The Health centers have become the largest primary care system in the United States. They provide timely treatment & preventive care There are more

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1 The Health centers have become the largest primary care system in the United States. They provide timely treatment & preventive care There are more than 700 new centers that have opened up as a result of the Affordable Care Act financed until new ones will be opened this year.

2 Federal Appropriations From 2000 to 2012, the number of Federally Qualified Health Centers (FQHCs) increased by 64%, from 730 health centers serving almost 10 million patients to nearly 1,200 health centers serving over 21 million patients. Between the American Recovery and Reinvestment Act (ARRA) and the Patient Protection and Affordable Care Act (ACA), the federal government has recently invested over $13B in health center infrastructure (FY2009-FY2016).

3 Most health centers have developed strategies for financial growth that include increasing the number of insured patients, working with Medicaid managed care, improving billing and collection practices, and becoming more operationally efficient. Targeted grant opportunities

4 The number of patients seen at these clinics has marched up steadily, year after year, so that by 2014, roughly a half-million New Jersey residents got their health care this way, according to the U.S. Department of Health and Human Services. About a third of those visits were for dental work.

5 NJ There are about a dozen examining rooms where 3,500 patients get dental work each month. Community Health Centers FQHC

6 8 offices in Morris, Sussex, Hunterdon, Warren, Somerset, and Essex Counties

7 New York FQHCs

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9 As of Fall 2014, the CDHC project has graduated 34 students who are now serving in 26 communities in eight states: Arizona, California, Montana, Minnesota, Oklahoma, Pennsylvania, Texas, Wisconsin.

10 As of Fall 2013, the CDHC project has graduated 34 students who are now serving in 26 communities in seven states: Arizona, California, Montana, New Mexico, Oklahoma and Wisconsin. Ms. Wood is also a certified public health dental hygiene practitioner in Pennsylvania, which allows her to provide dental hygiene services at federally qualified health centers as well as a variety of other settings. Her unique skills and training allow her to provide mobile dental hygiene services as well as education outreach programs in the community. "I love working as a CDHC, because it allows me to wrap the dental skills I had plus the social work skills I learned into my every-day work," said Ms. Wood. (Honesdale, PA.)

11 October 2013 As the CDHC transition phase goes into full swing, perhaps your state would be interested in having this new dental team member navigate patients into care in your office or health center. Your action could help address those critics who claim that there is a "shortage of dentists" and "no one takes care of the underserved. If a community college in your area would be interested in offering CDHC training, please let the ADA know. As of Fall 2013, the CDHC project has graduated 34 students who are now serving in 26 communities in seven states: Arizona, California, Montana, New Mexico, Oklahoma and Wisconsin.

12 The ADA continues to not define CDHCs as a midlevel oral health providers. CDHCs are not midlevel providers; they are not intended to take the place of dentists but, rather, to educate, prevent dental disease, and connect patients to dentists who will provide treatment.

13 Connecticut 2001 Medicaid Regulations, Sec. 17b All dental hygienists who participate in Medicaid shall be public health dental hygienists. The regulations cite what services will be reimbursed to dental hygienists and in which settings they can practice. Settings include a nursing home, a group home, a school without a dental clinic, a hospital without a dental clinic and a community health center without a dental clinic. Dental hygienists with 2 years experience may practice without supervision in institutions, public health facilities, group homes and schools.

14 Centers for Medicare & Medicaid Services (CMS) issues Informational Bulletin (7/2014) States have two options for reimbursing for services provided by dental professionals (dental hygienists, dental therapists and community dental health practitioners) who are supervised by dentists but are not themselves dentists: (a) states may pay claims filed by the affiliated dentist for services rendered by the dental professional; (b) states may allow the dental professional to enroll as Medicaid providers and directly bill Medicaid using their own Medicaid provider identification numbers. Either way comports with federal requirements

15 One trend in integrating oral health into medical offices is taking place in pediatric offices. At least 35 state Medicaid programs are paying medical providers for dental services such as fluoride varnish application, oral risk assessment and exam, and caretaker education Wall TP. Dental Medicaid Dental Health Policy Analysis Services. Chicago: American Dental Association Health Policy Resources Center