April 4, Dear John,

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1 DEPARTMENT OF HEALTH & HUMAN SERVICES Health Resources & Services Administration Midwest HRSA Field Office 233 North Michigan Avenue, Suite 200 Chicago, IL John Rossetti, DDS, MPH Chief Dental Officer, HRSA/MCHB Parklawn Building, Room 18A Fishers Lane Rockville, Maryland Dear John, April 4, 2001 During the initial round of HRSA supported oral health summits, Ohio utilized the $5000 requested to support its multi-pronged approach to improving access to dental care. Based on the project goals of the Ohio CISS grant and driven by the needs assessment data, this seven month process yielded excellent recommendations focusing on 1) Medicaid/SCHIP; 2) the delivery system, private and safety net; 3) community action; and 4) awareness, public and policy makers. At the same time, Ohio was selected as one of the states to participate in the National Governors Association (NGA) Policy Academy. Ohio continues to utilize the NGA process to develop a State Action Plan of commitments, responsibilities, and timelines based on the recommendations of the task force, but reflecting political realities. Concurrently, the Ohio Dental Association passed a resolution in support of the task force recommendation. Convening a statewide Oral Health summit will continue the evolution of the process for improving access to dental care for all Ohio citizens. The proposed summit s structure, intended participants, and budget are feasible and sound. The Ohio Department of Health is estimating the cost of this two-day summit to be $33,000. The requested $5000 of HRSA/HCFA support will be used to support the various speakers and logistics. I heartily support this request and hope that you will give it your utmost attention. If you have any questions, please call me at Thank you. Sincerely, Steven P. Geiermann, D.D.S. Regional Dental Consultant i

2 Ohio's Summit on Access to Dental Care Summit Goals: 1. Increase awareness of the problem of access to dental care and encourage local action and advocacy. 2. Provide communities the opportunity to gain skills needed to develop dental care access initiatives. 3. Create a forum for networking and sharing experiences. 4. Catalyze new partnerships to address the access to dental care problem. Intended Audience: City and County Health Departments* Community Action Agencies* County Department of Job and Family Services* Federally Qualified Health Centers* Ohio Family and Children First County Councils* Safety net dental programs* State agency staff* * = Primary audiences (most likely to attend) Dentists and dental hygienists Dental educators (dental schools, dental hygiene schools, residency programs) Dental/dental hygiene students Charitable giving community (community, family, health and private foundations) Head Start programs School nurses State legislators and county commissioners Emergency room MDs/DOs Regional Development District Commissions (including ARC) United Way Agencies Community leaders ODH funded community agencies ii

3 November 14, 2001 Agenda November 14-15, 2001 Columbus Convention Center Columbus, Ohio Preconference Clinical Sessions 9:00-12:00 Life Support (CPR) Infection Control 1:00-2:00 Opening Session Moderator: Mark D. Siegal, DDS, MPH, Chief Bureau of Oral Health Services Welcome and Opening Remarks Speaker: J. Nick Baird, MD Director of Health Access to Dental Care for Vulnerable Ohioans: The Numbers Don't Look Good Speaker: Mark D. Siegal, DDS, MPH, Chief Bureau of Oral Health Services Dr. Siegal is Ohio s State Dental Director. By the time of the Summit, his Department and the Ohio Department of Job and Family Services will have jointly released a comprehensive report on access to dental care in Ohio. Dr. Siegal coordinated the development of the recommendations of the Director of Health s Task Force on Access to Dental Care and the State Agency Action Plan for Improving Access to Dental Care. Needs of an Increasingly Diverse Population Speaker: Cheryl Boyce, Executive Director Ohio Commission on Minority Health Cheryl Boyce has been the Director of the Ohio Commission on Minority Health since it's inception in July The Commission was the first concerted effort by a state to address the disparity in health status between majority and minority populations. Making Access to Dental Care a State Policy Priority Speaker: Senator Raymond D. Rawson (Invited) Dr. Rawson is a dentist, a Nevada state senator and the director of a dental hygienist training program. He has taken a lead role on access to dental care, both in his state legislature and through the Reforming States Group (RSG), a voluntary organization of leaders in government from more than 40 states. The RSG meets regularly to assess their experience in making health policy. iii

