Oral Health Initiative Fact Sheet: New Mexico Oral Health Efforts
Many different public and private efforts to address the...
UNM also runs an active operating room program         Programs of the New Mexico Department of
 in Albuquerque for dental...
serving those who are low-income and without              SBHC is eligible for an EPSDT—similar to a well
 the means to pa...
form. Mira Consulting, Inc. has had a partnership      a pilot project with ABC Pediatrics in Roswell has
 with Albuquerqu...
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Oral Health Initiative Fact Sheet: New Mexico Oral Health Efforts


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Oral Health Initiative Fact Sheet: New Mexico Oral Health Efforts

  1. 1. Oral Health Initiative Fact Sheet: New Mexico Oral Health Efforts Many different public and private efforts to address the oral health needs of New Mexicans and the lack of access to quality affordable oral health care services are taking place throughout New Mexico. The following is a brief summary of some of these endeavors, as well as some of the issues they face. Workforce Development of Family & Community Services, and the Bernalillo County Partners in Health. Three clinics in Albuquerque provide a full range of dental services to qualifying, low income state residents. During 2008-2009, New Mexico Health Resources Services include general dentistry, pedodontics (NMHR) reported that it recruited 35 dentists who (children’s dentistry), prosthodontics, are serving primarily in rural community health orthodontics and emergency services. CDS has centers and with Indian Health Services (HIS) provided these services to thousands of patients facilities throughout the state. As this was an annually for the past 35 years. To get services, exceptional number of recruits, possibly due to patients must qualify either by being covered by the recession’s negative effect on opportunities one of these three contract funders, having for dental business start-up, the NMHR fears that Medicaid coverage, or through self-pay. several may leave when the economy gets better. Overall, however, NMHR has had greater success in retaining dentists recruited and placed in rural areas, rather than urban areas. The 2004-2005 academic year was the first full year of operation for the University of New Mexico’s (UNM) year-long dental residency program; the program is fully accredited with nor Community-based health centers (CHCs) have reporting requirements to the accrediting body. been slowly increasing the number of dental There are ten dental residents now going through providers on-site. Over the last 14 years, the this advanced training program, gaining skills in number of CHCs that offer dental clinics has specialty areas—like pediatric dentistry and oral increased from seven to approximately 45—and surgery—and seeing Medicaid patients, adults and these dental clinics are well-used. For example, La children, from underserved and rural areas of the Clinica del Norte in El Rito (Rio Arriba County) state. The dental residents each do rotations in provides one of the most-utilized dental clinics, various sites, practicing under the supervision of a serving patients from 17 surrounding counties, as dentist/faculty. Some of the rotation sites include well as Colorado residents. The Ben Archer CHC the First Choice clinic in South Valley, the now has seven dentists, and La Clinica de Familia Veterans’ Administration, Hidalgo Medical has dentists at multiple sites. There have been Services in Silver City, and Eastern New Mexico losses; last year the NM Department of Health Medical Center-Roswell. The program is actively (NMDOH) closed the community dental clinic in seeking additional partners throughout the state. Hobbs and this year the Las Cruces clinic closed. Last year, six of the seven residents remained in New Mexico—five in public health settings, three of which were located in rural areas. Community Dental Services (CDS) is funded in part by NMDOH, the city of Albuquerque’s Department Con Alma factsheet_NM Efforts_12-18-09 Page 1
  2. 2. UNM also runs an active operating room program Programs of the New Mexico Department of in Albuquerque for dental patients with Health (NMDOH) developmental disabilities or with complex medical issues from around the state; if Medicaid funding—which supports this program—were cut, Currently, the state does not have an oral health these patients would have no other means of surveillance system, and although legislation getting access to this dental care in the state. supporting this has been proposed, funding has not been allocated. This makes it difficult to gain up-to-date, credible data on the status of oral UNM dental faculty also participate in running a health in the population, which, in turn, negatively dental clinic and participating in outreach affects the ability to plan appropriate strategies to programs at Eastern New Mexico University address the issues. What data is available (ENMU), and work with Artesia General Hospital. indicates that New Mexico, especially in rural This site offers another operating room, like the areas and among children, faces severe oral one in Albuquerque that can be used to handle health problems. severe dental problems of those with developmental disabilities. The Office of Oral Health (ODH), Health Systems Bureau—in partnership with District II, Santa Fe Children’s Medical Services, funds two dental health case managers who serve Santa Fe and Rio The UNM dental hygiene program does outreach, Arriba Counties. This Dental Case Management providing Masters’ level dental hygiene faculty (DCM) program provides oral health education, and students to certain middle schools. In identifies children (many of them immigrants) particular, Van Buren, Grant, and Wilson middle with dental caries, assists the children’s families in schools, and Highland High School benefit from accessing dental health care services, and follows- this arrangement, which gives students primary up to ensure children are served. The case preventive dental care. In addition, a minimum of managers work in collaboration with the dental 90% of UNM dental hygiene graduates will stay sealant program implemented by the ODH in the and practice in the state. elementary schools. In the last year, approximately 531 children were served in these areas. One dental care center, the Central Family Reimbursement Issues Health Care Clinic in Rio Arriba County has been a key provider of services for these children. The ODH hopes to expand the DCM program to Bernalillo and Doña Ana Counties. In New Mexico, no real incentives exist for dental providers to accept Medicaid in payment for services. For one, Medicaid has a somewhat archaic billing system that does not appeal to The ODH also oversees a dental sealant program dental providers. Research shows that less than 1 in elementary schools, grades one through three percent of most New Mexico dentists’ patients (or one thorough six, depending on the school), were paid for by Medicaid. In 1987, only one throughout the state. In 2008-2009, 125 schools private dentist in Doña Ana County took Medicaid were served, and 6,091 children received sealants. patients, despite the fact that this area has the Of the third grade children seen, 26 percent—one second largest population in the state; the in four children—had dental decay severe enough percentage of dentists in this area currently taking to require treatment by a dentist. Currently, Medicaid patients has not changed much since funding for this program is sufficient to reach only that time. One advantage to seeing dentists in about 5 to 6 percent of the students in the state. public health centers is that the medical record The ODH funds seven contractors to provide system is electronic and more effective. preventive—including sealants—and restorative services to approximately 20,000 adults and children throughout the state, with emphasis on Con Alma factsheet_NM Efforts_12-18-09 Page 2
