Washington State Collaborative Oral Health Improvement Plan 2009-2014 Prioritization Criteria (non-financial): Strategic Area I: System Infrastructure (Partnerships, Funding, Technology) Goal 1: Mobilize and empower the public and community-based organizations to collectively identify and implement solutions for their oral health needs. Objective 1.1: Increase the number of community groups that work to identify oral health needs and define solutions thru advocacy and leveraging of resources by June 2010. 5.5 Space, refreshments, staff, communication : 1.1.1 Seek opportunities to gather community groups and businesses to discuss oral health and general health needs and solutions in related settings (schools, churches, clubs, worksites,.) 1.1.2 Foster and support state and local oral health coalitions Invite and promote active participation from a broad membership. Provide training on coalition sustainability, strategic planning, advocacy, media use,. 4 Promote involvement of oral health coalitions with chronic disease and other coalitions. Goal 2: Strengthen collaboration across health professions and related services in the public and private sectors.
(non-financial): Objective 2.1: Increase interaction among health professionals, educators, and social service organizations in order to optimize utilization of resources and follow best and promising practices by June 2011. 6.3 Communication, coordination : 2.1.1 Increase communication and coordination of activities among health professionals, educators, and social service organizations to optimize utilization of resources and identify efficient and effective practices. 2.1.2 Participate actively in the discussion of medical homes and health care reform at the national and state levels, and promote the inclusion of dental homes and oral health, respectively. 7 7 2.1.3 Leverage strengths and resources of public and private organizations to facilitate mutually beneficial partnerships. 5 Goal 3: Maintain and/or increase to provide Washington residents preventive and restorative oral health services. Objective 3.1: Work with policy makers and state agencies to maintain and/or increase for Medicaid and Public Health (State and Local Oral Health Programs), including the development of a financial case for investing in oral health by December 2013. : 7 3.1.1 Develop the financial case to show legislators the benefits of investing in the oral health of the state. 7 3.1.2 Submit proposal to legislature requesting improvement of Medicaid reimbursement mechanisms by considering effective initiatives modeled by other states. 7 3.1.3 Improve the coordination and timeliness of Medicaid reimbursement and payment. 7
(non-financial): 3.1.4 Enhance support and to the State and Local Oral Health Programs (Public Health) for their activities related to surveillance, oral health promotion, oral disease prevention, and service referral. 7 3.1.5 Expand collaboration with non-traditional partners to leverage current public and private oral health resources. 7 3.1.6 Increase to expand the state s community health clinics** to treat the underserved (**community health centers, free clinics, rural health clinics, public health clinics, mobile clinics, tribal clinics). 7 Objective 3.2: Work with policy makers and state agencies to maintain and/or increase to expand the state s community health clinics that care for the underserved by December 2013. 7 : 3.2.1 Support educational institutions ability to emphasize oral health training programs (dentistry, dental hygiene, EFDAs, dental assisting, and mid-level providers). 7 3.2.2 Increase to expand oral health residencies and student internships that promote clinical rotations in underserved areas. 7 3.2.3 Increase recruitment and retention of oral health providers in underserved areas through enhanced incentives, such as loan forgiveness and scholarship programs. 7 Objective 3.3: Work with policy makers and state agencies to maintain and/or increase to train and expand the oral health workforce including dental students, dental residents and providers that provide oral health services in underserved areas by December 2013. 7 Goal 4: Expand the use of proven technology to facilitate oral health promotion, dental education, and delivery of oral health services statewide.