4 2:00-3:30 Breakout sessions #1 Awareness to Action: Improving Access to Dental Care 1) Advocacy Skills Building: How to Educate Policy Makers About Oral Health Issues Role-playing session with 6-8 experienced coaches working with groups. Speaker: Kay Johnson, President Johnson Group Consulting, Inc. During the past 15 years, Kay Johnson has been involved in a wide variety of oral health policy development activities. Ms. Johnson has worked in advocacy and policy development roles for the Children s Defense Fund, the March of Dimes and the George Washington University. She has written papers, given professional presentations, provided policy training, and facilitated discussion about children's oral health. In this session, groups of participants will role-play with guidance from experienced coaches. 2) Public Engagement: Creating the Climate for Public Action on Oral Health Speaker: Richard N. Brandon, Ph.D., Director Washington Human Services Policy Center/Washington Kids Count University of Washington Seattle, Washington Dr. Brandon has partnered with the FrameWorks Institute and others to develop Citizens Watch for Kids Oral Health, also known as the Watch Your Mouth campaign, to create a public climate in which policy proposals to improve children s oral health are more likely to be understood and supported by the public and policymakers. 3) It s Not Just Teeth : The Oral Health-General Health Connection Speaker: A. Isabel Garcia, DDS, MPH Special Assistant for Science Transfer National Institute of Dental and Craniofacial Research National Institutes of Health Dr. Garcia coordinates NIDCR programs and activities designed to promote sciencebased practice and science education. This includes programs designed to communicate the most up-to-date scientific discoveries and health information to health care providers, educators and the public. NIDCR - one of components of the National Institutes of Health - supports and conducts research in oral health and supports research training and the timely transfer of research findings and information. 3:30 Break iv

5 4:00-6:00 Town Hall meeting This Town Hall-style meeting will create a forum for attendees to share their concerns about the access to oral health care problem with a panel of legislators. The session will have the feel of an informal hearing being held in a local town hall. Moderator: Burton Edelstein, DDS, MPH Director, Division of Community Health Columbia University School of Dental and Oral Surgery; Director, Children s Dental Health Project Ohio Legislators: A panel of six Ohio legislators will be invited 6:30-8:00 Reception (sponsored by Delta Dental) v

6 November 15, :30-8:30 Breakfast Roundtables Local Action: Strategies and Tools (20-25 minute roundtable presentations with one change of tables) 1. Athens County Dentist Outreach Model for Medicaid - Jack Frech, Director, Athens County Department of Job and Family Services 2. Elyria Dental Access Program Model Peg Vanek, DDS, Elyria Health Department Dental Program 3. School-Based Dental Sealant Programs Nancy Carter, RDH, MPH, Cincinnati Health Department 4. Ohio Department of Health Dental Grant Programs Carrie Farquhar, RDH, BS, Ohio Department of Health 5. Dental Health Professional Shortage Areas (DHPSA) designation Jodi Lang, RDH, BS, Ohio Department of Health 6. Safety Net Dental Clinic Manual Cathy Raymond, RDH, BS, Ohio Department of Health 7. Ohio Special Olympics-Special Smiles Edward Sterling, DDS, Nisonger Center, The Ohio State University 8. Water Fluoridation Information Sources Janet Pierson, RDH, BS, Ohio Department of Health 9. Oral Health Screening Surveys Sandy Brado, RDH, BS and Tina Fulks, RDH, BS, Ohio Department of Health 10. Ohio Oral Health Data Sources Dawn Miller, RDH, MBA, Ohio Department of Health 11. Dental OPTIONS Barbara Crawford, Greater Cincinnati Oral Health Council 12. Cincinnati Dental Sealant Program Follow-up Treatment Project Laurie Cincinnati Health Department case manager 13. Minority Oral Health Awareness Project Local agency that has been awarded an Ohio Department of Health grant to develop public awareness materials on oral health that are targeted to a specific minority community. 14. Cincinnati Dental Care for the Homeless Partnership-Lawrence Hill, DDS, MPH 15. An Overview of the Delta Dental Fund. Nancy Hostetler, Vice President and Susan Woods, Representative, Delta Dental Fund 16. Head Start Dental Initiative: Federal and State Activities - Shannon Cole, RDH, BS and John Rossetti, DDS, MPH 17. Starting a Safety Net Dental Clinic: Lessons Learned - Washington Co., Kathy Boersma 18. Recruitment and Retention of Dentists: Lynn Holland and Randy Runyon, Family Health Centers, Pike County. vi

