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  • A full listing of the Best Practice Approach Reports can be displayed. Quick access to open each report is also provided. .
  • The ASTDD homepage opens to the Best Practices Web page, which gives access to the Best Practice Approach Reports and State and Community Practice Examples . In addition, the Web page provides background information about the Project, provides access to the Project’s survey results, and offers other links of interest.
  • (PowerPoint/1.94MB)

    1. 1. Minnesota Oral Health Promotion Coalition Meeting Coalitions 2.0 Considerations for a Roadmap Reg Louie, DDS, MPH St. Paul, Minnesota June 12, 2009
    2. 2. Presentation Overview <ul><li>Minnesota Oral Health Summit – </li></ul><ul><li>Visions for Oral Health (2009) </li></ul><ul><li>Changing Paradigms in Oral Health </li></ul><ul><li>State Oral Health Models from CDC and </li></ul><ul><li>other Oral Health Coalitions </li></ul><ul><li>Tools from ASTDD </li></ul><ul><li>State Promising Practices </li></ul><ul><li>MOH Landscape SWOT  Roadmap to the Future </li></ul>
    3. 3. Minnesota OH Summit 2009 <ul><li>Minnesota Oral Health Summit -  </li></ul><ul><li>Oral Health Vision for the Future – 5 topic groups : </li></ul><ul><ul><li>Prevention, Education, Awareness </li></ul></ul><ul><ul><li>Policy and Funding </li></ul></ul><ul><ul><li>Access to Care </li></ul></ul><ul><ul><li>Workforce Development </li></ul></ul><ul><ul><li>Bridging Private/Public Sectors </li></ul></ul><ul><li>-  3 Oral Health Visions </li></ul><ul><li>for the Future </li></ul>
    4. 4. Changing Paradigms for Controlling Dental Caries <ul><li>Old Paradigm --> Surgical / ‘Drill & Fill’ </li></ul><ul><li>(dealing with consequences of disease) </li></ul><ul><li> </li></ul><ul><li>Later Paradigm: Prevention!!! </li></ul><ul><li>(generally “one size fits all”) </li></ul><ul><li> </li></ul><ul><li>“ Current” Paradigm: Early Intervention, Risk Assessment, Anticipatory Guidance, Individualized Prevention and Disease Management </li></ul><ul><li>(targeted, systematic, evidence-based approaches) </li></ul>Slide courtesy of Jim Crall
    5. 5. Rethinking Prevention: Broad Strategies / Goals <ul><li>Reduce the burden of disease through the efficient integration of: </li></ul><ul><ul><li>Health promotion </li></ul></ul><ul><ul><li>Preventive services </li></ul></ul><ul><ul><li>Disease management </li></ul></ul><ul><ul><li>Treatment services </li></ul></ul><ul><li>Expand access to ongoing diagnostic, preventive and treatment services in “dental homes” </li></ul><ul><li>Application of risk assessment and targeted, evidence-based interventions </li></ul>Crall JJ. Ped Dent 2006;28:96-101. Slide courtesy of Jim Crall
    6. 6. Minnesota Head Start PIR Data 2006-07 <ul><li>CHILDREN SERVED 15,709 - MN US </li></ul><ul><li>With health insurance 89% (93%) </li></ul><ul><li>“Dental home” 83% (86%) </li></ul><ul><li>PS* Dental exam 85% (88%) </li></ul><ul><li>PS* Preventive care 89% (85%) </li></ul><ul><li>PS* Needing treatment 28% (25%) </li></ul><ul><li>PS* Receiving treatment 84% (83%) </li></ul><ul><li>* Preschool Head Start Children Only </li></ul>
    7. 7. Minnesota Oral Health PIR Trends – Percent of Head Start Children (2004-07) <ul><li> 2004 2005 2006 2007 </li></ul><ul><li>Health insurance 87% 87% 88% 89% </li></ul><ul><li>“ Dental Home” 73% 73% 79% 83% </li></ul><ul><li>HS Preschool (3 to 5-years) </li></ul><ul><li>Dental Exam 63% 65% 74% 85% </li></ul><ul><li>Prevent. Care 44% 69% 90% 89% </li></ul><ul><li>Need Tx 20% 32% 28% 26% </li></ul><ul><li>Received Tx 70% 79% 83% 84% </li></ul>
    8. 8. Minnesota Early Head Start PIR Data (2006-07) <ul><li>INFANTS/TODDLERS (Birth to 3 years) </li></ul><ul><ul><li>Dental screenings at well-baby exams – 80% (68%) </li></ul></ul><ul><ul><li>Professional dental exams – 47% (54%) </li></ul></ul><ul><li>PREGNANT WOMEN/TEENS </li></ul><ul><ul><li>With health insurance – 95% (89%) </li></ul></ul><ul><ul><li>Receiving dental exams or Treatment – 42% (42%) </li></ul></ul>
    9. 9. CDC – Oral Health Infrastructure Development Cooperative Agreements <ul><li>2003-2008: 23 projects funded (12 States and 1 Pacific jurisdiction) </li></ul><ul><li>16 States funded in 2008 </li></ul><ul><li>8 specific/required areas of program focus (“recipient activities”) </li></ul>