(non-financial): Objective 4.1: Increase the use of e-health communication for oral health promotion, and the use of tele-health for dental education and delivery of clinical services by June 2013 3 : 4.1.1 Research and consider testing of new social networking technology to effectively communicate oral health information to different population groups statewide. 4.1.2 Enhance the use of tele-health with underserved areas to facilitate long-distance education and clinical training of students, consultation among professionals, and supervision of oral health providers and staff. 4.1.3 Expand the use of existing state s tele-health system (K-20) to provide oral health training to professionals, organizations, and community groups statewide. 3 3 3 Objective 4.2: Invest in the integration of electronic dental and medical records to improve communication among medical and dental providers by July 2012. 6 Strategic Area II: Oral Health Needs Assessment (Surveillance, Research, Evaluation) Goal 5: Expand the existing oral health surveillance system to provide comprehensive, timely and accurate reporting of oral health needs, outcomes and disparities. Objective 5.1: Identify data gaps and develop appropriate surveillance data indicators by December 2010. 5.8 : 5.1.1 Work with partners and stakeholders to identify data gaps in the current surveillance system. 7
(non-financial): Convene workgroup to identify gaps in the surveillance system and develop appropriate indicators/variables. 7 Identify resources and to collect surveillance data for new indicators/variables. ilinc, WSOHC, military, professional orgs 5.1.2 Improve the current oral health surveillance system by including collection and reporting of county level oral health data 4 Supplement county resources to allow collection and analysis of county level oral health data. 4 5.1.3 Strengthen collaborative data collection among partners and stakeholders to ensure comprehensive surveillance 7 Explore best marketing strategies to share results Require the use of standardized dental screening forms and centralized reporting of screening results by health professionals conducting dental screenings and sealant programs in schools. Collaborate with Head Start/ECEAP and WIC sites to collect data regarding oral health status and unmet treatment needs of young children. 7 Collaborate with hospitals/urgent care facilitates to collect data related to dental emergency visits. 5 Collaborate with senior centers, nursing homes, AAAs to collect data related to seniors oral health. 5 Objective 5.2: Share summarized surveillance information through the health care system to local public health, educational institutions, insurers, social services, policy makers, community-based organizations, communityhealth clinics and other partners as appropriate by June 2011. 5.5
(non-financial): : 5.2.1 Make data available to stakeholders in tailored and user-friendly format. 7 5.2.2 Share accomplishments and best/promising practices. 7 5.2.3 Disseminate state and county-based oral health data thru surveillance system webpage. 4 Collaborate with partners to develop a web based data clearinghouse 4 Goal 6: Develop and promote a research agenda that addresses the need for basic, translational and clinical research to advance oral health and eliminate oral health disparities. Objective 6.1: Develop and share a relevant research agenda to improve the oral health of the state s population by December 2010. 4.8 Community Colleges, UW, WSU, CWU, EWU : 6.1.1 Convene a workgroup of researchers, private and public health professionals to develop and prioritize a research agenda for our state. 5 6.1.2 Identify and support pilot projects as well as intervention research to test innovative oral health approaches. 3 6.1.3 Share scientific updates and evidence-based practices with the public, community-based organizations, health care providers and policymakers. 7 6.1.4 Promote collaborations to support clinical and community-based research. 4
(non-financial): 6.1.5 Promote the transformation of the practice of dental professions from a restorative focus to a prevention and wellness model of care. 5 Goal 7: Develop and implement a systematic methodology to evaluate oral health programs across the state. Objective 7.1: Determine and implement outcome measures as quality improvement tools to evaluate oral health programs by December 2011. 4 : 7.1.1 Share information about the importance of program outcomes as a quality improvement tool. 4 7.1.2 Share program evaluations to expand public knowledge about the effectiveness of oral health interventions. 4 Plan outcome measures that can be easily tracked and leads to consistent results. 4 Strategic Area III: Oral Health Promotion/Awareness (for the Public, Providers and Policy Makers) Goal 8: Raise oral health awareness in order to build support for policies and resources to address the state s oral health needs. Objective 8.1: Develop and share evidence-based and consistent oral health messages (as related to general health, chronic diseases, and achievements at school and work) to help the people and community-based organizations make healthy choices by December 2012. 5.3 : 8.1.1 Identify and target constituent groups of the public, communitiybased organizations, providers, and policy makers, and learn about their oral health information needs and how to most effectively deliver messages to each of them. 7 Media coordinator, technical assistance, cultural experts, staff, community liaisons
(non-financial): 8.1.2 Develop updated, evidence-based messages that show the relationship among oral health, chronic disease, and overall well-being, including school achievement and work productivity, tailored to each constituent group. 8.1.3 Develop appropriate and effective oral health education products. 5 Use cultural competency and health literacy principles to maximize communication. 5 Partner with the media to support the objective. 4 Involve target groups in the development of oral health education materials. 5 Objective 8.2: Develop and share relevant oral health information with policy makers to help build state and local health policy agendas aimed at decreasing oral health disparities in Washington by June 2013. 5.5 : 8.2.1 Initiate and promote oral health policy proposals based on priority oral health needs and disparities in the state identified through designated assessment processes and best practice recommendations. 4 8.2.2 Inform policymakers and administrators at local and state levels regarding oral health issues facing their constituencies. Research and develop 1-3 key consistent target messages for policy makers.