7 8:30-10:00 Plenary Session Partnering to Improve Access to Dental Care: First, You Have to Get Their Attention Moderator: Jack Dillenberg, DDS, MPH Public Health Speaker: Jack Dillenberg, DDS, MPH Dean, Arizona College of Dentistry and Oral Health former Associate Director for Public Health Programs California Department of Health Services Dr. Dillenberg is the former State Dental Director, Maternal and Child Health Director and State Health Director for the State of Arizona. Dr. Dillenberg is a past president of the Association of State and Territorial Health Officials. He is nationally recognized for his abilities to bring together coalitions and successfully tackle oral health and other health issues at the national, state and local levels. Private Dentists Speaker: Leroy P. Ash, DDS Dr. Ash, a private practitioner in Marietta, was a driving force behind the creation of the Southeastern Ohio Dental Clinic. Government Speaker: Opal Spears Scioto County Commissioner Ms. Spears was actively involved in the creation of the Carousel Center Dental Clinic in Portsmouth. Non-Government Program Speaker: Theresa Reagan, former Executive Director of Children s Health Alliance of Wisconsin Ms. Reagan was the primary mover behind a non-governmental agency taking a leadership role in advocating for successful policies and programs to improve access to dental care in Wisconsin. 10:00-10:30 Break 10:30-12:00 Skills Building Breakout Sessions #2 Breakout session #2 and #3 will be presented along three subject matter tracks. Several of the sessions presented in Round #2 will be repeated in Round #3. Track 1: Systems Building 1) New Frontiers in Medicaid Moderator: Don Schneider, DDS, MPH, Chief Dental Officer Health Care Financing Administration U.S. Department of Health and Human Services vii

8 This session will feature three state Medicaid programs that have made significant changes to their dental components. Presentations will focus on the specific changes, evaluation of their impact and discussion. National overview: Dr. Don Schneider Michigan Healthy Kids Dental Speaker: Steve A. Eklund, DDS, DrPH University of Michigan School of Public Health Alabama Speaker: John Searcy, MD, FAAP, Medical Director Alabama State Medicaid Agency South Carolina Speaker: J. Stan Thompson, BA, Director Division of Preventive and Ancillary Health Services South Carolina Department of Health and Human Services 2) Best Practices in Coalition Building Moderator: John Rossetti, DDS, MPH, Health Resources and Services Administration Washington Speaker: Beth Hines, RDH, MPH, Washington Department of Public Health, Ms. Hines was the project director of a federal grant project to develop a state coalitions and local coalitions in Washington. Her project developed a coalitionbuilding manual that is used widely across the country. She was a faculty member for the National Governors Association Policy Academy on Oral Health Access. Ohio Speaker: Shannon Cole, RDH, BS, Bureau of Oral Health Services Ohio Department of Health, Ms. Cole coordinates The Ohio Initiative, through which the Ohio Department of Health helps to catalyze the creation of local oral health coalitions and support the operation of existing coalitions to improve oral health. In addition, she has extensive experience with Head Start and other Maternal and Child programs. viii

9 Track 2: Safety Net Clinic Development and Operation 1) Ohio Medicaid Nuts and Bolts Speaker: Sukey Barnum, BA, MPA, Chief Bureau of Consumer and Program Support Office of Ohio Health Plans David Welsh Ohio Department of Job & Family Services This session will feature experts from the state s Medicaid program who will discuss how to become a Medicaid provider, billing, electronic billing. This will be a very interactive session, responding to audience questions. 2) Operating a Successful Safety Net Dental Clinic Speakers: Lawrence F. Hill, DDS, MPH, Dental Director, Cincinnati Health Department Dr. Hill has extensive experience in designing, building and operating clinics in Cincinnati s health center system. He has consulted with other safety net dental care programs and is the only dentist on the National Health Service Corps Advisory Committee. Track 3: Clinical 1) State of the Science in Dental Caries Diagnosis, Prevention and Treatment (includes Early Childhood Caries and Fluoride Varnish) Speaker: Amid Ismail, DDS, DrPH, Professor Department of Cariology, Restorative Sciences and Endodontics School of Dentistry University of Michigan Dr. Ismail has written and spoken extensively on dental caries diagnosis, treatment, and prevention. He has been an invited speaker at several National Institute of Dental and Craniofacial Research, National Institutes of Health conferences on dental caries. 2) Managing Patient Behavior (young children, MR/DD) Speaker: Paul Casamassimo, DDS, MS, Chairman Section on Pediatric Dentistry College of Dentistry The Ohio State University, Dr. Casamassimo also heads the Dental Department at Columbus Children s Hospital. He is the Immediate Past-President of the American Academy of Pediatric Dentistry and former Editor of the Journal of Pediatric Dentistry. He was the lead on the Bright Futures in Practice Oral Health Project. ix

