WWW.NNOHA.ORG

way to develop, implement

and evaluate the PCHH

concept to see if, indeed,

better health outcomes

and/or reduced costs are

achievable.

With the physical co-

location of multiple health

care services at a single

site, defined patient popu-

lations and an increasing

adoption of Electronic

Health Records, Health

Centers are logical organi-

zations to implement and

achieve the PCHH concept.

As part of a cooperative

agreement with HRSA,

NNOHA has agreed to

develop and implement a

training/technical assis-

tance plan to support

Health Centers in integrat-

ing oral health into their

Patient Centered Health

(Continued on page 2)

Irene Hilton, DDS, MPH

NNOHA Dental Consultant

We live in a time of rapid

change in the health care

field. New concepts and

terminology are emerging

as patients, health care

providers and funders seek

to access and/or provide

quality health care while

controlling costs. One

phrase that has recently

surfaced is the Patient Cen-

tered Health Home (PCHH).

The PCHH can be defined

as a place where all as-

pects of patient care be-

tween healthcare providers

(e.g., dental, medical, be-

havioral care and commu-

nity resources) are inte-

grated and coordinated,

with the goal of improving

health care quality and

outcomes and lowering

health care costs. In some

respects the PCHH is more

than just an actual location;

it is an approach to health

care delivery.

The goal of providing a

“health home” for all pa-

tients is a key element of

health care reform conver-

sations at national and

state levels. Across the

nation, demonstration pro-

jects are currently under-

NEW! Oral Health and the Patient Centered Health Home (PCHH) Action Guide

NOTE: The NNOHA newsletter is for information sharing & discussion purposes. NNOHA does not endorse all included viewpoints or authors.

Spring 2012 Volume 5, Issue 2

NATIONAL NETWORK FOR ORAL HEALTH ACCESS QUARTERLY NEWSLETTER

THANK YOU: David Sanford, Lynn Bethel, Dr. Gregory P. Heintschel, Dr. Dennis Lewis, Dr. Irene Hilton, Annette Zacharias, Maria Smith, Teddy Gray King, Morgan Gunning, and Jennifer Hein for contributing articles or information.

EDITORIAL BOARD: Dr. Dan Brody, Dr. Dennis Lewis, Dr. Amos Deinard, Dr. Lisa Jacob, Ellen Gould, Dr. Gail Redman, Dr. Forrest Peebles, Hope Salt-marsh, Dr. Maura Maloney, Dr. Kudzai Chikwava, Dr. Irene Hilton, Maria Smith (NNOHA Staff), Jennifer Hein (NNOHA Staff), and Mitsuko Ikeda (Editor).

If you have a suggestion for articles or authors to include in future newsletters, please con-tact Mitsuko Ikeda at mitsuko@nnoha.org.

Inside this issue:

Membership Survey 3

Member Spotlight 4

Mass. Dental Work-force 6

Advocacy 7

2012 NPOHC 6

Improving Patient Care Quality 10

Member Recogni-tion 14

The publication is available on the

NNOHA website at: http://

www.nnoha.org/generalpage.html

Patient-Centered Health Home

(Cont’d from page 1)

Home structures and to assess Health Centers’

current readiness to integrate oral health into

the PCHH.

As a first step in this multi-year project, NNOHA

conducted a needs assessment of Health Center

dental programs to identify “early adopter”

organizations that have made substantial pro-

gress integrating oral health into the PCHH. The

needs assessment and follow-up interviews re-

vealed characteristics and organizational fac-

tors of the early adopter Health Centers that

facilitated medical-dental integration and the

establishment of the PCHH, along with barriers

that hinder this achievement. Lastly, NNOHA

identified promising practices conducted in the

responding Health Centers related to integrat-

ing oral health with other Health Center ser-

vices.

Interviews with the Dental Directors of early

adopter Health Centers revealed the following

shared characteristics that contributed to the

ability to integrate oral health with the other

services.

� Leadership vision & support for integra-

tion of dental

� Dental integrated into the Health Center

executive team

� Co-location of dental with medical and

other health services

� An organizational culture of Quality Im-

provement

� Getting dental staff buy-in through un-

derstanding “why” integration is im-

portant

� Use of patient enabling services to facili-

tate integration

� Dental Director leadership

The assessment revealed two primary infra-

structure barriers to integration. The first was

that respondents stated that many of their clini-

cal sites did not have co-located medical and

dental services at the same site. A lack of in-

teroperability between the medical and dental

Electronic Health Record systems was cited as

another key barrier to increased integration

and communication.

Among the best practices developed by Health

Centers to further the integration of oral health

is the use of their clinical information systems to

generate lists of specific populations of medical

patients targeted for care in the dental clinic, to

track referrals from medical to dental, and to

use the IT system to identify and alert medical

providers about special populations targeted

for dental referral in real time during the medi-

cal appointment.

Health Centers used patient enabling service

staff such as Family Support Workers, Patient

Navigators and Health Coaches to make dental

appointments for clients, or had "open access"

procedures, referring pediatric patients to den-

tal department for same-day exam visits and

"max-packed visits," with immunizations in medi-

cal and an exam with the dentist in one visit.

Other programs located dental staff in pediat-

rics, primary care and WIC departments to fa-

cilitate integration.

