FLORIDA ORAL HEALTH ALLIANCE FEBRUARY 22, 2016 MEETING NOTES

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1 FLORIDA ORAL EALT ALLIANCE FEBRUARY 22, 2016 MEETING NOTES Florida Oral ealth Alliance Result: All Florida children, youth and families have good oral health and well-being, especially those that are vulnerable. eadline Indicator: Percentage of eligible Medicaid children ages 0-20 receiving any dental services eadline Indicator: Percentage of eligible Medicaid children ages 0-20 receiving any preventive dental service Meeting Results: By the end of this meeting participants will have: Shared understanding of each individual s progress on commitments to action Agreement regarding preventive services indicator Shared understanding of the children that the Florida Alliance aims to serve A review of strategies and subcommittees proposed at the previous meeting Next steps to move forward the Florida Alliance s structure for taking action The following Alliance members were present for the meeting (2/22/2016). Name Philippe Bilger Marcia Bynoe Inge Ford Farren urwitz Marguerite Lynch Ana Karina Mascarenhas Douglas Manning Dave Meadows Camilo Mejia Saran Rai Adam Reback Becky Smith Project Staff Deitre Epps, Facilitator Christine om, Project Manager Organization Florida Department of ealth (FDO) School Board of Broward County ealth Care District Palm Beach County ealth Choice Network ealth Care District Palm Beach County Nova Southeastern University School of Dental Medicine DentaQuest Foundation Liberty Dental Catalyst Miami Nova Southeastern University School of Dental Medicine FDO in Palm Beach County Miami Dade College School of Dental ygiene Florida Dental ygiene Association Results-Based Leadership Florida Institute for ealth Innovation 1

2 POPULATION ACCOUNTABILITY Results Statement(s): Florida Oral ealth Alliance Result: All Florida children, youth and families have good oral health and well-being, especially those that are vulnerable. Selected Indicators: Indicators= measures that help to quantify the achievement of the result. (Rated as high (), medium (M) or low (L) Candidate Indicators Percentage of Eligible Medicaid Children Ages 0-20 Receiving Any Dental Services Florida is now at 27% in 2014, 27% of Medicaid eligible children received dental service in that year. Communication Proxy Power Data Power Power Percentage of eligible Medicaid children and youth that received preventative dental services Number of preventable ER visits with oral health Turn the Curve report February 22, 2016 Result: All Florida children, youth and families have good oral health and well-being, especially those that are vulnerable. eadline Indicator Florida is now at 27% in 2014, 27% of Medicaid eligible children received dental service in that year. Application of Turn the Curve thinking: Adding another eadline Indicator The group decided to elevate the secondary indicator of preventive services to be another headline indicator with as much meaning as the all dental services indicator. 2

3 Story behind the data: Who are we serving? One percentage point improvement in Medicaid population = 30,000 children ages 0-20 Group reviewed cumulative story behind the data Discussion: What are you most connected to in this story? What role do you play? Rebecca (FDA/Miami Dade College Dental ygiene) FDA legislation to fix billing glitch to allow hygienists to bill Medicaid in order to provide more services Miami Dade College clinic closed during evening hours and weekends not able to see a lot of children Farren urwitz ealth Choice Network has a desire to standardize oral health measures to show story behind the data. Dr. Bilger Florida Department of ealth has need to focus on preventive care and oral health education Dave Meadows Liberty Dental sees need for education on the value of oral health making sure Medicaid eligible have services Marguerite Lynch ealth Care District of Palm Beach County available dental services not being accessed Dr. Manning DentaQuest feels that patients need adequate access to providers and protection against fraud abuse and waste Camilo Meija Catalyst Miami is building Miami-Dade oral health network to address efforts on behalf of community organizations. Group added to the story: Lack of asset maps that capture known resources and services locations Fragmented knowledge especially about advocacy and outreach Competing priorities have reduced access to oral health care (example competing priorities in schools, parents have competing priorities (life getting in the way) have reduced ability for them to get access). There is fragmented knowledge about advocacy organizations and community outreach ealth education needs to include how oral health connects to overall health Closed during evenings and weekends not seeing a lot of children Limited pool of money for Medicaid that has to be used effectively and that has led to fraud Miami Dade College has a list of dental clinics in Miami Dade County FQCs, CCs, Nova PBC ealth Care District is assessing school age children. Numbers that have been assessed nationally and in Florida Research agenda for understanding the story behind the data Christine gave overview of FII Oral ealth Consumer Advisory Council Miami-Dade Oral ealth Coalition is conducting community survey to include self reported oral health, barriers to treatment 3