10 12:00-1:45 Luncheon Improving Oral Health and Access to Dental Care: Where the Nation has Been and Where Ohio Must Go From Here Keynote Speaker: Burton Edelstein, DDS, MPH Dr. Edelstein, a pediatric dentist, is a nationally prominent advocate for children s oral health. He has spoken and published widely on issues relating to access to dental care, the Medicaid dental program, and childhood dental caries. Dr. Edelstein organized the Surgeon General s Workshop on Oral Health, in 2000, and helped to shape the federal Health Resources and Services Administration s Oral Health Initiative. From , when the Child Health Insurance Program was being crafted at the federal level, he was a legislative aide in the U.S. Senate Office of the Minority Leader. In addition to his other efforts, he heads Columbia University s National Oral Health Policy Center. 2:00-3:30 Skills Building Breakout sessions #3 Track 1: Systems Building 1) Tips for Procuring Private and Public Grant Funding Speakers: Kaki McGeary, The Anthem Foundation of Ohio Teri Donlin, The Ohio Osteopathic Heritage Foundations Steve Geiermann, DDS, HRSA, Region V Dental Consultant, U.S. Public Health Service (invited) This session will focus on identifying potential funders, the types of activities they tend to fund, and what they look for in proposals. Ms. Donlin and Ms. McGeary work for two Ohio private foundations that have identified dental care as a funding priority. Dr. Geiermann will discuss federal funding opportunities. Track 2: Safety Net Clinic Development and Operation 1) Ohio Medicaid Nuts and Bolts Speaker: Sukey Barnum, BA, MPA Chief Bureau of Consumer and Program Support Office of Ohio Health Plans David Welsh Ohio Department of Job & Family Services 2) Operating a Successful Safety Net Dental Clinic Speakers: Lawrence F. Hill, DDS, MPH, Dental Director, Cincinnati Health Department Track 3: Clinical 1) State of the Science in Dental Caries Diagnosis, Prevention and Treatment (includes Early Childhood Caries and Fluoride Varnish) Speaker: Amid Ismail, DDS, DrPH, Professor Department of Cariology, Restorative Sciences and Endodontics School of Dentistry University of Michigan x

11 2) Geriatric/Nursing Home Dentistry Speaker: Michael S. Strayer, DDS, MS, Associate Professor The Ohio State University College of Dentistry Dr. Strayer is the lead on issues and instruction relating to Geriatric Dentistry at the Ohio State University, College of Dentistry, in Columbus. Dr. Strayer is pastpresident of the Columbus Dental Society, past-chair of the Ohio Dental Association Subcouncil on Access and has served on the American Dental Association Council on Access, Prevention and Interprofessional Relations. 3) It s Not Just Teeth : The Oral Health-General Health Connection Speaker: A. Isabel Garcia, DDS, MPH Special Assistant for Science Transfer National Institute of Dental and Craniofacial Research National Institutes of Health 3:30 Conference Ends xi