For more Best Practices and useful tips to assist

your dental program in increasing communica-

tion and integration with medical and other de-

partments in your Health Center, check out the

entire Oral Health and the Patient Centered

Health Home (PCHH) Action Guide, which can be

downloaded at no cost at http://

www.nnoha.org/generalpage.html. Get a head

start on this important movement that will soon

be coming to your Health Center! ��

Page 2

“ Meet the Medical

Director, and push

prevention and

oral health as part

of general

health…you need

to be a champion

yourself.”

- A quote from one

of the early-adopter

Health Center

Dental Directors

Page 3

Volume 5, Issue 2 NNOHA Annual Membership Survey Reveals High Satisfaction Rates

Annette Zacharias

NNOHA Executive Director

First of all, on behalf of NNOHA staff and the

Board of Directors, I want to thank you for partici-

pating in the recent NNOHA Annual Membership

Survey. The NNOHA Membership Survey was dis-

tributed via email in March and April of 2012. Of

the 219 NNOHA members participating in the sur-

vey, 195 completed the entire survey. Here are

some highlights of the findings:

• The survey revealed the value of NNOHA re-

sources and support to its membership. Seventy

five percent of individuals rated the Operations

Manual for Health Center Oral Health Programs

as “Valuable” or “Extremely Valuable.” One

individual commented, “The Operations Manual

has been a phenomenal tool. I enjoy reading

and learning about how to become a Dental

Director because when the time comes for me to

step it up, I know I will be ready.”

• Another key resource is the Annual National Pri-

mary Oral Health Conference, with 74% of indi-

viduals rating the conference as “Valuable” or

“Extremely Valuable.” Members commented that

they enjoy the opportunity to network with their

peers and NNOHA leaders. They also appreci-

ate the availability of presentation slides on the

NNOHA website.

• A large number of NNOHA members who par-

ticipated in the Membership Survey are partici-

pating in advocacy efforts on behalf of Health

Centers and oral health. Sixty six percent of

participants have attended public hearings/

meetings, and 48% have given testimony at

public hearings/meetings. Participation in other

advocacy efforts is also strong, including group

meetings with policy makers/legislators (52%),

and letters to policy makers/legislators (65%). It

is wonderful to see our members advocating for

the underserved!

• Sixty two percent of respondents indicated that

they would be willing to hire new mid-level pro-

viders, if their states authorized or piloted such

programs.

The 2012 Membership Survey confirms what NNO-

HA members know about themselves. Our members

are an engaged, passionate and dedicated group,

working very hard to improve the oral health status

of people across America.

The survey results provide critical information for

NNOHA as we continue to improve the services and

resources to support our membership and set our

priorities in strategic development, programs, and

policy activities. More detailed results will be avail-

able on the NNOHA website in the near future.

Congratulations to the winners of our prizes: Karen

Dent-iPad, LeAnn Smith-NPOHC discounted registra-

tion, and Howard Bailit, William Souto, Mary Ann

Andrew and Cheryl Russo-gift cards. ��

Page 4

Maria Smith, MPA

NNOHA Project Coordinator

GraceMed Health Center, founded in 1979, is a

Christ-centered, non-profit Community Health Center

providing access to quality health, vision and dental

care for all residents of Wichita, Sedgwick County

and south central Kansas. GraceMed added dental

services to its clinics in 1996. Since 2005, GraceMed

has been offering a full range of preventive and

restorative dental services. GraceMed was awarded

the Henry Schein Cares Global Product Donation

in 2011. For this issue, NNOHA interviewed David

Sanford, CEO at GraceMed.

What is your community like?

Wichita is the largest city in Kansas with a metro

population just under 500,000. Our community has a

diverse population with rich cultural heritages. The

primary industry has traditionally been aircraft man-

ufacturing, but with the downturn in the economy, the

business sector is now more diverse.

In our county, it is estimated that 60,000 residents

are uninsured and another 55,000 qualify for Medi-

caid. Residents in these two categories comprise the

majority of our Health Center patients.

What challenges do you face that might be differ-

ent from other Health Centers?

Since only one small Community Health Center is lo-

cated in an adjacent county, we draw patients from

over 70 zip codes throughout south central Kansas.

As a result, we are not exclusively urban or rural, but

a combination of the two. Therefore, some obstacles

to care, such as transportation, are difficult to over-

come.

What are you doing well that you would like to

share with us?

From 1996 to 2004, dental services were offered

sporadically until GraceMed was able to hire a DDS

to take the program to the next level. We restarted

our dental clinic in 2005 and have grown to be one

of the two largest Community Health Center dental

clinics in the state. With four full-time and two part-

time dentists, we provide a full range of restorative

care services. We also have a very successful oral

health care outreach program. We visit at least one

delivery site in each of the 18 south central Kansas

counties and provide preventive services for low-

income children (e.g. schools) and senior adults living

in group residences (e.g. nursing homes). We have

10 dental hygienists, most with their Extended Care

Permit, who are allowed by the state to provide

care off-site. We have two vans to transport porta-

ble dental equipment and staff to our host sites. This

outreach program has been very successful!

Do you have any strong partnerships in the com-

munity?

