LOOKING FORWARD: 2017 UPDATE ON ORAL HEALTH IN MICHIGAN

LOOKING FORWARD: 2017 UPDATE ON ORAL HEALTH IN MICHIGAN

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE If you want to go fast, go alone. If you want to go far, go together. -African Proverb

OBJECTIVES 1. Overview of the Michigan landscape 2. Provide a State Oral Health Plan Update Year One Evaluation Discuss three main areas: Professional Integration Health Literacy Increased Access to Oral Health Care 3. Describe Collaboration and Accomplishments

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE FY17 new Budget items: Expand Healthy Kids Dental statewide Promote dental care for pregnant women Enhance dental utilization and outreach in LHDs Funding for the University of Detroit Mercy dental clinic FY17 ongoing Budget items: Funding for the Donated Dental Program Funding for the Developmental Dental Treatment Fund

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE FY17 proposed legislation with Oral Health impact Opioid bills SB 270, 272, 273, 274 HB 4408 Revisions to PA 161 program SB 256 Human Trafficking Other proposed legislation?

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE FY16-17 issues with Oral Health impact FLINT WATER CRISIS

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE 2020 State Oral Health Plan Recommended by CDC as it provides a framework for action Early 2015: MDHHS OHP and MOHC worked together to develop a five-year state oral health plan 3 focus areas were developed Professional integration Health literacy Increasing access within underserved populations Final plan was completed in December 2015 Released at MOHC conference in May 2016

PARTNERS WORKING TOWARD OPTIMAL ORAL HEALTH IN MICHIGAN Evaluation of Year 1 Implementation of the 2020 Michigan State Oral Health Plan

ASSESSMENT OF STAKEHOLDER ENGAGEMENT Oral Health Key Partner Survey Survey link emailed to 32 oral health partners Open approximately 4 weeks (Feb-Mar 2017) 19 completed surveys 59% response rate In the first year since plan dissemination: Are oral health partners aware of the 2020 State Oral Health Plan? Do oral health partners feel their organization s goals align with the focus areas in the 2020 Michigan State Oral Health Plan? How do oral health partners use the 2020 Michigan State Oral Health Plan? Overall, how engaged are oral health partners in implementing the 2020 State Oral Health plan?

RESULTS Efforts in disseminating and informing stakeholders of the 2020 SOHP were successful 94% 94% Partners who received the 2020 SOHP Partners who read the 2020 SOHP The majority of oral health partners were aware of and read the 2020 State Oral Health Plan

RESULTS Focus areas within the 2020 SOHP were also areas of focus for oral health partners 24% 47% 29% 0% Partners who said goals were completely aligned with SOHP Partners who said goals were mostly aligned with SOHP Partners who said goals were somewhat aligned with SOHP Partners who said goals were not at all aligned with SOHP

RESULTS Low Engagement Key partners were not aware of the SOHP and/or did not read the SOHP Moderate Engagement Key partners were aware of and read the SOHP, did not use the plan in 2016 but are willing to use the SOHP to make decisions or plans for action in 2017 5% High Engagement Key partners were aware of and read the SOHP and used the SOHP to make decisions or develop plans for action in 2016 Nearly half of partners were highly engaged in implementing the 2020 SOHP in 2016

RESULTS Highly engaged partners represented: Coalitions/Councils Educators Government/Policy Makers Providers There were no surveyed partners who represented community-based organizations, insurers/third party payers, or professional organizations that were highly engaged in implementing the 2020 SOHP in 2016.

RESULTS 14% In 2016, progress was made toward SOHP goal achievement Increase Access 71% Health Literacy 71% Professional Integration 100% % of partners who said their organizations goals were aligned with the SOHP focus areas % of partners whose work completed in 2016 related to one of the SOHP focus areas 14% 59% Fewer partners reported working on activities related to health literacy and professional integration compared to increasing access within underserved populations.