12 I. Program Overview Ohio Access to Dental Care Summit November 14-15, 2001 Final Report Over the past three years the Ohio Department of Health (ODH) has engaged in planning process to improve access to dental care. Beginning with the Director of Health's Task Force (DTF) on Access to Dental Care that was very inclusive, involving over 70 agencies and organizations. The resulting recommendations were the starting point for a smaller workgroup that developed a set of commitments by state agencies known as the State Agency Action Plan (SAAP) to improve access to dental care. An Ohio Dental Association task force decided to focus on gaps between the DTF recommendations and the SAAP. Among the commitments of the SAAP was for a statewide access to dental care summit conference. The access to dental care summit integrated all four focus areas of the recommendations of the Director of Health s Task Force on Access to Dental Care. The summit itself was an awarenessraising effort (Focus Area IV) aimed at communicating information about state level policy efforts and their potential local level impact (Focus Areas I and II). Summit participants had the opportunity to participate in a town hall meeting and voice emerging issues with policy makers. Furthermore, the summit offered considerable skill building opportunities to catalyze new local and state dental care access activity and nurture community efforts that are underway (Focus Area III). The summit was of interest to a variety of audiences including city and county health commissioners, safety net dental clinic administrators and dental clinic staff, dentists and dental hygienists, public health and school nurses, as well as staff of Community Action Agencies, Federally Qualified Health Centers, County Departments of Job and Family Services, Ohio Family and Children First County Councils, Head Start health coordinators and anyone else concerned about access to dental care. The specific objectives of the summit were to: 1) Increase awareness of the problem of access to dental care and encourage local action and advocacy. 2) Provide communities the opportunity to gain the skills needed to develop dental care access initiatives. 3) Create a forum for networking and sharing experiences. 4) Catalyze new partnerships to address the access to dental care problem. II. Program Accomplishments The town hall meeting provided an opportunity for concerned citizens to voice emerging issues with policy makers. The town hall meeting format was like that of a hearing. A panel of state policy makers was seated on a dais before the audience. Two floor microphones were positioned for audience members to use. Panelists had the opportunity to make brief statements prior to hearing from attendees. Audience participants spoke or "testified" about the scope of the access to dental care problem xii

13 and the majority of questions focused on Medicaid/SCHIP. Key questions were shared with panelists in advance along with other background material. The moderator, an expert in oral health and public policy, maintained the flow and provided a summary at the close of the town hall meeting. Panelists Representative Ray Miller Anne Harnish, Assistant Director, Ohio Department of Health Cheryl Boyce, Executive Director, Ohio Commission on Minority Health Barbara Edwards, Deputy Director, Ohio Department of Job and Family Services Moderator Columbia University's Dr. Burton Edelstein, Founding Director of the Children's Dental Health Project, moderated the panel. Dr. Edelstein is a pediatric dentist and a former Robert Wood Johnson Health Policy Fellow who served as a health legislative aide in the United States Senate during SCHIP enactment. The summit served as a springboard for action for continuing the momentum developed at the national level and in Ohio and disseminating it to the community level. The summit created opportunities to share Ohio data, programs and policy strategies; learn from nationally recognized speakers; participate in group discussions; network with peers and visit exhibitors from companies that specialize in developing dental clinics. The summit attendance was an impressive 251 people including dentists, dental hygienists, dental assistants, health commissioners, nurses, physicians and administrators from local agencies and programs in 88 counties. The summit was made possible with support from The Anthem Foundation of Ohio, The Osteopathic Heritage Foundations, Delta Dental Fund, The Ohio Dental Association, Health Resources and Services Administration and Association of State and Territorial Dental Directors and enabled workers in local agencies and programs with tight budgets to attend by covering costs that otherwise would have been recovered through potentially prohibitive registration fees. Conference registration was very affordable and contributed to maximum attendance. III. Evaluation A final report (48 pp.) summarizing participant evaluations was mailed January 10, 2002 to supporting agencies and organizations. xiii

14 Outcomes for each objective: 1) The ODH will monitor the number of community coalitions/partnerships and local oral health initiatives that are developed as a result of the summit via a tracking instrument for community development. 2) The multi-track design of the summit agenda offered an array of capacity building opportunities for people with various interests. The summit report summarizes session evaluations and participant's positive anecdotal comments reflect the quality of the sessions and the benefits and skills gained. 3) As a follow-up, ODH mailed the summit attendee list to all participants and encourages networking between individuals and agencies. 4) ODH is in the process of consulting safety net dental clinics and hopes to establish and maintain a communication infrastructure to best meet their needs. A number of comments by summit attendees, led BOHS to commit to convene a meeting of people interested in exploring the creation of a statewide oral health coalition. The first meeting was February 19, 2002 in Columbus, Ohio. The Ohio Primary Care Association has agreed for the time being to coordinate the statewide coalition. xiv