Yes, we have numerous strong partnerships. Educa-

tionally, we were the host site for our state’s Ad-

vanced Education in General Dentistry (AEGD) Pro-

gram during the first two years until they built and

occupied their own clinic building. Currently, we host

University of Missouri-Kansas City dentist rotations,

dental hygiene student rotations from Wichita State

University, and dental assistant rotations. We have a

close working relationship with USD 259 (Wichita)

and other school districts in the area in order to pro-

vide care for low-income students. We partner with

other social services agencies, such as Salvation Ar-

my, Catholic Charities, and Sedgwick County De-

partment on Aging, to ensure their clients have ac-

GraceMed Health Clinic (Wichita, Kansas)

BJ Walters (Dental Hygienist) with her patient

Page 5

Volume 5, Issue 2 M

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cess to quality oral health care services. We part-

ner with local hospitals in an effort to divert patients

with oral health care issues from

the ER to our clinic. We have

great relationships and support

from statewide agencies, such

as Oral Health Kansas and the

State of Kansas Office on Oral

Health. We definitely do not

exist in a vacuum; we depend

on our partnerships to continue

addressing oral health care

needs in our community.

How do you interface with the

medical department?

Both our medical and dental clinics use our practice

management system, eClinicalWorks (eCW). We

have yet to introduce electronic dental software for

clinical use.

There are a lot of cross-referrals at our satellite lo-

cations, which have both medical and dental capa-

bility. We continue to work with our staff at the main

clinic to ensure patients are referred from one clinic

to the other. We have had success, but this is a con-

stant process involving regular training and manage-

ment emphasis.

What do you “know now that you wish you knew

then” or what advice would you give to a new

Health Center Dental Director?

We were fortunate to have hired an experienced

dentist in 2005 to restart our dental practice. He

had over 20 years in private practice and brought

the positive aspects of a private practice dentist to

our clinic. That is, we develop and fill a regular

schedule for our dentists/patients, we provide a full

scope of dental services, we have an established

sliding fee scale based on fees by procedure, we

recruit and retain great providers, most with private

practice experience, and we contact our patients to

ensure they show up for their appointments, resulting

in a very low no-show rate. In general, we would

advise a new Dental Director to develop a strong

business model that will allow

the clinic to fulfill its mission, yet

develop a revenue stream that

provides sustainability for the

clinic.

What would you like decision

makers in DC to know about

Health Center dental pro-

grams?

We provide quality care at an

affordable cost and fill the void

left in most communities by the private dental com-

munity. We need to ensure that individuals have ac-

cess to quality dental care, even if that means ap-

proving the dental mid-level position (e.g. Regis-

tered Dental Practitioner in Kansas) in states where

“dental deserts” exist in selected geographical are-

as.

What is on your wish list for the future?

My general wish is that every person living in the

U.S. has access to quality, affordable dental care

services. I wish we had more dentists and dental hy-

gienists dedicated to community health. I wish den-

tists were not so ‘territorial’ and ‘protective’ of their

turf, but willing to work toward solutions to quality,

access, and cost issues. I wish we had more pediatric

dentists for low-income

children who are likely

to suffer from the

same oral health care

problems as their par-

ents. I wish we had

resources, both finan-

cial and workforce, to

address the challenge

low-income people

experience in access-

ing quality, afforda-

ble dental care. ��

Dr. Phillip Brockington (Dentist) and Suzanne

Thomas

Doreen Eyler (Hygiene Supervisor/Outreach)

Page 6

Massachusetts Expands Dental Workforce W

OR

KFO

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hygienists’ actions.

Community Health

Centers are a per-

fect partner for

this new profes-

sional. Not only

are Health Cen-

ters able to enter

into collaborative

agreements, but

they could also

serve as an access

point for the com-

prehensive and

continuous care that the hygienists’ patients

may need. Community Health Centers with-

out dental programs also offer an opportunity

to expand access to dental care by partnering

with public health dental hygienists using port-

able dental equipment. Through this partner-

ship, the Health Center could offer preventive

services in their pediatric medical setting, as

well as in women’s health departments and in

chronic disease programs, such as those serv-

ing individuals with diabetes.

Are public health dental hygienists improving

oral health care in the Commonwealth?

Though it is too early to tell, in their first year

of practice, public health dental hygienists

were reimbursed by Medicaid for more than

15,000 dental claims provided to almost 8,000

low-income residents, who may not have re-

ceived dental care otherwise. While the Mas-

sachusetts Medicaid program reimburses for

preventive services for adults, less than one

percent of the residents receiving their dental

services in year one were in that age category;

demonstrating that more work needs to be

done to promote the availability of this unique,

Lynn Bethel, RDH, MPH

Director, Office of Oral Health, Massachusetts

Department of Public Health

NNOHA Member

Governor Deval Patrick changed the dental

workforce landscape in Massachusetts on Janu-

ary 15, 2009, when he signed into law a new

category of dental hygienist. Public health den-

tal hygienists are licensed providers who may

provide the same scope of services without

the supervision of a dentist in a public health

setting, as they can under general supervision

in a private dental office. They can also be

directly reimbursed by Medicaid, offering the

potential for unserved and underserved resi-

dents to receive preventive dental care.

