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Fundamentals of Leading a Health Center Oral Health Program Meet the Team!

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Fundamentals of Leading a Health Center Oral Health Program Meet the Team! Fundamentals of Leading a Health Center Oral Health Program Meet the team! Ethan Kerns, DDS Scott Wolpin, DMD Tena Springer, RDH, MA An Nguyen, DDS, MPH Bob Russell, DDS, MPH Tina Sopiwnik, DMD Clifton Bush, MS Lisa Kearney, DDS Kecia Leary, DDS, MS Beverly Foster, DDS, MHA Nick Pfannenstiel, DDS Debby Myers, RDH Domenic Caluori, DDS, FIOCI David Kadar, DDS Ryan Tuscher, DDS Sybil Fortner, DDS Leah Schulz, DDS Duane Mata, DDS Donna Bridge, DMD Jeffery Moeller, DDS Janine Burkhardt, DMD, Randi Wingate, DDS FAGD Stacey Robben, DDS Welcome to the NNOHA conference! Who Are We? National Network for Oral Health Access (NNOHA) envisions a future in which individuals and communities are aware of the importance of oral health to overall health, engage in recommended oral health practices, and receive affordable, high quality oral health services. Achieving this vision requires everyone to have access to care, regardless of income or geography. History of NNOHA • Founded in 1991 • Identified need for peer-to- peer networking and collaboration among health center dental providers • Membership includes over 3,000 dental team members and supporters NNOHA’s Mission 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. NNOHA Resources • Webinars • Listserv • Promising Practices • Learning Collaboratives • Individual consultation/referral • Dashboard Quality Measures • Annual Conference www.nnoha.org or email [email protected] Operations Manuals Chapters: 1. Fundamentals 2. Leadership 3. Financials 4. Risk Management 5. Workforce and Staffing 6. Quality http://www.nnoha.org/resources/operations- manual/ National Oral Health Learning Institute (NOHLI) • Clinical leaders in a safety net dental programs with <5 years of experience • Online modules, webinars, and in-person trainings • Curriculum based on NNOHA’s Operations Manual and Patient Centered Health Home Action Guide NOHLI Cohort 7 • Next call for applications: NOHLI Cohort 9 (Summer of 2020) http://www.nnoha.org/programs-initatives/nohli/ About Today 12:30pm – 4:50pm Fundamentals • Review fundamentals needed for effective management of an excellent health center dental program • Two concurrent tracks for four critical program areas (Track A: Workforce and Staffing/Leadership; Track B: Risk Management/Quality) Pick your track! 4:50 – 5:20pm Breakouts – Palace 1 and 2 • Networking opportunity • Discover available resources • Share promising practices Today’s Schedule Track A – Palace 1/2 Track B – Palace 3 12:30-12:35pm Welcome (Ethan Kerns and Tena Springer) 12:35-1:35pm Fundamentals (Bob Russell) 1:35-2:35pm Financials (Kecia Leary, Clifton Bush) 2:35-2:50pm Break (Split into two groups in separate rooms) 2:50-3:50pm Workforce and Staffing Risk Management (Nick Pfannenstiel/Domenic (Ethan Kerns/Donna Bridge) Caluori) 3:50-4:50pm Leadership Quality (Tena Springer/Leah Schulz) (Ryan Tuscher/Janine Burkhardt) 4:50-5:20pm Breakouts* Breakouts* (All) (All) Breakout Sessions 4:50pm – Palace 1 and 2 Topics Leads 1. Fee Schedule/Sliding Fee Domenic Caluori and Donna Bridge 2. Peer Review Lisa Kearney and Sybil Fortner 3. No Shows/Scheduling Nick Pfannenstiel and Jeffery Moeller 4. Medical/Dental Integration An Nguyen and Randi Wingate 5. Infection Control Beverly Foster and Debby Myers 6. Managing Pts Experiencing Substance Scott Wolpin and Janine Burkhardt Abuse 7. School-Based Ethan Kerns and Duane Mata 8. Advocacy In and Out Tina Sopiwnik and Leah Schulz 9. Referral Follow Up Ryan Tuscher and Stacey Robben 10. Emerging Trends: Teledentistry and Bob Russell and David Kadar Dental Therapists Stop by the Coffee House! Date Time Topic Facilitator Monday, October 14 10:00-10:30am The Art of Mark Doherty and Venice Room Leadership Clifton Bush 3:00-3:30pm Dental Dashboard Colleen Lampron, Matt Horan, Carsten Frey Tuesday, October 15 10:00-10:30am Dental Team Janine Burkhardt Venice Room Recruitment and Domenic Strategies Caluori 3:00-3:30pm Scheduling Dori Bingham and Strategies Yogita Thakur Join us by the pool! • Opening reception is TONIGHT! 