(non-financial): Develop short and accurate legislative fact sheets that provide information about oral health needs and resources in their community. Objective 8.3: Develop and/or share evidence-based guidelines and best practices with health professionals and educators related to clinical and community-based oral health interventions by June 2011. 6 : 8.3.1 Apply strategies to enhance the adoption and maintenance of proven community-based and clinical interventions for oral health. 7 8.3.2 Educate medical professionals about oral health issues as a way to build effective referral links between the primary care and oral health communities. 5 8.3.3 Inform health professionals about resources, opportunities, and tools for oral health promotion, screening and referrals for all patients 7 8.3.4 Increase professional awareness of signs and reporting of child and seniors abuse and neglect from an oral health perspective. 5 Strategic Area IV: Oral Disease Prevention Goal 9: Promote evidence-based preventive activities that sustain oral health and prevent oral disease. Objective 9.1: Increase the proportion of our state s population served by public systems with community water fluoridation by December 2013. 6.2 : Consensus of collection of best practices 9.1.1 Disseminate updated, easy to read scientific information about the benefits of water fluoridation in preventing tooth decay. 7
(non-financial): 9.1.2 Promote efforts to sustain communities with fluoridated water systems and to enable willing communities to fluoridate their water systems. 9.1.3 Education policy makers and operators of water treatment plants about the benefits and costs of fluoridating drinking water. 7 9.1.4 Engage policy makers in supporting water fluoridation as a good strategy for reducing dental decay and health care costs for tax payers, families and employers. 7 9.1.5 Track progress in increasing the number of Washington State residents that have fluoridated drinking water 5 9.1.6 Support grant to assist communities in sustaining their prevention efforts 5 Objective 9.2: Increase the use of dental sealants in public and private settings by December 2012. 6.3 : 9.2.1 Increase the percentage of school-based dental sealant program in elementary schools. 7 Assist and support implementation of school-based sealant programs. 7 Promote collaborative activities between providers and local oral health programs to offer sealants in schools in accordance to the State Sealant Guidelines. 7
(non-financial): Promote the use of dental sealants among health care professionals Share scientific evidence for using dental sealants on incipient caries to dental providers. 5 Inform local education school boards about the prevention of disease benefits of school-based dental sealant programs. 9.2.2 Require standardized data collection and reporting protocols by all public and private school-based sealant providers. Objective 9.3: Increase the use of caries risk assessment by health professionals by December 2012. 4 : 9.3.1 Share best practices on risk assessment and oral health preventive practices for specific population groups (pregnant and child-bearing years, infancy, early childhood, middle childhood, seniors, among others ) with health professionals. 4 Staff early 9.3.2 Provide intra-professional training to all health care professionals on risk assessment and evidence-based preventive practices. Expertise; develop training plan/ dissemination plan 9.3.3 Explore the impact of mandatory dental screening in schools. 2 Objective 9.4: Increase the use of professionally applied fluorides in public and private settings by December 2012. 6 :
(non-financial): 9.4.1 Promote the use of professionally applied topical fluoride based on risk assessment. 7 9.4.2 Share national guidelines and/or best practices for professionally applied fluorides and supplements to healthcare professionals. 4 9.4.3 Encourage and increase awareness, provision and prescription of appropriate fluorides among the general population. 7 Guidelines are available Objective 9.5: Increase the use of oral cancer screenings by health care providers by December 2012. 6 : 9.5.1 Partner with cancer prevention-related groups, professional associations, dental insurers, and educational institutions to coordinate efforts and resources. 9.5.2 Share and promote the use of tailored messages to healthcare professionals related to oral cancer screening. Objective 9.6: Increase the use of tobacco cessation advice in dental offices by December 2012. 7 : 9.6.1 Partner with tobacco-related prevention groups, professional associations, insurers, and educational institutions to coordinate efforts and resources. 7 9.6.2 Tailor messages to healthcare professionals practices related to tobacco cessation. 7