When the legislation was signed into law, Sen-

ator Harriet Chandler, Co-Chair of the Legis-

lative Oral Health Caucus stated, “I applaud

Governor Patrick for recognizing the impact

this law will have in improving oral health care,

especially in certain areas of the Common-

wealth where there is a severe shortage of

quality dental care.”

Preventive services are necessary, but what if a

person is in pain or needs a filling? The Massa-

chusetts Board of Registration in Dentistry

requires that public health dental hygienists

have agreements with dentists willing to pro-

vide dental treatment for his or her patients.

Public health dental hygienists are also re-

quired to complete extra training and have a

signed collaborative agreement with a Massa-

chusetts licensed dentist. Collaborative agree-

ments are legal agreements between the hy-

gienist and the dentist, and include details re-

garding communication to ensure the public’s

health and safety. Dentists who sign collabora-

tive agreements are not responsible for the

“ Community Health

Centers are a

perfect partner for

this new

professional. Not

only are Health

Centers able to

enter into

collaborative

agreements, but

they could also

serve as an access

point for the

comprehensive

and continuous

care that the

hygienists’ patients

may need.”

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Volume 5, Issue A

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licensed dental professional.

In parallel with the creation of public health dental

hygienists, the Board of Registration in Dentistry

enacted additional regulations while providing den-

tal care in a public health setting. Some of these

include, requiring dentists and public health dental

hygienists to acquire a permit to operate a mobile

dental facility or a portable dental operation, as

well as providing their patients with the names of

dentists, Community Health Centers, or dental

school clinics located within a reasonable geograph-

ic distance from the patient's home which are will-

ing to accept referrals for emergency and follow up

dental care.

To support these new initiatives, the Massachusetts

Department of Public Health developed a Public

Health Dental Hygiene E-Toolkit to be used as a

resource for dental hygienists, dentists and resi-

dents. The online resource, which is updated regu-

larly, includes PowerPoint presentations, videos,

sample documents, and other sources of useful in-

formation to be used while providing dental care in

a public health setting.

As of April 2012, there are 21 dental hygienists

who have completed the required training, have a

signed a collaborative agreement and are Medicaid

providers. For more information on public health

dental hygiene practice in Massachusetts and to

access the PHDH E-Toolkit, visit the “Dental

Workforce” and “Public Health Dental Hygiene E-

Toolkit” links at www.mass.gov/dph/oralhealth. ��

The Pew Children’s Dental Campaign Wants to Hear from You!

Teddy Gray King, NNOHA Policy Consultant

We need your voice. Oral health leaders across the country have long known that access to dental care is a serious problem for too many kids. In fact, some 16.5 million underserved children face access barri-ers as a result of dentist shortages, misdistribution of dentists in the areas that need them the most and inadequate reimbursement rates from Medicaid. Additionally, the number of kids in need of care is projected to grow while the supply of dentists rela-tive to population is projected to decline over the next decade.

These access barriers have spurred a community of dentists across the country to advocate for dental workforce innovations designed to address the un-met need. Dentists involved in this community em-brace a wide array of workforce models that inte-grate into the existing dental team and are evidence based.

The Pew Children’s Dental Campaign invites you to sign up to join this community of like-minded oral health professionals who want to be part of this dia-logue. Members of the Pew Children’s Dental Cam-paign Access Champions will have the ability to re-view the latest research, interact with their peers, attend workshops, and influence key policy makers.

If you are interested in participating in the Pew Chil-dren’s Dental Campaign Access Champions group, please email Zach Snyder at zsnyder@pewtrusts.org for more information. ��

Editor’s Note:

Do you have any suggestions for resources NNOHA can

offer to dental hygienists through our website, webinars,

and conference sessions?

Please contact Mitsuko Ikeda, NNOHA Project Director, at

mitsuko@nnoha.org with your ideas!

“Introduction to Diagnosis and Management of Orafacial Pain and TMD for the General Dentist” (Pre-registration and additional $150 fee required)

Sunday, Sept. 30, 8:00am - 5:00pm Speaker: Omar F. Suarez, DMD, MAGD Diplomate, American Board of Orafacial Pain

SPECIAL SESSION:

REGISTER TODAY!

This is an 8 hour course focusing on the Diagnosis and Management of TMD. The Course is organized into several mod-ules, introduction to OFP, Functional anatomy and biomechanics of the TMJ, Pathophysiology, Evaluating patient with OFP, Differential Diagnosis and treatment/management options. Upon completion of this course the participant will gain deeper knowledge as to the Pathophysiology of TMD/OFP conditions, comprehensively evaluate a patient with Orofacial complaints, arrive at a differential diagnosis and recommend a course of action or intervention. A certificate of Comple-

tion will be awarded by Lutheran Medical Center, Department of Dental Medicine.

Register for the NPOHC and this great session at http://www.nnoha.org/conference/npohc.html!

Page 10

Gregory P. Heintschel, DDS, MBA

Chief Dental Officer, Michigan Community Dental

Clinics, Inc.

A challenge that we have accepted at Michigan

Community Dental Clinics (MCDC) is to ensure that

our dental professionals provide an ever-increasing

quality of care. As an extension of public health, our

organization cannot rely on profit to motivate staff

to provide quality care. We have made significant

changes in our operations and management to fol-

low a path of continuous quality improvement. As a

result of our efforts, we have seen significant growth

both in the number of clients served and the commu-

nities in which we have a presence.

