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Health care system approach to meet the oral health needs of medically indigent children

Lisa Gaarde Hartsock, MPH, Community Health Services, FirstHealth of the Carolinas, 155 Memorial Dr, PO Box 3000, Pinehurst, NC 28374, (910) 215-1922, lhartsock@firsthealth.org

Access to dental services in the mid-Carolinas was the most pressing unmet need in local school children, with greatest disparities among children eligible for public assistance or the free and reduced lunch program. Annual screenings in the schools documented that nearly 50% had dental needs with half presenting with urgent needs. The high rate of broken appointments and low priority of dental health by this population contributed to the problem. Few local dentists accepted public assistance and those who did received very low reimbursement. FirstHealth, the regional health care delivery system organized local medical and dental providers, public health officials and school administrators to develop an intervention. Through establishment of three pediatric “public health” centers in a “private practice” setting, over 60% of the children have received care. Establishing unique office policies and practice, the centers have been a role model for other system entities in assisting families in securing coverage and transportation. Qualification and reimbursement not only assists the financial sustainability of the centers, but also provides the family access to comprehensive medical care, mental health services and pharmaceuticals. Dentists, hygienists and auxiliary staff are employed by the health system and operate in the same division as the medical primary care clinics, case management and home care. FirstHealth is active in addressing policy issues that impact access, reimbursement and manpower issues at state and national levels and personally participated in the NC IOM study on access and the first-ever released oral health report by the US Surgeon General.

Learning Objectives:

Keywords: Oral Health, Access to Care

Related Web page: firsthealth.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: FirstHealth of the Carolinas, Inc.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Strengthening the Oral Health Safety Net: Community-based Delivery Modes for Underserved Communities

The 132nd Annual Meeting (November 6-10, 2004) of APHA