Recommendations For Further Success MDHHS OHP: A communication plan with strategies to engage partners can prompt action, increase collaboration, and facilitate buy-in from partners. Organized communication activities can also provide a means to update partners on achievements and recognize and celebrate successes. Outreach efforts should emphasize the need for action particularly around work to enhance professional integration and increase health literacy and invite moderately engaged partners to become highly engaged partners.

Recommendations For Further Success MDHHS OHP (cont d): Regular evaluation and monitoring should be continued through the lifespan of the plan to provide feedback on the extent of partner engagement and goal achievement, identify implementation issues and solutions, and make adjustments within the plan, if needed.

Recommendations For Further Success Oral Health Stakeholders: Use the 2020 Michigan State Oral Health Plan to make decisions and develop plans for action Collaborate with other stakeholders Participate in evaluation efforts

2020 Michigan Oral Health Plan Goal 1: By September 30, 2020, enhance professional integration between providers across Goal 2: By September 30, 2020, increase knowledge and awareness of the importance of oral health DRAFT the lifespan. 2020 STATE ORAL to overall HEALTH health. PLAN GOALS Goal 3: By September 30, 2020, increase access to oral health care among underserved and/or hard to reach populations.

Goal 1: By September 30, 2020, enhance professional integration between providers across the lifespan.

GOAL 1: ENHANCE PROFESSIONAL INTEGRATION BETWEEN PROVIDERS ACROSS THE LIFESPAN Objective 1.1: Establish an equitable payment rate for oral health services among both medical and dental providers. Objective 1.2: Increase the number of educational opportunities that allow oral health and other health care providers to work as a single team to address patient health care needs by 10%. Objective 1.3: Increase the number of programs that educate oral health providers on the social determinants of oral health among underserved or marginalized populations by 10%. Objective 1.4: Increase the number of oral health care providers who have formal relationships (e.g., Memorandum of Understanding for patient referrals) with other healthcare providers by 10%. Objective 1.5: Establish and maintain oral health guidelines within the Michigan Quality Improvement Consortium (MQIC) guidelines.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE Getting to the Heart of the Matter- Health System change within Dental Clinics to incorporate Tobacco Cessation policies Partners: Washtenaw HD, HD of Northwest Michigan, MPCA, and six FQHC dental clinics Conducted survey of dental providers on blood pressure screening, diabetes and pre-diabetes screening Results completed and report posted on website Partners: Delta Dental, Scantron, MDA, MDHA Next step: Host an advisory meeting and develop state guidelines for dental offices on blood pressure screening and diabetes screening

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE Future: Conduct another survey of dental offices regarding knowledge, beliefs, attitudes regarding HPV and Oral Cancer.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE Michigan Dental Registry (MiDR) Electronic Registry for both medical and dental providers Hosted behind the MiLogin portal Developed and promoted by Altarum Institute (Partner) as part of the Michigan Caries Prevention Program Provides information on oral health assessments and fluoride varnish applications by medical providers and referral mechanism to dental providers.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE MQIC 2017 Routine Preventive Services for Infants and Children (Birth to 24 months) guideline and alert Updated recommendations include: Recommendation Dental screening; adequate fluoridation; establish dental home When water fluoride < 0.6 ppm*, apply fluoride varnish for children at risk Autism screening** (with clinical suspicion or Medicaid) MQIC 2017 Routine Preventive Services for Children and Adolescents (Ages 2-21 years) guideline and alert Reviewed every two years MQIC website as of June 1, 2017

ORAL HEALTH AS A SOCIAL JUSTICE ISSUE Everyone should have the same opportunities to live a healthy life. A person in poor oral health is not healthy. It s our responsibility to advocate for and mobilize the many who don t have access to oral health care and prevention. Nobody should suffer from a chronic disease that is completely preventable. Until we all have an equal opportunity to live happy and healthy lives, we will live in an unjust society.