Michigan Community Dental

Clinics is a not-for-profit man-

agement services corporation

based in Boyne City, Michigan

that provides services to Medi-

caid patients and the working

poor. Over the last five years,

the organization has expand-

ed from 8 clinics in 2007 to 21

clinics in 2012, with plans to

add 4 or 5 more in the coming

year. In this time we have also

increased our number of em-

ployees from 67 to 280 with

30 full-time dentists, 30 part-

time dentists and 42 hygienists.

With our expanded locations, we have greatly im-

proved our ability to provide quality patient care to

the low-income communities in Michigan that included

67,000 unique individuals in 2011.

Our ability to expand the number of clinical sites

and increase services has been directly related to

the ability to do things that many other organiza-

tions have just begun to discuss. We have a model

of care similar to the private sector’s, including a

competitive pay structure and a stringent quality of

care program. In addition, we’ve implemented an

Electronic Dental Record (EDR) system that is vital to

achieve our goals. Our patient record is totally pa-

perless including digital patient radiographs. This

allows for a record to be accessible by any employ-

ee, for any patient, throughout our organization.

While others are in the process of moving in this di-

rection, we have accomplished it through our internal

efforts and externally with our strategic partners.

The first change implemented to improve care was

to change the dentists’ pay structure. The new struc-

ture combines base pay with a percentage of reve-

nue generated, with the percentage based upon a

relative value unit (RVU) regardless of remuneration

to the organization. The RVU is benchmarked to all

procedures based on the DPO fee schedule of Delta

Dental of Michigan. Almost immediately, production

increased by 20%, which was attributed to doctors

taking greater initiative and accountability for their

efficiency and productivity.

The second change implemented involved putting

systems in place to balance productivity with ever-

improving quality in the care rendered. Through this

strategy, it was determined that a culture needed to

be established that balanced quality and efficiency.

The medical and dental teams are now continually

exposed to this culture of continuous quality improve-

ment. As a result of this ongoing effort, the clinic has

achieved improved financial results, increased pa-

tient satisfaction, improved workforce satisfaction

and higher quality of care for those served. This cul-

ture has helped our doctors realize that ever-

improving quality of care positively affects their in-

come.

The third change involved implementing and main-

taining a very stringent quality improvement pro-

gram to ensure high standards when working with

community partners and government agencies.

Availability of the EDR is integral to the success of

this program as it provides crucial reports including

the ability to audit, document, and benchmark quali-

ty of care through the Clinic Chart Reviews (for ex-

Improving Patient Care Quality in 501(c)(3) Organizations PR

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Dr. Gregory P. Heintschel

Volume 5, Issue 2 N

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NNOHA Welcomes An Intern! Last month, Morgan Gunning joined the NNOHA team as an intern. Most of her time is spent working on the newsletter, job bank, membership and social media outreach.

Morgan Gunning is thrilled to intern at NNOHA. She is currently a junior at the University of Denver, majoring in Biology with a minor in both International Studies and Chemistry. Her long-term goal is to go to dental school, and she has recently felt a passion for serving low-income families and communities after going on a Dental Mission trip to Guatemala last summer. In Guatemala, she was able to educate individuals on the importance of dental care and do basic cleanings, temporary fillings, and assist with extractions. She is excited to be able to learn more about NNOHA and contribute to the organization with new ideas. She is a member of Delta Delta Delta Sorority, and loves hiking, skiing, and traveling.

Just Launched - NNOHA TA Resource! • NNOHA is excited to announce the latest section of its website: Technical Assistance page. NNOHA will be

updating this section as new resources become available. Visit this new webpage at: http://www.nnoha.org/technicalassistance/main.html

• As part of the launch, NNOHA presented a webinar, "Practice Management Technical Assistance: Delivering Sustainability to Health Center Dental Clinics,” on May 18. The archived presentation will be available on the NNOHA website at: http://www.nnoha.org/practicemanagement/webinars.html

Funding Alert: Applications are open for HRSA-13-140 Affordable Care Act - Grants for School-Based Health Center Capital (SBHCC) Program. Eligible applicants are a school-based health center or a sponsoring facility of a school-based health center. Application deadline is June 26, 2012. For more information, visit: http://www.hrsa.gov/grants/index.html

Mark Your Calendars! PBS Frontline is featuring an hour-long presentation on oral health on Tuesday, June 26. Stay tuned for further information through our Weekly Digest (http://www.nnoha.org/news/weekly_digest.html). ��

Did You NNOHA?

ample, failure of amalgams vs. composites); review

and benchmark dental and hygiene services; access

a radiographic database; provide standard, cen-

tralized access for procedures and materials; moni-

tor productivity between clinics and practitioners;

and interact in the database of Press Ganey in Pa-

tient Surveys (a survey of 1,000 of our patients di-

vided among all 21 of our facilities).

The RVU is also used in our quality assessments. Re-

ports can be drawn using RVU data that indicates

the prevalence of procedures being accomplished

by any particular provider or facility. Outliers can

be identified for both quality and adherence to ac-

ceptable standards of care. Once identified, ex-

ceptional practices can be shared among the organi-

zation so all may benefit through standardization of

the best practice. Moreover, potentially substand-

ard practices can be targeted for improvement.