(non-financial): Strategic Area V: Access to Oral Health Services (Services, Workforce, Insurance) Goal 10: Expand access to early intervention and high quality oral health services by addressing unmet needs and known barriers in urban and rural areas. Objective 10.1: Increase availability of public and private oral health services to all Washington residents by December 2013. 5.1 : 10.1.1 Inform the public and providers about existing local oral health services and referral networks. Need to expand the information to be distributed other ways (in addition to internet) Develop and maintain print and online resource guides with a list of available community health clinics, Medicaid providers, and referral networks. Develop a communications strategy to inform the public and providers about available resources for patients who need transportation and other support services for oral health services. 10.1.2 Expand capacity of community health clinics (community health centers, public health clinics, free clinics, and tribal clinics). 5 Identify barriers (resources, staffing, services) and solutions to expanding the number and staffing of community health clinics as necessary to meet their communities needs. 3 Encourage community health clinics to offer a broad range of oral health services to all age groups. 4
(non-financial): Research innovative oral health team approaches, including increased medical/dental integration to deliver more care. 7 Support interaction among community health clinics, local hospitals and local oral health programs to promote access to regular oral health care and decrease emergency room oral health visits. 7 10.1.3 Support or develop local coalitions in their efforts to secure oral health services for their communities. 4 Engage oral health providers and representatives of patients and caregivers in planning for the provision of oral health care in their communities. 4 Convene focus groups with local oral health coalitions, providers and others to identify specific needs, barriers and solutions. 4 Objective 10.2: Improve access to oral health care services for individuals from special populations (including pregnant women, children with special needs, people with disabilities, people with mental illness, people with HIV/AIDS, tribes, communities of color, the under/uninsured, the incarcerated, the undocumented, among others) by December 2013. 5.2 : 10.2.1 Look at and disseminate existing models and promising practices to address the oral health disparities among Washington residents of all ages, races and ethnicities. 10.2.2 Expand the use of mobile dental clinics to meet the needs of the under/uninsured as well as better coordination with medical providers. 4 10.2.3 Seek assistance and resources from state and local agencies to improve services and care for special populations. 7
(non-financial): 10.2.4 Expand the UW DECOD Program and promote other similar programs for special populations. 4 10.2.5 Continuously identify, evaluate and promote programs that increase access to oral health services, such as Community Health Access Program (CHAP), Access to Baby and Child Dentistry (ABCD), Oral Health Connections (ABCD look-alike for seniors), 211 linkages to oral health services, WDSA Access for Seniors, WithinReach, among others. 5 Goal 11: Increase the effectiveness of the oral health workforce by increasing its diversity, enhancing its education and strengthening its flexibility. Objective 11.1: Increase and recruitment efforts for diversity-based scholarships, internships, outreach activities and pipeline programs in dental and allied dental education by December 2013. 4.6 : 11.1.1 Increase for diversity-based scholarships, internships, and pipeline programs in dental, dental hygiene, EFDA, dental assisting and other related schools. 11.1.2 Encourage WA students of color in middle and high schools and colleges to consider careers in dentistry, dental hygiene, EFDA and dental assisting. 4 7 11.1.3 Offer training opportunities for internationally trained dentists to qualify for state licensure 2 11.1.4 Use non-traditional team approaches and settings to reach underserved groups and areas. 3 Explore different ways to expand the oral health workforce in rural areas, especially oral surgeons and other specialists. 7