  3. 3. serving those who are low-income and without SBHC is eligible for an EPSDT—similar to a well the means to pay for dental services. child exam—each year. This exam includes a visual oral health screening and oral hygiene education. The Office of School and Adolescent Health (OSAH)—funds 59 of the approximately 80 school- In terms of SBHCs and a workforce point of view, based health centers (SBHCs) in the state. the centers cannot retain oral health professionals Approximately 25 to 30 percent of students in because they are so poorly funded. Total funding each school use the SBHCs. State funding for the for each SBHC in the state is approximately SBHCs, based on school population, need, income $35,000; not only is this operating funding too low level of the community, and the like, ranges from to be effective, but the dental professionals must $60,000 to $150,000 per center. State funding also learn to accommodate an environment that is does not cover oral health care services at the not health system-oriented. There have been SBHC; currently only a handful of New Mexico’s issues with Medicaid and confidentiality with SBHCs provide some type of dental service, and school administrations. most of these find other sources of funding to support this care. Children, Youth and Families Department: Head Start Among those SBHCs providing oral health care of some type are the following. Three of the Elev8 New Mexico SBHCs—Gadsden, Wilson, and The Head Start program requires that all its pre- Laguna Middle Schools—have dental facilities and school children have a dental screening within 45 use part-time dental hygienists, as well as a days of enrolling. The program tries, as much as dentist who comes at least once a month to see possible, to have that screening done by dentists, students. The Gadsden Middle School SBHC has a so that if a child has dental treatment needs, contract with La Clinica de Familia to provide he/she can be more efficiently referred for dental care for the students. The San Felipe SBHC service. Dental hygienists are also used for this has facilities used by a dentist from the tribal clinic service. If Head Start children need further dental who sees the Native-American students for care, the program staff assist the family in making prevention and treatment; 480 students received appointments and gaining access to services. fluoride rinses in 2008-09. The Van Buren Middle Head Start also provides sealants for all its School SBHC has a dental clinic run by UNM’s participating children on-site at least twice a year. Division of Dental Hygiene and supported by a grant from Delta Dental to provide oral health to its students. The Fort Sumner SBHC provides its students with some cleaning and screening Mobile Dental Care services; the Des Moines SBHC brings in a dentist once a month to serve the students—a major step A few groups, under contract to the NMDOH or in accessibility since the town has no health care for fees, provide “mobile” dental health care to provider. The Quemado SBHC (Catron County), school children. ACC Mobile Dental Services supported by Presbyterian Medical Services, has mainly focuses on serving the military and recently set up arrangements to bring in a dental correctional facilities in the state, but it has hygienist once a month to serve students. provided a dental mobile van to schools, such as Navajo Prep, for a daily fee, to do cleanings, simple fillings, and screening. Participa!, Inc. NMDOH OSAH requires its SBHCs to provide Dental Services is a non-profit, portable program health education presentations in the schools; one staffed with dental professionals that can provide of these is to be on oral hygiene. In addition, the comprehensive dental exams, diagnostic x-rays, office also notes that any child (up to age 18) who dental cleanings, topical fluoride treatments and is enrolled in Medicaid, and who comes to an dental sealants for all students/children enrolled in Medicaid and who return a parental consent Con Alma factsheet_NM Efforts_12-18-09 Page 3
  4. 4. form. Mira Consulting, Inc. has had a partnership a pilot project with ABC Pediatrics in Roswell has with Albuquerque Public Schools to provide dental been in operation for six months, in which all the sealants to second and third grade students since clinic pediatricians have been applying fluoride 1998. varnish to children’s teeth. The fluoride prevention treatments are reimbursed at $18 per application. The project has reported anecdotal success—families and children like the service, Community Dental Services, Inc. is also under many children have been served, and physicians contract to the NMDOH to provide some mobile do not find the practice to be cumbersome. The dental health services, especially to the Santa Fe New Mexico Pediatric Society has already trained area. Basic dental care, including exams, x-rays, many of New Mexico’s pediatricians at their cleanings, fillings and extractions are provided to annual meeting, and has an online training qualifying residents at no cost. Services not program available for others. covered (prosthodontics, endodontics, etc.) are referred to the CDS Albuquerque-based clinics. Medicaid and qualifying self-pay patients are Even more important, in August 2009, Molina accepted. Healthcare stated that it is reimbursing any trained health care provider in its system $18 per Fluoride Treatments by Pediatricians application of fluoride varnish (reimbursement includes the cost of fluoride). Lovelace SALUD has also said it reimburses the same amount to The Pediatric Residency program at UNM received pediatricians. Blue Cross/Blue Shield SALUD and a grant from the American Association of Presbyterian Medical Services are being Pediatrics to bring a visiting oral health professor approached about following the same course of to UNM to provide training to pediatric residents action. If covered, this will be helpful in providing on the application of fluoride varnish. In addition, fluoride varnishes to many more Medicaid patients, especially children, in the state. Con Alma factsheet_NM Efforts_12-18-09 Page 4