WHY IS GRACE IN THE EMERGENCY ROOM? Why is Grace in the Emergency Room? Because Grace has a swollen face and an abscess in her mouth. Why does Grace have a swollen face and an abscess in her mouth? Because Grace has a persistent toothache. Why does Grace have a persistent toothache? Because Grace hasn t been to see a dentist. Why hasn t Grace been to see a dentist? Because Adapted from Boston Public Health Commission

Goal 2: By September 30, 2020, increase knowledge and awareness of the importance of oral health to overall health.

GOAL 2: INCREASE KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF ORAL HEALTH TO OVERALL HEALTH Objective 2.1: Develop and promote a website to educate health providers and consumers on all things related to oral health. Objective 2.2: Increase parent knowledge on how to prevent early childhood caries among children aged 0-3 by 10%. Objective 2.3: Increase consumer and health care provider knowledge of evidence-based prevention strategies by 10%. Objective 2.4: Create and support county advocacy networks across the state of Michigan. Objective 2.5: Implement oral health awareness activities within Michigan s 900 public school districts.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE NEW..Available as of March 2017 Perinatal Oral Health Module for WIC clients Educational module for both pregnant women and mother s of young children Clients develop their own action plan depending on their current belief s and actions Available to all states who utilize WIChealth.org for FREE! Partner: Western Michigan University and WIChealth.org

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE AGE 1 DENTAL DATA! Education offered through: Michigan Caries Prevention Program Babies Too! Varnish Michigan! Program Smiles for Life training

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE 2017 SEAL! MICHIGAN Grantee Profiles Ferris State University Hackley Health Center Health Department of Northwest Michigan Ingham Community Health Centers Oakland Primary Health Services Ottawa County Department of Public Health Smiles on Wheels ACE Smiles on Wheels Lower Peninsula Smiles on Wheels Upper Peninsula 1 Smiles on Wheels Upper Peninsula 2 University of Detroit Mercy Van Buren/Cass District Health Department Western Wayne Health Center

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE

Goal 3: By September 30, 2020, increase access to oral health care among underserved and/or hard to reach populations.

GOAL 3: INCREASE ACCESS TO ORAL HEALTH CARE AMONG UNDERSERVED AND/OR HARD TO REACH POPULATIONS. Objective 3.1: Increase the proportion of pregnant women who received comprehensive oral health care during pregnancy by 10%. Objective 3.2: Increase the proportion of infants, children, and young adults who received comprehensive dental services during the past year by 10%. Objective 3.3: Increase the proportion of adults and children with disabilities who received comprehensive dental services during the past year by 10%. Objective 3.4: Decrease the proportion of children, young adults, adults and older adults without dental insurance by 10%. Objective 3.5: Reduce the proportion of children, young adults, adults and older adults who experience difficulty, delays or barriers to receiving oral health care by 10%.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE COUNT YOUR SMILES-3 RD GRADE SCREENING Screenings took place in the 2015-2016 school year 103 schools participated 2,056 students were screened Screening results from open-mouth screenings of 3 rd grade students in Michigan, 2005, 2010 and 2016 SEAL! Michigan

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE COUNT YOUR SMILES-3 RD GRADE SCREENING Self-reported dental insurance status by parents for 3 rd grade students in Michigan, 2005, 2010, and 2016

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE SENIOR SMILES SURVEY 37 senior center/congregate meal sites across the state 5-Upper Peninsula 7-Upper Lower Peninsula 11-Wayne, Oakland, Macomb 14-Lower Peninsula 739 seniors screened Results to come.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE ORAL HEALTH DASHBOARD MEASURE For the time period 4/1/2016 to 3/31/2017, there were 472,078 children who received a preventive dental visit through Medicaid, which represents 53% of the eligible population.

LOOKING FORWARD: 2017 ORAL HEALTH UPDATE Coming together is a beginning; Keeping together is progress; Working together is success. Henry Ford

Christine Farrell, RDH, BSDH, MPA Oral Health Program Director Michigan Department of Health & Human Services Email: farrellc@michigan.gov