(non-financial): Objective 11.2: Evaluate dental and allied dental educational programs in their ability to address the state population s oral health needs and disparities by September 2011. 4.8 : 11.2.1 Share data on populations oral health needs and workforce with educational institutions and professional associations. 4 Need ongoing data & analysis for population & workforce needs. 11.2.2 Create partnership opportunities for educational institutions and professional associations to design community outreach and curriculum development activities. 5 Procede with the State Oral Heatlh Education Consortium 11.2.3 Increase opportunities for student involvement in public health projects and clinical rotations in underserved areas and tribes. 5 11.2.4 Support and expand interdisciplinary program models such as programs in the EWU/ UW School of Dentistry and the Dental Team Experience, among others, that focus on underserved areas. 4 Identify & adopt effective models 11.2.5 Study the economic model that leads to high dental student debts after graduation and ways to decrease it. 11.2.6 Seek opportunities to establish a dental public health residency in WA State. 5 Objective 11.3: Increase access to high quality oral health care by expanding the roles of oral health and medical providers and settings through accredited education and competency development by June 2012. 5.7 :
(non-financial): 11.3.1 Ensure joint training opportunities for all healthcare providers. 11.3.2 Provide opportunities for continuing education and training on the state s oral health needs and disparities (e.g., online, at state conferences,.) 11.3.3 Develop collaborative public health projects with oral health and other health care students and providers. 11.3.4 Increase incentives for providers to establish practices in underserved areas and/or work with underserved groups 11.3.5 Develop collaborative business models for provider to work with the underserved. 7 11.3.6 Reduce barriers for licensure and malpractice insurance of Volunteer/Retired Providers that work with the underserved. 5 11.3.7 Assure training and collaboration with emergency management personnel/community and oral health professionals about the potential effects on communities of man-made and natural disasters, and pursue opportunities to serve as medical/dental responders in the event of such events. 4 Goal 12: Make dental insurance available and affordable to all Washington residents, including those with special needs. Objective 12.1: Increase the proportion of Washington residents who have dental insurance coverage by December 2012. 6.3 :
(non-financial): 12.1.1 Engage dental insurers to discuss future dental insurance opportunities and innovative models. 7 12.1.2 Explore and provide more comprehensive coverage for people with special needs. 5 12.1.3 Work with the Office of Insurance Commissioner to increase the number of health insurance options in the state. 7 Strategic Area VI: Implementation and Sustainability Goal 13: Successfully implement the State Oral Health Plan through participation of committed statewide oral health leadership in the State Oral Health Coalition. Objective 13.1: A group of committed statewide oral health leadership will start to work collaboratively by February 2010 on the oversight, direction and monitoring of the next phases of the State Plan, including: 7 Development of a work plan with detailed information on how to accomplish each goal and objective; Creation of taskforces to focus on specific goals and/or objectives; Seeking and sustaining the engagement and commitment of communities, policy makers, providers and businesses to the implementation and sustainability of the State Plan s goals and objectives. : 13.1.1 Research different successful models for the oversight entity (e.g., the WA Diabetes Plan thru the Diabetes Coalition, and others) 7 13.1.2 Identify and apply criteria to prioritize goals, objectives, and action steps (what is possible to do with current and potential future resources, policy changes,.) 7 13.1.3 Assess partners resource levels, needs, and plan for collaborative resource development. 7
(non-financial): Objective 13.2: Conduct a mid-point evaluation and progress report of the State Oral Health Plan by December 2012. 7 : 13.2.1 Map and follow up on partners work and commitment to the different goals and objectives of the state plan (Alignment Wheel) 7 13.2.2 Create taskforces as to accomplish goals and objectives. 7