6pm – 8pm • Open bar and food • Caesar’s Palace pools Can’t lose focus of the Fundamentals Health Center Fundamentals Bob Russell, DDS, MPH 2019 Fundamentals NNOHA Annual Conference Learning Objectives • Discuss the characteristics of Health Center patient populations • Recognize common terms used to reference Health Center oral health programs • Describe how Health Centers are financed • List of partners Health Centers collaborate with • Learn where are Health Centers heading in the future Health Centers Public or private not-for-profit organizations that provide primary health services to populations with limited access to health care. Health Centers were created to increase access to care among underserved and medically disenfranchised populations. United States Department of Health & Human Services Examples of Health Centers HRSA 330 grant-supported programs can be: • Federally Qualified Health Centers (FQHCs) • Outpatient health programs/facilities operated by tribal organizations • Hospital-based • Dental schools • County public health departments Sources: U.S. Department of Health and Human Services Health Resources and Services Administration, bphc.hrsa.gov and CDA May 2009 Federally Qualified Health Centers (FQHCs) • Health care delivery organization must apply to be designated an FQHC by HRSA • Can be reimbursed for Medicaid visits in a different manner than private practice i.e. by encounter/visit • Can apply for Federal Torts Claim Act malpractice protection • Participate in federal student loan repayment programs Health Center vs. FQHC • Health Centers that also receive 330-HRSA grants are FQHCs • FQHC “look-alikes” do NOT receive 330- HRSA grant funding, for example, a county health department or a non-profit clinic, but can apply and also receive alternative Medicaid reimbursement such as the encounter based method Jordan Valley Community Health Center Springfield, MO Health Center Facts – 2018 UDS • Number Health Center programs receiving 330- grant funding: 1,362 • Number HC programs with dental programs: 1,088 or 80% • Total users: 28,379,680 • Number medical users: 23,827,122 • Number dental users: 6,406,667 • Dental Users: 22.6% all FQHC patients • Dental Users: 26.9% of all medical patients 2018 Age Demographics 70 60.05 60 50 40 30.78 30 20 11.13 10 0 0-17 18-64 65 and over Patients by % 2018 Demographics: Ethnicity • 63% identify as racial and/or ethnic minorities • Hispanic/Latino 37.27% • African-American 18.86% Percent of Poverty Level – HC users Over 200% 8% 101-200% 22% 100% and below 70% Common Chronic Conditions • 23.8 million medical users (2018) • 4.7 million: Hypertension • 2.5 million: Diabetes • 1.3 million: Asthma Scope of Service • Each HC has a defined scope of service • should be based on assessment of the health care needs of the Health Center service population • When a new service or a new site is added, a change in scope must be approved Primary Care Focus • Health Centers strive to provide community oriented primary care • Focus on family medicine, pediatrics, general dentistry, pediatric dentistry Public Health Focus • Develop policies and plans that support health on individual and community level • Emphasis is on health care that improves and maintains health • Focus on prevention, screening, patient self- management of chronic conditions Health Care Services Integration • Strength of HC is multiple services available in one location • Some only provide medical services • Most provide medical, dental, behavioral and ancillary services (social workers, enabling services, community outreach etc.) at the same site • Additional services: • optometry, pharmacy, lab, imaging, podiatry, WIC Leadership Launch Imagine your Health Center mirrors national data, and has capacity for only 1 in 4 medical patients to receive dental care. • How would you feel about this? • How would you determine who should access dental care? • Who else would need to be involved in this decision process? Ezra Medical Center Brooklyn, NY Dental Program Scope of Service • Phase I/Basic/Routine • Level I- Emergency care • Level II- Diagnostic & preventive care • Level III- Expected care: Routine periodontal, restorative (including endodontics) and surgical care • If not available on site, Level I & II care must be available through contractual arrangement (1998 & later programs) Dental Program Scope of Service • Phase II/Rehabilitative/Complex • Level IV- Recommended/Rehabilitative care: Complex periodontal, restorative (including endodontics) surgical care and prosthodontics. Other-than-routine specialty care. Scope of Service • Scope of service should be determined by the oral health needs of the HC population • Most HC dental programs provide a majority of Phase I care services • Many Phase II services have up-front fixed costs (i.e. prosthetic lab fees), which must be factored in the costs of delivering services 2018 Productivity • 5,099 DDS FTEs across HCs • 2,682 RDH FTEs across HCs • 37 Dental Therapists FTEs across HCs • 2,682 encounters/FTE DDS • 1,150 encounters/FTE RDH • 783 encounters/FTE DT 2018 Dental Productivity • 16,529,600 visits • 6,406,667 users • 2.58 visits/user annually Reasons for dental visits to CHC • 191,151 had an emergency visit • 475,139 had sealants • 1,023,903 had extractions or other surgery Health Center Financing • Source of mystery & myth • “government pays” • “free care” • “unfair competition”
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