SPECIAL PROJECT OF NATIONAL SIGNIFICANCE TENDERLOIN HEATH & - PowerPoint PPT Presentation

SPECIAL PROJECT OF NATIONAL SIGNIFICANCE TENDERLOIN HEATH & SFDPH ORAL HEALTH INITIATIVE Avantika Nath, DDS

PRESENTATION OVERVIEW Introduction Background Specific Program Objectives Barriers to Care Challenges Clinical Methodology Results Future Plans

INTRODUCTION 2006 - Health Resources and Services Administration (HRSA) funded 15 demonstration programs nationally to increase access to oral health care for persons living with HIV Tenderloin Health (TLH) was one of these sites and partnered with the SFDH for this project (TLH/SFDPH) The Health and Disability Working Group at the Boston University School of Public Health served as the National Technical Assistance and Evaluation Center

BACKGROUND Oral Health Care (OHC) is one of the top unmet medical needs in patients with HIV Improving access to OHC significantly improves health outcomes Engagement and retention in OHC leads to improved health-related Quality of Life Exploring innovations in OHC delivery will allow identification of the most efficient models

OBJECTIVES SPNS Objective “Increase access to OHC for People Living with HIV and AIDS (PLWH/A)” TLH/SDPH Objective Provide improved access to the Homeless PLWH/A within the Tenderloin District

BARRIERS TO CARE Structural No dental clinic in the TLH district Financial Patient either lack or are unaware of medical coverage Individual Discrimination due to HIV/AIDS, LGBT Language and educational limitations LGBT

SPECIFIC CHALLENGES Homeless patients are difficult to track since they move constantly Organizational instability at TLH Staff turnover Statewide MediCal/DentiCal cuts

CLINICAL METHOds - issues & SOLUTIONS Target population Triple Diagnosed Integration with primary care and medical case management Co-location with Medical services Unstably housed Dental Case Manager

CLINICAL METHODs - custom approach Multi-site Evaluation Eligibility criteria Baseline enrollment Patient surveys Utilization data Final data collection

CLINICAL METHODs - collaboration Partners & Linkages to Care Integration with Primary Care at SFDPH-Ward 86 at SFGH Referrals agencies Asian Pacific Islander and Wellness Center Larkin Street Youth Services Rehab Centers (Walden House,Ferguson Place) Community-Based Dental Partnership with UCSF for speciality services

RESULTS - significant changes Baselin 12 Good practices - improvement Outcome e Months Brushing Unmet need for 48% 17% OHC Flossing Bad practices - reduction Good Health of 38% 67% Teeth & Gums Smoking Candy consumption Oral Health 3.35 1.78 Symptoms Soda Consumption (Mean)

RESULTS - CLINICAL TLH Dental “ HOME ” established Established a LOCAL two-operatory dental clinic 450 of ~1500 HIV patients residing in the Tenderloin now being served by the dental clinic Speciality training provided to ALL staff to improve cultural sensitivity, especially towards LGBT

RESULTS - CLINICAL

RESULTS - CLINICAL

FUTURE PLANS SPNS officially ends 31st August 2011 Demonstration project No further funding Sustainability plan ~ half of the current SPNS sites A. Nath successfully applied for Ryan White Part A funds SFDPH will continue to partner with TLH

ACKNOWLEDGEMENTS TLH Staff SFDPH Dental Services Team Leaders D. Fernandez M. Ogbu B. Garcia