We have learned that using the right technology is

an essential tool to track quality of care provided to

patients. Dentrix Enterprise is the backbone of the

quality of care program since it allows any doctor to

access any patient record in any clinic.

Managing a not-for-profit dental organization to achieve positive quality outcomes is not easy. How-ever, we feel that we have achieved something spe-cial at Michigan Community Dental Clinics. We firm-ly believe that all citizens deserve high quality care and we are committed to being part of the solution in our state. I am happy to share our experiences with other organizations that are working to improve quality and customer experience for patients in need; feel free to contact me at GHeintschel@midental.org. ��

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Members of NNOHA's Membership Resources Committee have volunteered their time to review articles and stud-

ies that may be valuable to safety-net oral health programs. One of these reviews is listed below. To read more

literature reviews, including a new review on “Preventing Dental Caries Through School-Based Sealant Programs,

Updated Recommendations and Reviews of Evidence,” by Barbara Gooch, DMD, MPH, et. al., visit http://

www.nnoha.org/litreview.html. Please note that some of the full articles may require subscriptions or payment to

view.

Effectiveness of Preventive Dental Treatments by

Physicians for Young Medicaid Enrollees Bhavna T. Pahel, BDS, MPH, PhD, et al.

There are an increasing number of models involving medical based practi-

tioners applying cariostatic modalities, such as fluoride varnish to young

children at well child checks. There is very little evidence and very few re-

ports which measure the effectiveness of reducing dental caries with these alternative models of early oral health

interventions. This is not to say they are not effective; simply, there are few studies measuring the outcomes.

The “Into The Mouth of Babes” (IMB) program in North Carolina started in 2000. This study reports on the efficacy

of the North Carolina program from 2000 to 2006. The study revealed that the results were dose dependent.

The child had to receive at least 4 doses of fluoride varnish by 36 months to see a reduction in caries related

treatment up to 6 years of age. When the child did receive this minimal dose, there was a 17% reduction in car-

ies related treatment.

This study has implications to Health Center providers due to the high risk and resulting high caries rate of the

populations they serve. The Health Center dentist should look at models that incorporate methods of applying

fluoride varnish on very young children. The model the dentist develops should target minimally 4 to 6 varnish

applications by the child’s third birthday for maximum effectiveness.

Pediatrics 2011; Volume 127, Number 3, March 2011: e682-e689

Download at http://pediatrics.aappublications.org/content/127/3/e682.full.pdf

Special thank you to Dr. Dennis Lewis for contributing this literature review. ��

The national network is a consortium of practices and clinics devoted principally to

the oral health care of patients, but whose members investigate research questions

with practical impact that will improve the quality of dental care.

The goals are to conduct national oral health studies on topics of importance to practi-

tioners and their patients, to provide evidence to improve routine dental care, and to

facilitate movement of the latest evidence into routine clinical practice. A key objective

is to conduct studies that will improve the knowledge base for clinical decision-making.

The National Dental PBRN is now enrolling practitioners. You can enroll online by

clicking here (www.NationalDentalPBRN.org), and following directions from there.

For more information, visit: http://www.dentalpbrn.org/uploadeddocs/NDPBRN%20Overview_Newsletter_Format_042612.pdf

or contact Dr. Sonia K. Makhija, Network Director of Communications and Dissemination at dentalpbrn@uab.edu.

Volume 5, Issue 2

Page 13

Here are some upcoming conferences in 2012. For a more detailed list, please visit: http://www.nnoha.org/conference/links.html:

• The 2012 Dental Management Coalition (DMC) Meeting will take place June 3-5, 2012 in Philadelphia, PA. For more information,

visit http://www.dmcnet.org/.

• The U.S. National Oral Health Alliance is holding the Third Leadership Colloquium June 6-7, 2012 in San Francisco, CA. For more

information, visit http://www.usalliancefororalhealth.org/content/participate-third-leadership-colloquium-san-francisco.

• The 2012 American Dental Hygienists’ Association (ADHA) Annual Session will take place June 13-19, 2012, in Phoenix, AZ.

For more information, visit http://www.adha.org/annualsession2012/index.html.

• NACHC and its partners are offering a training, Enhancing Collaborative Management in Community Health Centers: De-

veloping Clinical-Operations Teams on June 18-21, 2012 in Seattle, Washington. Visit http://www.regonline.com/builder/site/

Default.aspx?EventID=1042611 for more details and online registration.

• The 2012 USPHS Scientific and Training Symposium will take place June 19-21, 2012 at the University of Maryland, College

Park, in Washington, DC. Visit http://www.phscofevents.org for details.

• The Academy of General Dentistry (AGD) Annual Meeting will occur June 21-24, 2012 in Philadelphia, PA at the Pennsylvania Con-

vention Center. For more information, visit www.agd.org.

• The 2012 MSDA National Medicaid and CHIP Oral Health Symposium will take place June 24-26, 2012 in Washington, DC.

For more information, visit: http://www.medicaiddental.org/events/index.html.

