School Based Comprehensive Oral Health Services Grantee Meeting

Donna BehrensThe Center for Health and Health Care in

SchoolsMay 30-31, 2012Washington DC

What do we mean?

• Integration (from the Latin integer, meaning whole or entire) generally means combining parts so that they work together or form a whole.

Collaboration

Collaboration

• Former surgeon general Joyce Elders– An unnatural act between

non consenting adults – We all say we want to

collaborate but what we really mean is that we want to continue doing things as we have always done them while others change to fit what we are doing

Levels of InteractionNetworking: Exchanging information for mutual benefit.

Coordination: Exchanging information and altering activities for mutual benefit.

Cooperation: Exchanging information, altering activities, and sharing resources for mutual benefit.

Collaboration: Exchanging information, altering activities, sharing resources, and initiating new synergistic activities and approaches for mutual benefit.

from COLLABORATION FOR A CHANGE Definitions, Decision-making models, Roles, and Collaboration Process Guide By Arthur T. Himmelman

Co-location vs integration

Medical Mental health

Oral health

How will you know when you are there?

• Medical, Mental Health and Dental ARE the school based health center

• Parents are active and engaged partners in care

• Oral health prevention is part of of the school

• SBHC oral is part of the greater oral health care community

What might get in the way?

• Oral health is not part of everyday thinking of medical and mental health staff

• Lack of interest or understanding of the importance of oral health by parents and community – supply and demand!

• Parent lack of involvement and shared responsibility

• The ability to find and retain good staff

• Requirements of multiple funders

• Partnering with multiple organizations and agencies

• Juggling everyone’s schedules to find times for everyone to meet

• Managing different patient scheduling needs for dental, mental and medical visits

• Integration of all clinical services into one chart

• Territorial behaviors from practitioners

• Expectations from the school administrators around access to information

• Consent process• Productivity • Communications between

providers (esp with mobile units and hub and spoke model)

• Student mobility

What to be thinking about…

• How to keep the focus not just on services but PREVENTION – pathology can overwhelm the service

• How to stay connected to sealant program in the schools if CDC funding goes to schools not providers

• How to deal with summer hours

• How to include oral health in case reviews and chart audits

• How to be seamless in care to students

• Who is going to be your champion in the school

More….

• If not offering restorative care on site, how do you secure access?

• How do you integrate oral health into school’s nutrition, tobacco use, injury prevention efforts?

• What are you going to do about consent issues?• What about Immigrant and refugee student

populations and cultural and language barriers to care, consent and communications?

• How will you deal with Issues around sharing of information?

Ideas?

• Use of common consent forms

• Introduce available oral health services through classroom education

• Schedule regular staff meetings that include all service components

• Organize cross education • Integrated clinical charts

Ideas

• Make sure information is able to be read and understood (language and literacy)

• Schedule open house and find opportunities to go into the community to talk about services and how to enroll

• Offer something specifically to adults/parents understanding the oral health care may not have historically been a priority

Who are your partners

• Superintendents of education, the school board, parents, teachers, coaches…

• Decision makers – state and local…

• Other providers in the community?

• Who else is in the school providing services? Ie After school, head start,

Sustainability…what is your business plan?

• The three E’s– Eligible services– Eligible providers– Eligible patients

• State practice act• How to fund non

reimbursable services• Enrollment and

outreach

Have Fun and Enjoy the ride!

Look around you… these people will be your best support system and your best friends for the next few years