Working Together to Improve Childrens Oral Health

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Working Together to Improve Childrens Oral Health

• Oral Health Initiative Webinar Series
• Office of Head Start
• Washington, DC
• April 23, 2009

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Welcome Remarks

• Remarks
• Robin Brocato, Health Program Specialist

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Child Focus, Inc.
Karen Balon, LPN Health Manager Barbara
Houchin, RN Health Manager
Barbara Winter, RD,LD Health and Nutrition
Coordinator Monica Alles-White MS,RD,LD Oral
Health Consultant
Cincinnati, OH (Region V)
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GOAL Improve the oral health status of
children

• APPROACH
• Increase knowledge base of staff, children and
  parents on importance of oral health
• Increase number of dental providers willing to
  see children ages 1 to 5 covered under Medicaid
• Expand preventive oral health practices through
  collaboration with providers serving same
  population (WIC, physicians, obstetricians)

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Successes

• Number of children served increased by
  complimenting OHI grant funds with United Way
  funds to serve a total of 6,170 children and
  their families
• Allowed for expertise in oral health for staff,
  implementation of prioritization system,
  development of action plans, individual parent
  calls, and follow up with individual providers
• Best practice in tooth brushing procedures
  following guidance from the Office of Head Start
  implemented in centers and home base programs

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Successes

• Revision of Oral Health Curriculum utilized in
  centers, implemented in home base programs
• Oral health education provided to over 3,000
  families with young children and an additional
  1,100 pregnant women through collaboration with
  additional service providers
• Gains made in promotion of preventive practices
  with approximately 700 fluoride varnish
  applications completed

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Successes

• Dental Screening completed, Treatment Needed,
  and Referred to added to physical exam form
• Development of parent survey designed to provide
  insight into parents attitudes regarding oral
  health

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Challenges

• Parent participation, transient families
• Increased caseloads for direct service staff
• Variations in data software used by programs
• Capitation rates for FQHCs related to
  reimbursement potential for fluoride varnish
  application

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Challenges

• Barriers in engaging private sector providers
• Provider issues with Medicaid program
• HIPAA regulations hinder ability to obtain
  documentation

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Child Focus, Inc.
Barbara Winter, RD,LD Health and Nutrition
Coordinator Hamilton County Educational Service
Center Early Learning Programs Head
Start [phone] Monica Alles-White
MS,RD,LD Oral Health Consultant CincySmiles
Foundation [phone]

• Karen Balon, LPN
• Health Manager
• Child Focus, Inc., Head Start and Early Head
  Start
• [phone], ext. 307
• Barbara Houchin, RN
• Health Manager
• Butler County Educational Service Center Head
  Start
• [phone]

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• Questions and Answers

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Community Action Partnership of Kern

• Deanna Vaughn
• Content Area Specialist-Health
• Romelia Ortiz
• Content Area Specialist-Education
• Bakersfield, CA (Region IX)

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Program Overview

• Kern County
• Geographic Area Covering 8,000 sq. miles
• Mix of Urban and Rural Communities
• Funded Enrollment HS 2,348
• Funded Enrollment EHS 224
• Funded Enrollment Pregnant Women - 20
• Funded Enrollment Migrant 108
• 51 Centers Home Base Options

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Challenge, We ThoughtTransportation

• Problem At the beginning of our OHI grant
  transportation was discussed as being the major
  barrier preventing families from accessing dental
  care, especially in our rural areas.

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Challenge, We ThoughtTransportation

• Solution - Purchased an Oral Health
  Initiative van used only to transport enrolled
  children and pregnant women to the dentist.
• Reality Check - Transportation was NOT the
  reason for low dental compliance. Our OHI van
  receives minimal usage.

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Real Challenges

• Lack of Parents Buy In
• Many parents did not understand the importance of
  good oral health and receiving regular dental
  exams. We found that education at parent meetings
  and in the childrens classroom was the only way
  to gain compliance.

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Real Challenges

• Staffs personal fears of the dentist
• During Oral Health focus groups and trainings,
  many staff shared that they were fearful of
  dental visits.
• One site supervisor shared that all her teeth
  were removed at a very young age.
• A teaching staff shared that a dental visit for
  her was so traumatic she did not want to see a
  child go through that experience.

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Strategies Used With Staff to Help With Fears Of
the Dentist
Strategies Used With Staff to Help With Fears Of
the Dentist

• In order to help children with their fears staff
  need to first address and understand their own
  fears....
• Make sure your dental provider is aware of your
  fears or concerns during your first office visit.
• Ask the dentist to explain the process and what
  to expect during the exam or actual procedure.