    10. 10. CDC – OH Infrastructure Development Cooperative Agreements (2008-13) Eight Recipient Activities <ul><li>Program Infrastructure: Staffing, management and support </li></ul><ul><li>Data collection and surveillance </li></ul><ul><li>Strategic Planning – State OH Plan </li></ul><ul><li>Partnerships and coalitions </li></ul><ul><li>Access to and utilization of preventive interventions </li></ul><ul><li>Policy development </li></ul><ul><li>Evaluation </li></ul><ul><li>Program collaboration </li></ul>
    11. 11. What is a Coalition? <ul><li>Definition: a group of individuals and/or organizations with common interest who agree to work together toward a common goal </li></ul><ul><li>Coalitions may be loose associations in which members work for short time to achieve a specific goal; and then disband, or they may also become organizations in themselves, with governing bodies, particular community responsibilities, funding and permanence </li></ul><ul><li>Regardless of their size and structure, they exist to create and/or support efforts to reach a particular set of goals </li></ul>Slide courtesy of Teresa Schwab 1/09
    12. 12. Goals of a Coalition <ul><li>Coalition goals are as varied as coalitions themselves, but often contain elements of one or more of the following: </li></ul><ul><li>Influencing or developing public policy, usually around a specific issue. </li></ul><ul><li>Changing people's behavior. </li></ul><ul><li>Building a healthy community. </li></ul>Slide courtesy of Teresa Schwab 1/09
    13. 13. Why Develop a Coaliltion? <ul><li>Concentrate the community's focus on a particular problem. </li></ul><ul><li>Create alliances among those who might not normally work together. </li></ul><ul><li>Keep the community's approach to issues consistent. </li></ul>Slide courtesy of Teresa Schwab 1/09
    14. 15. ASTDD- Infrastructure Development Tools <ul><li>Surveillance Methodologies </li></ul><ul><li>Policy and Systems Strategies </li></ul><ul><li>Best Practices Models </li></ul><ul><ul><li>Policy: Coalitions, Oral Health Plans, Mandates </li></ul></ul><ul><li>State OH Program Review Manual </li></ul><ul><ul><li>Core functions, competencies and activities </li></ul></ul><ul><li>http:// www.astdd.org/index.php </li></ul>
    15. 16. State &Territorial Dental Public Health Activities
    16. 17. Best Practice Approaches
    17. 18. State Promising Practices <ul><li>Infrastructure Development (including coalitions)-Nevada and other CDC funded states – AK, CO, AR, IL, SC, TX </li></ul><ul><li>Kansas – Philanthropic funded coalition and state Oral Health initiative </li></ul><ul><li>Massachusetts – Special legislative commission on Oral Health </li></ul><ul><li>New Mexico – Tax considerations for dentists </li></ul>
    18. 19. State Promising Practices (2) <ul><li>State Oral Health Plans (NV, ME, IL, KS) </li></ul><ul><li>Statutory Mandate for State Oral Health Program (some w/ definitions for state dental director or dental officer) - Iowa </li></ul><ul><li>Maryland – Dental Action Committee convened by Secretary of HMH in response to Deamonte Driver; state funding for infrastructure and increasing access </li></ul>
    19. 20. Statewide Efforts to Expand Access to Care for Young Children <ul><li>Washington ABCD Program </li></ul><ul><ul><li>Training for general dentists to treat very young children </li></ul></ul><ul><ul><li>Enhanced reimbursement (XIX) </li></ul></ul><ul><li>North Carolina “ Into the Mouths of Babes ” </li></ul><ul><ul><li>Prevent ECE by reimbursing peds, FPs, CHCs for Px and referrals for dental care </li></ul></ul><ul><ul><li>Partners: NCAP, NCAFP, NCDS, NCAPD, UNC, NCDM, NCDPH </li></ul></ul><ul><li>California First 5 Initiative </li></ul><ul><ul><li>Training for general dentists </li></ul></ul><ul><ul><li>Training for primary care providers </li></ul></ul>
    20. 21. Nevada State Oral Health <ul><li>1999 – Report of Governor’s Advisory Board </li></ul><ul><li>(rec’ds, redirect MCH Title V grant) </li></ul><ul><li>2002 – CDC Grant, Series of Regional Summits (formed coalitions) </li></ul><ul><li>2004 – Summit 2.0, More representative state OH plan keyed to HP2010/SG OH Report </li></ul><ul><li>2005 – Summit 3.0, special focus on non-urban areas/regional plans </li></ul><ul><li>2008 – Evaluation and Summit 4.0 re: 2004 plan, 4 policy work groups : change perceptions & increase awareness; expand prevention; improve access; assure dental workforce; and, renewal of competitive CDC grant </li></ul>