• The 2012 National School-Based Health Care Convention will take place June 24-27, 2012 in Albuquerque, NM. For more in-

formation, visit: http://www.nasbhc.org/site/c.ckLQKbOVLkK6E/b.7505261/k.2727/Convention.htm

• APHA Annual Meeting & Exposition will take place June 26-29, 2012 in Charlotte, NC. For more information, visit http://

www.apha.org/meetings.

• The Business of Dentistry Conference 2012 will take place July 12-14, 2012, in Las Vegas, NV. Visit http://

www.businessofdentistry.com/ for more information.

• The Hispanic Dental Association (HDA) Annual Meeting will take place July 20-24, 2012 in Boca Raton, FL. For more information,

visit http://www.hdassoc.org/.

• The National Dental Association (NDA) 99th Annual Convention will take place July 20-24, 2012 at the Boca Raton Resort & Club

in Boca Raton, FL. For more information, visit www.ndaonline.org.

• NACHC’s 2012 Community Health Institute & EXPO will take place at The Peabody Orlando in Orlando, FL from September 7-

11, 2011. For more information visit http://meetings.nachc.com/?page_id=83.

• The annual National Rural Recruitment and Retention Network conference and membership meeting will occur September 18-

20, 2012 in Tacoma, WA. For more information, visit https://www.3rnet.org/.

• The 2012 National Primary Oral Health Conference will take place September 30-October 3, 2012 at the Hilton Torrey Pines

Hotel in La Jolla, CA. Register online at http://www.nnoha.org/conference/npohc.html. ��

Upcoming Conferences & Events

Find NNOHA

on social media!

Oral Health News Event Alerts

NNOHA Updates

Page 14

Member Recognition

ORGANIZATIONAL AND ASSOCIATION MEMBERS

These organizations became 2012 Organizational or Association Members of NNOHA between February 1, 2012 and May 1, 2012. We recognize their commitment to supporting NNOHA and improving access to oral health services for the underserved.

• Arizona School of Dentistry & Oral Health: A. T. Still Uni-versity – Wayne Cottam

• Association of State and Territorial Dental Directors (ASTDD) – Christine Wood

• Blue Ridge Health Center, Inc.: Blue Ridge Medical Center – Susan Seal

• Iowa Primary Care Association – Nancy Adrianse

• Central Counties Health Centers, Inc. – Craig Glover

• Cherry Street Health Services, Inc. – Chris Shea

• Clinicas Del Camino Real, Inc. – Shyam M. Krishnan

• Community Clinic at St. Francis House: St. Francis House NWA, Inc. – Kathy Grisham

• Community Health Center of Fort Dodge, Inc. – Jennifer Genua-McDaniel

• Community Health Centers, Inc. (Winter Garden, FL) – Bar-bara Snell

• Community University Health Care Center: University of Minnesota – Jeffrey Luke

• Comprehensive Community Health Centers – Armineh Tavi-tian

• Dental Aid, Inc. – Dennis Lewis

• Denver Health – Community Health Dental: Denver Health Medical Center – Paul Melinkovich

• Erie Family Health Center – Lee Francis

• Esperanza Health Center – Susan Post

• Ezras Choilim Health Center – Joel Mittelman

• Family Healthcare – Nancy Neff

• Flint Hills Community Health Center – Phillip Davis

• Gaston Family Health Services, Inc. – William Donigan

• Georgia Mountains Health – Steven Miracle

• Health Access Washoe County-HAWC, Inc. – Daniel Ahearn

• Health Care for the Homeless, Inc. – Louise Treherne

• Iowa Primary Care Association – Nancy Adrianse

• La Familia Medical Center – Linda Renner

• Legacy Community Health Services, Inc. – Tyrone Springs

• Lutheran Family Health Center Network – Neal Demby

• Maine Primary Care Association – Kevin Lewis

• Minnesota Association of Community Health Centers – Rhonda Degelau

• Morton Comprehensive Health Services, Inc. – Roberts Sanders

• Neighborcare Health – Martin Lieberman

• Piedmont Health Services, Inc. – Brian Toomey

• Primary Health Care Center of Dade, Inc.: Primary Healthcare Centers – Diana Allen

• Refuah Health Center – Nechama Frome

• San Benito Health Foundation – Rosa Vivian Fernandez

• Shasta Community Health Center – Cheryl Russo

• Shenandoah Valley Medical System – David Fant

• South County Community Health Center, Inc.: Ravenswood Family Health Center – Yogita Thakur

• Southeast Lancaster Health Services – Melissa Hamers

• The Floating Hospital – Sean Granahan

• Treasure Coast Community Health – Vicki Soule

• United Medical Centers – Alma Gonzales

• United Methodist Mexican American Ministries – Stephanie Waggoner

• Valley Community Health Centers – Sharon Ericson

• Valley Healthcare System, Inc. – Juliane Reynolds

• Vernon J. Harris East End Community Health Center – Tracy Causey

• Virginia Garcia Memorial Health Center – Lisa Bozzetti

• Washington Dental Service Foundation – Laura Smith

• West County Health Center: Russian River Dental Clinic – Stephen Gregory Chadwick

• Westside Family Healthcare – Thomas E. Stephens

• Will County Community Health Center: Dental – DeAnn Bednowicz

Volume 5, Issue 2

INDIVIDUAL MEMBERS

NNOHA currently has over 2,000 members. The following people have initiated or renewed their membership between Febru-ary 1, 2012 and May 1, 2012, and we recognize them for their commitment.

