Oral health coalitions A critical element of success

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Oral health coalitionsA critical element of
successbut why?

• Minnesota Oral Health Summit
• January 23, 2009

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What is a Coalition?

• Definition a group of individuals and/or
  organizations with a common interest who agree to
  work together toward a common goal.
• Coalitions may be loose associations in which
  members work for a short time to achieve a
  specific goal, and then disband, or they may also
  become organizations in themselves, with
  governing bodies, particular community
  responsibilities, funding, and permanence.
• Regardless of their size and structure, they
  exist to create and/or support efforts to reach a
  particular set of goals.

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Goals of a Coalition

• Coalition goals are as varied as coalitions
  themselves, but often contain elements of one or
  more of the following
• Influencing or developing public policy, usually
  around a specific issue.
• Changing people's behavior.
• Building a healthy community.

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Why Develop a Coaliltion?

• Concentrate the community's focus on a particular
  problem.
• Create alliances among those who might not
  normally work together.
• Keep the community's approach to issues
  consistent.

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Early View of Oral Health in Kansas

• No dental school, limited number of dental
  hygiene programs
• Very limited dental services offered in safety
  net clinics
• No Medicaid coverage for adult dental services
• Very few providers accepting Medicaid or SCHIP
• No state leadership or funding
• Relatively no data
• Programs focused at the community level, with
  little impact
• LOTS of frustration
• One pricipal funder with oral health as a
  priority (interest in community water
  fluoridation)

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The Straw that Broke the Camels Back
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Something Had to be Done!

• The answer? A coalition!
• Convened multiple interested stakeholders
• Formed steering committee
• Engaged professional support
• Initiated regular communication
• Determined areas of priority
• Created a short-term strategic plan
• Hired an Executive Director
• Oral Health Kansas (OHK) was born in 2003

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OHK Mission Priorities

• Mission
• To improve oral
• health in Kansas
• through advocacy,
• public awareness
• and education

• Priority Areas
• Workforce
• Access to Care
• Prevention
• Oral Health Status
• Leadership

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OHK Public Policy Success

• State office of oral health dental director
• Legislative task force on access for adults
• Medicaid reimbursement to physicians for
  application of fluoride varnish
• AEGD clinical residency program
• Extension of Medicaid dental benefits to certain
  adult populations (frail elders developmentally
  and physically disabled and head injured
  pregnant women)
• Extended Care Permit law for registered dental
  hygienists
• Changes made to the Dental Practice Act to allow
  rural areas more flexibility to hire dental
  providers
• Oral health included in health reform conversation

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OHK Programs and Projects

• Annual oral health conference
• Dental Champions Leadership Program
• Extended Care Permit project designed to increase
  the number of RDHs and community based programs
  providing preventive oral health services
• System of care projects for specific populations,
  including the developmentally disabled and frail
  elders
• Sponsored reports The Declining Supply of
  Dental Services Implications for Access and
  Options for Reform (KHI, 2005) and Kansas Health
  Reform Options for Adding Dental Benefits
  (NASHP, 2008) Oral Health Report Card (OHA,
  2009)

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Elements of Success

• Vision, leadership passion
• Collaboration
• Funding
• Members from multiple disciplines, including some
  unusual suspects
• Advocay infused throughout all priority areas
• Coalition independent of the OOH
• Focus on systems level change, in advocacy
  programs
• Decisions made by consensus, put off issues that
  caused controversy
• Early victories trust credibility

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A View of Kansas Today

• Increase in the number of dentists accepting
  Medicaid/SCHIP
• Educational opportunities soon to be available
  for dentists through AEGD program, increased
  number of dental hygiene training programs
• Safety net clinic capacity has nearly tripled
  since 2003, thanks in large part to the shared
  investments of private philanthropy and the state
  of Kansas
• Dental hub and spoke model implemented in the
  safety net system
• Approximately 90 RDHs now taking advantage of
  Extended Care Permits

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And, Kansas Grade Today?
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Resources

• Coalition building University of Kansas
  Community Tool Box at www.ctb.ku.edu
• Kansas oral health data and reports Kansas
  Health Institute at www.khi.org
• Oral Health Kansas at www.oralhealthkansas.org
• Contact me Teresa Schwab at tschwab_at_sunflower.co
  m or at 785.393.0039.