Problem Addressed: Oral Health

Healthy People 2010 Objective: 21

Web Address: None

SNAPSHOT

The Rural Health Dental Program of northwestern Wisconsin represents a collaborative effort to provide oral health education and treatment to a 15-county rural area. Utilizing a combination of rural dental clinics and mobile clinics, the program provides dental services to low-income families, disabled individuals, and residents of nursing facilities¾a population that would not otherwise have access to dental care.

THE MODEL

Blueprint: The Rural Health Dental Program, through its outreach efforts, serves nearly one-third of the northwestern portion of Wisconsin. The program is a collaborative effort between the Cooperative Educational Services Agency #11 (CESA 11); Chippewa Valley Technical College (CVTC); Northern Wisconsin Center for the Developmentally Delayed; and Barron, Polk, Chippewa, Dunn, and Sawyer County Health Departments. CESA 11 serves as the fiscal and operational managing agency. CVTC houses one of the dental clinics, and dental hygiene and dental assistance students at the college provide services while gaining valuable experience. The Center for the Developmentally Delayed allows the program to utilize its clinic space to provide outreach to disabled patients. The five health departments provide outreach services by assisting patients with information and scheduling at the four clinics.

The program provides complete oral health treatment and prevention services, with the exception of endodonics and orthodonics. Due to the lack of major industry, most families live below the federal poverty level, and most communities lack a water fluoridation system. Although families qualify for public assistance, low reimbursement to providers prevents many from accepting medical assistance patients. Therefore, this population is extremely vulnerable to oral disease. To provide this service, four clinics are located throughout the area and housed in consortium member agency buildings (CVTC College, a health department, a nursing facility, and a community dental clinic) at no cost. In addition, there is a mobile unit component that transports dental equipment to schools, Head Start centers, and nursing facilities allowing on-site dental care. The dental equipment is state of the art, and patient information is managed through dental-practice-specific software.

Staffing has expanded over the course of the past five years to include four part-time dentists, two full-time dentists, two full-time dental hygienists, four full-time dental assistants, and a director. The patient population includes low-income families (below 185 percent of federal poverty level), individuals with disabilities, and those living in supervised-care facilities.

Making a Difference: In 2002, the program anticipated over 6,000 visits. The clinics historically report 4,000 patient encounters per year, and each clinic has a waiting list of over 300 patients. As part of the program’s evaluation and assessment, patients are tracked by age, ethnicity, disability, income level, and type of services received.

Beginnings: The program began in 1996 in response to the frustration of the CESA 11 Head Start health coordinator in finding dental providers for Head Start children. Annual dental exams are required for children enrolled in the Head Start program; however, due to low reimbursements, many dental providers stopped accepting medical assistance patients. The coordinator applied for and received a three year Federal Rural Health Outreach Grant. Continuation funding for 1999-2001 was facilitated by the region’s U.S. Congressman. Funding for the center for 2002-2003 is through establishment of funding as a state budget line item.

Challenges and Solutions: The primary challenge is the difficulty in recruiting dentists to work with this patient population. Another challenge involves educating state and federal policymakers as to the need to expand medical assistance funding to encourage dental providers to accept more of these patients. The program is 50 percent self-sustaining through Medicaid reimbursement. Unfortunately, costs continue to exceed revenue.

The program has received numerous awards and recognitions, including the Wisconsin Public Health Association Distinguished Service to Public Health Award (1998); Head Start Award for Promoting Oral Health (1998); and Wisconsin Maternal and Child Health Coalition Achievement Award (1999). It was named as one of Wisconsin’s Top Ten Rural Health Initiatives (2000).

PROGRAM CONTACT INFORMATION

Sharon Haugerud

Rural Health Dental Clinic

225 Ostermann Drive

Turtle Lake, WI 54889

Phone: (715) 986-2020

Fax: (715) 986-2041