Denise Acosta, Van Ahn Le, Donna Altshul, Theresa Anselmo, Angela Bailey, Howard Bailit, Kathleen Balthasar, Jade Bernard,

Merinda Berkett, Dori Bingham, Nadine Boe, Rowland Browder, D. Gregory Chadwick, Janice Chaw, Miguel A. Cintron Bermu-

dez, Charles Connell, Stephen Crane, Michael Crutcher, Tyree Davis, Yede Dennis, Deepak Devarajan, Sohini Dhar, Mark

Doherty, Lynn Douglas Mouden, Michael Downing, Edward Dye, Timothy Eaton, Ivan Egan, Rachel Fanska, Georgia Fischer, John

Foster, Wendy Frosh, Sangeeta Gajendra, Gregg Gilbert, Danielle Goldsmith, Joan Grcevic, LaVonne Hammelman, Marni

Hansill, Health Hillinger, Irene Hilton, Meghan Hodges, Robert Isman, Karlene Ketola, Corey Koch, Sarah Kolo, Nancy Koshetar,

Satish Kumar, Gregory La Chance, Amy Lalick, James Lasaponara, Ju Lawrence, Eric Lawton, Inez Lopez, Estelle Luckenbach,

Jack Luomanen, Carol Ann Lutey, Mary Mariani, Mary McCabe, Diane Medina, Tami J. Miller, Anita Mitchell, Frazier Moore, Jr.,

Talia Moses, Christopher Nelson, Linda Niessen, Carol Niforatos, Alex Pijpaert, Afua Richardson, Alicia Risner-Bauman, Tamala

Sandifer Tineo McDowell, Deb Schardt, Michael Scholtz, Leah Schulz, Amanda Michelle Serrano, Mary Beth Shea, Travis Shear-

er, Sonia Sheck, Daina Smith, James Strohschein, Lisa Swenson, Sandra L. Tesch, Brandi Thompson, Frank Torrisi, Jammie To-

sevski, Francisco Vargas, Chad Vargas, Gabriel Vargas, Marina Vinnikova. Geneva Walker, Heather Whitt, Matthew Williams,

Scott Wolpin, Jennie Wren Denmark, Diana Zschaschel ��

A New Resource for a New Future | 2012 Call for Applications

Deadline: June 25, 2012, 3 p.m. ET

The newly established Dental Pipeline National Learning Institute (NLI) provides an opportunity for dental edu-cators and their community partners to address the problems of access and workforce disparities. The NLI has

received demonstration-project funding by the Robert Wood Johnson Foundation for two years. Based on proven, effective Dental Pipeline strategies, the NLI will give participating schools and their community partners the tools and resources to successfully implement Pipeline programs.

Please visit http://www.adea.org/PipelineNLI for the brochure and a link to the application.

For a recording of the technical assistance webinar that was held on May 14th, please visit http://bit.ly/NLIwebinar to hear an overview of the program and common technical assistance requests related to partnership requirements and project specifications.

Page 15

NATIONAL NETWORK FOR

ORAL HEALTH ACCESS

PMB: 329 | 3700 Quebec

Street, Unit 100

Denver , CO 80207-1639

Phone: (303) 957-0635 | Fax:

(866) 316-4995

E-mail: info@nnoha.org

RETURN SERVICE REQUESTED

This publication was supported by Grant/Cooperative Agreement No. #U30CS09745 from the Health Resources and Ser-vices Administration Bureau of Primary Health Care (HRSA/BPHC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA/BPHC.

The National Network for Oral Health Access (NNOHA) is a nationwide network of dental providers who care for patients in safety-net systems. These providers understand that oral disease can affect a person's speech, appearance, health, and quality of life and that inadequate access to oral health services is a significant problem for low-income individuals. The members of NNOHA are com-mitted to improving the overall health of the country's underserved individuals through increased access to oral health services.

“ Mission of NNOHA is to improve the oral health of underserved populations and contribute to overall health through

leadership, advocacy, and support to oral health providers in safety-net systems.”

2012 NNOHA MEMBERSHIP APPLICATION October 1, 2011-September 30,2012

Please complete the following information and mail to: PMB: 329, 3700 Quebec Street, Unit 100,

Denver, CO 80207-1639

Select one: ____ Annual Individual membership $50.00 ____ Dental Hygienists or Dental Assistants $30.00 ____ Annual Organizational/University membership $350.00 Contact Information: _______________________________________ Name

_______________________________________ Title

_______________________________________ Organization

_______________________________________ Address

_______________________________________

_______________________________________ Phone

_______________________________________ E-mail

____ Annual Association membership $350.00 ____ Annual Student membership Complimentary Annual Fee Committees: ____ I am interested in receiving committee information.

____ I am not interested in participating on a committee at this time. Method of Payment:

_____ Check _____ Bill Me _____ Credit Card

_________________________________________ Credit Card # Security Code Exp. Date

_________________________________________ Signature

(If you select organizational membership, please attach a separate sheet with names, titles, and E-mail address of those included.)