4 FDA has an FDO grant to complete Basic Screening Surveys of three populations: ead Start, 3 rd grade, older adults To be included on data development agenda Workforce survey for dentists and hygienists Christine om reviewed with the group a new dental data visualization tool available through ACA: Group observations about the data included: Oral ealth Education Group Differences by regions allows lower utilizing counties to be targeted by geography, race, ethnicity Difference in counties. Alliance should target efforts there where there is a lower percentage of utilization Able to examine higher performing areas and figure out what is working Age differences call for participatory guidance targeting maternal child health Overall percentages are high. National average is around 60%. Some of the counties are approaching national average 2-3 year olds need more service: vulnerable population birth 2 years (good time for maternal education; anticipatory guidance) Barriers group What is other? Ethnicity igh utilization in 2 nd and 3 rd grade schools have things in place Where is the Medicaid gap? Increase 2-3-year-old participation Funding/policy group Bell curve shows opportunities to target young children and older adolescents Data doesn t compare to other groups besides Medicaid Managed care profiles show how different plans serve different populations. Missing populations: special needs ow does this inform the work? Shows who is providing service resource for communities What do we propose to do? What is different? What is creative? What is innovative about our strategies? Contributed on February 22, 2016 Focus Area Oral ealth Education Barriers Increased funding Prioritized Factor Strategy Leverage Feasibility Specificity Value Lack of information regarding available services and how to access them Inadequate funding does not provide access to services which leads to a low number of providers, lack of coverage, and benefits. Improve 2-3 year-old participation by increasing engagement and training of non-dental workforce in placement of fluoride varnish application ACA change fee schedule to reallocate funds to incentivize prevention /M 4

5 Barriers to care Services are not meeting the needs of the population Lack of information regarding available services and how to access them Develop ER diversion programs (linking ER to local dentists, call service for dental, health plans medical monitor encounters for ER services to flag dental codes to prevent future utilization of ER for routine dental services call service for dental, health plans medical monitor encounters for ER services to flag P:L A:M M/ Oral ealth Education Policy Policy Services are not meeting the needs of the population Increase oral health literacy in low utilization counties by partnering with community stakeholders to maximize local resources. Enact statutory requirements mandatory oral exam to start school year (state policy) Enact statutory requirement for consent forms for dental school based services change to opt out instead of opt in (state policy) (Same as physical health) P: A: /M / M P: A: Additional small group strategies (rated low): Identify community assets and resources in low utilization counties to partner with an develop a strategy for oral health in that community: o Partner to increase data in specific counties by accessing public health leaders o Low cost to build social capital and network o Easy to determine the needs within timeframe o Increase utilization to provide prevention Change ACA fee schedule reallocate funds to incentive prevention pay for performance o ACA determine rates and add to health plans based upon targets and not past performance ER diversion Community water fluoridation Medical-Dental increase age for reimbursement Who else can play a role in turning the curve? What new partners do we need to add? Who is using data? Florida CAIN Colgate Bright Smiles Office of National Coordinator meaningful use guidelines and EDIS measures (national organization) Additional MOs/Insurance companies CMS Re-engage: Children s Trust, Palm Beach County CSC 5

6 Working subcommittees Oral health education Phillippe Bilger Marguerite Lynch Fabio Nascimento Jose Peralta William Staten Erica Thomas Kevin Thomas Meg Wallace Barriers to oral health Santra Denis Inge Ford Jason irsch Douglas Manning Camilo Mejia Saran Rai Krista Wagner Funding Doug Manning Jason irsch Policy (new subcommittee from 2.22 meeting) Ana Karina Mascarenhas Marcia Bynoe Next meeting: Friday, March 18, am 3 pm Children s Services Council of Palm Beach County 2300 igh Ridge Road Boynton Beach, FL