EaSY Does It: EaSY Does It: EExpansion of xpansion of SServices to ervices to

your Dental Program’s your Dental Program’s YYoungest Patientsoungest Patients

Scott Wolpin, DMDScott Wolpin, DMDChief of Dental ServicesChief of Dental Services

Choptank Community Health System, Choptank Community Health System, Inc.Inc.

Eastern Shore of MarylandEastern Shore of Maryland

Choptank Community Choptank Community Health System (CCHS)Health System (CCHS)

Rural, community health centerRural, community health center 7 primary care sites and 14 health care providers 7 primary care sites and 14 health care providers

offering offer a full range of primary health care offering offer a full range of primary health care services for all area residentsservices for all area residents

Community based services provided in five school Community based services provided in five school based wellness centers, and the migrant health based wellness centers, and the migrant health projectproject

In 2001 CCHS was awarded funding from the BPHC In 2001 CCHS was awarded funding from the BPHC to develop comprehensive oral health care services to develop comprehensive oral health care services at one of its primary care sites - Federalsburg at one of its primary care sites - Federalsburg Dental Center. Dental Center.

““The Funnel Effect” The Funnel Effect” – D. – D. RosensteinRosenstein

CCHS’s In-house CCHS’s In-house referralsreferrals

CCHS’s school-CCHS’s school-

based dental based dental program referralsprogram referrals

Children with acute Children with acute

care needs are care needs are seen the same day seen the same day for definitive care for definitive care (open access). (open access).

Why do it??Why do it??

““EaSY Does It”EaSY Does It”

AAn innovative partnership between n innovative partnership between a rural, community health center a rural, community health center [CCHS] and a dental school [UMDS] [CCHS] and a dental school [UMDS] where a native Spanish speaking where a native Spanish speaking pediatric dentist provides clinical pediatric dentist provides clinical services four days a week at our services four days a week at our health center’s dental clinic. health center’s dental clinic.

Community ResponsivenessCommunity Responsiveness

The Maryland Department of The Maryland Department of Health and Mental Hygiene and Health and Mental Hygiene and UMDS collect oral health data on UMDS collect oral health data on children everychildren every five five years in an effort years in an effort to describe the oral health status of to describe the oral health status of school-aged children in Marylandschool-aged children in Maryland

UMDS Pediatric Dentistry UMDS Pediatric Dentistry FellowshipFellowship

Guess what??Guess what??

The 2000 statewide study revealed that Eastern Shore children have:The 2000 statewide study revealed that Eastern Shore children have:

the highest mean number of decayed teeththe highest mean number of decayed teeth highest proportion of dental decay history made up by untreated highest proportion of dental decay history made up by untreated

decaydecay

And are:And are:

the least likely to have benefited from dental sealants statewide the least likely to have benefited from dental sealants statewide

least likely to have visited a dentistleast likely to have visited a dentist and most likely to have their parents report unmet oral health and most likely to have their parents report unmet oral health

care needscare needs

InnovationInnovation

Collaboration/IntegrationCollaboration/Integration““EaSY Does It” is a jointly developed shared EaSY Does It” is a jointly developed shared

vision to improve the oral health status of vision to improve the oral health status of Maryland’s most needy children where:Maryland’s most needy children where:

Both individual and organizational agendas Both individual and organizational agendas are valued in reaching this common goal. are valued in reaching this common goal.

Clear expectations are drafted in a Clear expectations are drafted in a Memorandum of Agreement (MOA)Memorandum of Agreement (MOA)

OutcomesOutcomes

In 2004, the CCHS dental In 2004, the CCHS dental center saw 3248 patients for center saw 3248 patients for 6,687 visits. Sixty percent of 6,687 visits. Sixty percent of the patients were under 19 the patients were under 19 years of age and 12 percent years of age and 12 percent were five years of age or were five years of age or younger.younger.

Replication/SustainabilityReplication/Sustainability

The “EaSY Does It” partnership is a The “EaSY Does It” partnership is a revenue revenue neutralneutral program for both the UMDS and program for both the UMDS and community health center. community health center.

Donations from the Maryland State Office of Donations from the Maryland State Office of Oral Health and Managed Care Oral Health and Managed Care Organizations [MCO’s] that administer the Organizations [MCO’s] that administer the State Medicaid program have afforded a State Medicaid program have afforded a local hospital O.R. to be equipped for dental local hospital O.R. to be equipped for dental services provided by the pediatric fellow. services provided by the pediatric fellow.

ChallengesChallenges

legislation legislation writing a good business plan writing a good business plan facility capacityfacility capacity recruiting adequate support staffrecruiting adequate support staff the fellow’s satisfaction of the the fellow’s satisfaction of the

workplace.workplace.

Administrative EffectivenessAdministrative Effectiveness

Chart audits, peer review surveys and Chart audits, peer review surveys and patient questionnaires are evaluated to patient questionnaires are evaluated to assure quality. assure quality.

The only resources needed to operate the The only resources needed to operate the program are: availability of nitrous oxide program are: availability of nitrous oxide sedation, adequately trained support staff sedation, adequately trained support staff and facility capacity (a quiet room and facility capacity (a quiet room outfitted with dental equipment for outfitted with dental equipment for restorative care). restorative care).

In an effort to continuously In an effort to continuously improve a program you must improve a program you must always look to what opportunities always look to what opportunities might be obtainable. Funding is might be obtainable. Funding is often the most difficult piece of often the most difficult piece of any public health initiative but any public health initiative but there are several alternative there are several alternative opportunities. opportunities.

Contact Information for Contact Information for Pediatric Fellowship ProgramPediatric Fellowship Program

Harold S. Goodman, DMD,MPHHarold S. Goodman, DMD,MPHDirectorDirectorPediatric Fellowship ProgramPediatric Fellowship ProgramDepartment of Health Promotion and PolicyDepartment of Health Promotion and PolicyDental SchoolDental SchoolUniversity of Maryland at BaltimoreUniversity of Maryland at Baltimore666 West Baltimore Street666 West Baltimore StreetRoom 3 E 10Room 3 E 10Baltimore, MD 21201Baltimore, MD 21201410-706-7970410-706-7970410-706-3028 (FAX)410-706-3028 (FAX)hgoodman@umaryland.eduhgoodman@umaryland.edu

Scott Wolpin, DMDScott Wolpin, DMDDental DirectorDental DirectorChoptank Community Health System, IncChoptank Community Health System, Incswolpin@choptankhealth.comswolpin@choptankhealth.com

Questions?Questions?