Smiles for Life Curriculum in their practice. • Develop and disseminate to fluoride varnish tool kit to dental and health professionals.
  • 6. Access to Dental Services • Increase transparency on MCO funding, RFP process, utilization, access, and quality for dental services • Allow an enhanced reimbursement for dentists to see children under age 3 (i.e. 15%) • Encourage dental professionals to become Medicaid providers and to locate to rural areas.

Editor's Notes

  1. Hello – thank you so much for the opportunity to share a few of the Kentucky Oral Health Coalition’s recommendations for the state’s role in improving oral health for all in Kentucky. My name is Lacey McNary and I represent the KOHC. I work primarily on children’s oral health issues for Kentucky Youth Advocates. The KOHC is a statewide group of over 60 members of diverse backgrounds who are connected by their passion for improving the state’s child health outcomes. These recommendations are just a few highlights of the many approached that could be taken by the state on this issue. We look forward to standing with you and doing our part as well. We are excited that oral health has such a staring role in this initiative and we will work hard to see that the goals are met.
  2. I do not have time today to highlight some of the GREAT needs that our state has in the oral health department – I will say that: -- hospitals are spending a lot of money when folks go to the ER for horrible dental pain, -- children are missing too much school due to oral health pain, and -- adults are not able to fully participate in the work force when they are constantly bothered by dental pain. I will not belabor the point, but dental issues are infections – infections that when not treated or easily prevented can turn deadly. My recommendations today will focus very quickly at a 30,000 foot view 4 areas: -- Data and Planning -- Strengthening and Maintaining Current Effective Prevention Programs -- Increasing Medical / Dental Collaborations -- Improving Access to Dental Services I will lift up one recommendation for your consideration in each area You have in front of you: -- KOHC Brochure -- KOHC Data Infographic that discusses some of the stats and areas for improvement -- KOHC Policy Recommendations for KY Health Now
  3. KY has not had a surveillance of the oral health status since the early 2000’s. How are we to know the extent of the problem? Many other states do this – we need to ensure that it is done on a regular basis. Given all of the changes in the health care system in KY, it is important that we are not leaving groups of people behind. We know WHAT GETS MEASURED GETS CHANGED
  4. One new policy that was recently put into place is the REQUIRED KINDERGARTEN DENTAL SCREENING. We have seen the data from the first few years and recommend that the state takes another look at the effectiveness, data collection requirements, and follow through support for parents, schools, and health providers. We believe the point of this policy is to improve child health outcomes and KEEP CHILDREN IN SCHOOL LEARNING. We fear that this may be just a check off box that schools, parents, health providers, and other are not utilizing to its most effective. Our coalition is currently working with many people around the state to assess this policy and will have some specific recommendations by the fall for improvements. Let’s get this right for kids! Some Ideas include: Same category for dental as immunization Refuse school entry without screening Include on mandatory form list January 1 deadline? Parents held responsible – how to do this while acknowledging barriers to getting care? Social services involvement for medical (dental) neglect is last straw, but can be effective – but also disruptive School report cards Monetary penalty for schools Linkage agreements – private dentists, oral health programs, schools
  5. Medical / Dental Collaboration is kind of a buzz word, but we believe in the power of the practice to move the needle for kids and families. A specific example that we propose to you today is to encourage and incentivize NON-DENTAL HEALTH PROFESSIONALS (such as pediatricians and nurses) to apply fluoride varnish on children – especially those who are the most vulnerable. This inexpensive services takes 3 minutes and has huge prevention benefits that can combat poor nutrition and prevention decisions at home such as drinking too much juice, not brushing teeth, and general nutrition deficits. I would like to see MCOs get on board fully in encouraging, promoting, and reimbursing this practice among their providers networks. We want to surround children with positive messages and practices about good oral health and we believe that getting medical doctors on board is one way to attack that problem.
  6. Obviously this is a BIG AREA OF FOCUS for all of us. It is not an easy answer or fix – but it needs to be addressed in a BIG WAY. In talking with partners and seeing the numbers of children served go down over time, we are very concerned about how children are accessing dental services. We do not have a clear understanding of the managed care process, funding for dental services, and utilization and would like an opportunity to share our partners thoughts and ideas on this. We are hopeful that this initiative will bring some of this to light. I was talking with some early childhood professionals yesterday about oral health and one of them described an oral health crisis in her county – Trigg County – They are about to have 0 dental providers who will see children on Medicaid – this is something that needs to be addressed before we have a more serious incident. Thank you so much for your time and we look forward to learning about next steps and being invited to being involved on a high level. Have a great day!