Delivering Dental Care to Rural DD Patients in Missouri –

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Delivering Dental Care to Rural DD Patients in Missouri –




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Presentations text content in Delivering Dental Care to Rural DD Patients in Missouri –

Slide1

Delivering Dental Care to Rural DD Patients in Missouri – Elks Mobile Dental Program

John Dane, DDS, FAAHD, DBSCD

Dental Director

Truman Medical Center Lakewood

April 2014 SCDA Conference

Slide2

MISSION

To provide basic dental care to developmentally disabled and physically challenged persons in Missouri without regard to their ability to pay.

Slide3

GOALS

Provide dental services to a most under served dental population

Work in cooperation with Missouri Bureau of Special Health Care Needs and Department of Mental Health

Coordinate efforts with the MO. Elks Association (BPOE)

Slide4

Breaking Down Barriers

Financial

Transportation

Willing/trained dentist

Equipment

Appointment time

Slide5

History

Started in 1969 Missouri Department of Health and Missouri Elks Association (BPOE)

Elks purchased equipment DOH supplied the operational funding.

DOH operated program until 1977 – Contracted with Washington University SOD then added TMC/UMKC SOD in 1979

1981 TMC became sole provider.

Slide6

Public/Private Partnership

Missouri Elks Benevolent Trust Major philanthropic effort

Missouri Departments of Health and Mental Health

UMKC/TMC educational and hospital support.

Slide7

ELKS MOBILE DENTAL PROGRAM  

Patient Eligibility

1

. Children and adults who have developmental disabilities or intellectual disabilities (DD/ID) as identified by the Department of Mental Health, Division of Developmental Disabilities.

  

2. Individuals, must be screened for their eligibility and their ability to receive treatment in a mobile clinic with the aid of local anesthesia when indicated.

The Missouri Elks urge all eligible individuals currently under the care of a private dentist to continue treatment with him/her.

Dane, J; Elks Mobile Dental Program 2012-13

Slide8

Staffing

Dentist-

Dental Assistant

Staff takes on many roles

.

Patient care

chair side

reception

administration

unit repairs

contact sponsors

fund raising

Slide9

Clinics in Operation

Well designed coaches

Instrument processing

Supply storage

Vacuum and compressors

Wheelchair accessible

2 chairs minimum

X-ray – digital or film based

Patient records – EDR or paper

Slide10

Mobile Dental Units

Various Clinic configurations over the years

Trailers

Less expensive but required someone to move them

More chairs (3)

Self propelled units

Winnebago type units

International Harvesters Truck

Commercial vehicles

Slide11

Self Propelled Units

Self propelled units

Winnebago type units

International Harvesters Truck

Commercial vehicles

Slide12

Patient Accessibility

Slide13

Where to go?

Best locations are where DD patients already have contacts for services!

Regional Centers for DD

State Schools for DD

Sheltered Workshops

Group homes

Elks Lodges

Slide14

Missouri has several counties with 1 or no dentists.

Slide15

Missouri Elks Lodges

Slide16

Lodges are in rural locations

Slide17

Slide18

Qualified Locations

Must have Electrical Connections – 220volt 50 amp service

Must have water – usually a garden hose faucet will do

Sanitary Sewers – grey water disposal.

Slide19

Schedule

Patients from every county in MO are seen (114)

Stops are from 2-10 weeks in length

3 unit

schedules, 41

locations in the State of

Missouri

Based on demand – 30 visits

Moving units in a “circle”

Certain stays based on weather and time of year.

Slide20

Contacting Customers

List from Mo Dept of MH

Data base of patients seen

Post cards, letters – parents/guardians

Agency contacts

Case Worker contacts

Web page

Emails

Newspaper articles/radio spots

Slide21

Where do the staff stay?

Slide22

Financials 2013

Personnel - $209,658 (72%)

Travel/per diem - $49,315 (17%)

Supplies – $20,546 (7%)

Repairs - $6,599 (2.2%)

Office supplies $6,038 (2%)

Total $290,276

Slide23

Dane, J; Elks Mobile Dental Program 2012-13

State Funding

Slide24

Dane, J; Elks Mobile Dental Program 2012-13

Medicaid cuts for adult dental services effected the Program

Slide25

Financials

Year

Patient Visits

Value of Care

2002

2925

$325,783

2003

2523

$416,221

2004*

1781

$280,573

2005

2065

$420,228

2006

3438

$707,727

2007

3507

$751,571

2008 (decreased funding)

3507

$425,113

Dane, J; Elks Mobile Dental Program 2012-13

Slide26

Fund Raising

Direct Lobbying with State Legislature

Funding from Local Board of Services for MR

Grants from local philanthropy

Hope Waivers

Slide27

State Dental Board

Missouri Dental Board has regulated Mobile Dental Units since the 1980’s – requiring that dentists delivering care in nursing homes have a plan for follow up services

Complaints from local providers about school based programs

Several hearings with dental board regarding mobile services

Slide28

Pearls

Keep mobile units simple

Be sure your plumbing is warm or dry

Dental equipment doesn’t like 20 miles of bad road

Be clear about your mission.

Work within the limitations of your practice

Keep your sponsors and agencies happy

Let people know about the value of the care you deliver

On board restrooms are not worth the trouble

Slide29


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