    21. 22. Oral Health Kansas Sponsors <ul><li>Blue Cross and Blue Shield of Kansas Foundation Delta Dental Plan of Kansas Foundation Health Care Foundation of Greater Kansas City Kansas Council on Developmental Disabilities Kansas Dental Association Kansas Dental Charitable Foundation Kansas Health Foundation Kansas State Office of Oral Health Sunflower Foundation The REACH Health Care Foundation United Methodist Health Ministry Fund </li></ul>
    22. 23. Framework for South Carolina More Smiling Faces Project <ul><li>Integrated Network: </li></ul><ul><li>Dental </li></ul><ul><li>Medical </li></ul><ul><li>CHCs </li></ul><ul><li>Churches/Faith Groups </li></ul><ul><li>School/Preschool </li></ul><ul><li>Programs </li></ul>Community Education: Consistent OH Messages <ul><li>Pediatric OH </li></ul><ul><li>Training: </li></ul><ul><li>Medical providers </li></ul><ul><li>Dental providers </li></ul>Outreach to Medical Home: Integrate OH promotion and disease prevention into the medical home <ul><li>System Linkage: </li></ul><ul><li>Patient navigator links </li></ul><ul><li>Link medical homes with dental providers </li></ul><ul><li>Link patients to resources </li></ul><ul><li>Screen for Medicaid or insurance eligibility </li></ul><ul><li>Arrange transportation for target population </li></ul>Local Advisory Committee Combining Resources for Improved Oral Health for Children Slide courtesy of Christine Veschusio
    23. 24. State Medicaid Dental Program Changes (2007) 4 +60% 75 th percentile of dentists’ fees Tennessee 12 >+30% 30% increase Virginia 36 +73% 75 th percentile of dentists’ fees South Carolina 12 +300% 100% of Delta Dental Premier rates Michigan ( Healthy Kids Dental Program ) 54 +58% 75 th percentile of dentists’ fees Indiana 27 +546% (to 1,674 of 4,000) 75 th percentile of dentists’ fees Georgia 48 From 1 private dentist to 108 (of 302 licensed dentists) 85% of each dentist’s submitted charges Delaware 24 +39% 100% of Blue Cross rates Alabama Intervals (mos.) Between Rate Increases and Changes in Provider Participation Changes in Dentists’ Participation in Medicaid Following Rate Increases Adjustments Made to Medicaid Rates (Market-based Benchmarks) STATE
    24. 25. Minnesota Oral Health Landscape – SWOT Analysis Strengths <ul><li>Efforts of stakeholders and partners convening to proactively define and address issues affecting oral health in Minnesota </li></ul>
    25. 26. SWOT Weaknesses <ul><li>The extent of the access problem and continuing/growing reservoir of need </li></ul><ul><li>Emerging SOHP and no broad based, cohesive state oral health advocacy entity and need to define future path </li></ul>
    26. 27. SWOT “Threats” or Challenges <ul><li>A very challenging state economy and infrastructure constraints </li></ul><ul><li>Provider issues, including aging cohort and inadequate replacements </li></ul><ul><li>Distribution of workforce vs. population </li></ul><ul><li>Growing diversity of population </li></ul>
    27. 28. SWOT Opportunities <ul><li>New five-year CDC grant to Minnesota Department of Health for Oral Health Infrastructure Enhancement and Program Improvement </li></ul><ul><li>Build on the commitment and hard work of key stakeholders to deploy new strategies and to enhance existing ones to address the issues in oral health </li></ul><ul><li>New provider models to enhance access </li></ul><ul><li>Broaden the circle of partners and cultivate consensus “agenda” </li></ul>
    28. 29. SWOT … then what? <ul><li>SWOT </li></ul><ul><li>(systematic assessment) </li></ul><ul><li> </li></ul><ul><li>Priorities </li></ul><ul><li>(importance/impact vs. changeability) </li></ul><ul><li> </li></ul><ul><li>Goals, Objectives, Outcomes </li></ul><ul><li>(process and effect, time-framed, measurable, realistic) </li></ul><ul><li> </li></ul><ul><li>Action Steps, Activities, Resources </li></ul><ul><li>(intentional actions and implementer) </li></ul><ul><li> </li></ul><ul><li>Evaluation </li></ul><ul><li> </li></ul>
    29. 30. Active Coalition + Partnerships and Collaborations = More Direct Path to Improved Oral Health for the People of Minnesota <ul><li>Thank you! </li></ul><ul><li>[email_address] </li></ul>

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