South Hampton Roads Dental Safety Net Convening Monday, June 18, 2018 Norfolk, VA
Welcome! • Name • Organization • Who does your organization serve? • Why are you here today?
Desired Outcomes • Shared understanding of how we got here • Shared understanding of VaOHC’s role in facilitating the SHR Oral Health Alliance • Shared understanding of what is happening in other parts of VA to increase utilization of the dental safety net • Consensus on next steps to enhance dental safety net coordination and utilization
Virginia Oral Health Coalition Striving to ensure all Virginians have access to affordable comprehensive health care that is inclusive of oral health Advocacy | Provider Education | Public Awareness 4
Guiding Principles Virginians know that good oral health is essential to overall health. The prevalence of dental disease is reduced in Virginia through prevention activities and early diagnosis and treatment. The oral health workforce in Virginia adequately meets the needs of its citizens by working to the full extent of their education and training. Medical and dental providers and educators understand the links between oral health and overall health and work to ensure Virginians receive comprehensive care. Virginians have access to quality, affordable, and comprehensive dental insurance coverage.
Provider Education Pregnancy and Early Childhood • Partnering with CHIP of Virginia to train CHWs and home visitors • Fluoride varnish and oral health integration training for pediatric medical providers Special Needs • Providing continuing education to dental professionals on techniques and resources to care for individuals with special health care needs Oral Health Integration • Safety Net Learning Collaborative • Oral Health Integration Toolkit 6
Virginia Oral Health Report Card
Regional Alliances • Working groups with different structures and focus areas • Measurable goals and action plans • Data-Driven • System change focus • not just programs and education • Timeframe for implementation depends on the stakeholders involved Determined not to recreate the wheel or develop more silos
The Coalition’s Role in the Alliances We provide the backbone support to enable local and regional partners to collaborate more effectively to improve oral health. Convener • Facilitator • Topical expertise • Resources and tools • Register by August 14: http://bit.ly/VaOHCAug2018
The Coalition is focused on deepening the leadership capacity of regional oral health alliance members and co-creating a sustainable infrastructure to continue their work. Participants from regional oral health alliances will gain or build upon the skills to Lead community-driven, collaborative • initiatives, Garner support for collective action and • policy change, and Build the infrastructure for sustainable Register by August 14: • system change. http://bit.ly/VaOHCAug2018
How Did We Get Here? Feb. 2018 Summer October Spring 2018 TODAY! 2018 2017 • Discuss • Over 35 • Convened a • Over 50 • Ongoing opportunities participants planning participants stakeholder to increase group of 9 in kick-off engagement • Refined goals safety net members forum further • Minus 9-to-5 collaboration • Designed oral • Examined and Aging • Identified • Identify health forum oral health potential Adults Affinity specific next to kick-off data partners and Group steps collaborative snapshot for existing the region efforts coalitions that could address • Reviewed and • Identified parts of the potential provided goa ls feedback on regional oral health goals and data for the strategies to improve oral region health for specific populations • The Alliance was formed
What Did We Learn?
What’s Working Well Safety Net Services • Integrated medical-dental model • Mobile van (HRCAP/HRCHC) • Pre-pay option lowers no-show rates Patient Education • Access Partnership connects patients to resources Support Programs • Dental vouchers • Homeless Connect What else?
Opportunities Coordinating Services • More communication among safety net sites about eligibility, hours, and populations • Coordination of emergency services • Referring partner/social service education about services and benefits available Transportation • Transport to dental services between 9 and 11 a.m. Most appointments are booked during this time, which overloads the I-ride system. There are no weekend services, and Uber and Lyft drivers are not prepared for potential medical issues of seniors. Cost • Sliding scale fees still too much for some patients Language • Language and cultural barriers • Documentation issues lead to fear, care avoidance
Identified Goals and Strategies • Goal: Increase the number of uninsured/under-insured adult with an established dental home by improving collaboration among free and low-cost dental providers. • Strategies: – Convene a safety net group to share information and develop a resource sheet. – Explore qualitative data about barriers to utilization of care. – Work on a referral system for safety net partners – Improve coordination with CCEVA’s dental voucher program. Medicaid expansion means that nearly 37,000 adults in SHR will be eligible for coverage Jan 1, 2019
What is Happening Outside of SHR?
Examples • Capacity Mapping: – Working with another regional coalition to map and survey safety net clinics and determine capacity to meet demand for services (including dental) • Qualitative Research: – Identify barriers from patient perspective • Integration Collaborative
Medicaid Expansion This is a BIG deal! 18
Coverage in Virginia Medicare No dental benefits • Medicaid and FAMIS Comprehensive dental • coverage for children & pregnant women Extraction benefit for adults • – Caretaker adults – Aged, blind and disabled Traditional Dental Benefit Prevention services are free • Yearly cap • Exchange Dental Benefit Adult • – No mandate – No subsidies
• 400,000 newly What does this eligible adults – 37,500 in SHR actually mean? • Effective Jan 1 or before – Enrollment opening TBD • State Plan Amendment • 1115 waiver – Work requirements – Cost sharing • Limited dental benefit – Extraction – MCO enhanced benefit (ex: cleaning) 20
Dental Coverage - Medicaid * Income limits vary by family size www.coverva.org 21
Coverage Gains by Locality Locality Could Gain Coverage* Chesapeake City 5,700 Franklin City 600 Isle of Wight County 1,000 Norfolk City 12,600 Portsmouth City 4,300 Southampton County 700 Suffolk City 2,100 Virginia Beach City 10,600 Total 37,600 *Uninsured nonelderly adults up to 138 percent FPL residing in localities, some may not meet all eligibility requirements. Source: TCI analysis of US Census Bureau ACS 5-year data, 2012-2018. Updated: January 3, 2018.
South Hampton Roads Oral Health Alliance Safety Net Convening Monday, June 18, 2018 | 11:30 am – 1:30 pm United Way of South Hampton Roads, Norfolk, VA Participant List Virginia Oral Health Coalition Staff: Sarah Bedard Holland, Chief Executive Officer Lauren Gray, Program and Engagement Manager Lauren Sawyer, Communications Manager Sarah Stemrich, Office and Program Coordinator Participant Name: Organization: Beatriz Amberman Virginia Coalition of Latino Organizations Kathleen Banfield United Way of South Hampton Roads Valda Branch Southeastern Virginia Health System Lakeshia Calhoun Hope House Foundation Theresa Chopito Hampton Roads Community Action Program Dr. Catherine Christie Scott Hampton Roads Community Health Center Nikia Cobbs Catholic Charities of Eastern Virginia Melissa Eggen Obici Healthcare Foundation Angela Futrell Southeastern Virginia Health System Ashley Greene Western Tidewater Free Clinic Theresa Jackason-Pope Western Tidewater Community Services Board Brad Lazernick Senior Services of Southeastern Virginia Ginger Melton Hampton Roads Community Health Center Kevin Otey Hampton Roads Community Action Program Dourina Petersen Chesapeake Care Linda Rice Hampton Roads Community Foundation Brandon Rodgers Western Tidewater Community Services Board Shatina Simpson Catholic Charities of Eastern Virginia Phyllis Stoneburner Sentara Obici Hospital Jennifer Tomar Park Place Health and Dental Clinic Nancy Welch Chesapeake Health Department Barbara Willis Hampton Roads Community Health Center Karen Youmans Access Partnership Steve Zollos Senior Services of Southeastern Virginia
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