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Strategies Used With Staff to Help With Fears Of
the Dentist

• Understand your individual dental treatment plan.
• Take your favorite book to read in the waiting
  room.
• Once in the dental chair, think of a favorite
  song or positive affirmations.
• Believe that frequent check ups are the key to
  preventing traumatic dental experiences.

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Successes Dental Roster

• 51 dental providers in Kern County have agreed to
  see children ages 1 to 5 and pregnant women.
• All 51 providers will serve our children and
  pregnant women without dental insurance and
  accept our fee schedule for payment.
• 2/51 dentists remain standing members of our
  Health Services Advisory Committee.

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• Deanna Vaughn
• Content Area Specialist-Health
• dvaughn_at_CAPK.ORG
• Romelia Ortiz
• Content Area Specialist-Education
• rortiz_at_CAPK.ORG

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• Questions and Answers

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The Institute for Human and Social Development

• Martha Alcantara
• Oral Health Project Coordinator
• San Mateo County, CA
• (Region IX)

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Program Overview

• San Mateo County
• Spans from the Pacific Coast to the San Francisco
  Bay
• Mixture of urban and rural agricultural
  communities
• Funded enrollment for Head Start 632
• Funded enrollment for Early Head Start 98
• Enrolled in Center-Based 634
• Enrolled in Home-Based 77
• Enrolled in Family Childcare 19

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Project Goals

• Promote community awareness by building
  partnerships
• Education for families, children and staff
• Xylitol prevention program
• Case Management
• Improve dental provider referral network

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Successes!!

• Community Partnerships
• Adopt a Site, Create a Smile Program Dental
  offices adopted 1-2 sites and provided dental
  screenings, dental education and/or provided
  blocked appointments

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Education

• Utilize First Smiles, Cavity Free Kids dental
  curriculum-CB, HB, and FCC
• Family, child and staff dental workshops
• Implemented xylitol based program

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Challenges

• Declining number of dentists serving patients
  with Medi-Cal, healthy families and healthy kids
• Parents/caregivers state -- its hard to take a
  child to the dentist due to work schedules, not
  seen as a priority
• Dental exams are not perceived as urgent by
  family workers in comparison to other health
  requirements

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• Martha Alcantara
• MAlcantara_at_ihsdinc.org

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• Questions and Answers

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Oral Health Initiative GranteesConnecting,
Sharing, and Learning Knowledge Inspires
Innovative Thinking
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov
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Objectives
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov

• To become familiar with the features and layout
  of the Oral Health sub-landing page
• To become familiar with the review process for
  external contributors
• To understand the steps in developing content for
  the ECLKC
• To collect lessons learned from OHI grantee
  activities

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Oral Health http//eclkc.ohs.acf.hhs.gov/hslc/e
cdh/Health/Oral20Health
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov

• Introduction
• Featured Resources
• Additional Resources
• Office of Head Start
• Partners
• University of Washington Innovation and
  Improvement Grantee

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Oral Health Initiative Grantees as External
Contributors to the ECLKC
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov

• Want to submit a document? Ask yourself the
  following questions
• Has OHS expressed an interest?
• Does the content type meet the ECLKC Style
  Standards?
• (For example, appropriate reading level,
  supports 508 compliance, signed permissions for
  photos and videos, etc.)
• Has your organization recorded the lessons
  learned? (SHARE template)

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Oral Health Initiative Grantees as External
Contributors to the ECLKC
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov

• If you answered yes to those three questions,
  then you are ready!
• The Process
• Submit content type (brochure, tip sheets, etc.)
  in any following format (pdf, word document,
  etc.) to OHS
• OHS and a panel will review the content based on
  criteria. For example What is the purpose and
  nature?
• Has the organization submitted the SHARE document?

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Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov
Why Do We Have Style Standards?
Style standards ensure that content has a
consistent look and feel.
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SHARELessons Learned from OHI grantees
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov

• Situation Describe the context
• Hurdle Describe the challenges
• Action Describe the steps
• Result Identify the steps taken/not taken
• Evaluation Offer the best preventive or
  corrective measure

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Questions?
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov
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Contact Information
Early Childhood Learning Knowledge Center
(ECLKC) ECLKC.ohs.acf.hhs.gov
Cecelia A. Gordian Subject Matter
Expert-Health Head Start Knowledge and
Information Management Services
(HSKIMS) 202-737-1030 ext. 113 ceceliag_at_headstarti
nfo.org
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Closing Remarks

• Remarks
• Robin Brocato, Health Program Specialist
• Next OHI Webinar Series
• Date May 7, 2009
• Time 200 p.m. (EST)